Turkiye Klinikleri Journal of Sports Sciences

.: ORIGINAL RESEARCH
Obesity Associated Morphology Leads Lateral Balance Distortion and Increased Energy Consumption During Treadmill Walking
Obeziteye Bağlı Morfoloji Koşu Bandında Yürüme Sırasında Lateral Denge Bozukluğu ve Artmış Enerji Tüketimine Neden Olur
Dilan Deniz KOYUNCUa, Uğur DALa, Zeynep ALTINKAYAa, Merve TÜRKEGÜNb
aMersin University Faculty of Medicine, Department of Physiology, Mersin, TURKEY
bMersin University Faculty of Medicine, Biostatistics and Medical Informatics, Mersin, TURKEY
Turkiye Klinikleri J Sports Sci. 2020;12(2):184-92
doi: 10.5336/sportsci.2019-71863
Article Language: EN
Full Text
ABSTRACT
 Objective: Obese and overweight adults have low levels of adherence to the sports activities compared to their normal-weight counterparts. As obese individuals having greater body weight and change in walking biomechanics compared to normal gait pattern may lead increased walking energy expenditure. In this study, we have aimed to explain increased energy expenditure of obese subjects in terms of possible differences in gait variables comparing with normal-weights. Material and Methods: There were 2 groups as normal-weight and obese subjects, each including 14 healthy male participants. The energy expenditure of participants was measured via indirect calorimetry in resting and walking in 3 walking speeds conditions as preferred walking speed (PWS), <30% slower than PWS and >30% higher than PWS. The spatiotemporal variables and displacement of center of body mass (COM) were recorded simultaneously with walking energy expenditure measurement. Results: The resting oxygen consumption (VO2) was significantly higher in obese subjects (p<0.001). The significance was disappeared when resting VO2 normalized to fat-free mass of subjects (p=0.951). VO2 was significantly different between 2 groups in all walking conditions (p=0.002, p=0.001, p=0.039, respectively). The step width of obese participants was significantly higher in all walking conditions (p=0.001, p<0.000, p=0.000, respectively). COM mediolateral displacement was significantly higher in obese subjects in all walking speeds (p<0.000, p<0.000, p<0.000, respectively). However, vertical displacement of COM did not change significantly between 2 groups (p=0.820, p=0.301, p=0.219, respectively). While mediolateral displacement of COM was decreased, vertical displacement was increased significantly with each speed increment. Conclusion: The lateral balance is affected more in obese individuals; they prefer to walk in wider step width to keep mediolateral movement of COM in lateral limits; in turn use more energy compared to normal-weights.

Keywords: COM; gait analysis; indirect calorimetry; spatiotemporal gait variables; obesity
ÖZET
 Amaç: Obez ve/veya fazla kilolu yetişkinler, normal kilodaki yaşıtlarına göre spor aktivitelerine düşük düzeyde bağlılığa sahiptirler. Obez bireylerin daha fazla vücut ağırlığına sahip olması ve yürüme biyomekaniklerinde normal yürüme modeline kıyasla olan değişimlere bağlı olarak artmış yürüme enerji tüketimine neden olabilir. Bu çalışmada, obez katılımcıların artmış enerji tüketimlerini, yürüme parametrelerinde normal kilodakilere oranla labilecek değişiklikler karşılaştırılarak açıklamayı hedeflemekteyiz. Gereç ve Yöntemler: Normal-kilolu ve obez katılımcılar olmak üzere 2 grup vardı, her grupta 14 sağlıklı erkek katılımcı yer almaktaydı. Katılımcıların enerji tüketimi, dinlenme ve 3 yürüme hızı; Tercih Edilen Yürüme Hızı (TEYH), TEYH'den <%30 daha yavaş, TEYH'den >%30 daha hızlı koşullarında olmak üzere indirekt kalorimetre ile ölçüldü. Spasyal ve temporal parametreler ve vücut kütle merkezi (VKM)'nin yer değişimi, yürüme enerji tüketimi ölçümü ile eş zamanlı kaydedildi. Bulgular: Dinlenme sırasında oksijen tüketimi (VO2) obez katılımcılarda fark edilir derecede yüksek bulundu (p<0,000). Bu fark, dinlenme sırasında tüketilen VO2 katılımcıların yağsız vücut kütlesi ile normalize edildiğinde ortadan kalktı (p=0,951). Tüm yürüme koşullarında, VO2 2 grup arasında belirgin derecede farklı bulundu (sırasıyla p=0,002, p=0,001, p=0,039). Obez katılımcıların adım genişliği, tüm yürüme koşullarında daha fazla bulundu (sırasıyla p=0,001, p<0,000, p=0,000). VKM'nin yatay düzlemde yer değişimi, obez katılımcılarda tüm yürüme koşullarında belirgin derecede daha yüksek bulundu (sırasıyla p<0,000, p<0,000, p<0,000). Ancak, VKM'nin düşey düzlemde yer değişimi 2 grup arasında fark edilir derecede değişmedi (sırasıyla p=0,820, p=0,301, p=0,219). Her yürüme hızı artışı ile birlikte, VKM'nin yatay düzlemde yer değişimi azalırken, düşey düzlemde yer değişimi belirgin derecede arttı. Sonuç: Obez bireylerde yatay düzlemde denge daha çok etkilenir, VKM'nin yatay düzlemdeki hareketini yatayda ulaşılabilecek maksimum sınırlar içerisinde tutmak için daha geniş adım genişliğinde yürümeyi tercih ederler, sonuç olarak da normal kilolulara göre daha çok enerji kullanırlar.

Anahtar Kelimeler: VKM; yürüme analizi; indirekt kalorimetre; spasyal ve temporal yürüme değişkenleri; obezite
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