Department of Kinesiology, Temple University, Philadelphia, PA, USA.
Arch Phys Med Rehabil. 2009 Dec;90(12):2146-54. doi: 10.1016/j.apmr.2009.07.024.
Shultz SP, Sitler MR, Tierney RT, Hillstrom HJ, Song J. Effects of pediatric obesity on joint kinematics and kinetics during 2 walking cadences.
To determine whether differences existed in lower-extremity joint biomechanics during self-selected walking cadence (SW) and fast walking cadence (FW) in overweight- and normal-weight children.
Survey.
Institutional gait study center.
Participants (N=20; mean age +/- SD, 10.4+/-1.6y) from referred and volunteer samples were classified based on body mass index percentiles and stratified by age and sex. Exclusion criteria were a history of diabetes, neuromuscular disorder, or recent lower-extremity injury.
Not applicable.
Sagittal, frontal, and transverse plane angular displacements (degrees) and peak moments (newton meters) at the hip, knee, and ankle joints.
The level of significance was set at P less than .008. Compared with normal-weight children, overweight children had greater absolute peak joint moments at the hip (flexor, extensor, abductor, external rotator), the knee (flexor, extensor, abductor, adductor, internal rotator), and the ankle (plantarflexor, inverter, external/internal rotators). After including body weight as a covariate, overweight children had greater peak ankle dorsiflexor moments than normal-weight children. No kinematic differences existed between groups. Greater peak hip extensor moments and less peak ankle inverter moments occurred during FW than SW. There was greater angular displacement during hip flexion as well as less angular displacement at the hip (extension, abduction), knee (flexion, extension), and ankle (plantarflexion, inversion) during FW than SW.
Overweight children experienced increased joint moments, which can have long-term orthopedic implications and suggest a need for more nonweight-bearing activities within exercise prescription. The percent of increase in joint moments from SW to FW was not different for overweight and normal-weight children. These findings can be used in developing an exercise prescription that must involve weight-bearing activity.
确定超重和正常体重儿童在自主选择的行走步速（SW）和快速行走步速（FW）下，下肢关节生物力学是否存在差异。
调查。
机构步态研究中心。
来自推荐和志愿者样本的参与者（N=20；平均年龄+/-标准差，10.4+/-1.6y）根据体重指数百分位进行分类，并按年龄和性别分层。排除标准为糖尿病、神经肌肉疾病或近期下肢损伤史。
不适用。
髋关节、膝关节和踝关节矢状面、额状面和横断面的角位移（度）和峰值力矩（牛顿米）。
显著性水平设为 P 小于.008。与正常体重儿童相比，超重儿童髋关节（屈肌、伸肌、外展肌、外旋肌）、膝关节（屈肌、伸肌、外展肌、内收肌、内旋肌）和踝关节（跖屈肌、内翻肌、内/外旋肌）的绝对峰值关节力矩更大。包括体重作为协变量后，超重儿童的踝关节背屈峰值力矩大于正常体重儿童。组间无运动学差异。FW 时髋关节伸肌峰值力矩更大，踝关节内翻峰值力矩更小。FW 时髋关节屈肌和膝关节伸展时的角度位移更大，髋关节（伸展、外展）、膝关节（弯曲、伸展）和踝关节（跖屈、内翻）的角度位移更小。
超重儿童的关节力矩增加，这可能对长期骨科有影响，并表明在运动处方中需要更多的非承重活动。从 SW 到 FW，超重和正常体重儿童的关节力矩增加百分比没有差异。这些发现可用于制定必须包括负重活动的运动处方。
