Biomedical Engineering Reference
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Table 2 Comparative foot anthropometrics (normalised to foot length) of obese (n = 103),
overweight (n = 128) and non-overweight (n = 81) older adults
Variable
Obese versus
non-overweight
Overweight versus
non-overweight
Obese versus
overweight
Ball of foot circumference
:
0
0
Instep circumference
:
:
:
Ball of foot breadth
:
0
0
Ball of foot height
:
:
:
Heel breadth
:
:
:
1st toe height
:
0
:
5th toe height
:
0
0
Instep height
0
0
0
Mickle and Steele, unpublished; see Fig.
3
for dimensions
: significantly greater value, ; significantly lower value; 0 no significant difference in the values
4.4.2 Effects of Obesity in Older Adults on Plantar Pressures
Only limited research was located that examined the effect of bearing excess body
mass on the plantar pressures generated by older obese individuals, revealing that
obesity was associated with higher dynamic plantar pressures. Similar to obese
adults [
85
], the older obese participants displayed increased pressure-time inte-
grals under the heel, first and second metatarsals, and hallux regions of the foot
compared to their non-overweight counterparts (Mickle & Steele, unpublished).
Previous research has similarly revealed that obese postmenopausal women gen-
erated higher peak pressure in metatarsal areas 1, 4, and 5, the midfoot and lateral
heel, and higher absolute impulses in all metatarsal and heel areas compared to
non-obese women [
130
].
Like their younger counterparts, a significant relationship has been found
between high plantar pressures and foot pain in older people [
131
]. It would appear
that the increased mechanical loading that is associated with the need to continually
bear excessive mass, evidenced by the higher plantar pressures, could contribute to
excess strain of the musculoskeletal structures of the foot in older obese individuals,
possibly resulting in low grade inflammation or obesity-related conditions such as
diabetes or osteoarthritis [
121
]. However, longitudinal studies are required to
confirm or dispute this notion. How these higher plantar pressures are associated
with foot pain are described below.
4.4.3 Effects of Obesity in Older Adults on Foot Pain
McCarthy et al. [
128
] examined the relationship between chronic pain and obesity in
a cohort of 840 older individuals. In the cohort 436 participants reported chronic pain
(age = 80.6 years; 71.6 % female; BMI = 27.2 kg/m
2
), whereas 404 participants
were without chronic pain (age = 80.5 years; 53.6 % female; BMI = 25.8 kg/m
2
).
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