The Effect of Different Body Mass Index Levels on Static and Dynamic Postural Balance Performance in Adults

Abstract

Background and Purpose: It was aimed to examine the static and dynamic postural balance performance in adults with different Body Mass Index (BMI) levels. Methods: Study was conducted in Üsküdar Diabetes and Obesity Treatment Center between September and October 2021. Participants were divided into 5 groups according to BMI scores: normal-weight, overweight, 1st degree obese, 2nd degree obese, and 3rd degree obese. The static and dynamic balance performance of participants were assessed by the Limits of Stability (LOS) and modified Clinical Test of Sensory Integration of Balance (m-CTSIB) tests. Results: For LOS parameters, there was a significant difference between groups in reaction time scores only for the backward direction (p<0.05). The endpoint and maximum excursions measurements except for the backward and directional control measurements except for the backward and right were significantly different between groups with the worst scores for 3rd degree obese group (p<0.05). For the m-CTSIB test, there was a significant difference between groups in all parameters except the eyes open condition on foam surface (p<0.05). Conclusion: The 3rd degree obese individuals are the most affected subgroup in terms of dynamic balance, we recommended that rehabilitation and fall prevention programs should primarily focus on 3rd degree obese individuals.

Keywords

• Limits of stability test
• modified clinical test of sensory integration of balance
• postural balance
• body mass index

References

1. 1. Bray GA, Frühbeck G, Ryan DH, Wilding JP. Management of obesity. The Lancet. 2016;387(10031):1947-1956.
2. 2. WHO EC. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004;363(9403):157-163.
3. 3. Forhan MA, Law MC, Vrkljan BH, Taylor VH. The experience of participation in everyday occupations for adults with obesity. Can J Occup Ther. 2010;77(4):210-218.
4. 4. Hue O, Simoneau M, Marcotte J, ve ark. Body weight is a strong predictor of postural stability. Gait Posture. 2007;26(1):32-38.
5. 5. Timurtaş E, Avci EE, Demirbüken İ, Akgün İ, Sertbaş Y, Polat MG. The Relationship Between Fat Tissue & Lean Body Mass and Sit to Stand Task in Obese Individuals. Clin Exp Health Sci. 2021;11(2):191-295.
6. 6. Balaban Ö, Nacır B, Erdem H, Karagöz A. The evaluation of the balance function. J PM&R Science. 2009;12:133-39.
7. 7. Garcia PA, de Queiroz LL, Caetano MBD, e Silva KHCV, da Silva Hamu TCD. Obesity is associated with postural balance on unstable surfaces but not with fear of falling in older adults. Braz J Phys Ther. 2021;25(3):311-318.
8. 8. Villarrasa-Sapiña I, García-Massó X, Serra-Añó P, Garcia-Lucerga C, Gonzalez L-M, Lurbe E. Differences in intermittent postural control between normal-weight and obese children. Gait Posture. 2016;49:1-6.

9. 9. Fjeldstad C, Pardo G, Frederiksen C, Bemben D, Bemben M. Assessment of postural balance in multiple sclerosis. Int J MS Care. 2009;11(1):1-5.
10. 10. Steinberg N, Adams R, Waddington G, Karin J, Tirosh O. Is There a correlation between static and dynamic postural balance among young male and female dancers? J Mot Behav. 2017;49(2):163-171.
11. 11. Do Nascimento J, Silva C, Dos Santos H, de Almeida Ferreira J, De Andrade P. A preliminary study of static and dynamic balance in sedentary obese young adults: the relationship between BMI, posture and postural balance. Clin Obes. 2017;7(6):377-383.
12. 12. Fatih G, Ersöz G. Kor antrenmanın 8-14 yaş grubu tenis sporcularının kor kuvveti, statik ve dinamik denge özellikleri üzerindeki etkisinin değerlendirilmesi. SPORMETRE Beden Eğitimi ve Spor Bilimleri Dergisi. 2017;15(3):129-138.
13. 13. Aronne LJ. Classification of obesity and assessment of obesity‐related health risks. Obes Res. 2002;10(S12):105S-115S.
14. 14. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-191.
15. 15. SPSS I. IBM SPSS statistics base 20. Chicago, IL: SPSS Inc. 2011;15
16. 16. Juras G, Słomka K, Fredyk A, Sobota G, Bacik B. Evaluation of the limits of stability (LOS) balance test. J Hum Kinet. 2008;19(1):39-52.
17. 17. Bučková K, Lobotková J, Hirjaková Z, Bzdúšková D, Hlavačka F. Postural control assessed by limit of stability in obese adults. Act Nerv Super Rediviva. 2014;56(3-4):87-90.
18. 18. Ercan S, Baskurt Z, Baskurt F, Cetin C. Balance disorder, falling risks and fear of falling in obese individuals: cross-sectional clinical research in Isparta. J Pak Med Assoc. 2020;70(1):17-23.
19. 19. Cau N, Cimolin V, Galli M, ve ark. Center of pressure displacements during gait initiation in individuals with obesity. J Neuroeng Rehabil. 2014;11(1):1-8.
20. 20. Tomlinson D, Erskine R, Morse C, Winwood K, Onambélé-Pearson G. The impact of obesity on skeletal muscle strength and structure through adolescence to old age. Biogerontology. 2016;17(3):467-483.
21. 21. Maktouf W, Boyas S, Beaune B, Durand S. Differences in lower extremity muscular coactivation during postural control between healthy and obese adults. Gait Posture. 2020;81:197-204.
22. 22. Liu Z-Q, Yang F. Obesity may not induce dynamic stability disadvantage during overground walking among young adults. PLoS One. 2017;12(1):e0169766.
23. 23. Carral JMC, Ayán C, Sturzinger L, Gonzalez G. Relationships between body mass index and static and dynamic balance in active and inactive older adults. J Geriatr Phys Ther. 2019;42(4):E85-E90.
24. 24. Dawson N, Dzurino D, Karleskint M, Tucker J. Examining the reliability, correlation, and validity of commonly used assessment tools to measure balance. Health Sci Rep. 2018;1(12):e98.
25. 25. Benetti FA, Bacha IL, Garrido AB, Greve JMDA. Analyses of balance and flexibility of obese patients undergoing bariatric surgery. Clinics. 2016;71:78-81.
26. 26. Emara A, Mahmoud S, Emira M. Effect of body weight on static and dynamic posturography. The Egyptian Journal of Otolaryngology. 2020;36(1):1-8.
27. 27. Rossi-Izquierdo M, Santos-Pérez S, Faraldo-García A, ve ark. Impact of obesity in elderly patients with postural instability. Aging Clin Exp Res. 2016;28(3):423-428.
28. 28. Dutil M, Handrigan GA, Corbeil P, ve ark. The impact of obesity on balance control in community-dwelling older women. Age. 2013;35(3):883-890.
29. 29. Master NSB. NeuroCom® SMART Balance Master® User Manual. In: Master NSB, editor. 2021.