Mechanical Engineering Department, Northern Arizona University, Flagstaff, AZ, 86001, USA.
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA.
Gait Posture. 2019 Sep;73:209-214. doi: 10.1016/j.gaitpost.2019.07.307. Epub 2019 Jul 23.
Obesity increases a child's risk of developing knee pain across the lifespan, potentially through elevated patellofemoral joint loads that occur during habitual weight-bearing activities.
Do obese children have greater absolute and patellar-area-normalized patellofemoral joint forces compared to healthy weight children during walking?
We utilized a cross-sectional design to address the aims of this study. Experimental biomechanics data were collected during treadmill walking in 10 healthy-weight and 10 obese 8-12 year-olds. We used radiographic images to develop subject-specific musculoskeletal models, generated walking simulations from the experimental data, and predicted patellofemoral joint contact force using established techniques.
We found that the obese children had 1.98 times greater absolute (p = 0.002) and 1.81 times greater patellar-area-normalized (p = 0.008) patellofemoral joint contact forces compared to the healthy-weight children. We observed a stronger relationship between absolute patellofemoral joint contact force and BMI (r=0.58) than between patellofemoral joint contact force and body fat percentage (r=0.38).
Our results indicate that obese children walk with increased patellofemoral loads in absolute terms and also relative to the area of the articulating surfaces, which likely contributes to the increased risk of knee pain in this pediatric population. This information, which provides a baseline comparison for future longitudinal studies, also informs the type and frequency of physical activity prescription aimed at reducing the risk of knee injury and improving long-term outcomes.
肥胖会增加儿童在整个生命周期中患膝关节疼痛的风险，这可能是由于习惯性负重活动中髌股关节负荷增加所致。
与健康体重儿童相比，肥胖儿童在行走时髌股关节的绝对力和髌股关节面积归一化力是否更大？
我们采用横断面设计来解决本研究的目的。在 10 名健康体重和 10 名肥胖 8-12 岁儿童的跑步机行走过程中，我们利用影像学图像来开发特定于个体的肌肉骨骼模型，从实验数据生成行走模拟，并使用既定技术预测髌股关节接触力。
我们发现肥胖儿童的髌股关节绝对（p = 0.002）和髌股关节面积归一化（p = 0.008）接触力比健康体重儿童分别大 1.98 倍和 1.81 倍。我们观察到髌股关节绝对接触力与 BMI（r=0.58）之间的关系比髌股关节接触力与体脂百分比（r=0.38）之间的关系更强。
我们的结果表明，肥胖儿童行走时髌股关节的负荷绝对值增加，相对于关节表面的面积也增加，这可能导致该儿童群体膝关节疼痛的风险增加。这些信息为未来的纵向研究提供了基线比较，也为旨在降低膝关节损伤风险和改善长期结果的体育活动处方的类型和频率提供了信息。
