Effect of Body Mass Index on Dynamic Plantar Pressure, Spatiotemporal Parameters, and Gait Symmetry

Background/Objectives: Previous studies have shown that excess body weight influences plantar pressure. However, the specific impact of Body Mass Index (BMI) on dynamic pressure distribution during different phases of walking, as well as its effect on load symmetry between the feet, requires further investigation. This study aimed to evaluate the effects of varying BMI categories on dynamic plantar pressure, spatiotemporal gait parameters, and load symmetry. Methods: A retrospective analysis of pre-existing records from 300 adults (2017–2025) classified as normal weight, overweight, and obese was conducted. Dynamic plantar pressure, contact time, and gait speed across four stance phases were assessed using baropodometric platforms. Bilateral differences were evaluated via the symmetry index (SI). Results: Overweight and obese individuals exhibited higher plantar pressures and prolonged contact times, particularly during the forefoot contact phase (FFCP) (p < 0.001). Gait speed decreased inversely with BMI across all phases. Despite these kinematic adaptations, BMI-related load asymmetry occurred only during the initial contact phase (ICP) (p < 0.001), restoring stability in subsequent phases. Conclusions: Excess body mass is associated with targeted mechanical overload of the forefoot rather than uniform stress across the foot. To manage inertia and maintain symmetry, individuals with high BMI may adopt spatiotemporal strategies that reduce speed and extend double support, potentially prioritizing stability over propulsive efficiency. These findings suggest that orthotic interventions for individuals with high BMI may benefit from prioritizing forefoot offloading, although prospective studies are needed.