Clinical Orthopaedics and Related Research®

, Volume 471, Issue 4, pp 1236–1244

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

  • Sharon Bout-Tabaku
  • Matthew S. Briggs
  • Laura C. Schmitt
Symposium: Childhood Obesity and Musculoskeletal Problems

DOI: 10.1007/s11999-012-2620-0

Cite this article as:
Bout-Tabaku, S., Briggs, M.S. & Schmitt, L.C. Clin Orthop Relat Res (2013) 471: 1236. doi:10.1007/s11999-012-2620-0



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.

Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Sharon Bout-Tabaku
    • 1
    • 2
    • 3
  • Matthew S. Briggs
    • 4
    • 5
    • 6
  • Laura C. Schmitt
    • 5
    • 6
  1. 1.Division of Rheumatology, Department of PediatricsNationwide Children’s HospitalColumbusUSA
  2. 2.Department of Pediatrics, College of MedicineThe Ohio State UniversityColumbusUSA
  3. 3.Center for Clinical Epidemiology and BiostatisticsUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  4. 4.Health and Rehabilitation Sciences PhD Program, School of Health and Rehabilitation Sciences, College of MedicineThe Ohio State UniversityColumbusUSA
  5. 5.Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of MedicineThe Ohio State UniversityColumbusUSA
  6. 6.Sports Health and Performance Institute, OSU Sports MedicineOhio State’s Wexner Medical CenterColumbusUSA

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