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Effects of Body Mass Index and Walking Speed in Gait Biomechanics of Young Adult Males
Gait biomechanics of forty male subjects was evaluated at normal and fast walking speeds. The forty subjects composed four groups based on their body mass index, with ten subjects in each of the groups: underweight, normal weight, overweight and obese. To our knowledge this is the first comprehensive 3-dimensional kinetic and kinematic gait analysis of all four groups based on body mass index. The obese subjects walked with significantly slower gait speed by taking shorter steps and strides, while having significantly higher step widths and longer gait cycle times than the other subjects. The obese subjects spent significantly less time in single support and more time in double support than their non-obese counterparts. These adjustments in temporal characteristics for the obese participants may be as a result of the gait compensation for the additional body weight in order to give them the most efficient, stable and balanced walking ability. Body mass index affected significantly the forces and moments at the ankle, knee and hip in the medial-lateral plane while speed effects were more prominent in the sagittal and transverse planes. These results suggest that an increase in the body weight would affect the gait stability while increasing the speed will affect the gait progression. Contrary to most researchers beliefs that an increase of the body weight would increase the forces and moments of the knee in all three planes, this study was able to prove that the actual forces and moments in the medial-lateral plane for the knee joint decrease while the ones in the sagittal plane increase. On the other hand, the hip joint in the medial-lateral plane displays the highest forces and moment for the obese subjects. These results are indicative of a gait compensation related to increasing body weight in the medial-lateral compartment of the lower extremity joints. Recommendations for further studies and follow up experiments are enclosed
Altered mechano-chemical environment in hip articular cartilage: effect of obesity
The production of extracellular matrix (ECM) components of articular cartilage is regulated, among other factors, by an intercellular signaling mechanism mediated by the interaction of cell surface receptors (CSR) with insulin-like growth factor-1 (IGF-1). In ECM, the presence of binding proteins (IGFBP) hinders IGF-1 delivery to CSR. It has been reported that levels of IGF-1 and IGFBP in obese population are, respectively, lower and higher than those found in normal population. In this study, an experimental-numerical approach was adopted to quantify the effect of this metabolic alteration found in obese population on the homeostasis of femoral hip cartilage. A new computational model, based on the mechano-electrochemical mixture theory, was developed to describe competitive binding kinetics of IGF-1 with IGFBP and CSR, and associated glycosaminoglycan (GAG) biosynthesis. Moreover, a gait analysis was carried out on obese and normal subjects to experimentally characterize mechanical loads on hip cartilage during walking. This information was deployed into the model to account for effects of physiologically relevant tissue deformation on GAG production in ECM. Numerical simulations were performed to compare GAG biosynthesis in femoral hip cartilage of normal and obese subjects. Results indicated that the lower ratio of IGF-1 to IGFBP found in obese population reduces cartilage GAG concentration up to 18 % when compared to normal population. Moreover, moderate physical activity, such as walking, has a modest beneficial effect on GAG production. The findings of this study suggest that IGF-1/IGFBP metabolic unbalance should be accounted for when considering the association of obesity with hip osteoarthritis