Gait Changes after Weight Loss on Adolescent with Severe Obesity after Sleeve Gastrectomy

BACKGROUND:It has been highlighted that obesity influences the gait reducing walking velocity, stride length, ankle dorsal flexion at initial contact and ankle power generation. Meanwhile, step width, double support, hip flexion, knee extension during stance, hip moment and ankle power absorption was described increased. A tendency to the normalization of these parameters occur when subjects reduced their weight during growth.OBJECTIVE:We studied the effect of fast weight loss due to Sleeve Gastrectomy on gait pattern of adolescent with severe obesity. The aim is to assess the functional benefit of the surgery.SETTING:Pediatric hospital, public health, Italy.METHODS:11 patients before and after 1 year from surgery and 10 controls participated to the study. We studied the gait with an optoelectronic system and two force plates. We evaluated both kinetics and kinematics of walking. Then we looked at the differences between the pre- vs post-surgery and with the control group.RESULTS:Step length and velocity were lower and step width was bigger in adolescent with obesity. Kinematic and kinetic parameters were altered. After surgery we observed the reduction of several gait alteration. Meanwhile, after 1 year alterations at the level of the foot, the knee and the pelvis persist.CONCLUSION:The sudden loss of weight highlighted the presence of long-term effects on the locomotor system. The results discourage intense walking activities before the weight loss and we suggest further studies for evaluating the necessity of a rehabilitative intervention.