Do obese adults walk differently in shoes vs. barefoot?
Musculoskeletal issues such as low back and neck pain as well as hip and knee osteoarthritis are often linked to obesity.
Consequently, weight-loss is commonly recommended as a means to reduce the above mentioned musculoskeletal issues causing pain. The problem occurs when weight-bearing exercises as simple as walking places overwhelming loads on the lower limb joints.
In search of a solution to this dilemma, this study examined to see if they could find any observable differences in the walking gait pattern in obese individuals in shoes compared with those barefoot.
A total of 10 obese individuals who had a Body Mass Index (BMI) between 30 and 40 kg/m2 participated in the study. Subjects were excluded from the study if they had comorbidities such as cardiovascular, metabolic or renal issues. Also, to prevent muscular build interfering with the intent of the study, the participants had their waist circumference measured and were only included if they exceeded 100 cm for men and 90 cm for women.
The participants walked over a flat tandem-belt instrumented treadmill which had inbuilt force plates while being observed through systems which measure speed and biomechanics. They did this while wearing their own athletic footwear, and subsequently barefoot.
The results showed reduced stride length and stance times but doubled support times, with associated decrease in ground reaction forces. It also showed that the ankle was plantarflexed at contact when barefoot, but dorsiflexed when shod.
Although this biomechanical observation is not a study which examined the efficacy of a treatment, as physiotherapists we could use this type of information to guide our rehabilitation process.
> From: Dames et al., Gait Posture 70 (2019) 79-83 (Epub ahead of print). All rights reserved to Elsevier B.V. Click here for the online summary.