Effects of body mass index on foot posture alignment and core stability in a healthy adult population

Foot biomechanics and core stability (CS) play significant roles in the quality of standing and walking. Minor alterations in body composition may influence base support or CS strategies. The aim of this study was to investigate the effect of the body mass index (BMI) on the foot posture index (FPI) and CS in a healthy adult population. A total of 39 healthy adult subjects with a mean age of 24.3 ± 6.4 years and overweight BMI values between 25 and 29.9 kg/m 2 (27.43± 6.1 kg/m 2 ) participated in this study. Foot biomechanics were analyzed using the FPI. CS was assessed using a plank test with a time-to-failure trial. The Spearman correlation coefficient indicated a significant correlation between BMI and both the FPI (r= 0.504, P= 0.001) and CS (r= -0.34, P= 0.036). Present study concluded that an overweight BMI influences foot posture alignment and body stability. Consequently, BMI should be considered during rehabilitation management for lower extremity injuries and body balance. Keywords: Foot posture, Core stability, Body mass index research INTRODUCTION The number of individuals with excessive body weight is rapidly increasing in many countries. In terms of global burden of disease, more than one-third of all adults are currently overweight or obese CS has been defined as "the body's ability to control the trunk in response to internal and external disturbances, including the forces generated from distal body segments as well as from expected or unexpected perturbations" The FPI is considered a novel, valuable and reliable diagnostic clinical tool to quantify positional variations of the foot. The FPI measures foot posture in three planes and two anatomical segments and take into consideration six assessment criteria. Foot posture alignment deviations, including pronation and supination, may be evaluated using the FPI Regardless of whether BMI variations affect the FPI and CS, the elucidation of a possible relationship between an overweight BMI and the FPI and CS is important for developing preventive strategies to improve the quality of life. Hence, the aim of this study was to investigate the correlational effects of BMI variations on the FPI and CS. MATERIALS AND METHODS Thirty-nine nonathletic, male university students aged 22-27 years with a mean age of 24.3±6.4 yr, height of 171.96±5.51 cm, weight of 82.9±17.2 kg, BMI between 25 and 29.9 kg/m 2 (27.43±6.1 kg/m 2 ) and FPI values between 0 and +10 (5.54±3.1) voluntarily participated in this study. The study exclusion criteria consisted of any sign of foot pain, reduced tactile and thermal foot sensibility, peripheral neuropathy, a history of patellofemoral pain syndrome, plantar fasciitis, back pain, a BMI>30 kg/m 2 , limblength discrepancy, anterior or posterior tibialis dysfunction or evidence of a systemic or musculoskeletal disease within the past six months that would affect daily activities. Foot biomechanics and CS were assessed using the FPI and a plank test, respectively. All the protocols were approved by the ethical committee on human research and followed ethical standards. Assessment procedures Body mass index The World Health Organization classifies individuals into three groups based on body mass: normal (BMI<25 kg/m , 1997). The heights of participants were measured using a stadiometer (Invicta Stadiometer, Invicta, London, UK) with a calibrated analog scale. The weights of participants were measured with a scale (Breuer electronics scale) with a precision of 0.01 kg. During the measurements, the subjects had bare feet and wore only underwear, and the measurements were recorded in kg. The height of each subject was measured in an upright position with a metal bar that was fixed to a sensitive bascule. Special attention was given to ensure that the subject's body was fully upright and their mandible was parallel to the ground. Height values were recorded in cm. The BMI, which is a useful measurement for evaluating excess body fat, was calculated as the body weight divided by the square of the height (kg/m 2 ) for each individual Core stability The CS was measured by anterior core muscular-endurance testing, which consisted of a single time-to-failure trial in a timed prone bridge position Foot posture index The biomechanical assessments of the foot were conducted by http://dx.doi.org/10.12965/jer.1632600.300 AlAbdulwahab SS and Kachanathu SJ • Body mass index on stability 184 http://www.e-jer.org the same assessor using the FPI, as described by RESULTS The SPSS ver. 17.0 (SPSS Inc., Chicago, IL, USA) was used for data analysis. The values are reported as the mean±standard deviation The results of the current study indicate a significant association between varying BMI and the FPI (r=0.5, P=0.001) and CS (r=-0.34, P=0.036) (Table 2) in healthy subjects. This observation indicates that an overweight BMI may have an effect on variation of the FPI and CS. Thus, the BMI may be an important variable that must be considered during lower extremity rehabilitation. DISCUSSION The aim of this study was to examine the effect of an overweight BMI on the FPI and CS. Our findings indicate that an overweight BMI influences the FPI and CS. These findings are consistent with a previous study, which observed that obese women tended to present with flatter feet, and obese men tended to present with more pronated feet One possible explanation for the negative relationship between an increasing BMI and the FPI is that excess bodyweight leads to greater mechanical loading of the foot. It has been suggested that fat mass may be the cause of the outward appearance of a "flat" foot in obese individuals Interestingly, our biomechanical assessment of the FPI indicated that individuals with an overweight BMI tended to have flat feet. Accordingly, a higher prevalence of obesity has been observed in individuals with flat feet It is known that adipose tissue accumulates at the abdominal region in obese individuals. Moreover, it is interesting to note that the rectus abdominal muscle shows the greatest fatty infiltration, followed by the lateral abdominal muscle and erector spinae, in overweight and obese individuals (Ryan and Harduarsingh-Per- AlAbdulwahab SS and Kachanathu SJ • Body mass index on stability maul, 2014). These higher levels of intramuscular fat have been associated with reduced functional capacity in healthy older adults The present study emphasizes the importance of the correlation between BMI and CS as CS is critical for the transfer of energy from the larger torso to the smaller extremities during many sports and activities Our study results are consistent with previous studies showing that the endurance of core muscles is correlated with a reduced back endurance test Most studies have examined the training aspects of CS, and few studies have investigated the benefits of CS in normal adults. Despite having an overweight BMI, the participants of this study were considered healthy subjects and were not limited in their functional activities. Furthermore, the BMI is the most commonly used general indicator of adiposity but does not distinguish between fat and lean body masses The present study revealed a strong correlation between a higher BMI and the FPI and CS. These study variables should be considered during preventive rehabilitation. During physical treatment and rehabilitation, the identification of a poor FPI and a lack of CS are considered risk factors for lower extremity musculoskeletal injurie

Early Mobilization with Double Elbow Crutches Early Mobilization with Double Elbow Crutches on Stability and Functional Knee Score in Patients With Anterior Cruciate Ligament Repair

Abstracts: Objective: Anterior Cruciate Ligament (ACL) is the most commonly torned ligament in the sporting activities, athletes desiring to return to physical activities that require use of the ACL need surgical reconstruction and proper rehabilitation. In the recent years, there have been advancements in the surgical techniques as the femoral tunnel positioning has been shifted from vertical position to more stable oblique position, thus it is a necessary to investigate the effect of early mobilization with the double elbow crutches and its outcome responses. Methods: Total 40 subjects of day one post ACL oblique repair with mean age of 30±3.6 yrs. were participated in the study. Subjects were divided into Group-A and Group-B for rehabilitation with double elbow crutches and walker respectively, along with conventional exercises for 6 weeks. At 4 th week both crutches and walker were discarded in both groups. Rehabilitation outcomes were assessed by static, dynamic stability and lysholm knee functional score were assessed at 4 th , 6 th weeks post operatively for both groups. Results: There was significant difference between static, dynamic stability and lysholm knee functional score at 4 th and 6 th weeks when compared within each group (p<0.001). Between group comparison showed insignificant difference in outcomes such as static stability (p=0.18; p=0.55) dynamic stability (p=0.09; p=0.06) and lysholm score (p=0.51; 0.65) at 4 th and 6th week post repair respectively. Conclusion: It is concluded that knee Stability and lysholm functional knee score was significantly improved by early mobilization with double elbow crutches and walker independently although there is no significant difference between double elbow crutches and walker in post oblique ACL surgical repair rehabilitation. [ John S NJIRM 2012; 3(2) : 152-158

Self-Reported Musculoskeletal Disorders and Quality of Life in Supermarket Cashiers

Supermarket cashiers face a significant amount of stress, including time constraints, mental pressure, and physical demands that require repetitive movements. The job description of a supermarket cashier involves work-related risk factors that may lead to musculoskeletal disorder (MSD) symptoms. This study aimed to investigate supermarket cashiers to determine the prevalence of MSD symptoms and their quality of life. Data were collected from a convenience sample of supermarket cashiers working in Saudi Arabia. Information included direct questions on pain in the previous 12 months, demographic data, and health- or occupation-related factors. Moreover, data was collected based on the 36-item short form survey (SF-36), and descriptive statistics were computed. A total of 193 supermarket cashiers participated in this study. The sample included 140 men (72.5%) and 53 women (27.5%), with a mean age of 27.2 ± 6.4 years. The majority of the participants (90%) had MSD symptoms in at least one body region, with the neck (66.84%) and lower back (65.80%) constituting the most prominent regions. The mean SF-36 scores were higher in participants without pain compared to participants with pain in all domains, except for the physical functioning domain. The high prevalence of MSD symptoms among young cashiers suggest the need for additional investigations to determine the risk factors of these disorders. Additionally, this study recommends preventive procedures to reduce the prevalence of MSD symptoms among cashiers