title: Rapid changes in gait, musculoskeletal pain, and quality of life after bariatric surgery.
abstract: BACKGROUND
  Joint pain is a common musculoskeletal complaint of morbidly obese patients that can result in gait abnormalities, perceived mobility limitations, and declining quality of life (QOL). It is not yet known whether weight loss 3 months after bariatric surgery can induce favorable changes in joint pain, gait, perceived mobility, and QOL. Our objectives were to examine whether participants who had undergone bariatric surgery (n = 25; laparoscopic Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding) demonstrate improvements in joint pain, gait (speed, stride/step length, width of base of support, toe angles, single/double support, swing and stance time, functional ambulatory profile), mobility, and QOL by 3 months compared with nonsurgical controls (n = 20). The setting was an orthopedics laboratory at a university hospital in the United States.
  
  
  METHODS
  The present study was a prospective, comparative study. Numeric pain scales (indicating the presence and severity of pain), mobility-related surveys, and the Medical Outcomes Study short-form 36-item questionnaire (SF-36) were completed, and gait and walking speed were assessed at baseline and at month 3.
  
  
  RESULTS
  The bariatric group lost an average of 21.6 ± 7.7 kg. Significant differences existed between the 2 groups at month 3 in step length, heel to heel base of support, and the percentage of time spent in single and double support during the gait cycle (all P <.05). The severity of low back pain and knee pain decreased by 54% and 34%, respectively, with no changes in the control group (P = .05). The walking speed increased by 15% in the bariatric group (108-123 cm/s; P <.05) but not in the control group. Compared with the control group, fewer bariatric patients perceived limitations with walking and stair climbing by month 3. The bariatric group had a 4.8-cm increase in step length, 2.6% increase in single support time during the gait cycle, and 2.5-cm reduction in the base of support (all P <.05). The SF-36 physical component scores increased 11.8 points in the bariatric group compared with the control group, which showed no improvement by month 3 (P <.0001).
  
  
  CONCLUSIONS
  Improvements in some, but not all, gait parameters, walking speed, and QOL and of perceived functional limitations occur by 3 months after a bariatric procedure.
authors.affiliation: Interdisciplinary Center of Musculoskeletal Training and Research, Department of Orthopaedics and Rehabilitation, Division of Research, University of Florida College of Medicine, Gainesville, Florida 32607, USA. vincehk@ortho.ufl.edu
authors.forename: Heather K
authors.initials: HK
authors.lastname: Vincent
authors.forename: Kfir
authors.initials: K
authors.lastname: Ben-David
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Conrad
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Lamb
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Seay
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Vincent
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000517:prevention & control; D001823:Body Composition; D016022:Case-Control Studies; D005260:Female; D005684:Gait; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000517:prevention & control*; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D016138:Walking; D015431:Weight Loss