Influence of Obesity on Foot Loading Characteristics in Gait for Children Aged 1 to 12 YearsReportar como inadecuado

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Overweight and obesity are increasing health problems that are not restricted to adults only. Childhood obesity is associated with metabolic, psychological and musculoskeletal comorbidities. However, knowledge about the effect of obesity on the foot function across maturation is lacking. Decreased foot function with disproportional loading characteristics is expected for obese children. The aim of this study was to examine foot loading characteristics during gait of normal-weight, overweight and obese children aged 1–12 years.


A total of 10382 children aged one to twelve years were enrolled in the study. Finally, 7575 children m-f: n = 3630-3945; 7.0±2.9yr; 1.23±0.19m; 26.6±10.6kg; BMI: 17.1±2.4kg-m2 were included for complete case data analysis. Children were categorized to normal-weight ≥3rd and <90th percentile; n = 6458, overweight ≥90rd and <97th percentile; n = 746 or obese >97th percentile; n = 371 according to the German reference system that is based on age and gender-specific body mass indices BMI. Plantar pressure measurements were assessed during gait on an instrumented walkway. Contact area, arch index AI, peak pressure PP and force time integral FTI were calculated for the total, fore-, mid- and hindfoot. Data was analyzed descriptively mean ± SD followed by ANOVA-Welch-test according to homogeneity of variances: yes-no for group differences according to BMI categorization normal-weight, overweight, obesity and for each age group 1 to 12yrs post-hoc Tukey Kramer-Dunnett’s C; α = 0.05.


Mean walking velocity was 0.95 ± 0.25 m-s with no differences between normal-weight, overweight or obese children p = 0.0841. Results show higher foot contact area, arch index, peak pressure and force time integral in overweight and obese children p<0.001. Obese children showed the 1.48-fold 1 year-old to 3.49-fold 10 year-old midfoot loading FTI compared to normal-weight.


Additional body mass leads to higher overall load, with disproportional impact on the midfoot area and longitudinal foot arch showing characteristic foot loading patterns. Already the feet of one and two year old children are significantly affected. Childhood overweight and obesity is not compensated by the musculoskeletal system. To avoid excessive foot loading with potential risk of discomfort or pain in childhood, prevention strategies should be developed and validated for children with a high body mass index and functional changes in the midfoot area. The presented plantar pressure values could additionally serve as reference data to identify suspicious foot loading patterns in children.

Autor: Steffen Mueller , Anja Carlsohn, Juliane Mueller, Heiner Baur, Frank Mayer



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