, Volume 471, Issue 4, pp 1236-1244
Date: 12 Oct 2012

Lower Extremity Pain Is Associated With Reduced Function and Psychosocial Health in Obese Children

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Childhood obesity is associated with reduced quality of life, physical fitness, and a higher prevalence of lower extremity (LE) pain; however, it is unclear whether and how these factors are related.


For this study we asked if obese children with LE pain (LE+) had higher BMI-Z scores, lower physical function and psychosocial health, and lower physical fitness compared with obese children without LE pain (LE−). We determined the association of BMI-Z score with physical function, psychosocial health, or physical fitness in obese children.


Medical charts of 183 obese children were reviewed. Recorded data included anthropometrics, demographics, reports of musculoskeletal pain, Pediatric Quality of Life (PedsQL)-Physical Function score, PedsQL-Psychosocial Health score, and physical fitness levels. Data from 175 individuals were included in the analysis, with 51 in the LE+ group and 124 in the LE− group. Statistical analysis included Mann-Whitney U tests and Spearman’s rank order correlations.


Between the LE+ and LE− groups, BMI-Z and physical fitness scores were not different. The LE+ group scored worse on the PedsQL-Physical Function scale (LE+: 72.4 [17.1], LE−: 79.5 [15.0]) and PedsQL-Psychosocial Health scale (LE+: 70.0 [16.1], LE−: 75.8 [16.3]). BMI-Z scores negatively correlated with PedsQL-Physical Function scores, PedsQL-Psychosocial Health scores, and physical fitness scores.


Our findings indicate that LE pain should be considered in the evaluation and management of children who are obese.

Level of Evidence

Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Research support was received (SB-T) from an Arthritis Foundation Clinical to Research Transition Award.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation including waiver of informed consent and that all investigations were conducted in conformity with ethical principles of research.