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Lower Body Biomechanics in Obesity
Presenter: Antonio Howard, MD
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Knowledge Gap: 
The purpose of this activity is to educate healthcare providers with the most up-to-date information on 
Lower Body Biomechanics in Obesity. 

Target Audience
The target audience includes all healthcare professionals such as physicians, nurses, pharmacists and allied health professionals who would like to learn about 
Lower Body Biomechanics in Obesity and how it pertains to their respective profession.

Release and Expiration Dates
12/19/2017 -12/19/2020


1.Explain the literature on the effects of obesity on the biomechanics of lower extremity motion 

2.Apply these changes to common functional impairments observed in clinical practice   

3.Discuss suggestions for activity modification and exercise prescription and the obese


Donnelly, Joseph E., Steven N. Blair, John M. Jakicic, Melinda M. Manore, Janet W. Rankin, and Bryan K. Smith. "Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults." Medicine & Science in Sports & Exercise 41.2 (2009): 459-71.

Haight, Derek J., Zachary F. Lerner, Wayne J. Board, and Raymond C. Browning. "A Comparison of Slow, Uphill and Fast, Level Walking on Lower Extremity Biomechanics and Tibiofemoral Joint Loading in Obese and Nonobese Adults." Journal of Orthopaedic Research J. Orthop. Res. 32.2 (2013): 324-30.

Runhaar, J., B. W. Koes, S. Clockaerts, and S. M. A. Bierma-Zeinstra. "A Systematic Review on Changed Biomechanics of Lower Extremities in Obese Individuals: A Possible Role in Development of Osteoarthritis." Obesity Reviews 12.12 (2011): 1071-082.

Bhupinder Singh, PT ; H. John Yack, PT; Shelby L. Francis, BS, MS; Kathleen F. Janz, PhD. “Biomechanical loads during commonly rehabilitation exercises in obese individuals.” IJSPT  10.2 (2015): 189 – 196.

Marco Branco, Rita Santos-Rocha, Filomena Vieira. “Biomechanics of Gait during Pregnancy.” The Scientific World Journal (2014).

Sunaga, Y., Anan, M., & Shinkoda, K. Biomechanics of rising from a chair and walking in pregnant women. Applied Ergonomics, 44 (2013): 792-798.

Aguiar, L., Santos-Rocha, R., Vieira, F., Branco, M., Andrade, C., Veloso, A. ” Comparison between overweight due to pregnancy and due to added weight to simulate body mass distribution in pregnancy.” Gait & Posture (2015).

Ng, J., Richardson, C., Kippers, V., & Parnianpour, M. “Comparison of lumbar range of movement and lumbar lordosis in back pain patients and matched controls.” Journal of Rehabilitation Medicine, (2002): 109-113.

Sonia Maria Fabris, Antonio Carlos Valez, Shirley Aparecida Fabris de Souza, Joel Faintuch, Ivan Cecconello; Mauro Pedroni Junior. “Computerized Baropodometry In Obese Patients.” Obesity Surgery, 16, (2006): 1574-1578.

Westlake, C., Milner, C., Zhang, S., & Fitzhugh, E. “Do thigh circumference and mass changes alter knee biomechanics during walking.” Gait & Posture 37 (2013): 359–362.

Russell, E., Braun, B., & Hamill, J.  “Does Stride Length Influence Metabolic Cost And Biomechanical Risk Factors For Knee Osteoarthritis In Obese Women?” Clinical Biomechanics, (2010): 438-443.

Radzimski, A., Mündermann, A., & Sole, G.”Effect of footwear on the external knee adduction moment — A systematic review.” The Knee, (2012): 163-175.

Gilleard, W., & Smith, T. “Effect of obesity on posture and hip joint moments during a standing task, and trunk forward flexion motion.” Int J Obes Relat Metab Disord International Journal of Obesity, (2006):267-271.

Woojin Park , Jaiganesh Ramachandran , Paul Weisman & Eui S. Jung. “Obesity effect on male active joint range of motion.” Ergonomics,(2010) 53:1, 102-108.

Lerner, Z., Board, W., & Browning, R. “Effects of obesity on lower extremity muscle function during walking at two speeds. “ Gait & Posture, (2014): 978-984.

Strutzenberger, G., Richter, A., Schneider, M., Mündermann, A., Schwameder, H. “Effects of obesity on the biomechanics of stair-walking in children.” Gait & Posture, (2011): 119-125.

Song, J., Kane, R., Tango, D., Veur, S., Furmato, J., Komaroff, E., & Foster, G. “Effects of weight loss on foot structure and function in obese adults: A pilot randomized controlled trial.” Gait & Posture, (2015): 86-92.

Backholer, K., Wong, E., Freak-Poli, R., Walls, H., & Peeters, A. ”Increasing body weight and risk of limitations in activities of daily living: A systematic review and meta-analysis.” Obesity Reviews, (2011): 456-468.

Castro, M., Abreu, S., Pinto, V., Santos, R., Machado, L., Vaz, M., & Vilas-Boas, J. “Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces.” Applied Ergonomics, (2014): 1028-1034.

Messier, S., Pater, M., Beavers, D., Legault, C., Loeser, R., Hunter, D., & Devita, P. “Influences of alignment and obesity on knee joint loading in osteoarthritic gait.” Osteoarthritis and Cartilage 22 (2014) 912-917.

Elizabeth M. Russell, Joseph Hamill. “Lateral wedges decrease biomechanical risk factors for knee osteoarthritis in obese women.” Journal of Biomechanics 44, (2011): 2286–2291.

Bragge, T., Lyytinen, T., Hakkarainen, M., Vartiainen, P., Liikavainio, T., Karjalainen, P., Arokoski, J. “Lower impulsive loadings following intensive weight loss after bariatric surgery in level and stair walking: A preliminary study.” The Knee 21, (2014): 534–540.

Runhaar, J., M. Van Middelkoop, M. Reijman, D. Vroegindeweij, E. H. G. Oei, and S. M. A. Bierma-Zeinstra. "Malalignment: A Possible Target for Prevention of Incident Knee Osteoarthritis in Overweight and Obese Women." Rheumatology (2014): 1618-624.

Teasdale, N., O. Hue, J. Marcotte, F. Berrigan, M. Simoneau, J. Doré, P. Marceau, S. Marceau, and A. Tremblay. "Reducing Weight Increases Postural Stability in Obese and Morbid Obese Men." Int J Obes Relat Metab Disord International Journal of Obesity (2006): 153-60.

Lou, Shu-Zon, You-Li Chou, Pei-Hsi Chou, Chii-Jeng Lin, Uyi-Chi Chen, and Fong-Chin Su. "Sit-to-stand at Different Periods of Pregnancy." Clinical Biomechanics (2001): 194-98.

Butterworth, P. A., K. B. Landorf, W. Gilleard, D. M. Urquhart, and H. B. Menz. "The Association between Body Composition and Foot Structure and Function: A Systematic Review." Obes Rev Obesity Reviews (2013): 348-57.

Swift, Damon L., Neil M. Johannsen, Carl J. Lavie, Conrad P. Earnest, and Timothy S. Church. "The Role of Exercise and Physical Activity in Weight Loss and Maintenance." Progress in Cardiovascular Diseases (2014): 441-47.

Messier, Stephen P., David J. Gutekunst, Cralen Davis, and Paul Devita. "Weight Loss Reduces Knee-joint Loads in Overweight and Obese Older Adults with Knee Osteoarthritis." Arthritis & Rheumatism (2005): 2026-032.

An R, Shi Y.  “Body weight status and onset of functional limitations in U.S. middle-aged and older adults.” Disabil Health J. (2015) Jul;8(3):336-44.

Lisko I, Stenholm S, Raitanen J, Hurme M, Hervonen A, Jylhä M, Tiainen K. “Association of Body Mass Index and Waist Circumference With Physical Functioning: The Vitality 90+ Study.” J Gerontol A Biol Sci Med Sci. (2015) Jul; 70(7):885-91.

Biographical Info:

Antonio Howard, MD 

Antonio T. Howard, M.B.B.S., has joined the Department of Physical Medicine and Rehabilitation as an Assistant Professor and sees patients with musculoskeletal/sports complaints on the main campus. Dr. Howard earned his Bachelor of Medicine, Bachelor of Surgery from the University of the West Indies - Cave Hill campus in 2006. He practiced in primary care and as a team physician in Barbados for several years before completing residency training in physical medicine and rehabilitation at Montefiore Medical Center in New York. He has also completed fellowship training in primary care sports medicine at Summa Health in Akron, Ohio.


Speaker Disclosures:
The planners, speakers, moderators, peer reviewers and /or panelists of this CE activity have no relevant financial relationships with commercial interests to disclose.

Kim Miller  
Susan Smith Dodson
Mark Jansen

Antonio Howard, MD 

Peer Reviewers: 
Kim Miller, MCHES

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