The Impact of Obesity and Weight Loss on Gait in Adults - The Mechanobiology of Obesity and Related Diseases - page 124

2.2 Methods of Gait Analysis
Recent progress in measurement technology and methodology has made it possible
to achieve a comprehensive perspective of gait. Gait analysis can be used as a
clinical tool to evaluate different kinds of patient groups in order to obtain insights
into the pathology of a specific disease and the effect of therapy or surgical
intervention, or be utilized to plan appropriate rehabilitation programs [ 42 , 61 ].
Modern gait analysis enables the quantitative systematic assessment of various
aspects of human locomotion. This can be achieved by using different types of
sensors to quantitatively measure appropriate signals such as acceleration using
skin-mounted accelerometers (SMAs), muscle activation with electromyography
(EMG), plantar pressures with pressure measurement insoles, ground reaction
forces (GRFs) with force plates, and joint angles with goniometers (Figs. 2 and 3 )
[ 28 ]. These data can be integrated with three-dimensional body kinematics, which
can be obtained using an optical motion capture system [ 42 , 61 ]. Finally, several
spatio-temporal (e.g. walking speed, stride length (SL), step frequency (SF), and
contact times), kinematic (e.g. joint angles, angular velocities, and accelerations),
and kinetic (e.g. body accelerations, GRFs, joint moments, power), as well as other
biomechanical variables (e.g. muscle activity, energy expenditure) can be analyzed
and reported [ 28 ]. Joint angles and moments throughout the gait cycle are widely
reported. These variables are presented in Fig. 4 .
3 Spatio-Temporal Variables and Joint Kinematics
in the Obese
3.1 Spatio-Temporal Variables
Although motion and gait analysis laboratories and biomechanical measurements
are relatively common, a comparably small number of studies have reported these
basic gait variables in obese adults compared to normal-weight subjects. In the
majority of studies, the authors have concluded that obese subjects exhibit a slower
preferred walking speed than normal-weight subjects (Table 1 )[ 11 , 16 , 23 , 24 , 40 ,
49 , 51 ]. Runhaar et al. [ 47 ] reported on average a 0.3 m/s slower absolute walking
speed when walking at the self-selected speed. However, there have also been
studies in which the gait speed did not significantly differ between obese and
normal-weight subjects [ 4 , 49 , 59 ].
Furthermore, obese individuals generally appear to have a shorter stride length
[ 10 , 11 , 23 , 24 , 40 , 48 , 51 ], a lower step frequency [ 10 , 11 , 40 , 51 ], a longer stance
phase duration [ 12 , 23 , 24 , 51 , 59 ], a shorter swing phase [ 12 ], a greater step width
[ 11 , 23 , 51 ] and a longer double support phase [ 7 , 24 ] compared to normal-weight
individuals at the self-selected walking speed (Table 1 ).