School of Health, Sport and Bioscience, University of East London, Stratford, London, England.
J Foot Ankle Res. 2013 Aug 28;6(1):36. doi: 10.1186/1757-1146-6-36.
Childhood obesity is thought to predispose to structural foot changes and altered foot function. Little is currently understood about whether similar changes occur in overweight children. The aim of this study was determine foot loading characteristics in obese, overweight and normal weight children aged 7 to 11 years during level walking.
Dynamic plantar pressures were measured in 22 obese, 22 overweight and 56 normal weight children recruited from local primary and secondary schools in East London. Peak pressure, peak force, normalised peak force, pressure-time and force-time integrals were analysed at six regions of the plantar foot: lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint and hallux. A one-way ANOVA was used to test for significant differences in variables across the groups. Where differences existed Tukey post-hoc tests were used to ascertain the location of the difference.
Children who were obese and overweight demonstrated significantly (p<0.05) higher peak pressures and peak forces as well as significantly higher force-time and pressure-time integrals under the midfoot and 2nd-5th metatarsal regions. After normalisation of peak force, similar trends existed where the obese and overweight children demonstrated significantly (p<0.05) greater loading at the midfoot and 2nd-5th metatarsals.
Findings from this study indicated that overweight children, as young as seven, displayed differences in foot loading during walking, when compared with normal weight children. These findings were consistent with loading patterns of children who were obese and suggest that early assessment and intervention may be required in overweight children to mitigate against the development of musculoskeletal complications associated with excessive body mass.
儿童肥胖被认为易导致足部结构改变和足部功能改变。目前对于超重儿童是否会发生类似变化知之甚少。本研究旨在确定 7 至 11 岁肥胖、超重和正常体重儿童在水平行走时的足部受力特征。
从伦敦东部的当地小学和中学招募了 22 名肥胖儿童、22 名超重儿童和 56 名正常体重儿童，测量其足底动态压力。在足底的六个区域（外侧足跟、内侧足跟、中足、第一跖趾关节、第二至第五跖趾关节和大脚趾）分析峰值压力、峰值力、归一化峰值力、压力时间和力时间积分。使用单向方差分析检验组间变量的显著差异。如果存在差异，则使用 Tukey 事后检验确定差异的位置。
肥胖和超重的儿童在中足和第二至第五跖骨区域的峰值压力和峰值力以及力时间和压力时间积分显著更高（p<0.05）。归一化峰值力后，肥胖和超重儿童在中足和第二至第五跖骨区域的受力明显更大，存在类似的趋势（p<0.05）。
本研究的结果表明，与正常体重儿童相比，即使在 7 岁时，超重儿童在行走时足部受力也存在差异。这些发现与肥胖儿童的受力模式一致，表明超重儿童可能需要早期评估和干预，以减轻与体重过大相关的肌肉骨骼并发症的发生。
