Rapid changes in gait, musculoskeletal pain, and quality of life after bariatric surgery

Surg Obes Relat Dis. 2012 May-Jun;8(3):346-54. doi: 10.1016/j.soard.2011.11.020. Epub 2012 Jan 16.


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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arthralgia / prevention & control
  • Body Composition
  • Case-Control Studies
  • Female
  • Gait*
  • Gastric Bypass / methods*
  • Gastroplasty / methods*
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain / prevention & control*
  • Obesity, Morbid / surgery*
  • Prospective Studies
  • Quality of Life*
  • Walking
  • Weight Loss