title: Postural changes in morbidly obese patients.
abstract: BACKGROUND
  Postural deviations in morbidly obese individuals may contribute to low self-esteem and to long-term adverse effects on bones and joints. In a case-control study, the axial skeleton was investigated, to disclose the main abnormalities found in obese compared to non-obese groups.
  
  
  METHODS
  2 groups were compared. Group 1, severely obese patients (n= 32), age 41.5 +/- 8.2 years, BMI 49.4 +/- 6.6 kg/m2, 93.8% females, and group 2 non-obese (n= 30), age 43.5 +/- 5.8 years, BMI 24.6 +/- 5.1 kg/m2, 96.7% females, had their posture analyzed through clinical examination and radiological imaging. Variables measured were anterior, lateral and posterior angular deviation from the vertical body axis at the head, shoulders, pelvis, Thales triangle, spine, knees, ankles and feet. Data are shown as a percentage of abnormal angles in the 2 groups.
  
  
  RESULTS
  On anterior analysis of the 2 groups, disturbances affected head (37.5% vs 13.3%), Thales angle (78.1% vs 53.3%), knees (84.4% vs 33.3%), legs (59.4% vs 30.0%) and support base (59.4% vs 26.7%) (P<0.05). On posterior view, the spine was the deranged segment (87.5% vs 36.7%) (P<0.05), and on lateral assessment, 100% of the results were abnormal.
  
  
  CONCLUSIONS
  1) Individuals with morbid obesity present important postural alterations. 2) Seriously altered posture was the rule for the obese population in this study, especially in the spine, knees and feet. 3) Most patients had compatible clinical complaints, but they rarely associated the bone and joint pain with the obesity and axial skeleton deviations. 4) Planned physical activity should be part of the treatment of severe obesity, in order to correct deviations, prevent new ones, and improve quality of life.
authors.affiliation: Department of Physical Therapy, Londrina State University, Londrina, Paraná, Brazil. shirley@inbrapenet.com.br
authors.forename: Shirley Aparecida
authors.initials: SA
authors.lastname: Fabris de Souza
authors.forename: Joel
authors.initials: J
authors.lastname: Faintuch
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Valezi
authors.forename: Antonio Fernando
authors.initials: AF
authors.lastname: Sant'Anna
authors.forename: Joaquim José
authors.initials: JJ
authors.lastname: Gama-Rodrigues
authors.forename: Inês Cristina
authors.initials: IC
authors.lastname: de Batista Fonseca
authors.forename: Roberta Donadio
authors.initials: RD
authors.lastname: de Melo
mesh_terms: D000328:Adult; D001837:Body Weights and Measures; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology*; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology*; D011187:Posture / Q000502:physiology*