# The role of obesity in physiological stress, balance, and proprioception during repetitive manual material handling tasks

## TL;DR

Obese individuals experience higher fatigue and balance issues during repetitive manual tasks, increasing their fall risk.

## Contribution

This study links obesity with increased physiological stress and balance impairment during manual handling tasks.

## Key findings

- Higher BMI correlates with increased energy expenditure during carrying and pushing/pulling tasks.
- Obese individuals show greater knee proprioception loss and balance decline under high physiological stress.
- Fatigue levels in obese individuals during repetitive tasks increase fall risk.

## Abstract

Manual laborers often experience fatigue-related incidents, which increase their risk of balance disturbances and falls. Previous research indicates that obese individuals may reach critical fatigue levels during repetitive lifting. This study examines whether this BMI-based fatigue pattern also applies to other manual handling activities. Therefore, assessing balance impairment under high physiological stress conditions will help quantify the increased fall risk in obese individuals. Thirty participants performed carrying and pushing/pulling tasks, with weights determined using the Liberty Mutual Equations to align with NIOSH criteria. Balance tests were conducted before and after each task. A two-way ANOVA compared energy expenditure rate (EER) across BMI classifications and sex, while a mixed-effects model analyzed the effects of EER, BMI, and sex on balance and proprioception tests. Results indicated a positive correlation between BMI and EER for both carrying (p = 0.003) and pushing/pulling (p = 0.013). In the mixed-effects model, BMI (p = 0.032) and EER (p = 0.037) were positively correlated with knee proprioception loss, whereas EER was negatively correlated with balance (p = 0.020). These findings confirm that obese individuals face critical fatigue levels, as well as impaired proprioception and balance, during repetitive handling tasks.