Effects of Body Mass Index on Mechanical Properties of the Plantar Fascia and Heel Pad in Asymptomatic Participants

2017 ◽  
Vol 38 (7) ◽  
pp. 779-784 ◽  
Author(s):  
Serkan Taş ◽  
Nilgün Bek ◽  
Mehmet Ruhi Onur ◽  
Feza Korkusuz

Background: Musculoskeletal foot disorders have a high incidence among overweight and obese individuals. One of the important factors causing this high incidence may be plantar fascia and heel pad (HP)–related mechanical changes occurring in these individuals. The aim of the present study was to investigate the plantar fascia and HP stiffness and thickness parameters in overweight and obese individuals and compare these values with those of normal-weight individuals. Methods: This study was carried out in 87 (52 female, 35 male) healthy sedentary individuals between the ages of 19 and 58 years (34 ± 11 years). Participants were subsequently categorized according to body mass index (BMI) as normal weight (18.5 kg/m2 < BMI < 25 kg/m2) or overweight and obese (BMI ≥25 kg/m2). Plantar fascia and HP thickness and stiffness were measured with an ultrasonography device using a linear ultrasonography probe. Results: Overweight and obese individuals had higher HP thickness ( P < .001), plantar fascia thickness ( P = .001), heel pad microchamber layer (MIC) stiffness ( P < .001), and heel pad macrochamber layer (MAC) stiffness ( P < .001), whereas they had lower plantar fascia stiffness ( P < .001) compared with the individuals with normal weight. BMI had a moderate correlation with HP thickness ( P < .001, r = 0.500), plantar fascia thickness ( P = .001, r = 0.536), MIC stiffness ( P < .001, r = 0.496), and MAC stiffness ( P < .001, r = 0.425). A negative and moderate correlation was found between BMI and plantar fascia stiffness ( P < .001, r = –0.439). Conclusion: Increased BMI causes a decrease in the stiffness of plantar fascia and an increase in the thickness of the plantar fascia as well as the thickness and stiffness of HP. Increased body mass could cause changes in the mechanical properties of HP and plantar fascia. Level of Evidence: Level 3, comparative study.

2020 ◽  
Vol 9 (2) ◽  
pp. 32-39
Author(s):  
Prashant Khatiwada ◽  
Dinesh Chataut ◽  
Kamal Subedi

Introduction: To study the sonographic appearance of plantar fascia in clinically suspected cases of plantar fasciitis (PFs) using both quantitative and qualitative parameters, and to establish the correlation between plantar fasciitis, body mass index (BMI) and heel pad thickness (HPT). Methods: In this case controlled analytical study, we sonographically evaluated 100 patients with clinical plantar fasciitis (unilateral: 90, bilateral: 10 with mean age 46.9yrs) and control group of 60 (120 heels) healthy volunteers with mean age 45.3yrs. Plantar Fascia Thickness (PFT), HPT, hypoechogenity, biconvexity, perifascial fluid, intrafascial calcification and subcalcaneal spurs were evaluated sonographically. PFT was measured 5mm distal to the calcaneal insertion of plantar aponeurosis. The unloaded HPT was measured from the skin surface to the nearest calcaneal tuberosity. Results: Mean Plantar Fascia Thickness (PFT) and Heel Pad Thickness (HPT) are greater on the symptomatic side for patients with unilateral and bilateral PFs than on the asymptomatic side for patients with unilateral PFs, and also control subjects (PFT values are 4.41 ± 0.59, 4.63 ± 0.55, 2.83 ± 0.36, 2.62± 0.37 mm, and HPT values 17.64 ± 1.07, 17.28 ± 1.10, 16.91 ± 1.06, 16.73 ± 1.13 mm, respectively) (p <0.0001). Mean BMI values of the case and control groups are 26.14 ± 1.9 and 24.42 ± 0.89 Kg/m2, respectively (p <0.05). We found hypoechogenicity of plantar fascia in 80 cases (72.7%), calcaneal spur in 69 cases (62.7%), biconvexity in 11 cases (10%) and perifascial fluid in 16 cases (14.5%) within the plantar fasciitis group (110 symptomatic heels). Conclusion: Increased plantar fascia thickness, increased heel pad thickness and hypoechogenicity of plantar fascia are consistent sonographic findings in plantar fasciitis. Its occurrence has significant relation to high BMI.


2021 ◽  
pp. 205141582110140
Author(s):  
DNSA Wibowo ◽  
Doddy M Soebadi ◽  
Fikri Rizaldi

Objectives: The aim of this study was to evaluate the impact of body mass index (BMI) on percutaneous nephrolithotomy (PCNL) outcomes and complications for nephrolithiasis. Patients and methods: Patients with a history of PCNL surgery from 2012 to 2017 in Dr. Soetomo General-Academic Hospital were retrospectively evaluated. Patients were then categorized into four groups: underweight (BMI <18.5 kg/m2), normal (BMI 18.5 to 24.99 kg/m2), overweight (BMI ⩾25–29.9 kg/m2), and obese (BMI ⩾30 kg/m2). The association between BMI, subjects’ characteristics, length of stay, stone-free rate (SFR), and complications were analyzed using one-way analysis of variance (ANOVA) and univariate logistic regression. Results: The study included 430 male patients (58%) and 310 female patients (42%). They were classified based on their BMI into underweight ( n = 5, 1%), normal weight ( n = 291, 39%), overweight ( n = 271, 37%), and obese ( n = 173, 23%) groups. The underweight BMI group had a higher average blood loss ( p=0.002) compared to the other groups; however, the univariate logistic regression showed that BMI had no significant effect on SFR ( p=0.491). Conclusion: PCNL is safe and feasible to be performed in patients with different BMI as obesity has no impact on the outcomes and complications associated with PCNL. Level of evidence 3


2017 ◽  
Vol 11 (5) ◽  
pp. 403-409 ◽  
Author(s):  
Serkan Taş

Background. The purpose of the study was to investigate the plantar fascia and heel fat pad stiffness and thickness parameters in females and compare these values with those of males. Methods. This study was carried out in 60 healthy sedentary participants (30 female, 30 male) between the ages of 19 and 50 years. Shear wave velocity (SWV) and thickness of the plantar fascia and heel fat pad were measured with an ultrasonography device. Results. Males had a higher plantar fascia ( P = .037) and heel fat pad ( P = .001) thickness compared with females, but SWV of the plantar fascia ( P = .673), heel fat pad microchamber layer ( P = .240), and heel fat pad macrochamber layer ( P = .636) were similar in both groups. Body mass had a strong correlation with the plantar fascia ( r = 0.64, P < .001) and heel fat pad thickness ( r = 0.68, P < .001). Height had a moderate correlation with the plantar fascia ( r = 0.44, P < .001) and heel fat pad thickness ( r = 0.42, P = .001). Conclusion. Plantar fascia and heel fat pad stiffness were similar in both genders; however, females had a lower plantar fascia and heel fat pad thickness compared with males. Correlation analysis results suggest that higher plantar fascia and heel fat pad thickness in males may be related to higher body mass and height. Levels of Evidence: Level III: Retrospective comparative study


2019 ◽  
Vol 8 (1) ◽  
pp. 72 ◽  
Author(s):  
Yang-Hyun Kim ◽  
Seon Kim ◽  
Kyung-Do Han ◽  
Jin-Hyung Jung ◽  
Seong-Su Lee ◽  
...  

Background: Waist circumference (WC) is an index of abdominal obesity and associated with co-morbidities and mortality. Higher WC is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality. Methods: A total of 23,263,878 subjects (men = 11,813,850 and women = 11,450,028) who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85–90 cm in men and 80–85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC. Results: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65–85 years than subjects aged 40–65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1.156, 1.412, and 1.614 in normal BMI and 1.145, 1.401, and 1.909 in overweight, respectively). Conclusion: There was a linear association between WC and all-cause mortality across all BMI categories even in the subjects with normal or overweight BMI. Physicians should check WC routinely even in the subjects with normal weight or overweight.


Author(s):  
K. Subramanyam ◽  
Dr. P. Subhash Babu

Obesity has become one of the major health issues in India. WHO defines obesity as “A condition with excessive fat accumulation in the body to the extent that the health and wellbeing are adversely affected”. Obesity results from a complex interaction of genetic, behavioral, environmental and socioeconomic factors causing an imbalance in energy production and expenditure. Peak expiratory flow rate is the maximum rate of airflow that can be generated during forced expiratory manoeuvre starting from total lung capacity. The simplicity of the method is its main advantage. It is measured by using a standard Wright Peak Flow Meter or mini Wright Meter. The aim of the study is to see the effect of body mass index on Peak Expiratory Flow Rate values in young adults. The place of a study was done tertiary health care centre, in India for the period of 6 months. Study was performed on 80 subjects age group 20 -30 years, categorised as normal weight BMI =18.5 -24.99 kg/m2 and overweight BMI =25-29.99 kg/m2. There were 40 normal weight BMI (Group A) and 40 over weight BMI (Group B). BMI affects PEFR. Increase in BMI decreases PEFR. Early identification of risk individuals prior to the onset of disease is imperative in our developing country. Keywords: BMI, PEFR.


2019 ◽  
Vol 15 (3) ◽  
pp. 215-223
Author(s):  
Tanya Sapundzhieva ◽  
Rositsa Karalilova ◽  
Anastas Batalov

Aim: To investigate the impact of body mass index (BMI) on clinical disease activity indices and clinical and sonographic remission rates in patients with rheumatoid arthritis (RA). Patients and Methods: Sixty-three patients with RA were categorized according to BMI score into three groups: normal (BMI<25), overweight (BMI 25-30) and obese (BMI≥30). Thirty-three of them were treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), and 30 with biologic DMARDs (bDMARDs). Patients underwent clinical and laboratory assessment and musculoskeletal ultrasound examination (MSUS) at baseline and at 6 months after initiation of therapy. We evaluated the rate of clinical and sonographic remission (defined as Power Doppler score (PD) = 0) and its correlation with BMI score. Results: In the csDMARDs group, 60% of the normal weight patients reached DAS28 remission; 33.3% of the overweight; and 0% of the obese patients. In the bDMARDs group, the percentage of remission was as follows: 60% in the normal weight subgroup, 33.3% in the overweight; and 15.8% in the obese. Within the csDMARDs treatment group, two significant correlations were found: BMI score–DAS 28 at 6th month, rs = .372, p = .033; BMI score–DAS 28 categories, rs = .447, p = .014. Within the bDMARDs group, three significant correlations were identified: BMI score–PDUS at sixth month, rs = .506, p =.004; BMI score–DAS 28, rs = .511, p = .004; BMI score–DAS 28 categories, rs = .592, p = .001. Sonographic remission rates at 6 months were significantly higher in the normal BMI category in both treatment groups. Conclusion: BMI influences the treatment response, clinical disease activity indices and the rates of clinical and sonographic remission in patients with RA. Obesity and overweight are associated with lower remission rates regardless of the type of treatment.


2021 ◽  
pp. 014556132098051
Author(s):  
Matula Tareerath ◽  
Peerachatra Mangmeesri

Objectives: To retrospectively investigate the reliability of the age-based formula, year/4 + 3.5 mm in predicting size and year/2 + 12 cm in predicting insertion depth of preformed endotracheal tubes in children and correlate these data with the body mass index. Patients and Methods: Patients were classified into 4 groups according to their nutritional status: thinness, normal weight, overweight, and obesity; we then retrospectively compared the actual size of endotracheal tube and insertion depth to the predicting age-based formula and to the respective bend-to-tip distance of the used preformed tubes. Results: Altogether, 300 patients were included. The actual endotracheal tube size corresponded with the Motoyama formula (64.7%, 90% CI: 60.0-69.1), except for thin patients, where the calculated size was too large (0.5 mm). The insertion depth could be predicted within the range of the bend-to-tip distance and age-based formula in 85.0% (90% CI: 81.3-88.0) of patients. Conclusion: Prediction of the size of cuffed preformed endotracheal tubes using the formula of Motoyama was accurate in most patients, except in thin patients (body mass index < −2 SD). The insertion depth of the tubes was mostly in the range of the age-based-formula to the bend-to-tip distance.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Louise Lundborg ◽  
Xingrong Liu ◽  
Katarina Åberg ◽  
Anna Sandström ◽  
Ellen L. Tilden ◽  
...  

AbstractTo evaluate associations between early-pregnancy body mass index (BMI) and active first stage labour duration, accounting for possible interaction with maternal age, we conducted a cohort study of women with spontaneous onset of labour allocated to Robson group 1. Quantile regression analysis was performed to estimate first stage labour duration between BMI categories in two maternal age subgroups (more and less than 30 years). Results show that obesity (BMI > 30) among younger women (< 30 years) increased the median labour duration of first stage by 30 min compared with normal weight women (BMI < 25), and time difference estimated at the 90th quantile was more than 1 h. Active first stage labour time differences between obese and normal weight women was modified by maternal age. In conclusion: (a) obesity is associated with longer duration of first stage of labour, and (b) maternal age is an effect modifier for this association. This novel finding of an effect modification between BMI and maternal age contributes to the body of evidence that supports a more individualized approach when describing labour duration.


Author(s):  
Fatou Jatta ◽  
Johanne Sundby ◽  
Siri Vangen ◽  
Benedikte Victoria Lindskog ◽  
Ingvil Krarup Sørbye ◽  
...  

Aims: To explore the association between maternal origin and birthplace, and caesarean section (CS) by pre-pregnancy body mass index (BMI) and length of residence. Methods: We linked records from 118,459 primiparous women in the Medical Birth Registry of Norway between 2013 and 2017 with data from the National Population Register. We categorized pre-pregnancy BMI (kg/m2) into underweight (<18.5), normal weight (18.5–24.9) and overweight/obese (≥25). Multinomial regression analysis estimated crude and adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) for emergency and elective CS. Results: Compared to normal weight women from Norway, women from Sub-Saharan Africa and Southeast Asia/Pacific had a decreased risk of elective CS (aRRR = 0.57, 95% CI 0.37–0.87 and aRRR = 0.56, 0.41–0.77, respectively). Overweight/obese women from Europe/Central Asia had the highest risk of elective CS (aRRR = 1.42, 1.09–1.86). Both normal weight and overweight/obese Sub-Saharan African women had the highest risks of emergency CS (aRRR = 2.61, 2.28-2.99; 2.18, 1.81-2.63, respectively). Compared to women from high-income countries, the risk of elective CS was increasing with a longer length of residence among European/Central Asian women. Newly arrived migrants from Sub-Saharan Africa had the highest risk of emergency CS. Conclusion: Women from Sub-Saharan Africa had more than two times the risk of emergency CS compared to women originating from Norway, regardless of pre-pregnancy BMI.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)


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