The Wingate College of Physical Education and Sport Sciences, Wingate Institute, Netanya, Israel.
Child Health and Sport Center, Pediatric Department, Meir Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Phys Occup Ther Pediatr. 2020;40(3):330-344. doi: 10.1080/01942638.2019.1672848. Epub 2019 Oct 8.
To investigate differences in Achilles tendon structure between children with overweight/obesity and children with normal weight. Twenty-two children with obesity, 10 children with overweight, and 44 children with normal weight participated in the study. BMI% was calculated. The Achilles tendon was examined using ultrasound tissue characterization (UTC) imaging to capture a three-dimensional structure of four echo-type fibers and a cross-sectional area. A significantly higher percentile of echo-types II, a lower percentile of echo-types III and IV, and a lower cross-sectional area were found for children with normal weight compared with children with overweight/obesity ( < .05). Following a piecewise linear regression model according to tendon structure, a BMI percentile of 75% was found to be the most accurate cutoff point of the children into the "unaffected" (BMI% <75%) and "affected" tendon structure groups (BMI% ≥ 75%), as the children with BMI%≥75% already had an Achilles tendon structure similar to that of the children with overweight/obesity. Tendon integrity as examined with UTC differs between children with obesity and children with normal weight. Children with a BMI percentile of ≥75 already demonstrate a different tendon structure pattern compared with children with BMI percentile of <75. This may put children with obesity at a greater risk of injury and should be addressed when applying an exercise program for children with overweight/obesity.
探讨超重/肥胖儿童与正常体重儿童跟腱结构的差异。
本研究纳入 22 名肥胖儿童、10 名超重儿童和 44 名正常体重儿童。计算 BMI%。使用超声组织特征成像（UTC）检查跟腱，以获取四种回声类型纤维和横截面积的三维结构。与超重/肥胖儿童相比，正常体重儿童的回声类型 II 的百分位数更高，回声类型 III 和 IV 的百分位数更低，横截面积更小（<0.05）。根据跟腱结构的分段线性回归模型，发现 BMI%为 75%是将儿童分为“未受影响”（BMI%<75%）和“受影响”跟腱结构组（BMI%≥75%）的最准确截断点，因为 BMI%≥75%的儿童的跟腱结构已经类似于超重/肥胖儿童。
UTC 检查的跟腱完整性在肥胖儿童和正常体重儿童之间存在差异。BMI%≥75%的儿童与 BMI%<75%的儿童相比，已经表现出不同的跟腱结构模式。这可能使肥胖儿童更容易受伤，在为超重/肥胖儿童制定运动计划时应加以考虑。
