Obesity Alters Balance and Movement Control

The effect of rebound exercise on cognition and balance of females with overweight and obesity

Balance issues have been reported to be common among females with overweight or obesity with associated fall risks. Despite the increasing reports of the negative impacts of obesity on balance and cognition, there is a scarcity of research aimed at evaluating effective interventions. To examine the effects of rebound exercises on cognition and balance among females with overweight and obesity. This Quasi-experimental study used the purposive sampling method to recruit 20 female students (aged 17-35 years) with overweight and obese at the Evangel University Akaeze, Ebonyi State Nigeria. Rebound exercise intervention was administered to all participants at the gym for 30 minutes in each session, three times a week for six weeks, while their cognitive performances, stationary balance, and dynamic balance were measured pre-and post-trial using Trail Marking Test Apparatuses, Unilateral Pedal Tests, and Meter Backward Walk Test respectively. There was a significant (p < 0.001) difference in the participants' cognition values across weeks 1, 3, and 6 with a progressive improvement over time. There was also a significant (p < 0.05) difference in the participants' static and dynamic balance values across weeks 1, 3, and 6 with a progressive improvement in balance performance over time. Rebound exercise significantly improved the cognition and balance of females with overweight or obese. This finding suggests a promising intervention to improve balance and cognitive-related problems in this population. Registered retrospectively in the Pan African Clinical Trial Registry, identification number for the registry is PACTR202405746557031. Dated 2 May 2024.

Impact of Overweight on Spatial-Temporal Gait Parameters During Obstacle Crossing in Young Adults: A Cross-Sectional Study

Background: Overweight may present an additional challenge when crossing obstacles. More specifically it may affect adequate foot clearance to reduce the risk of obstacle contact. Thus, the objective of this study was to compare obstacle clearance and spatial-temporal gait parameters during obstacle crossing in young adults with normal body weight and overweight. Methods: Twenty-eight and fifteen individuals were categorized into normal body mass index (18.5-25 kg/m2) and overweight (25-30 kg/m2), respectively. The participants walked along a walkway at their preferred speed and stepped over an obstacle. Spatial-temporal parameters were calculated during the approaching (stride before obstacle) and the crossing (step over the obstacle) phases. Additionally, the leading and trailing foot placements prior to and after the obstacle and toe clearance were calculated. Results: No significant differences were found for the approach, the crossing phases and leading and trailing toe clearance. Analysis of foot placement distance prior to and after the obstacle showed that, compared to the individuals with normal body weight, overweight individuals significantly increased the leading foot placement distance prior to the obstacle (+7 cm, ↑ 6.7%) and increased the trailing foot placement distance after the obstacle (+8.1 cm, ↑ 9%). Conclusions: Our findings indicated that overweight individuals have a different obstacle crossing behavior regarding foot placement distance prior to and after the obstacle compared to normal-weight individuals without differences in spatial-temporal gait parameters or toe clearances. However, the results did not suggest that participants with overweight show a higher risk of tripping.

Effects of Different Auditory Stimuli and Cognitive Tasks on Balance in Healthy Young Adults

INTRODUCTION

This study investigated the effect of different auditory stimuli and cognitive tasks on balance in healthy young adults.

METHODS

Thirty-three participants, aged 23.33 ± 2.43 years, were included in the study. The hearing levels of the participants were determined. Static and dynamic postural stability and limits of stability (LOS) tests were performed in the absence of auditory stimuli, in the presence of spondee word lists at 70 dB(A) and in the presence of spondee+white noise (-6 dB signal-to-noise ratio [SNR]), while auditory stimuli were presented bilaterally with supra-aural headphones. Participants were asked to repeat the words they listened to while performing balance-related tasks.

RESULTS

No significant differences between the three conditions were observed in the postural stability and LOS results. Increase in total repetition error was observed as the listening task became more difficult.

CONCLUSION

The presence of auditory stimuli and the cognitive tasks did not cause any changes in the participants' balance.

Alterations in skeletal muscle morphology and mechanics in juvenile male Sprague Dawley rats exposed to a high-fat high-sucrose diet

Although once a health concern largely considered in adults, the obesity epidemic is now prevalent in pediatric populations. While detrimental effects on skeletal muscle function have been seen in adulthood, the effects of obesity on skeletal muscle function in childhood is not clearly understood. The purpose of this study was to determine if the consumption of a high-fat high-sucrose (HFS) diet, starting in the post-weaning period, leads to changes in skeletal muscle morphology and mechanics after 14 weeks on the HFS diet. Eighteen 3-week-old male CD-Sprague Dawley rats were randomly assigned to a HFS (C-HFS, n = 10) or standard chow diet (C-CHOW, n = 8). Outcome measures included: weekly energy intake, activity levels, oxygen consumption, body mass, body composition, metabolic profile, serum protein levels, and medial gastrocnemius gene expression, morphology, and mechanics. The main findings from this study were that C-HFS rats: (1) had a greater body mass and percent body fat than control rats; (2) showed early signs of metabolic syndrome; (3) demonstrated potential impairment in muscle remodeling; (4) produced lower relative muscle force; and (5) had a shift in the force-length relationship, indicating that the medial gastrocnemius had shorter muscle fiber lengths compared to those of C-CHOW rats. Based on the results of this study, we conclude that exposure to a HFS diet led to increased body mass, body fat percentage, and early signs of metabolic syndrome, resulting in functional deficits in MG of childhood rats.

Assessment of functional mobility and gait during a timed up and go test in adults with total blindness

BACKGROUND

The loss of vision leads to behavioral and motor adaptations that do not necessarily translate to good functioning with regards to daily tasks.

AIM

To investigate differences in functional mobility in adults with total blindness, and analyze differences in spatiotemporal gait variables with and without the use of a cane, and wearing shoes or barefoot.

METHODS

We used an inertial measurement unit to assess the spatiotemporal parameters of the gait and functional mobility in seven subjects with total blindness and four sighted participants during the timed up and go test (TUG) test performed under conditions: barefoot/shod; and with/without a cane (blind subjects).

RESULTS

Significant differences between groups were found in total TUG test time and in the sub-phases when the blind subjects executed the TUG barefoot and without a cane (p < .01). Other differences were found in trunk movement during sit-to-stand, and stand-to-sit where blind subjects when without cane and barefoot, they had a greater range of motion than sighted subjects (p < .01). Also, BMI has a moderate to strong influence in the execution of the TUG in blind subjects (p < .05) CONCLUSION: This study showed that, when using a gait-assistance device and wearing shoes, blind subjects have similar functional mobility and gait as sighted subjects, suggesting that an external haptic reference can compensate for the lack of vision. Knowledge of these differences can provide a better understanding of the adaptive behavior in this population, thereby assisting in minimizing the occurrence of trauma and falls.

Evaluation of center of mass estimation for obese using statically equivalent serial chain

The complex structure of the human body makes its center of mass (CoM) estimation very challenging. The typically used estimation methods usually suffer from large estimation errors when applied to bodies with structural differences. Thus, a reliable estimation method is of utmost importance. In this paper, we present a detailed evaluation of a subject-specific CoM estimation technique named Statically Equivalent Serial Chain (SESC) by investigating its estimation ability over two different groups of subjects (Fit and Obese) in comparison to the segmental analysis method. For this study, we used an IMU-based motion capture system and a force platform to record the joint angles and corresponding center of pressure (CoP) values of twenty-five participants while performing a series of static postures. The root-mean-square errors (RMSE) of SESC's estimation for both groups showed close and lower mean values, whereas the segmental analysis method showed significantly larger RMSE values in comparison to SESC (p < 0.05). In addition, we used the Bland-Altman analysis to evaluate the agreement between the two techniques and the ground truth CoP, which showed the accuracy, precision, and reliability of SESC over both groups. In contrast, the segmental analysis method did not present neither accurate nor precise estimations, as our analysis revealed considerable fixed and proportional biases.

Plantar pressure alterations associated with increased BMI in young adults

BACKGROUND

Despite evidence suggesting that excess weight is linked to gait alterations and foot disorders, its effect on peak plantar pressure (PPP) variability and complexity during walking remains poorly understood.

RESEARCH QUESTION

This study aimed to examine the influence of overweight (BMI ≥ 25) on the dynamic PPP distribution during gait using traditional and nonlinear dynamic measures in young college students.

METHODS

Fifty-two overweight (BMI >25, average 29.3 ± 4.02) and sixty-four control college students (BMI<25, 21.7 ± 1.76) aged 18-25 years, walked across a Tekscan gait assessment system at their preferred speed. A t-test or a Mann Whitney U test was used for analysis, subject to data normality. Kinematic, kinetic, spatiotemporal, and GaitEn (sample entropy of 2D spatial PPP maps) for window lengths (m=2) at various filtering levels (r) were used to explore the impact of BMI on PPP alterations.

RESULTS AND SIGNIFICANCE

The overweight group exhibited significantly higher mean PPP. The PPP under the forefoot region was also significantly higher for the overweight group as compared to the heel. The mean GaitEn values of overweight and control groups were found significantly different at r = (0.7-0.8) x STD, where GaitEn of the control group was relatively higher, which indicates better gait performance as compared to the overweight group in alignment with previous studies. A significant correlation of GaitEn with STD of PPP was revealed for the overweight group only, suggesting that overweight could significantly change the regularity or the complexity of the PPP series. Although no spatiotemporal parameters (stride length, step length, step width) were significantly affected by the increased BMI, GaitEn dynamic measure, along with spatiotemporal (decrease in gait velocity and cadence with increased BMI), and kinetic measures (increased maximum forces and plantar pressure with increased BMI), were significantly affected by overweight, indicating the feasibility of assessing the impact of increased BMI using pressure platforms in clinical settings.

Factors of Obesity and Metabolically Healthy Obesity in Asia

The East Asian region (China, Japan, and South Korea) is comprised of almost 1.5 billion people and recent industrialization has brought with it a pandemic of rising obesity, even in children. As these countries are rapidly aging and functioning at sub-replacement birthrates, the burgeoning costs of obesity-related care may threaten socialized healthcare systems and quality of life. However, a condition called metabolically healthy obesity (MHO) has been found to be without immediate cardiopulmonary or diabetic risk. Thus, maintenance of the MHO condition for the obese in East Asia could buffer the burden of long-term obesity care on medical systems and knowledge of the biochemical, genetic, and physiological milieu associated with it could also provide new targets for intervention. Diverse physiological, psychological, environmental, and social factors play a role in obesogenesis and the transition of MHO to a metabolically unhealthy obesity. This review will give a broad survey of the various causes of obesity and MHO, with special emphasis on the East Asian population and studies from that region.

Differences in the manifestation of balance according to BMI levels for women students of the Faculty of Physical Education and Sports

Abstract Background: Static and dynamic balance are factors of major importance in the manifestation of human motor skills at a higher level. Purpose: The determination of vari-ations in the performance of balance tests for young women students at the Faculty of Physical Education and Sports (48 cases in the 1st year of bachelor's degree), divided and analyzed 3 BMI levels (underweight / 7 cases, normal weight / 34 cases and overweight / 7 cases) and comparing these results with other similar research. Material and method: The testing of the group was scheduled at the Research Center for Human Performance, be-longing to the Faculty of Physical Education and Sports in Galați, in the month of April of the 2018-2019 academic year. For the assessment of balance, 7 tests were used, of which 4 associated with dynamic postural stability (Walk and turn field sobriety test/errors, Func-tional reach test/cm, Fukuda test/degrees of rotation, Bass test/ points) and 3 measuring static stability (Flamingo test/falls, One leg standing with eyes closed/sec, Stork test/sec). Nonparametric tests (Mann-Whitney U) were applied to compare differences between batches. Results: The average values of underweight and normal-weight women are better than those of overweight women for the entire set of assessment tests. The underweight group has the best results for the Standing balance test, Functional reach test, Flamingo test, Walk and turn field sobriety test, Fukuda test, and the normal weight women for Stork test, respectively Bass test. We found a lack of significant thresholds when comparing the results between the 3 groups (P> 0.05) for Stork test, Standing balance test and Functional reach test, so the working hypothesis formulated is only partially confirmed. The only significant difference between underweight and normal weight (P <0.05) is found in the Flamingo test, with better values for underweight. Significant difference thresholds for Flamingo test and Fukuda test are recorded between the underweight and overweight groups (Z values have associated thresholds P<0.05). The most significant differences are found between the normal weight and overweight groups (P <0.05), respectively for the Bass test, Fukuda test and Walk and turn field sobriety test. Conclusion: Constant physical activity (as a feature of the analyzed group) reduces the chances of significant differences in all balance tests between BMI levels. Keywords: female students; university specialization; static and dynamic postural control; physical activity

CD36 deficiency inhibits proliferation by cell cycle control in skeletal muscle cells

Obesity-related muscular dysfunction and relative muscle atrophy affect an increasing number of people. Elucidating the molecular mechanisms of skeletal muscle cell development and growth may contribute to the maintenance of skeletal muscle mass in obesity. Fatty acid translocase (FAT/CD36), as a long-chain fatty acid transport protein, is crucial for lipid metabolism and signaling. CD36 is known to function in myogenic differentiation, and whether it affects the proliferation of skeletal muscle cells and the underlying mechanisms remain unclear. In this study, the effect of CD36 deficiency on skeletal muscle cell viability and proliferation was examined using C2C12 myoblasts. Results showed that the deletion of CD36 enhanced the inhibitory effect of PA on the proliferation and the promotion of apoptosis in skeletal muscle cells. Intriguingly, the silencing of CD36 suppressed cell proliferation by preventing the cell cycle from the G0/G1 phase to the S phase in a cyclin D1/CDK4-dependent manner. Overall, we demonstrated that CD36 was involved in skeletal muscle cell proliferation by cell cycle control, and these findings might facilitate the treatment of obesity-related muscle wasting.

Partial Unweighting in Obese Persons Enhances Tactile Transmission From the Periphery to Cortical Areas: Impact on Postural Adjustments

Tactile plantar information is known to play an important role in balance maintenance and to contribute to the setting of anticipatory postural adjustments (APAs) prior to stepping. Previous studies have suggested that somatosensory processes do not function optimally for obese individuals due to the increased pressure of the plantar sole resulting in balance issues. Here, we investigated whether decreasing the compression of the mechanoreceptors by unweighting the plantar sole would enhance tactile sensory processes leading to an increased stability and an accurate setting of the APAs in obese individuals. More specifically, we tested the hypothesis that the somatosensory cortex response to electric stimulation (SEP) of the plantar sole in standing obese persons will be greater with reduced body weight than with their effective weight. The level of unweighting was calculated for each participant to correspond to a healthy body mass index. We showed an increase SEP amplitude in the unweighted condition compared to the effective body weight for all participants. This increase can be explained by the reduction of weight itself but also by the modified distribution of the pressure exerted onto the foot sole. Indeed, in the unweighted condition, the vertical ground reaction forces are evenly distributed over the surface of the foot. This suggests that decreasing and equalizing the pressure applied on the plantar mechanoreceptors results in an increase in somatosensory transmission and sensory processes for obese persons when unweighted. These sensory processes are crucial prior to step initiation and for setting the anticipatory postural adjustments (i.e., thrust). These cortical changes could have contributed to the observed changes in the spatiotemporal characteristics of the thrust prior to step initiation.

The Association of Gender and Body Mass Index on the Values of Static and Dynamic Balance of University Students (A Cross-Sectional Design Study)

The balance of the body conditions the quality and efficiency of the movements in daily and sports activities, its impairment generating problems in the manifestation of motor skills for all age groups. The aim of this study is to analyze how the gender and BMI values of university students influence the results of the static and dynamic balance tests applied. The investigated group consists of 195 undergraduate students, from various specializations of the Dunărea de Jos University in Galați (99 males and 96 females, ages = 20.16 ± 1.98, BMI = 24.15 ± 5.68). The independent variables gender and BMI levels (underweight, normal weight and overweight/obese) were defined. The participants were evaluated in May 2019 using a series of 7 tests: one leg standing test with eyes closed, stork test, flamingo test, Bass test, functional reach test, walk and turn field sobriety test and Fukuda test. The results provided using multivariate analysis (MANOVA) indicate balanced performance for the gender variable, but with significantly better values for women in the one leg standing test, flamingo test and functional reach test (F values are associated with thresholds p < 0.05). Men obtain slightly better, but statistically insignificant (p > 0.05), performances on the stork test, Bass test and Fukuda test. The BMI step comparison confirms the difficulties of the overweight group in assessing balance, with the lowest scores in maintaining static positions and the most errors in dynamic balance tests, with significant differences from normal and underweight in most tests (p < 0.05). An interesting aspect is the slightly superior performance of the underweight compared to the normal weight group, for the one leg standing test, flamingo test and walk and turn field sobriety test. The analysis of Spearman correlation coefficients indicates a number of significant associations between elevated BMI values and decreased performance on balance tests.

Effects of Plyometric Exercises versus Flatfoot Corrective Exercises on Postural Control and Foot Posture in Obese Children with a Flexible Flatfoot

BACKGROUND

Obesity contributes to the acquired flatfoot deformity which in turn impairs balance.

AIM

The purpose of the current study was to compare the effect of plyometric exercises with flatfoot corrective exercises on balance, foot posture, and functional mobility in obese children with a flexible flatfoot.

METHODS

Forty-seven children participated in the study. Their age ranged from 7 to 11 years. Participants were randomly divided into 3 groups: experimental group I (EGI), experimental group II (EGII), and the control group (CG). The EGI received plyometric exercises and the EGII received corrective exercises, 2 sessions weekly for 10 weeks. The control group did not perform any planned physical activities. The Prokin system was used to assess balance, the timed up and go test (TUG) was used to assess functional mobility, and the navicular drop test (NDT) was used to assess foot posture.

RESULTS

EGI showed significant improvement in all balance parameters, foot posture, and TUG. EGII showed improvement in the ellipse area and perimeter in addition to foot posture and TUG.

CONCLUSION

Plyometric exercises and foot correction exercises had a positive effect on foot posture, balance, and functional mobility in obese children with flatfeet.

Helping Children with Obesity "Move Well" To Move More: An Applied Clinical Review

ABSTRACT

Children with obesity experience musculoskeletal pain and reduced physical function and well-being, which collectively impact their fitness, strength, motor skills, and even their ability to undertake simple tasks, like walking and climbing stairs. Disrupting obesity-related disability may be critical to increasing children's physical activity. Thus, barriers to movement should be considered by health practitioners to improve the efficacy of prescribed physical activity. This applied clinical review highlights key subjective and objective findings from a hypothetical case scenario, linking those findings to the research evidence, before exploring strategies to enhance movement and increase physical activity.

Comparison of gluteus medius strength between individuals with obesity and normal-weight individuals: a cross-sectional study

Background

The hip abductor muscles, primarily the gluteus medius, play an important role in stabilizing the pelvis during gait. Gluteus medius weakness is associated with biomechanical changes and musculoskeletal disorders. Individuals with obesity can have great difficulty maintaining abductor muscular function due to being overweight and possibly experiencing a decrease in muscle mass. However, it is still unclear whether the musculature of person with obesity can compensate for these changes. Therefore, the aim of this study was to compare gluteus medius strength between individuals with obesity and normal-weight individuals using a digital hand-held dynamometer.

Methods

Twenty-five participants with obesity (BMI > 35 kg/m²) were matched for sex, age, and height with normal-weight individuals. Gluteus medius strength was measured by a single examiner using a belt-stabilized hand-held digital dynamometer placed on the knee of the individuals positioned in lateral decubitus. Three measurements were recorded with rest intervals, and only the highest value measured for each limb was used for analysis. The differences between pairs were calculated, and the normality of the data was assessed using the Shapiro-Wilk test (p < 0.05). The matrices of the variables were standardized and analysed using principal component analysis (PCA).

Results

For the strength variables (Newtons) on both sides, no significant differences were detected between the groups (p > 0.05). However, significant differences were detected in these variables between the groups (p < 0.05) when the measurements were normalized to body weight (Newtons/kilograms). PCA indicated that both the absolute and normalized values of strength are lower in participants with obesity than in normal-weight.

Conclusions

These findings suggest that people with obesity could have the same or less strength (PCA) to move more mass, which may imply a relative weakness that induces functional limitations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04470-8.

Regulatory Action of Plasma from Patients with Obesity and Diabetes towards Muscle Cells Differentiation and Bioenergetics Revealed by the C2C12 Cell Model and MicroRNA Analysis

Obesity and type 2 diabetes mellitus (T2DM) are often combined and pathologically affect many tissues due to changes in circulating bioactive molecules. In this work, we evaluated the effect of blood plasma from obese (OB) patients or from obese patients comorbid with diabetes (OBD) on skeletal muscle function and metabolic state. We employed the mouse myoblasts C2C12 differentiation model to test the regulatory effect of plasma exposure at several levels: (1) cell morphology; (2) functional activity of mitochondria; (3) expression levels of several mitochondria regulators, i.e., Atgl, Pgc1b, and miR-378a-3p. Existing databases were used to computationally predict and analyze mir-378a-3p potential targets. We show that short-term exposure to OB or OBD patients' plasma is sufficient to affect C2C12 properties. In fact, the expression of genes that regulate skeletal muscle differentiation and growth was downregulated in both OB- and OBD-treated cells, maximal mitochondrial respiration rate was downregulated in the OBD group, while in the OB group, a metabolic switch to glycolysis was detected. These alterations correlated with a decrease in ATGL and Pgc1b expression in the OB group and with an increase of miR-378a-3p levels in the OBD group.

Comparison of muscle activity during sit-to-stand movement at different chair heights between obese and normal-weight subjects

The purpose of present study was to compare the tibialis anterior (TA), rectus femoris (RF), and erector spinae (ES) muscle activities at variety chair height during sit-to-stand (STS) on normal weight and obese subjects. Also, we compared the muscle activity difference between the normal weight and obese subjects. The study included 26 subjects (normal weight 13 and obese 13). Each subject performed STS at three chair heights (40 cm, 50 cm, 60 cm) and TA, RF, and ES muscle activities measured. According to the results of the measurement, muscle activation of TA showed significantly higher than RF and ES muscle activation during STS at all chair heights on obese subjects. The muscle activation of TA showed significantly higher than RF muscle activation during STS at all chair heights on normal weight subjects. The muscle activation of RF and ES showed significantly higher in normal weight subjects than obese subjects at 40 cm and 50 cm of chair heights. However, the TA muscle activation showed no significant difference between normal weight subjects and obese subjects. This study’s results suggested that obese subjects should practice the use of RF and ES muscles in a low-height chair during STS.

Effect of bee bread on some biochemical parameters and skeletal muscle histology of high-fat diet-induced obese Sprague-Dawley rats

The effect of bee bread (BB) on the biochemical parameters-body weights, calorie intake, Lee obesity indices, serum amylase, aspartate and alanine amino transferases, skeletal muscle activities of creatine kinase, superoxide dismutase, glutathione peroxidase, catalase, malondialdehyde, glutathione-S-transferase, total antioxidant activity, endogenous secretory receptor for advanced glycation end products (esRAGE), and muscle histology of high-fat diet (HFD) obese rats-was studied. Thirty-six male Sprague-Dawley rats were divided into six groups: Control: received rat feed and water (1 ml/kg); HFD: received HFD and water (1 ml/kg): BB or orlistat preventive: received HFD and BB (0.5 g/kg) or HFD and orlistat (10 mg/kg; weeks 1 to 12); BB or orlistat treated: received HFD and BB (0.5 g/kg) or HFD and orlistat (10 mg/kg; weeks 6 to 12), following obesity induction. At week 12, HFD group had altered (p < .05) levels of some biochemical parameters which were modulated by BB and corroborated by muscle histology. PRACTICAL APPLICATIONS: Obesity is a global health problem, which prevalence has continued to be on the increase due to changes in lifestyle and dietary behavior. Additionally, the approaches that currently are being used for the treatment of this disease have not been able to successfully reverse obesity and its associated complications. The current study which showed that bee bread prevented or attenuated obesity-induced muscular pathology, places bee bread in the spotlight as a functional food that could be useful in preventing or mitigating obesity-induced muscular pathology.

Obesity impairs performing and learning a timing perception task regardless of the body position

Obesity has been associated with poorer sensorimotor performance. However, it remains unclear whether these obesity-related impairments can be mitigated by practice. In the present study, we sought to investigate the effects of practice on performing and learning a temporal estimation task, in women with and without obesity. The experimental task consisted of synchronizing the arrival of two rectangles at a target point. Limited to the pressing of a switch, the task was intended to minimize possible muscular fatigue, self-generated perturbations to balance and the need to accelerate/decelerate body segments. Participants were allowed to choose the displacement velocity of the rectangle they controlled and were informed that they would not be offered any choice over it during a test to come. To control for the effect of different body positions on sensorimotor performance and learning, the 19 women with obesity (BMI = 40.0 + 7.33, age = 44.2 + 6.6) and 20 without obesity (BMI = 22.3 + 1.95, age = 43 + 6.9) were assigned into 4 groups, according to their BMI and body position assumed during practice (standing upright with feet together or sitting). As no significant differences concerning body position were found, the data were reanalysed disregarding this factor. Results revealed that while both groups reduced errors during the Acquisition, participants with obesity showed poorer performance (Acquisition) and sensorimotor learning (Transfer). Given the experimental task and adopted procedures, our results tend to support the hypothesis that hindered perception and/or integration of sensory information is associated with obesity.

Older but not younger adults rely on multijoint coordination to stabilize the swinging limb when performing a novel cued walking task

Motor flexibility, the ability to employ multiple motor strategies to meet task demands, may facilitate ambulation in complex environments that constrain movements; loss of motor flexibility may impair mobility. The purpose of this study was to determine the effects of obesity (a specific model of mobility impairment) and advanced age on motor flexibility during a task that constrained foot placement while walking. Twenty-one community-dwelling obese (OB) and 25 normal weight (NW) older adults (46 total older adults-OA) and 10 younger adults (YA) walked normally on a treadmill (baseline) then walked while stepping on lighted cues projected onto the treadmill at locations corresponding to average foot placement during normal walking (cued). The uncontrolled manifold (UCM) analysis was used to partition total variance in a set of seven lower-limb segment angles into components that did ("bad" variance) and did not ("good" variance) affect step-to-step variance in the trajectory of the swing foot. Motor flexibility was operationalized as an increase (baseline to cued) in total variance with an increase in good variance that exceeded the change in bad variance. There was no significant group × walking task interaction for total and good variance for OB vs NW, but there was a strong and significant interaction effect for OA vs YA (p < 0.01; Cohen's d > 1.0). Whereas YA reduced both good and bad variance, OA increased good variance beyond the change in bad variance. In OA, these changes were associated with several functional measures of mobility. Cued walking may place greater demands on OA requiring greater reliance on motor flexibility, although otherwise healthy older obese adults may be able to compensate for functional and cognitive declines associated with obesity by increasing motor flexibility under such tasks. The extent to which motor flexibility is employed during novel or constrained tasks may be a biomarker of healthy aging and a target for (re)habilitation.

Obesity, but not overweight, is associated with plantar light touch sensation in children aged 8 to 16 years: A cross-sectional study

OBJECTIVE

Increased foot-ground contact loading engenders adaptive glabrous skin thickening and can decrease mechanoreceptor acuity and alter plantar cutaneous sensation. There has not been any research on whether overweight and obesity are similarly associated with normal plantar cutaneous sensation scores in children. This study investigated the associations between normal plantar cutaneous sensation scores and weight status (i.e., healthy weight, overweight, and obesity) in a sample of youth.

METHODS

Plantar sensation was tested among 122 participants aged 8 to 16 years (10.3 ± 1.8 years; 140.0 ± 11.2 cm; 44.2 ± 16.0 kg) across the forefoot, midfoot, and rearfoot using Semmes-Weinstein pressure aesthesiometry (0.07 g and 0.4 g monofilaments). Weight status was determined using the Centers for Disease Control and Prevention growth charts. Age- and sex-adjusted models were used to explore the relationships between normal plantar sensation scores and weight status. Significant two-tailed tests were set at p < .05.

RESULTS

Only obesity was inversely associated with normal plantar sensation scores on the left (β = -.241; p = .009) and right (β = -.222; p = .018) forefeet, left (β = -.322; p = .001) and right (β = -.253; p = .007) midfeet, and left (β = -.286; p = .002) and right (β = -.228; p = .014) wholefeet (relative to healthy weight) when using the 0.07 g monofilament. There was no association between obesity and plantar sensation when using the 0.4 g monofilament.

CONCLUSIONS

Obesity is associated with diminished light touch plantar sensation. Considering previously reported higher mechanical loading and the fact that Merkel cells and the Aβfibers that innervate them are superficial to the hypodermis, adaptive glabrous skin thickening (rather than fat pad thickness) may underlie this association. Contrary to previous suggestions, overweight is not associated with decreased plantar cutaneous sensation.

Effect of Adding Proprioceptive Exercise to Balance Training in Older Adults with Diabetes: A Systematic Review

INTRODUCTION

Accidental fall is a serious problem in older adults. The incidence of accidental fall increases by any dysfunction in the proprioceptive system. The function of the proprioceptive system usually is much affected in people with Diabetes Mellitus (DM), particularly in older ages. However, proprioceptive exercise significantly improves the balance control in older adults, no systematic review demonstrated its effectiveness in improving the balance control in older adults with DM. Thus, this systematic review was conducted to examine the effectiveness of adding proprioceptive exercise to any balance training in older adults with DM.

METHODS

A systematic search was performed in five major databases. The inclusion criteria of this search included older adults with DM, peripheral neuropathy, randomized control trial, and proprioceptive dysfunction. The exclusion criterion of this search included any study where participants had a history of a disease that might affect the balance control such as ataxia, stroke, and Parkinsonism. The outcome of interest was the importance of including proprioceptive exercise in increasing the effectiveness of balance training in older adults with DM.

RESULTS

Nine RCTs met the inclusion criteria for this systematic review. Seven studies of these nine studies included randomization details. Only two studies included the blindness, and only one of them included double blindness. The description of the withdrawal of participants was shown in eight studies. All the included studies used a control group and accomplished the homogeny between subjects in the both groups.

CONCLUSION

This systematic review showed that proprioceptive exercise is a vital component that should be included in any balance training to gain short-term improvement in the balance control in older adults with DM.

Increased physical activity does not improve obesity-induced decreases in muscle quality in zebrafish (Danio rerio)

Obesity has a negative effect on muscle contractile function, and the effects of obesity are not reversed by weight loss. It is therefore important to determine how muscle function can be restored, and exercise is the most promising approach. We tested the hypothesis (in zebrafish, Danio rerio) that moderate aerobic exercise (forced swimming for 30 min/day, raising metabolic rates to at least twice resting levels) will alleviate the negative effects of obesity on muscle function. We allocated zebrafish randomly to experimental treatments in a fully factorial design with diet treatment [three levels: lean control, diet-induced obese, obese followed by weight loss (obese-lean)], and exercise (exercise and sedentary control) as independent factors. Treatments were conducted for 10 wk, and we measured locomotor performance, isolated muscle mechanics, and myosin heavy chain composition. Obesity led to decreased muscle force production per unit area ( P = 0.01), and slowed muscle contraction ( P = 0.004) and relaxation rates ( P = 0.02). These effects were not reversible by weight loss or exercise. However, at the level implemented in our experimental animals, neither diet nor exercise affected swimming performance or myosin heavy chain concentrations. The moderate levels of exercise we implemented therefore are not sufficient to reverse the effects of obesity on muscle function, and higher intensity or a combination of modes of exercise may be necessary to improve muscle quality during obesity and following weight loss.

NEW & NOTEWORTHY Obesity can have a negative effect on muscle function and thereby compromise mobility. Even though aerobic exercise has many physiological benefits in obese and normal-weight individuals, we show that in zebrafish aerobic exercise does not improve obesity-induced reductions in muscle contractile function. A combination between different modes of exercise may be more effective than aerobic exercise alone.

Benefits of Activity-Based Interventions Among Female Adolescents Who Are Overweight and Obese

PURPOSE

The purpose of this study was to compare the effects of 2 activity-based motor interventions among female adolescents who are overweight and obese.

METHODS

This study was conducted in a low-income community of Cape Town, South Africa. The study involved 52 participants classified as overweight and obese. Participants were randomly assigned to task-oriented functional training or Wii Fit intervention. Both interventions were 45 minutes of active training once a week for 14 weeks. Outcome measures included aerobic fitness, motor coordination, and self-efficacy. Data were collected before and after the interventions.

RESULTS

Participants in both groups demonstrated significant improvement in aerobic fitness and motor coordination but not self-efficacy. However, no between-group differences were observed on any of the outcomes.

CONCLUSIONS

Activity-based interventions may improve aerobic fitness and motor coordination in female adolescents who are overweight and obese and may also help prevent declines in physical fitness and coordination in this population.

Wavelet-Based Analysis of Physical Activity and Sleep Movement Data from Wearable Sensors among Obese Adults

Decreased physical activity in obese individuals is associated with a prevalence of cardiovascular and metabolic disorders. Physicians usually recommend that obese individuals change their lifestyle, specifically changes in diet, exercise, and other physical activities for obesity management. Therefore, understanding physical activity and sleep behavior is an essential aspect of obesity management. With innovations in mobile and electronic health care technologies, wearable inertial sensors have been used extensively over the past decade for monitoring human activities. Despite significant progress with the wearable inertial sensing technology, there is a knowledge gap among researchers regarding how to analyze longitudinal multi-day inertial sensor data to explore activities of daily living (ADL) and sleep behavior. The purpose of this study was to explore new clinically relevant metrics using movement amplitude and frequency from longitudinal wearable sensor data in obese and non-obese young adults. We utilized wavelet analysis to determine movement frequencies on longitudinal multi-day wearable sensor data. In this study, we recruited 10 obese and 10 non-obese young subjects. We found that obese participants performed more low-frequency (0.1 Hz) movements and fewer movements of high frequency (1.1–1.4 Hz) compared to non-obese counterparts. Both obese and non-obese subjects were active during the 00:00–06:00 time interval. In addition, obesity affected sleep with significantly fewer transitions, and obese individuals showed low values of root mean square transition accelerations throughout the night. This study is critical for obesity management to prevent unhealthy weight gain by the recommendations of physical activity based on our results. Longitudinal multi-day monitoring using wearable sensors has great potential to be integrated into routine health care checkups to prevent obesity and promote physical activities.

Obesity, bone density relative to body weight and prevalent vertebral fracture at age 62 years: the Newcastle thousand families study

Obesity increases the likelihood of prevalent vertebral fracture (VF) in men and women at age 62 years. The higher absolute bone mineral density (BMD) observed in obese individuals is disproportionate to body weight, and this may partly explain the greater prevalence of VF in this group.

INTRODUCTION

Obesity is a global epidemic, and there remains uncertainty over the effect of obesity on skeletal health, particularly in the context of osteoporosis. The aim of this study was to investigate associations of body mass index (BMI) and obesity with BMD and prevalent VF in men and women aged 62 years.

METHODS

Three hundred and forty-two men and women aged 62.5 ± 0.5 years from the Newcastle Thousand Families Study birth cohort underwent DXA evaluations of femoral neck and lumbar spine BMD and of the lateral spine for vertebral fracture assessment.

RESULTS

The likelihood of prevalent VF was significantly increased in men when compared to women (OR = 2.7, p < 0.001, 95% Cl 1.7-4.4). As BMI increased in women, so did the likelihood of prevalent any-grade VF (OR = 1.09, p = 0.006, 95% CI 1.02-1.17). Compared to normal weight women, obese women were more likely to have at least one VF (OR = 2.65, p = 0.025, CI 1.13-6.20) and at least one grade 1 vertebral deformity (OR = 4.39, p = 0.005, CI 1.57-12.28). Obese men were more likely to have a grade 2 and/or grade 3 VF compared to men of normal weight (OR = 3.36, p = 0.032, CI 1.11-10.16). In men and women, BMI was negatively associated with femoral neck BMD/weight (R = - 0.65, R = - 0.66, p < 0.001) and lumbar spine BMD/weight (R = - 0.66, R - 0.60, p < 0.001).

CONCLUSIONS

Obesity appears to be a risk factor for prevalent VF, and although absolute BMD is higher in obese individuals, this does not appear commensurate to their increased body weight.

Fear of falling in obese women under 50 years of age: a cross-sectional study with exploration of the relationship with physical activity

Background

An understanding of capacity for physical activity in obese populations should help guide interventions to promote physical activity. Fear of falling is a phenomenon reported in the elderly, which is associated with reduced mobility and lower physical activity levels. However, although falls are reportedly common in obese adults, fear of falling and its relationship with activity has not been investigated in younger obese populations.

Methods

In a cross-sectional study, fear of falling was measured in 63 women aged 18 to 49 years, with mean BMI 42.1 kg/m² (SD 10.3) using the Modified Falls Efficacy (MFES), the Consequences of Falling (COF) and the Modified Survey of Activities and Fear of Falling in the Elderly (MSAFFE) scales. The choice of scales was informed by prior qualitative interviews with obese younger women. Physical activity levels were measured at the same time using the International Physical Activity Questionnaire. The mean score for fear of falling scales, with 95% confidence intervals, were estimated. Chi-square tests and t-tests were used to explore differences in age, body mass index and fear of falling scores between fallers and non-fallers. For each fear of falling scale, binomial logistic regression was used to explore its relationship with physical activity.

Results

Mean scores suggested high levels of fear of falling: MFES [mean 7.7 (SD 2.7); median 8.5]; COF [mean 31.3 (SD 9.4)]; MSAFFE [mean 25.9 (SD 8.7); median 23]. Scores were significantly worse in fallers (n = 42) compared to non-fallers (n = 21). MFES and MSAFFE were independently associated with lower levels of physical activity [odds ratio = 0.65, 95% Cl 0.44 to 0.96 and odds ratio = 1.14, 95% CI 1.01 to 1.28 respectively], when adjusted for age, BMI and depression.

Conclusions

This study confirms that fear of falling is present in obese women under 50 years of age. It suggests that it is associated with low levels of physical activity. These novel findings warrant further research to understand capacity for physical and incidental activity in obese adults in both genders and suggest innovative interventions to promote lifestyle changes and/or consideration of falls prevention in this population.

Do wearable sensors add meaningful information to the Timed Up and Go test? A study on obese women

The purpose of this study was to validate Time Up and Go test (TUG) as measured by a single Inertial Measurement Unit (IMU) placed on the lower back to that measured by a stopwatch in obese and normal weight women; in addition, the comparison of the performance of TUG test between obese and healthy women using the instrumented TUG (iTUG). Forty-four severely obese women and 14 age-matched healthy women were assessed simultaneously by IMU and stopwatch. The comparison between manual and instrumented assessment of total time duration showed no significant differences both in the healthy (8.32 ± 0.96 s vs. 8.52 ± 0.97 s, p > 0.05) and in the obese group (9.99 ± 2.28 s vs. 9.81 ± 2.52 s; p > 0.05). The comparison between obese and healthy group exhibited significant differences in terms of total time duration both during manual and iTUG, which is longer in obese women than normal weight women. The duration of the sub-phases in obese group is longer with the exception of sit-to-stand and stand-to-sit phase, with lower turning velocity both in mid- and final turning sub-phase. The results suggest that the iTUG is an objective and fast mobility test and it could add useful information to the manual TUG for clinical practice.

The effects of obesity on skeletal muscle contractile function

Obesity can cause a decline in contractile function of skeletal muscle, thereby reducing mobility and promoting obesity-associated health risks. We reviewed the literature to establish the current state-of-knowledge of how obesity affects skeletal muscle contraction and relaxation. At a cellular level, the dominant effects of obesity are disrupted calcium signalling and 5'-adenosine monophosphate-activated protein kinase (AMPK) activity. As a result, there is a shift from slow to fast muscle fibre types. Decreased AMPK activity promotes the class II histone deacetylase (HDAC)-mediated inhibition of the myocyte enhancer factor 2 (MEF2). MEF2 promotes slow fibre type expression, and its activity is stimulated by the calcium-dependent phosphatase calcineurin. Obesity-induced attenuation of calcium signalling via its effects on calcineurin, as well as on adiponectin and actinin affects excitation-contraction coupling and excitation-transcription coupling in the myocyte. These molecular changes affect muscle contractile function and phenotype, and thereby in vivo and in vitro muscle performance. In vivo, obesity can increase the absolute force and power produced by increasing the demand on weight-supporting muscle. However, when normalised to body mass, muscle performance of obese individuals is reduced. Isolated muscle preparations show that obesity often leads to a decrease in force produced per muscle cross-sectional area, and power produced per muscle mass. Obesity and ageing have similar physiological consequences. The synergistic effects of obesity and ageing on muscle function may exacerbate morbidity and mortality. Important future research directions include determining: the relationship between time course of weight gain and changes in muscle function; the relative effects of weight gain and high-fat diet feeding per se; the effects of obesity on muscle function during ageing; and if the effects of obesity on muscle function are reversible.

Musculoskeletal Fitness Measures Are Not Created Equal: An Assessment of School Children in Corpus Christi, Texas

This study investigated current obesity prevalence and associations between musculoskeletal fitness test scores and the odds of being underweight, overweight, or obese compared to having a healthy weight in elementary school children in Corpus Christi, Texas. The sample analyzed consisted of 492 public elementary school children between kindergarten and fifth grade. Their ages ranged from 5 to 11 years. Trunk lift, 90° push-up, curl-up, and back saver sit and reach tests were administered. Weight status was determined using BMI scores and the CDC growth charts. Obesity prevalence remains high among elementary school-aged children in Corpus Christi, Texas. Higher 90° push-up test scores were most consistently associated with decreased odds of being obese as compared to being overweight and having healthy weight except in kindergarten. Conversely, higher trunk lift test scores were associated with increased odds of being obese in second and fourth grades. When children achieved the minimum score to be classified in the Healthy Fitness Zone, those with healthy weight had similarly low musculoskeletal fitness (i.e., abdominal strength and endurance, hamstring flexibility, and trunk extensor strength and flexibility) as peers with overweight and obesity, especially in the lower grades. It was concluded that increased obesity prevalence in higher grades may be precipitated (at least in part) by low musculoskeletal fitness in the lower grades, especially kindergarten. Given previous associations in the literature, low musculoskeletal fitness may be symptomatic of poor motor skill competence in the current sample. These findings suggest a need for early and focused school-based interventions that leverage both known and novel strategies to combat pediatric obesity in Corpus Christi.

Static postural control among school-aged youth with Down syndrome: A systematic review

BACKGROUND

Youth with Down syndrome are characterized by motor delays when compared to typically developing (TD) youth, which may be explained by a lower postural control or reduced postural tone.

OBJECTIVE

In the present article, we summarize research comparing the static postural control, assessed by posturography, between youth with Down syndrome and TD youth.

METHODS

A systematic literature search was performed in 10 databases and seven studies, published between 2001 and 2017, met our inclusion criteria.

RESULTS

Based on the present reviewed findings, it is impossible to conclude that children with Down syndrome present significantly lower static postural control compared to TD children. In contrast, findings showed that adolescents with Down syndrome tended to present significantly lower static postural control compared to TD adolescents when visual and plantar cutaneous inputs were disturbed separately or simultaneously.

CONCLUSION

The present findings should be interpreted with caution given the limitations of the small number of reviewed studies. Therefore, the static postural control among youth with Down syndrome should be further investigated in future rigorous studies examining the contribution of a range of sensory information.

Relationship of Obesity With Gait and Balance in People With Multiple Sclerosis

OBJECTIVE

The aim of this study was to examine the relationship of obesity with walking and balance in people with multiple sclerosis.

DESIGN

This was a cross-sectional study performed at the Multiple Sclerosis Center, Sheba Medical Center, Israel. Four hundred thirty-six people with multiple sclerosis were divided into obese (n = 178) and normal-weight (n = 258) groups. Spatiotemporal parameters of gait, 2-Minute Walk test, 6-Minute Walk test, Timed Up and Go test, Timed 25-Foot Walk test, Multiple Sclerosis Walking Scale self-reported questionnaire, and posturography measures were determined.

RESULTS

Compared with normal-weight patients, obese subjects walked significantly slower [98.7 (SD, 29.2) m/s vs. 106.4 (SD, 29.2) m/s; P = 0.01], with shorter step lengths [54.8 (SD, 11.6) cm vs. 58.1 (SD, 10.7) cm; P = 0.003] and a wider step width [12.1 (SD, 3.7) cm vs. 10.9 (SD, 4.6) cm; P = 0.01]. Furthermore, the obese group walked a shorter distance on the 6-Minute Walk test [378.2 (SD, 145.5) m vs. 426.1 (SD, 129.8) m; P ≤ 0.001] and slower on the Timed 25-Foot Walk test [9.0 (SD, 8.0) seconds vs. 7.2 (SD, 2.4) seconds; P = 0.006] and the Timed Up and Go test [9.2 (SD, 6.3) seconds vs. 10.0 (SD, 6.1) seconds; P = 0.002]. No significant differences between groups were noted in the Multiple Sclerosis Walking Scale self-reported questionnaire and postural control measures.

CONCLUSION

Obesity affects walking but not postural control in people with multiple sclerosis despite the level of neurological disability.

A High-fat Diet Induces a Loss of Midbrain Dopaminergic Neuronal Function That Underlies Motor Abnormalities

Movement defects in obesity are associated with peripheral muscle defects, arthritis, and dysfunction of motor control by the brain. Although movement functionality is negatively correlated with obesity, the brain regions and downstream signaling pathways associated with movement defects in obesity are unclear. A dopaminergic neuronal pathway from the substantia nigra (SN) to the striatum is responsible for regulating grip strength and motor initiation through tyrosine hydroxylase (TH) activity-dependent dopamine release. We found that mice fed a high-fat diet exhibited decreased movement in open-field tests and an increase in missteps in a vertical grid test compared with normally fed mice. This motor abnormality was associated with a significant reduction of TH in the SN and striatum. We further found that phosphorylation of c-Jun N-terminal kinase (JNK), which modulates TH expression in the SN and striatum, was decreased under excess-energy conditions. Our findings suggest that high calorie intake impairs motor function through JNK-dependent dysregulation of TH in the SN and striatum.

Association of the body mass index with the overall stability index in young adult Saudi males

OBJECTIVES

Studies have focused on obesity-induced balance instability in the older population, which has been understudied in young adults. This study aimed to determine the impact of obesity on dynamic balance in young adult Saudi males.

METHODS

A cross-sectional study of 704 young adult males aged between 18 and 35 years from Umm Al-Qura University, Makkah, KSA, was performed. The obesity-induced balance was evaluated with a Biodex Balance System apparatus with a movable platform, and the overall stability index (OSI) was measured as an indicator of dynamic balance. Participants with a body mass index (BMI) ≥30 kg/m2 were considered obese.

RESULTS

The mean age and BMI of the participants was 20 years and 25.6 kg/m2, respectively. The mean OSI of the entire sample was 0.9, and the OSI values increased significantly (p < 0.001) with increasing BMI. The adjusted correlation between OSI and BMI was 0.487 (p < 0.001). Logistic regression showed that for each one-unit increment in BMI, there was an expected rise of 0.115 units in the OSI value. The receiver operating characteristic curve showed that the optimal threshold of the weight and BMI cutoff points that optimized the OSI values were 18.8 kg/m2 and 54.5 kg, respectively, with high sensitivity and specificity values. In addition, BMI affected approximately 23% of the total variability on balance (partial eta squared = 0.227, p < 0.001).

CONCLUSION

Obesity has a clear impact on dynamic balance in the selected young males. Weight management programs for obese subjects should be encouraged to optimize BMI and weight, which can attenuate balance stability.

Obesity-induced decreases in muscle performance are not reversed by weight loss

BACKGROUND/OBJECTIVES

Obesity can affect muscle phenotypes, and may thereby constrain movement and energy expenditure. Weight loss is a common and intuitive intervention for obesity, but it is not known whether the effects of obesity on muscle function are reversible by weight loss. Here we tested whether obesity-induced changes in muscle metabolic and contractile phenotypes are reversible by weight loss.

SUBJECTS/METHODS

We used zebrafish (Danio rerio) in a factorial design to compare energy metabolism, locomotor capacity, muscle isometric force and work-loop power output, and myosin heavy chain (MHC) composition between lean fish, diet-induced obese fish, and fish that were obese and then returned to lean body mass following diet restriction.

RESULTS

Obesity increased resting metabolic rates (P<0.001) and decreased maximal metabolic rates (P=0.030), but these changes were reversible by weight loss, and were not associated with changes in muscle citrate synthase activity. In contrast, obesity-induced decreases in locomotor performance (P=0.0034), and isolated muscle isometric stress (P=0.01), work-loop power output (P<0.001) and relaxation rates (P=0.012) were not reversed by weight loss. Similarly, obesity-induced decreases in concentrations of fast and slow MHCs, and a shift toward fast MHCs were not reversed by weight loss.

CONCLUSION

Obesity-induced changes in locomotor performance and muscle contractile function were not reversible by weight loss. These results show that weight loss alone may not be a sufficient intervention.

Effects of weight management program on postural stability and neuromuscular function among obese children: study protocol for a randomized controlled trial

Background

Childhood obesity is one of the most critical public health problems in the world. It is associated with low neuromuscular function and postural deformities. Whether weight loss can improve postural stability and neuromuscular control, benefit daily activities, or prevent injury is unknown. Therefore, this study attempts to investigate the effect of a 6 month weight management program on postural stability and neuromuscular control among obese children.

Methods/design

We will conduct a prospective, single-blind, randomized controlled trial with 120 prepubescent obese children. Participants will be randomly assigned to a weight management group or a control group. The weight management group will participate in a dietary and exercise program. The control group will receive health education. After the intervention, participants will be followed for 6 months with no active intervention. The primary and secondary outcomes will be assessed at the baseline, and after 6 months and 12 months. Primary outcome measures will include body weight, body height, body mass index, waist circumference, hip circumference, and body fat percentage. Secondary outcome measures will include three-dimensional functional biomechanics in different tasks, proprioception tests of the knee and ankle, neuromuscular response of the leg muscles, and muscle strength tests of the knee and ankle. Furthermore, adverse events will be recorded and analyzed. An intention-to-treat analysis will be performed if any participants withdraw from the trial.

Discussion

The important features of this trial include the randomization procedures and large sample size. This study attempts to estimate the effect of weight loss intervention on outcomes, including daily life function, postural stability, and neuromuscular control in prepubescent obese children. Therefore, our results can be useful for obese children, medical staff, and healthcare decision makers.

Trial registration

Chinese Clinical Trial Registry ChiCTR-IOB-15005874.

Impaired plantar sensitivity among the obese is associated with increased postural sway

Impaired foot plantar sensitivity has been hypothesized among individuals who are obese, and may contribute to their impaired balanced during quiet standing. The objective of this study was to investigate the effects of obesity on plantar sensitivity, and explore the relationship between plantar sensitivity and balance during quiet standing. Thirty-nine young adults from the university population participated in the study including 19 obese and 20 non-obese adults. Plantar sensitivity was measured as the force threshold at which an increasing force applied to the plantar surface of the foot was first perceived, and the force threshold at which a decreasing force was last perceived. Measurements were obtained while standing, and at two locations on the plantar surface of the dominant foot. Postural sway during quiet standing was then measured under three different sensory conditions. Results indicated less sensitive plantar sensitivity and increased postural sway among the obese, and statistically significant correlations between plantar sensitivity and postural sway that were characterized as weak to moderate in strength. As such, impaired plantar sensitivity among individuals who are obese may be a mechanism by which obesity degrades standing balance among these individuals.

Musculoskeletal Function and Obesity: Implications for Physical Activity

However quantified, obesity is a global health problem of significant magnitude. The condition is no longer limited to the developed world, with an increasing proportion of low-to-middle income countries burdened by obesity and its comorbidities. Specifically, obesity is a risk factor for a raft of psychosocial, physiological, cardiovascular, and metabolic problems. The carriage of excess body weight, including an unhealthy proportion of body fat, also has important implications for musculoskeletal health. To date, this important relationship has not received as much attention by the research community. Coincidentally, there has been a heightened interest in the role of physical activity and exercise across the lifespan in the prevention, treatment and management of obesity. This paper considers some of the more common musculoskeletal problems in children, adolescents and adults with implications for the overweight and obese and their meaningful engagement in physical activity.