Tirosh Oren, Steinberg Nili, Nemet Dan, Eliakim Alon, Orland Guy
School of Health Sciences, Swinburne University of Technology, Australia.
The Wingate College of Physical Education and Sports Sciences at the Wingate Institute, Israel.
Gait Posture. 2019 Feb;68:101-105. doi: 10.1016/j.gaitpost.2018.11.006. Epub 2018 Nov 11.
Being overweight may increase the risk for developing stress fracture, as overweight adults and children were reported to have greater pressure peaks and rates under the heel during walking when compared with their normal-weight counterparts. Biofeedback gait retraining was shown to reduce ground impact magnitude in adults but not yet in children.
The study examined whether overweight children have greater tibia peak positive acceleration (PPA) at ground impact during fast walking and running compared to healthy weight children, and whether visual feedback gait retraining program can be used to reduce PPA in overweight children.
Twenty five overweight and 12 healthy weight children participated in the study. Overweight children were randomly assigned into either feedback group or control no-feedback group of 8 sessions training program over 2-weeks. Tibia PPA at ground impact output from a wearable inertial sensor attached to the tibia was the feedback displayed on a monitor placed in front of the treadmill during walking and running.
Compared to healthy weight children, overweight participants showed significant greater PPA values in running (p < 0.05), but not in fast walking. Feedback group significantly reduced PPA by 16% (p < 0.01), and these changes persisted at the 1-month follow-up.
Tibia PPA may be used in evaluating overweight children as a risk assessment to potential injuries due to high ground impact during running. Gait retraining using real-time feedback of tibia PPA may be useful in rehabilitation programs to reduce ground impact in overweight children.
超重可能会增加发生应力性骨折的风险，因为据报道，与体重正常的成年人和儿童相比，超重的成年人和儿童在行走时足跟下方的压力峰值和压力变化率更大。生物反馈步态再训练已被证明可以降低成年人的地面冲击力，但在儿童中尚未得到证实。
本研究旨在探讨与健康体重儿童相比，超重儿童在快走和跑步时地面撞击时胫骨峰值正向加速度（PPA）是否更高，以及视觉反馈步态再训练计划是否可用于降低超重儿童的PPA。
25名超重儿童和12名健康体重儿童参与了本研究。超重儿童被随机分为反馈组或无反馈对照组，进行为期2周的8节训练课程。附着在胫骨上的可穿戴惯性传感器输出的地面撞击时的胫骨PPA是在跑步机前放置的监视器上显示的反馈信息，在行走和跑步过程中均可看到。
与健康体重儿童相比，超重参与者在跑步时的PPA值显著更高（p<0.05），但在快走时没有显著差异。反馈组的PPA显著降低了16%（p<0.01），这些变化在1个月的随访中持续存在。
胫骨PPA可用于评估超重儿童，作为对跑步时高地面冲击力导致潜在损伤的风险评估。使用胫骨PPA实时反馈的步态再训练可能有助于康复计划，以减少超重儿童的地面冲击力。
