What is the Impact of Excessive Body Mass on the Biomechanical Walking Characteristics in 7 to 11 Year Old Children

Childhood obesity is associated with multiple health co-morbidities and various musculoskeletal disorders, affecting the lower limb and feet. Limited research has been undertaken which quantifies the impact of obesity on the function of the paediatric foot and lower limb. Furthermore, it is yet undetermined whether overweight children display similar functional changes as their obese counterparts. The primary aim of this research was to advance understanding on foot function and lower limb biomechanical movement characteristics in children; analysing differences between obese, overweight and normal weight children.

Having determined the reliability of the measurement protocols, 100 children were recruited for assessment of body mass status and plantar foot loading. Following this, a sub-group of 45 children were recruited and three-dimensional gait analysis was undertaken. Plantar foot loading and lower limb temporal-spatial, kinematic and kinetic gait characteristics were analysed during barefoot level walking. Multiple regression was undertaken to determine relationships between body mass status, foot loading and lower limb gait biomechanics.

Findings demonstrated that overweight and obese children displayed marked differences in foot loading and lower limb gait biomechanics when compared to normal weight children. The research identified that increased loading at the midfoot and 2nd- 5th metatarsals significantly predicted change in the kinematic and kinetic walking parameters at the hip and ankle in overweight and obese children. These findings provide evidence of an atypical biomechanical function of the foot and lower limb. This work advances understanding on the implications of excessive body mass on the functional characteristics of the paediatric foot and lower limb. This research identifies for the first time, differences in foot loading and lower limb gait biomechanics in overweight and obese children relative to those of normal weight. This work also provides important information as to the use of plantar pressure assessment in predicting change to the lower limb biomechanical movement characteristics of these children. This work underpins the need for further longitudinal work that further enhances our understanding on the consequences of excessive body mass on the foot and lower limb musculoskeletal and locomotor systems in children.