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This cross-sectional study aims to investigate the relationship between postural habits and body awareness with functional performance across different body mass index (BMI) categories in women. Participants will be categorized into four groups based on BMI (normal weight, overweight, obesity class I, and obesity class II-III). Postural habits and awareness, body awareness, and functional performance will be assessed using validated questionnaires and performance-based tests. The study also aims to explore the potential contribution of central adiposity (waist circumference) and psychological factors to these relationships. Findings are expected to provide a more comprehensive understanding of the biomechanical and perceptual factors associated with obesity.
Obesity is a growing global public health concern that affects not only metabolic and cardiovascular systems but also musculoskeletal health, postural control, and proprioceptive mechanisms. Increased body mass and altered fat distribution, particularly abdominal adiposity, may lead to biomechanical changes such as anterior shift of the center of mass, altered load distribution, and increased stress on the lower extremities. These changes may negatively influence functional performance and postural organization.
Body awareness is a multidimensional construct involving the perception, interpretation, and regulation of internal bodily sensations, while postural habits reflect behavioral patterns related to body alignment in daily activities. Although previous studies have examined body awareness and functional performance in individuals with obesity, findings regarding their interrelationships remain inconsistent. Additionally, the combined evaluation of postural habits, body awareness, and functional performance across BMI categories is limited in the literature.
This study is designed as a cross-sectional, comparative investigation including women aged 18-65 years. Participants will be classified into four BMI categories according to World Health Organization criteria. Postural habits and awareness will be assessed using the Posture Habits and Awareness Scale (PHAS), and body awareness will be evaluated using the Body Awareness Questionnaire (BAQ). Functional performance will be measured using the Timed Up and Go (TUG) test and the Five Times Sit-to-Stand (5×STS) test. A composite functional performance index will be created using standardized scores of these tests.
Anthropometric measurements including BMI and waist circumference will be obtained to assess general and central obesity. Additional variables such as physical activity level and psychological status (anxiety and depression) will also be evaluated.
The primary objective is to examine whether postural habits and body awareness differ across BMI categories and how these variables are associated with functional performance. Furthermore, the study aims to determine whether central adiposity contributes independently to these relationships when controlling for functional performance and psychological factors.
It is hypothesized that higher BMI levels will be associated with altered postural habits and body awareness, and that decreased functional performance will play a mediating role in these relationships. Additionally, waist circumference is expected to have an independent effect on postural and perceptual parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Normal Weight | Women aged 18-65 years with a body mass index (BMI) between 18.5 and 24.9 kg/m². Participants in this group represent the normal weight category and will be evaluated for postural habits, body awareness, and functional performance. |
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| Overweight | Women aged 18-65 years with a BMI between 25.0 and 29.9 kg/m². This group includes participants classified as overweight and will undergo the same assessments as other groups |
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| Obesity Class I | Women aged 18-65 years with a BMI between 30.0 and 34.9 kg/m². Participants in this group represent obesity class I and will be assessed for postural habits, body awareness, and functional performance. |
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| Obesity Class II-III | Women aged 18-65 years with a BMI of 35.0 kg/m² or higher. This group includes participants with higher levels of obesity and will undergo the same evaluation protocol. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Observational Assessment | Other | Participants will undergo a comprehensive observational assessment including anthropometric measurements, self-reported questionnaires, and performance-based functional tests. Body mass index and waist circumference will be measured to classify participants into BMI categories. Postural habits and awareness will be evaluated using the Posture Habits and Awareness Scale (PHAS), and body awareness will be assessed the Body Awareness Questionnaire (BAQ). Functional performance will be measured using the Timed Up and Go (TUG) test and the Five Times Sit-to-Stand (5×STS) test. No therapeutic or experimental intervention will be applied. |
| Measure | Description | Time Frame |
|---|---|---|
| Postural Habits and Awareness Level (PHAS Score) | Postural habits and awareness will be assessed using the Postural Habits and Awareness Scale (PHAS), a validated self-reported questionnaire. The total score ranges from 21 to 105, with higher scores indicating better postural habits and greater awareness. The primary outcome will be the total PHAS score and its comparison across body mass index (BMI) categories, as well as its association with functional performance. | Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Body Awareness Level (BAQ Score) | Body awareness will be assessed using the Body Awareness Questionnaire (BAQ), a validated self-reported instrument measuring sensitivity to normal bodily processes. The total score ranges from 18 to 126, with higher scores indicating greater body awareness. The BAQ score will be analyzed across BMI categories and in relation to postural habits and functional performance. |
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Inclusion Criteria:
Exclusion Criteria:
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The study population will consist of women aged 18-65 years recruited from the general community. Participants will be categorized into four groups based on body mass index (BMI): normal weight, overweight, obesity class I, and obesity class II-III.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mine PEKESEN KURTÇA P PEKESEN KURTÇA, PhD | Contact | +903623121919 | mine.pekesenkurtca@omu.edu.tr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ondokuz Mayis University | Samsun | Samsun | 55270 | Turkey (Türkiye) |
The individual participant data will not be shared due to privacy concerns and restrictions in the informed consent provided by participants
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
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| Baseline |
| Functional Mobility (Timed Up and Go Test) | Functional mobility and dynamic balance will be evaluated using the Timed Up and Go (TUG) Test. The time required to stand up from a chair, walk 3 meters, turn, return, and sit down will be recorded in seconds. Scores range from 0 to an upper limit depending on performance, with lower times indicating better functional mobility and balance. | baseline |
| Lower Extremity Functional Strength (5 Times Sit-to-Stand Test) | Lower extremity functional strength will be assessed using the Five Times Sit-to-Stand Test (5×STS). The time required to complete five repetitions of sit-to-stand will be recorded in seconds. Scores range from 0 to an upper limit depending on performance, with lower times indicating better functional performance. | Baseline |
| Composite Functional Performance Index | A composite functional performance index will be calculated by converting Timed Up and Go Test and Five Times Sit-to-Stand Test results into z-scores and averaging them. The index has no fixed minimum or maximum value, as it is derived from standardized scores. Higher scores indicate poorer functional performance. This index will be used to examine associations with postural habits, body awareness, and BMI categories. | Baseline |
| Waist Circumference (Central Obesity Indicator) | Waist circumference will be measured using standardized procedures to assess central adiposity. Values will be recorded in centimeters. There is no fixed minimum or maximum value, and higher values indicate greater central obesity. This measure will be analyzed as a continuous variable and as an indicator of central obesity in relation to postural habits, body awareness, and functional performance. | Baseline |
| Physical Activity Level (IPAQ-SF) | Physical activity level will be assessed using the International Physical Activity Questionnaire - Short Form (IPAQ-SF). Total physical activity will be calculated as MET-minutes per week. Scores theoretically range from 0 to very high values depending on activity level, with higher scores indicating greater physical activity. | Baseline |
| Psychological Status (HADS Score) | Anxiety and depression levels will be assessed using the Hospital Anxiety and Depression Scale (HADS). The scale consists of two subscales: anxiety (HADS-A) and depression (HADS-D), each ranging from 0 to 21. Higher scores indicate greater symptom severity (worse psychological status). These variables will be considered in relation to primary and secondary outcomes. | Baseline |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |