Soft Tissue Deformations Contribute to the Mechanics of Walking in Obese Adults

摘要

Obesity not only adds to the mass that must be carried during walking but also changes body composition. Although extra mass causes roughly proportional increases in musculoskeletal loading, less well understood is the effect of relatively soft and mechanically compliant adipose tissue. Purpose: This purpose of this study was to estimate the work performed by soft tissue deformations during walking. The soft tissue would be expected to experience damped oscillations, particularly from high force transients after heel strike, and could potentially change the mechanical work demands for walking. Methods: We analyzed treadmill walking data at 1.25 ms(-1) for 11 obese (BMI >30 kgm(-2)) and nine nonobese (BMI <30 kgm(-2)) adults. The soft tissue work was quantified with a method that compares the work performed by lower extremity joints as derived using assumptions of rigid body segments, with that estimated without rigid body assumptions. Results: Relative to body mass, obese and nonobese individuals perform similar amounts of mechanical work. However, negative work performed by soft tissues was significantly greater in obese individuals (P = 0.0102), equivalent to approximately 0.36 Jkg(-1) vs 0.27 Jkg(-1) in nonobese individuals. The negative (dissipative) work by soft tissues occurred mainly after heel strike and, for obese individuals, was comparable in magnitude to the total negative work from all of the joints combined (0.34 Jkg(-1) vs 0.33 Jkg(-1) for obese and nonobese adults, respectively). Although the joints performed a relatively similar amount of work overall, obese individuals performed less negative work actively at the knee. Conclusions: The greater proportion of soft tissues in obese individuals results in substantial changes in the amount, location, and timing of work and may also affect metabolic energy expenditure during walking.