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Monfrini R, Rossetto G, Scalona E, Galli M, Cimolin V, Lopomo NF. Technological Solutions for Human Movement Analysis in Obese Subjects: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23063175. [PMID: 36991886 PMCID: PMC10059733 DOI: 10.3390/s23063175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
Obesity has a critical impact on musculoskeletal systems, and excessive weight directly affects the ability of subjects to realize movements. It is important to monitor the activities of obese subjects, their functional limitations, and the overall risks related to specific motor tasks. From this perspective, this systematic review identified and summarized the main technologies specifically used to acquire and quantify movements in scientific studies involving obese subjects. The search for articles was carried out on electronic databases, i.e., PubMed, Scopus, and Web of Science. We included observational studies performed on adult obese subjects whenever reporting quantitative information concerning their movement. The articles must have been written in English, published after 2010, and concerned subjects who were primarily diagnosed with obesity, thus excluding confounding diseases. Marker-based optoelectronic stereophotogrammetric systems resulted to be the most adopted solution for movement analysis focused on obesity; indeed, wearable technologies based on magneto-inertial measurement units (MIMUs) were recently adopted for analyzing obese subjects. Further, these systems are usually integrated with force platforms, so as to have information about the ground reaction forces. However, few studies specifically reported the reliability and limitations of these approaches due to soft tissue artifacts and crosstalk, which turned out to be the most relevant problems to deal with in this context. In this perspective, in spite of their inherent limitations, medical imaging techniques-such as Magnetic Resonance Imaging (MRI) and biplane radiography-should be used to improve the accuracy of biomechanical evaluations in obese people, and to systematically validate less-invasive approaches.
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Affiliation(s)
- Riccardo Monfrini
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
| | - Gianluca Rossetto
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
| | - Emilia Scalona
- Dipartimento di Specialità Medico-Chururgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, MI, Italy
| | - Veronica Cimolin
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, MI, Italy
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo, 28824 Oggebbio, VB, Italy
| | - Nicola Francesco Lopomo
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
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Volume Fluctuations in Active and Nonactive Transtibial Prosthetics Users. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2669484. [PMID: 36132074 PMCID: PMC9484881 DOI: 10.1155/2022/2669484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/07/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022]
Abstract
This study aims to evaluate the validity and reliability of the Biosculptor’s Bioscanner system in capturing transtibial residual limb volume fluctuations in active and nonactive amputees during walking activity. Residual limb volume was obtained by measuring the limb circumference after amputees walked for 5 to 25 minutes for five consecutive days. The comparison of mean circumference between Bioscanner and manual measurements (i.e., tape measure) showed that the Bioscanner gave a higher estimation of circumference for the different amputees. Short-term changes in girth and volume due to an activity such as walking do not fluctuate uniformly. The results reflected as such as nonconsistence circumference change identified at different locations of the circumference profiles. Both amputees experienced a significant increase in circumference at the distal end of the limbs after 5 minutes of walking (7.35% change in nonactive and 8.83% in active amputees), and the measurement decreased as amputees walked longer. At 4-8 cm below the mid-patella tendon (pressure tolerant areas), both amputees experienced minor changes in the size of their circumference. The residual limb volume calculation resulted in the percentage difference between the two methods ranging from 2.4% to 9.3%. Pearson coefficient correlation obtained showed a high correlation between the two techniques, ranging from 0.97 to 1. The analysis of the limit of agreements showed that the majority of measurements were closed to the mean, suggesting that Bioscanner and manual techniques may be interchangeable and agree with one another. This study has implied that Bioscanner is comparable to the standard measurement method and may serve as an alternative tool in managing daily residual limb volume change.
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Lv Y, Xu J, Fang H, Zhang X, Wang Q. Data-Mined Continuous Hip-knee Coordination Mapping with Motion Lag for Lower-limb Prosthesis Control. IEEE Trans Neural Syst Rehabil Eng 2022; 30:1557-1566. [PMID: 35657834 DOI: 10.1109/tnsre.2022.3179978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Trajectory planning of the knee joint plays an essential role in controlling the lower limb prosthesis. Nowadays, the idea of mapping the trajectory of the healthy limb to the motion trajectory of the prosthetic joint has begun to emerge. However, establishing a simple and intuitive coordination mapping is still challenging. This paper employs the method of experimental data mining to explore such a coordination mapping. The coordination indexes, i.e., the mean absolute relative phase (MARP) and the deviation phase (DP), are obtained from experimental data. Statistical results covering different subjects indicate that the hip motion possesses a stable phase difference with the knee, inspiring us to construct a hip-knee Motion-Lagged Coordination Mapping (MLCM). The MLCM first introduces a time lag to the hip motion to avoid conventional integral or differential calculations. The model in polynomials, which is proved more efficient than Gaussian process regression and neural network learning, is then constructed to represent the mapping from the lagged hip motion to the knee motion. In addition, a strong linear correlation between hip-knee MARP and hip-knee motion lag is discovered for the first time. By using the MLCM, one can generate the knee trajectory for the prosthesis control only via the hip motion of the healthy limb, indicating less sensing and better robustness. Numerical simulations show that the prosthesis can achieve normal gaits at different walking speeds.
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Taborri J, Santuz A, Brüll L, Arampatzis A, Rossi S. Measuring Kinematic Response to Perturbed Locomotion in Young Adults. SENSORS 2022; 22:s22020672. [PMID: 35062633 PMCID: PMC8778052 DOI: 10.3390/s22020672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 12/15/2022]
Abstract
Daily life activities often require humans to perform locomotion in challenging scenarios. In this context, this study aimed at investigating the effects induced by anterior-posterior (AP) and medio-lateral (ML) perturbations on walking. Through this aim, the experimental protocol involved 12 participants who performed three tasks on a treadmill consisting of one unperturbed and two perturbed walking tests. Inertial measurement units were used to gather lower limb kinematics. Parameters related to joint angles, as the range of motion (ROM) and its variability (CoV), as well as the inter-joint coordination in terms of continuous relative phase (CRP) were computed. The AP perturbation seemed to be more challenging causing differences with respect to normal walking in both the variability of the ROM and the CRP amplitude and variability. As ML, only the ankle showed different behavior in terms of joint angle and CRP variability. In both tasks, a shortening of the stance was found. The findings should be considered when implementing perturbed rehabilitative protocols for falling reduction.
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Affiliation(s)
- Juri Taborri
- Department of Economics, Engineering, Society and Business Organization (DEIM), University of Tuscia, 01100 Viterbo, Italy;
| | - Alessandro Santuz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (A.S.); (L.B.); (A.A.)
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Leon Brüll
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (A.S.); (L.B.); (A.A.)
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Network Aging Research, Heidelberg University, 69117 Heidelberg, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (A.S.); (L.B.); (A.A.)
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Stefano Rossi
- Department of Economics, Engineering, Society and Business Organization (DEIM), University of Tuscia, 01100 Viterbo, Italy;
- Correspondence: ; Tel.: +39-07-6135-7049
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Abstract
Ultra-low-velocity knee dislocations are historically rare but increasingly common events. They occur most frequently in obese, morbidly obese, and super obese patients during everyday activities, but they can be as severe or more severe than high-velocity knee dislocations. Ultra-low-velocity knee dislocations frequently are associated with neurovascular injury and other complications. Diagnosis, early reduction, and identification and treatment of vascular injuries are critical to reducing the risk of limb ischemia and possibly amputation. Given the size of the limb, maintenance of reduction in these patients almost always requires external fixation. Although surgery on morbidly obese patients may be technically challenging, surgical reconstruction leads to improved subjective and objective results and is recommended.
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Affiliation(s)
- Patrick J Smith
- Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN
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Intra-limb and muscular coordination during walking on slopes. Eur J Appl Physiol 2020; 120:1841-1854. [DOI: 10.1007/s00421-020-04415-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
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Tatarelli A, Serrao M, Varrecchia T, Fiori L, Draicchio F, Silvetti A, Conforto S, De Marchis C, Ranavolo A. Global Muscle Coactivation of the Sound Limb in Gait of People with Transfemoral and Transtibial Amputation. SENSORS 2020; 20:s20092543. [PMID: 32365715 PMCID: PMC7249183 DOI: 10.3390/s20092543] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/25/2022]
Abstract
The aim of this study was to analyze the effect of the level of amputation and various prosthetic devices on the muscle activation of the sound limb in people with unilateral transfemoral and transtibial amputation. We calculated the global coactivation of 12 muscles using the time-varying multimuscle coactivation function method in 37 subjects with unilateral transfemoral amputation (10, 16, and 11 with mechanical, electronic, and bionic prostheses, respectively), 11 subjects with transtibial amputation, and 22 healthy subjects representing the control group. The results highlighted that people with amputation had a global coactivation temporal profile similar to that of healthy subjects. However, amputation increased the level of the simultaneous activation of many muscles during the loading response and push-off phases of the gait cycle and decreased it in the midstance and swing subphases. This increased coactivation probably plays a role in prosthetic gait asymmetry and energy consumption. Furthermore, people with amputation and wearing electronic prosthesis showed lower global coactivation when compared with people wearing mechanical and bionic prostheses. These findings suggest that the global lower limb coactivation behavior can be a useful tool to analyze the motor control strategies adopted and the ability to adapt to the prosthetic device.
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Affiliation(s)
- Antonella Tatarelli
- Department of Human Neurosciences, University of Rome Sapienza, 00185 Rome, Italy
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
- Correspondence:
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, 04100 Latina, Italy;
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
| | - Lorenzo Fiori
- Department of Physiology and Pharmacology, University of Rome Sapienza, 00185 Rome, Italy;
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
| | - Alessio Silvetti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
| | - Silvia Conforto
- Department of Engineering, Roma TRE University, 00185 Rome, Italy; (S.C.); (C.D.M.)
| | - Cristiano De Marchis
- Department of Engineering, Roma TRE University, 00185 Rome, Italy; (S.C.); (C.D.M.)
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
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Reactive Postural Responses to Continuous Yaw Perturbations in Healthy Humans: The Effect of Aging. SENSORS 2019; 20:s20010063. [PMID: 31861945 PMCID: PMC6982827 DOI: 10.3390/s20010063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 12/19/2022]
Abstract
Maintaining balance stability while turning in a quasi-static stance and/or in dynamic motion requires proper recovery mechanisms to manage sudden center-of-mass displacement. Furthermore, falls during turning are among the main concerns of community-dwelling elderly population. This study investigates the effect of aging on reactive postural responses to continuous yaw perturbations on a cohort of 10 young adults (mean age 28 ± 3 years old) and 10 older adults (mean age 61 ± 4 years old). Subjects underwent external continuous yaw perturbations provided by the RotoBit1D platform. Different conditions of visual feedback (eyes opened and eyes closed) and perturbation intensity, i.e., sinusoidal rotations on the horizontal plane at different frequencies (0.2 Hz and 0.3 Hz), were applied. Kinematics of axial body segments was gathered using three inertial measurement units. In order to measure reactive postural responses, we measured body-absolute and joint absolute rotations, center-of-mass displacement, body sway, and inter-joint coordination. Older adults showed significant reduction in horizontal rotations of body segments and joints, as well as in center-of-mass displacement. Furthermore, older adults manifested a greater variability in reactive postural responses than younger adults. The abnormal reactive postural responses observed in older adults might contribute to the well-known age-related difficulty in dealing with balance control during turning.
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Dames KD, Heise GD, Hydock DS, Smith JD. Obese adults walk differently in shoes than while barefoot. Gait Posture 2019; 70:79-83. [PMID: 30826691 DOI: 10.1016/j.gaitpost.2019.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Some comparisons between walking gait of obese and non-obese adults have been made during barefoot conditions, and others while shod. Methodological differences, footwear conditions, and gait speed disparities among the research done on overweight individuals were the factors motivating the present study. RESEARCH QUESTION The present study was designed to compare gait kinematics and kinetics of obese adults between two footwear conditions (barefoot versus shod) at a set walking speed. METHODS Ten obese (body mass index > 30 kg.m-2), but otherwise healthy adults (age = 26 ± 3 years, height = 1.79 ± 0.10 m, mass = 108.46 ± 13.25 kg) participated in this study. Ground reaction forces and 3D kinematic data were simultaneously collected as participants walked overground at 1.5 m.s-1 in barefoot and shod conditions. RESULTS Walking barefoot reduced ankle, knee, and hip ranges of motion, and stride length, stance time, and double support time were also reduced. Kinetic outcomes included smaller peak vertical and anterior-posterior ground reaction forces and knee joint moments while barefoot. SIGNIFICANCE Footwear condition significantly influences key gait variables in obese adults. Conflicting conclusions from previous investigations of gait in obese adults may be a consequence of differing footwear conditions.
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Affiliation(s)
- Kevin D Dames
- Kinesiology Department, SUNY Cortland, Cortland, NY, USA.
| | - Gary D Heise
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
| | - David S Hydock
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
| | - Jeremy D Smith
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
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Gill SV. Effects of obesity class on flat ground walking and obstacle negotiation. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2019; 19:448-454. [PMID: 31789295 PMCID: PMC6944801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Although much is known about the impact of obesity on gait, not much is understood about how classes of obesity affect movement. The purpose of this study was to examine the effects of weight classification on walking. METHODS Sixty-seven women with normal BMI (n=13), overweight/Class I obesity (n=18), Class II obesity (n=16), and Class III obesity (n=20) participated. Gait parameters (velocity and percent of the gait cycle spent in swing and stance phases) were collected as participants walked on flat ground and crossed three obstacle heights. RESULTS Adults with normal BMI had faster velocities (F(3,63)=12.60, p=.000017), shorter portions of the gait cycle spent in stance (F(3,62)=7.29, p=.00029), and a larger percent of the gait cycle spent in swing than those with higher BMI scores (F(3,62)=5.43, p=.002). Adults with overweight/Class I obesity had faster velocities than those with Class III obesity (p=.000082, d=1.20) as well as less variable velocities than those with Class II (p=.002, d=-.40) and Class III (p=.01, d=-1.0) obesity. No differences in velocity were found between those with Class II and Class III obesity (p=.12, d=.57). CONCLUSIONS These results suggest the need to encourage adults to decrease overweight/Class I obesity but that an equally important goal is to prevent an increase in BMI leading to Class II obesity.
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Affiliation(s)
- Simone V. Gill
- Boston University Department of Occupational Therapy,Boston University Department of Medicine,Boston University Department of Psychological & Brain Sciences,Corresponding author: Simone V. Gill, PhD, 635 Commonwealth Avenue, Boston, MA, 02215 E-mail:
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Ghesmaty Sangachin M, Cavuoto LA, Wang Y. Use of various obesity measurement and classification methods in occupational safety and health research: a systematic review of the literature. BMC OBESITY 2018; 5:28. [PMID: 30410773 PMCID: PMC6211422 DOI: 10.1186/s40608-018-0205-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 06/21/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study systematically examined obesity research in occupational safety and health regarding the use of various obesity measurement and classification methods. METHODS A systematic search of the PubMed database on English language publications from 2000 to 2015 using related keywords and search of citations resulted in selection of 126 studies. They were categorized into two groups based on their main research question: 1) general physical or mental work-related functioning; and 2) task or body part specific functioning. RESULTS Regardless of the study group, body mass index (BMI) was the most frequently used measure. Over 63% of the studies relied solely on BMI to define obesity. In only 22% of the studies, body fat was directly measured by methods such as dual energy x-ray absorptiometry. Abdominal obesity was defined using waist circumference in recent years, and waist-hip ratio in earlier years. Inconsistent cut-offs have also been used across studies investigating similar topics. CONCLUSIONS Few authors acknowledged the limitations of using indirect obesity measures. This is in part due to the limited understanding of some occupational safety and health researchers regarding the complex issues surrounding obesity classification and also the mixed recommendations over the past 2-3 decades and across populations. Efforts need to be made to promote appropriate obesity measurement and reporting in this field.
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Affiliation(s)
| | - Lora A. Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, 324 Bell Hall, Buffalo, NY 14260 USA
| | - Youfa Wang
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN USA
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Varrecchia T, Rinaldi M, Serrao M, Draicchio F, Conte C, Conforto S, Schmid M, Ranavolo A. Global lower limb muscle coactivation during walking at different speeds: Relationship between spatio-temporal, kinematic, kinetic, and energetic parameters. J Electromyogr Kinesiol 2018; 43:148-157. [PMID: 30292137 DOI: 10.1016/j.jelekin.2018.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/01/2018] [Accepted: 09/27/2018] [Indexed: 12/12/2022] Open
Abstract
Muscle coactivation is the mechanism that regulates the simultaneous activity of antagonist muscles around the same joint. During walking, muscle joint coactivation varies within the gait cycle according to the functional role of the lower limb joints. In the present study, we used a time-varying multi-muscle coactivation function (TMCf) with the aim of investigating the coactivation of 12 lower limb muscles and its relationship with the gait cycle, gait speed (low, self-selected, and fast), ground reaction force, gait variability, and mechanical energy consumption, and recovery in a sample of 20 healthy subjects. Results show that the TMCf is speed dependent and highly repeatable within and between subjects, similar to the vertical force profile, and negatively correlated with energy recovery and positively correlated with both energy consumption and balance-related gait parameters. These findings suggest that the global lower limb coactivation behavior could be a useful measure of the motor control strategy, limb stiffness, postural stability, energy efficiency optimization, and several aspects in pathological conditions.
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Affiliation(s)
- T Varrecchia
- Department of Engineering, Roma TRE University, Rome, Italy
| | - M Rinaldi
- Department of Engineering, Roma TRE University, Rome, Italy
| | - M Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy; Rehabilitation Centre, Policlinico Italia, Rome, Italy
| | - F Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - C Conte
- Fondazione Don Gnocchi, Milan, Italy
| | - S Conforto
- Department of Engineering, Roma TRE University, Rome, Italy
| | - M Schmid
- Department of Engineering, Roma TRE University, Rome, Italy
| | - A Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
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Prediction equation to estimate heart rate at individual ventilatory threshold in female and male obese adults. PLoS One 2018; 13:e0197255. [PMID: 29750822 PMCID: PMC5947910 DOI: 10.1371/journal.pone.0197255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/30/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Prescribing individualized moderate exercise intensity is a useful method to reach positive effects on health status in obese adults. This study aimed to establish a practical reference equation to estimate the heart rate (HR) at individual ventilatory threshold (IVT) (HRIVT). Methods One hundred sixty-one obese subjects were clinically evaluated and characterized by anthropometric and body composition. Participants performed the six-minute walking test (6-MWT) and the cardiopulmonary exercise test to assess IVT. Multiple regression analysis for HRIVT, including 6-MWT, anthropometric, and body composition parameters, as independent variables, was performed for both gender separately. A cross-validation study was also performed to determine the accuracy of the prediction equation. Results Whereas HRIVT was not significantly different between males (121.5±18.3 bpm) and females (117.6±17.1 bpm), it differently correlated with physical and performance parameters. Therefore, two sex-specific equations were developed including 6-MWTHR and HRrest (R2 = 0.69 and 0.65 and root mean square errors of 8.8 and 10.1 bpm for females and males, respectively). Conclusion In conclusion, in female and male obese adults, the 6-MWT might be used to predict HR at IVT. These outcomes are useful to prescribe optimal physical activity intensity when gold standard methods (e.g. gas exchange analysis) are unavailable.
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Long JT, Neogi S, Caldwell CM, DeLange MP. Variation inflation factor-based regression modeling of anthropometric measures and temporal-spatial performance: Modeling approach and implications for clinical utility. Clin Biomech (Bristol, Avon) 2018; 51:51-57. [PMID: 29202310 DOI: 10.1016/j.clinbiomech.2017.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 11/02/2017] [Accepted: 11/17/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Understanding the relationship of underlying anthropometry to temporal-spatial performance is critical to appropriate assessment of patients with ambulatory dysfunction. The current body of literature has established the importance of limb length in this relationship. This study sought to re-examine these relationships in light of recent trends in body habitus and obesity, using Variation Inflation Factor analysis to optimize the model. METHODS Elementary school children (n=452; ages 5-13) were tested during walking at a self-selected speed across an instrumented walkway. Temporal-spatial and anthropometric measures were compiled for all children. The relationship between temporal-spatial and anthropometric measures was assessed using regression modeling with Variation Inflation Factor optimization. FINDINGS Body weight was identified as a significant predictor of cycle duration, stride length, stance duration, and step width during initial modeling. However, it did not meet the constraints imposed during Variation Inflation Factor optimization and was removed from the final models. The final optimized models identified significant relationships between both temporal-spatial parameters of interest and other temporal-spatial measures, with the best fit identified for walking speed (R2=0.6148). INTERPRETATION The use of the Variation Inflation Factor constraint during the regression modeling process ensured final models composed of truly independent predictor variables. The resulting models are highly robust and highlight the complex relationships between body structure, functional conditions, and walking performance. These models have value for routine clinical assessment of ambulatory dysfunction, and may provide a foundation for classifying temporal-spatial performance in the context of multiple contributing parameters.
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Affiliation(s)
- Jason T Long
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
| | - Smriti Neogi
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
| | - Cailee M Caldwell
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
| | - Matthew P DeLange
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
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Donini LM, Rosano A, Di Lazzaro L, Poggiogalle E, Lubrano C, Migliaccio S, Carbonelli M, Pinto A, Lenzi A. Validation of the Italian version of the Laval questionnaire: health-related quality of life in subjects with obesity. Health Qual Life Outcomes 2017; 15:101. [PMID: 28506319 PMCID: PMC5432971 DOI: 10.1186/s12955-017-0671-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/28/2017] [Indexed: 01/22/2023] Open
Abstract
Background Obesity is associated to increased risk of metabolic comorbidity as well as increased mortality. Notably, obesity is also associated to the impairment of the psychological status and of quality of life. Only three questionnaires are available in the Italian language evaluating the health-related quality of life in subjects with obesity. The aim of the present study was to test the validity and reliability of the Italian version of the Laval Questionnaire. Methods The original French version was translated into Italian and back-translated by a French native speaker. 273 subjects with obesity (Body Mass Index ≥ 30 kg/m2) were enrolled; the Italian version of the Laval Questionnaire and the O.R.Well-97 questionnaire were administered in order to assess health- related quality of life. The Laval questionnaire consists of 44 items distributed in 6 domains (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interaction, sexual life). Disability and overall psychopathology levels were assessed through the TSD-OC test (SIO test for obesity correlated disabilities) and the SCL-90 (Symptom Checklist-90) questionnaire, respectively. To verify the validity of the Italian version, the analysis of internal consistency, test-retest reliability, and construct validity were performed. Results The observed proportion of agreement concordance of results was 50.2% with Cohen’s K = 0.336 (CI 95%: 0.267–0.404), indicating a fair agreement between the two tests. Test-retest correlation was statistically significant (ρ = 0.82; p < 0.01); validity (standardized Chronbach’s alpha) was considered reliable (α > 0.70). The analysis of construct validity showed a statistically significant association in terms of both total score (ρ = −0.66) and scores at each single domain (p < 0.01). A high correlation (p < 0.01) was observed between Laval questionnaire total and single domain scores and other related measures (Body Mass Index, TSD-OC scores, SCL-90 global severity index), revealing a high construct validity of the test. Conclusions The Italian version of the Laval Questionnaire is a valid and reliable measure to assess the health-related quality of life in subjects with obesity.
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Affiliation(s)
- Lorenzo Maria Donini
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy. .,"Sapienza" University of Rome, Department of Experimental Medicine- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Research Unit, p.le Aldo Moro n.5, 00185, Rome, Italy.
| | | | - Luca Di Lazzaro
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Eleonora Poggiogalle
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Carla Lubrano
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | | | | | - Alessandro Pinto
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Lenzi
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
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Disability, Physical Inactivity, and Impaired Health-Related Quality of Life Are Not Different in Metabolically Healthy vs. Unhealthy Obese Subjects. Nutrients 2016; 8:nu8120759. [PMID: 27897994 PMCID: PMC5188414 DOI: 10.3390/nu8120759] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/06/2016] [Accepted: 11/16/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity represents a major health hazard, affecting morbidity, psychological status, physical functionality, quality of life, and mortality. The aim of the present study was to explore the differences between metabolically healthy (MHO) and metabolically unhealthy (MUO) obese subjects with regard to physical activity, disability, and health-related quality of life (HR-QoL). METHODS All subjects underwent a multidimensional evaluation, encompassing the assessment of body composition, metabolic biomarkers and inflammation, physical activity level (IPAQ questionnaire), disability (TSD-OC test), and HR-QoL (SF-36 questionnaire). MHO and MUO were defined based on the absence or the presence of the metabolic syndrome, respectively. RESULTS 253 subjects were included (54 men and 199 women; age: 51.7 ± 12.8 vs. 50.3 ± 11.7 years, p = 0.46; BMI: 38.1 ± 5.7 vs. 38.9 ± 6.7 kg/m², p = 0.37). No significant difference was observed in body composition. There was no difference between MHO and MUO considering inflammation (hs-CRP: 6517.1 ± 11,409.9 vs. 5294.1 ± 5612.2 g/L; p = 0.37), physical inactivity (IPAQ score below 3000 METs-min/week in 77.6% of MHO vs. 80% of MUO subjects; p = 0.36), obesity-related disability (TSD-OC score > 33%, indicating a high level of obesity-related disability, in 20.2% of MHO vs. 26.5% of MUO subjects; p = 0.28), and the HR-QoL (SF-36 total score: 60 ± 20.8 vs. 62.8 ± 18.2, p = 0.27). DISCUSSION AND CONCLUSION The metabolic comorbidity and the impairment of functional ability and psycho-social functioning may have a different timing in the natural history of obesity. Alterations in the physical activity level and mobility disabilities may precede the onset of metabolic abnormalities. (Trial registration 2369 prot 166/12-registered 23 February 2012; Amendment 223/14-registered 13 February 2014).
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Willener AST, Handrich Y, Halsey LG, Strike S. Fat King Penguins Are Less Steady on Their Feet. PLoS One 2016; 11:e0147784. [PMID: 26886216 PMCID: PMC4757033 DOI: 10.1371/journal.pone.0147784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 01/10/2016] [Indexed: 11/25/2022] Open
Abstract
Returning to the shore after a feeding sojourn at sea, king penguins often undertake a relatively long terrestrial journey to the breeding colony carrying a heavy, mostly frontal, accumulation of fat along with food in the stomach for chick-provisioning. There they must survive a fasting period of up to a month in duration, during which their complete reliance on endogenous energy stores results in a dramatic loss in body mass. Our aim was to determine if the king penguin’s walking gait changes with variations in body mass. We investigated this by walking king penguins on a treadmill while instrumented with an acceleration data logger. The stride frequency, dynamic body acceleration (DBA) and posture of fat (pre-fasting; 13.2 kg) and slim (post fasting; 11 kg) king penguins were assessed while they walked at the same speed (1.4km/h) on a treadmill. Paired statistical tests indicated no evidence for a difference in dynamic body acceleration or stride frequency between the two body masses however there was substantially less variability in both leaning angle and the leaning amplitude of the body when the birds were slimmer. Furthermore, there was some evidence that the slimmer birds exhibited a decrease in waddling amplitude. We suggest the increase in variability of both leaning angle and amplitude, as well as a possibly greater variability in the waddling amplitude, is likely to result from the frontal fat accumulation when the birds are heavier, which may move the centre of mass anteriorly, resulting in a less stable upright posture. This study is the first to use accelerometry to better understand the gait of a species within a specific ecological context: the considerable body mass change exhibited by king penguins.
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Affiliation(s)
- Astrid S. T. Willener
- Department of Life Sciences, University of Roehampton, London, United Kingdom
- Université de Strasbourg, Institut Pluridisciplinaire Hubert CURIEN, Strasbourg, France
- Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7178, Strasbourg, France
- * E-mail:
| | - Yves Handrich
- Université de Strasbourg, Institut Pluridisciplinaire Hubert CURIEN, Strasbourg, France
- Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7178, Strasbourg, France
| | - Lewis G. Halsey
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | - Siobhán Strike
- Department of Life Sciences, University of Roehampton, London, United Kingdom
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Zdziarski LA, Chen C, Horodyski M, Vincent KR, Vincent HK. Kinematic, Cardiopulmonary, and Metabolic Responses of Overweight Runners While Running at Self-Selected and Standardized Speeds. PM R 2015; 8:152-60. [PMID: 26146194 DOI: 10.1016/j.pmrj.2015.06.441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/05/2015] [Accepted: 06/11/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the differences in kinematic, cardiopulmonary, and metabolic responses between overweight and healthy weight runners at a self-selected and standard running speed. DESIGN Comparative descriptive study. SETTING Tertiary care institution, university-affiliated research laboratory. PARTICIPANTS Overweight runners (n = 21) were matched with runners of healthy weight (n = 42). METHODS Participants ran at self-selected and standardized speeds (13.6 km/h). Sagittal plane joint kinematics were captured simultaneously with cardiopulmonary and metabolic measures using a motion capture system and portable gas analyzer, respectively. MAIN OUTCOME MEASUREMENTS Spatiotemporal parameters (cadence, step width and length, center of gravity displacement, stance time) joint kinematics, oxygen cost, heart rate, ventilation and energy expenditure. RESULTS At the self-selected speed, overweight individuals ran slower (8.5 ± 1.3 versus 10.0 ± 1.6 km/h) and had slower cadence (163 versus 169 steps/min; P < .05). The sagittal plane range of motion (ROM) for flexion-extension at the ankle, knee, hip, and anterior pelvic tilt were all less in overweight runners compared to healthy weight runners (all P < .05). At self-selected speed and 13.6 km/h, energy expenditure was higher in the overweight runners compared to their healthy weight counterparts (P < .05). At 13.6 km/h, only the frontal hip and pelvis ROM were higher in the overweight versus the healthy weight runners (P < .05), and energy expenditure, net energy cost, and minute ventilation were higher in the overweight runners compared to the healthy weight runners (P < .05). CONCLUSION At self-selected running speeds, the overweight runners demonstrated gait strategies (less joint ROM, less vertical displacement, and shorter step lengths) that resulted in cardiopulmonary and energetic responses similar to those of healthy weight individuals.
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Affiliation(s)
- Laura Ann Zdziarski
- Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(∗)
| | - Cong Chen
- Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(†)
| | - Marybeth Horodyski
- Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(‡)
| | - Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(§)
| | - Heather K Vincent
- Division of Research, UF Orthopaedics and Sports Medicine Institute, University of Florida, PO Box 112727, Gainesville, FL 32611(‖).
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Gill S. The impact of weight classification on safety: timing steps to adapt to external constraints. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2015; 15:103-8. [PMID: 25730658 PMCID: PMC5123614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of the current study was to evaluate how weight classification influences safety by examining adults' ability to meet a timing constraint: walking to the pace of an audio metronome. METHODS With a cross-sectional design, walking parameters were collected as 55 adults with normal (n=30) and overweight (n=25) body mass index scores walked to slow, normal, and fast audio metronome paces. RESULTS Between group comparisons showed that at the fast pace, those with overweight body mass index (BMI) had longer double limb support and stance times and slower cadences than the normal weight group (all ps<0.05). Examinations of participants' ability to meet the metronome paces revealed that participants who were overweight had higher cadences at the slow and fast paces (all ps<0.05). CONCLUSIONS Findings suggest that those with overweight BMI alter their gait to maintain biomechanical stability. Understanding how excess weight influences gait adaptation can inform interventions to improve safety for individuals with obesity.
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Affiliation(s)
- S.V. Gill
- Boston University, Department of Occupational Therapy, Boston, MA; Boston University Program in Rehabilitation Sciences (PhD); Boston University Department of Medicine; Boston University Undergraduate Program in Neuroscience; Boston University Department of Psychological & Brain Sciences,Corresponding author: Simone V. Gill, College of Health and Rehabilitation Sciences: Sargent College, Department of Occupational Therapy, 635 Commonwealth Avenue, Boston, MA, 02215, United States E-mail:
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Donini LM, Cuzzolaro M, Gnessi L, Lubrano C, Migliaccio S, Aversa A, Pinto A, Lenzi A. Obesity treatment: results after 4 years of a Nutritional and Psycho-Physical Rehabilitation Program in an outpatient setting. Eat Weight Disord 2014; 19:249-60. [PMID: 24577668 DOI: 10.1007/s40519-014-0107-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 02/05/2014] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Obesity is a chronic disease as well as a risk factor for cardiovascular, metabolic and osteoarticular diseases, affecting the psychosocial health and the quality of life. Recent evidence suggests that the adequate treatment of obesity should provide a multidimensional multidisciplinary approach including nutritional therapy, psycho-educational classes and physical reconditioning/motor rehabilitation. The aim of this approach should be to maintain the results over time with a positive impact on the obesity-related cardiovascular and metabolic risk. AIM OF THE STUDY To evaluate the effectiveness of a multidisciplinary Nutritional and Psycho-Physical Reconditioning Program (NPPRP) in an outpatient setting. MATERIALS AND METHODS The observational prospective cohort study involved subjects, aged from 18 to 65 years, with a BMI >30 kg/m(2), who were followed up over 48 months. After the first nutritional and psychological examination, patients who refused NPPRP were treated according to standard nutrition procedures (SNT). Patients were followed through monthly medical examinations and then by annual telephonic structured interviews for 4 years. Changes in body weight, eating behavior, physical activity performance, and the occurrence of clinical obesity-related complications were considered as outcome measures. RESULTS Of 464 enrolled patients, 161 (34.7%) took part in the follow-up. From the enrollment to the end of follow-up, weight loss was greater in the NPPRP group than in the SNP group (-8.08 ± 10 kg versus -3.0 ± 6 kg). After 4 years eating behavior improved in both groups. The percentage of patients who continued to perform physical activity was higher in the NPPRP group than in the SNT group (61.0 versus 34.1%). The SNT group reported complications more frequently than the NPPRP group: hypertension (19 versus 5.8%), dyslipidemia (19.4 versus 12.7%), and skeletal problems (26.9 versus 17.5%). The main reasons for drop-out from the rehabilitation program were logistic problems (distance or time) in both groups; disappointment was higher in the SNT group than in the NPPRP group (37.8 versus 15.6%). CONCLUSION A multidimensional multidisciplinary approach including nutritional intervention and psycho-physical rehabilitation, set against a conventional diet therapy, was more effective in the long-term outcome of obesity with regard to weight loss, physical activity, possible eating disorders, and obesity-related complications.
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Affiliation(s)
- Lorenzo M Donini
- Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy,
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