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People who are obese sustain very high foot pressures when standing, with potential consequences to their feet soles’ cutaneous sensibility. In the current investigation, we performed a detailed assessment of foot sole sensibility in women with morbid obesity ( n = 13; age = 38.85, SD = 8.09 years) status in comparison with leaner women ( n = 13; age = 37.62, SD = 7.10 years). We estimated tactile feet sole sensibility through graduated monofilament light touch applied at several hotspots of both feet soles, covering the toes, metatarsal heads, midfoot internal and lateral arches, and heel. Intergroup comparisons per foot sole region indicated significantly lower sensibility for the group with morbid obesity under the fifth and third metatarsal heads, midfoot lateral and internal arches and heel. We found a large variation across the sole regions, with the lowest difference between the obese and lean groups observed under the hallux (18%) and the largest difference observed under the lateral arch of the midfoot (76%). Correlation analyses between body weight and sensibility scores revealed a significant positive correlation among participants who were leaner ( rs = 0.56, p = 0.05) but not among participants who were obese ( rs = –0.06, p = 0.83). Mainly, our results showed that morbid obesity was associated with significantly higher cutaneous sensibility thresholds, with large variability of the sensibility deficit across different regions of both feet soles. Due to its functional relevance for body balance control, reduced sensibility thresholds among women who are morbidly obese may have implications for stance stability.
Este ensaio tem como objetivo propor demandas para estudos que podem compor o contexto reflexivo a ser incentivado pelo Núcleo de Direitos Humanos (NDH) da Escola de Educação Física e Esporte (EEFE) da Universidade de São Paulo (USP). Sobre a ótica do acesso e da promoção da educação em direitos humanos como temática, adota os direitos que NDH selecionou para contemplar ações educativas na EEFE-USP: acesso, igualdade, liberdade, proteção e permanência. Assume que os direitos humanos, ao mesmo tempo que fundamentam, mantêm uma relação de sinergia com o desenvolvimento humano. E mais, desenvolvimento e direitos, apenas serão alcançados a partir do entendimento do corpo que somos. Mais especificamente, sobre o desenvolvimento e os direitos, sugere uma reflexão com base nos pilares apresentados pelo Programa das Nações Unidas para o Desenvolvimento (PNUD). Para o corpo que somos, menciona a noção de corporeidade. Ainda, propõe uma reflexão a partir da fenomenologia e das ciências cognitivas. Apoiado na compreensão que a escola é um espaço importante na formação do ser humano, cuja relação desenvolvimento humano, corpo e direitos humanos pode ser valorizada e explorada, apresenta uma reflexão sobre o mover-se corporal dentro de um modelo de Escola Ativa proposto pelo PNUD. Por fim, conclui que as reflexões propostas são necessárias e atuais, pois enfatizam a experiência que é possível ser vivida pela corporeidade. Isso é fundamental para o desenvolvimento e a garantia dos direitos.
An important health-related problem of obesity is reduced stance stability, leading to increased chance of falling. In the present experiment, we aimed to compare stability in quiet and in dynamic body balance between women with morbid obesity (n = 13, body mass index [BMI] > 40 Kg/m2, mean age = 38.85 years) and with healthy body weight (lean) (n = 13; BMI < 25 Kg/m2, mean age = 37.62 years), evaluating the extent to which quiet and dynamic balance stability are associated with plantar sensibility. Quiet stance was evaluated in different visual and support base conditions. The dynamic task consisted of rhythmic flexion—extension movements at the hip and shoulder, manipulating vision availability. The plantar sensibility threshold was measured through application of monofilaments on the feet soles. The results showed that the morbidly obese, in comparison with the lean women, had higher plantar sensibility thresholds, and a reduced balance stability in quiet standing. Mediolateral stance stability on the malleable surface was strongly correlated with plantar sensibility in the obese women. Analysis of dynamic balance showed no effect of obesity and weaker correlations with plantar sensibility. Our results suggest that reduced plantar sensibility in morbidly obese women may underlie their diminished stance stability, while dynamic balance control seems to be unaffected by their reduced plantar sensibility.
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