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The Relationship Between Physical Activity Level and Movement Quality in Aging Adults with Obesity

Rekant, Julie (2023) The Relationship Between Physical Activity Level and Movement Quality in Aging Adults with Obesity. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Adults with obesity are at increased risk of injuries and disability as they age. Physical inactivity and poor functional mobility contribute to injury and disability development. Subtle changes in mobility are difficult to identify with standard outcome measures, however detecting these early changes can direct interventions to decrease injury and disability. The goals of this dissertation were to evaluate inertial measurement unit (IMU)-based motion capture for describing gait in normal weight adults and adults with obesity, and to determine the association of physical activity level (PAL) with measures of movement quality and musculoskeletal disability development risk in middle-aged and older adults with high body mass indexes (BMIs).
To evaluate IMU-based motion capture, 10 normal weight adults and 10 adults with obesity walked while equipped with IMUs and optokinetic motion capture (OMC). In normal weight adults, IMUs showed greater agreement with OMC in the sagittal plane compared to frontal and transverse planes. Differences of greater than 5° between IMUs and OMC existed during gait in all planes. Angles measured at clinically meaningful timepoints were poorly associated between IMUs and OMC. Similar findings were observed in adults with obesity, with additional issues observed for hip angles.
Amount of physical activity was associated with movement quality in middle-aged and older adults with high BMIs. A cross-sectional analysis of 42 middle-aged adults with obesity found PAL was associated with better balance and gait when instrumented tests were used to detect subtle changes in performance. Middle-aged adults with obesity with higher PALs demonstrated decreased kinetic markers of musculoskeletal impairment during walking. Different patterns in muscle oxygenation were observed during fatigability tests requiring further exploration. Future longitudinal studies are warranted to establish the temporal direction of associations observed between PAL and movement measures.
This dissertation takes the first step towards leveraging wearable sensors to identify changes in mobility patterns predictive of disability development in aging adults with obesity. Future work should establish standards of use for implementing wearable sensor technologies into clinical practice to improve patient care, and direct interventions to disrupt the disability development process and compress years of disability in aging adults with obesity.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Rekant, Juliejulie.rekant@pitt.edujur290000-0003-0568-589X
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairChambers, Aprilajchambers@pitt.eduajcst490000-0002-5473-4267
Committee MemberBrach, Jenniferjbrach@pitt.edujbrach0000-0002-7793-2004
Committee MemberHuppert, Theodorehuppert1@pitt.eduhuppert10000-0001-8426-5759
Committee MemberRedfern, Markmredfern@pitt.edumredfern0000-0003-0097-4641
Committee MemberRothenberger, Scottrothenberger@pitt.edurothenberger0000-0001-8300-5947
Date: 13 June 2023
Date Type: Publication
Defense Date: 6 December 2022
Approval Date: 13 June 2023
Submission Date: 17 January 2023
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 301
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Bioengineering
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: body mass index, physical activity, mobility, aging
Date Deposited: 13 Jun 2023 14:20
Last Modified: 13 Jun 2023 14:20


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