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Childhood obesity and its impact on the characteristics of gait stance phases: a cross-sectional study

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Abstract

This study aimed to investigate the variations in foot type, laxity, dynamic characteristics of gait, and the characteristics of the stance phase of gait, in relation to body mass index (BMI) and groups of children of different ages. Additionally, it aimed to explore the correlations between BMI and these variables across children groups of different ages. A cross-sectional study was conducted involving 196 infants aged between 5 and 10 years old. The variables assessed included BMI, foot type, laxity, dynamic variables, and characteristics of the stance phase of gait. Significant variations were observed in foot type, laxity, certain dynamic variables, and characteristics of the stance phase of gait between normoweight (NW) and overweight/obese (OW/OB) groups among children aged between 5 and 10 years old (p ranged between 0.019 and 0.050). Moreover, BMI was also positively associated with the initial forefoot contact, heel off, total duration of the step, and forefoot contact phase of children 7 to 10 years of age (p ranged between < 0.010 and 0.040).

  Conclusion: Children who are OW/OB had alterations at different stages of gait. Being OW/OB is related to alterations of the phases of gait mainly from 7 to 10 years of age, and spending more time in each of the phases of walking. This could indicate that children who are OW/OB, in addition to walking slower, overload the musculoskeletal system, subjecting their joints and muscles to greater stress.

What is Known:

• Children who are overweight (OW) and obese (OB) can experience changes in their musculoskeletal systems, posture, and gait due to increased body mass index.

• OW and OB children experience additional stress on their musculoskeletal systems, impacting posture, biomechanics, mobility, physical activity, and daily tasks. Excessive plantar loading is linked to foot pain in adults.

What is New:

• Body mass index was positively associated with initial forefoot contact, heel off, total duration of the step, and forefoot contact phase in children aged 7 to 10 years old. OW/OB children aged 5–6 exhibited less ankle dorsiflexion and smaller relaxed calcaneal stance position (RCSP) as compared to normal-weight children.

• Obese children aged 5–6 showed less pronation excursion, suggesting altered frontal plane movement due to RCSP differences. Children aged 7–8 who are OW/OB spent more time in certain gait phases, particularly in the forefoot contact phase. Being OW/OB is linked to altered gait parameters such as initial forefoot, heel off, total step duration, and forefoot contact phase. Being OW/OB was associated with a longer forefoot contact phase, particularly in the right foot.

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Abbreviations

BMI:

Body mass index

FF:

Flat feet

FPI:

Foot posture index

ICC:

Intraclass correlation coefficient

JH:

Joint hypermobility

LLAS:

The lower limb assessment score

NW:

Normoweight

OB:

Obese

OW:

Overweight

RCSP:

The relaxed calcaneal stance position

WHO:

World Health Organization

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Author information

Authors and Affiliations

  1. Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos nº135, Guadalupe , 30107, Murcia, Spain

    Cristina Molina-García & Andrés López-del-Amo-Lorente

  2. Department of Nursing and Podiatry, University of Malaga, 29071, Málaga, Andalucía, Spain

    Laura Ramos-Petersen & Carlos Martínez-Sebastián

  3. Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain

    José Daniel Jiménez-García & Francisco Álvarez-Salvago

  4. Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, 46010, Valencia, Spain

    Francisco Álvarez-Salvago

  5. ExPhy Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cádiz, Spain

    Daniel Velázquez-Díaz

  6. AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, 32803, USA

    Daniel Velázquez-Díaz

Authors
  1. Cristina Molina-García
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  2. Andrés López-del-Amo-Lorente
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  7. Daniel Velázquez-Díaz
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Cristina Molina-García, Andrés López-del-Amo-Lorente, Laura Ramos-Petersen and Carlos Martínez-Sebastián. The first draft of the manuscript was written by Cristina Molina-García, Jose Daniel Jiménez-García, Francisco Álvarez-Salvago and Daniel Velázquez-Díaz. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Francisco Álvarez-Salvago.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Catholic University of de Murcia (Date 25-02-2022/Nº CE022205).

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Written informed consent was obtained from the parents.

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The authors affirm that human research participants provided informed consent for publication of this article.

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The authors have no relevant financial or non-financial interests to disclose.

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Communicated by Gregorio Milani

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Molina-García, C., López-del-Amo-Lorente, A., Ramos-Petersen, L. et al. Childhood obesity and its impact on the characteristics of gait stance phases: a cross-sectional study. Eur J Pediatr 183, 123–134 (2024). https://doi.org/10.1007/s00431-023-05268-7

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