The influence of body mass on the temporal parameters of peripubescent gait

doi:10.1016/j.gaitpost.2007.09.003

Gait & Posture

Volume 27, Issue 4, May 2008, Pages 719-721

https://doi.org/10.1016/j.gaitpost.2007.09.003 Get rights and content

Introduction

The concern of childhood obesity is one of international alarm and an area of medical practice demanding further research. It has been reported that obesity “is now arguably the most common medical problem in childhood [1].”

The preliminary work on the influence of obesity on gait was conducted by Hills and Parker [2]. This study evaluated the gait pattern of 10 obese prepubescents (8.5–10.9 years) and 10 non-obese prepubescents (8.5–10.9 years) and concluded that obese subjects consistently presented with longer double limb support periods. These differences in periods of double support duration have been attributed by the authors to a “tentative ambulation”. The authors also indicated that there was a higher degree of asymmetry with the obese subjects leading to “a predisposition to inefficiency, awkwardness and tentative movement”.

In a similar study McGraw et al. [3] also concluded that instability during gait could be related to carrying excessive body mass. For this study 20 male subjects (10 obese, 10 non-obese and aged between 8 and 10 years) were recruited in a study which evaluated gait and postural stability. The authors concluded that obese subjects displayed increased double-stance duration and decreased single stance duration. The findings reported from both studies must be interpreted with caution as methodological inaccuracies with regards to the classification of childhood obesity and sample size affect the external validity of the work.

With this current lack of literature it is with urgency that further research is established in order to further develop a comprehensive understanding of childhood obesity and its complications.

Section snippets

Methods

Prior to data collection, ethical approval for the study was sought and granted from the School of Health and Social Care, Glasgow Caledonian University.

Forty-four children aged 9–11 years were conveniently sampled from two primary schools. Children presenting with any physical impairment to their gait were excluded from the study.

Participants were classified into weight category in accordance with their Body Mass Index Standard Deviation Score (BMI SDS) [5]. The calculation of the BMI SDS

Data analysis

Analysis of the collected data was conducted on SPSS™ Version 11.5.

A post hoc power calculation was performed to establish the statistical power of the findings from the research. The results of the power calculation identified that in a two sample t-test with both samples having 22 subjects, the power would be approximately 89–90%.

To establish differences in temporal gait parameters between the two groups (excessive body mass versus normal weight), Independent sample t-tests were conducted.

Results

Forty-four children aged 9–11 years (9.5 ± 0.6 years) were included in the analysis (see Table 1); 22 normal weight subjects (11 female and 11 male) and 22 subjects with excessive body mass (12 female and 10 male). Mean BMI SDS for the normal weight group was −0.16 (±0.14) and 2.05 (±0.14) for those with excessive body mass was. The recorded values for temporal gait parameters are presented in Table 2.

Table 3 presents the Independent t-test analysis; these indicated that differences were

Discussion

The findings reported concur with previously published literature [2] with respect to increased double limb support duration in children with excessive body mass. These findings are also in accordance with previous work pertaining to reduced cadence, increased double limb support and decreased single limb support when obese children were compared with children of expected body mass [3].

The significant differences in temporal gait parameters were found between children with excessive body mass

Conflict of interest

The lead researcher (S.M.) was supported with Ph.D. funding from the Royal Hospital for Sick Children, Glasgow.

First page preview

Click to open first page preview

View PDF

References (8)

B. McGraw et al.
Gait and postural stability in obese and nonobese prepubertal boys
Arch Phys Med Rehabil
(2000)
A. Duhamel et al.
Statistical tools for clinical gait analysis
Gait Posture
(2004)
Armstrong, J., Reilly, J.J., & Child Health Information Team. The prevalence of obesity and undernutrition in Scottish...
A.P. Hills et al.
Gait asymmetry in obese children
Neuro-Orthopedics
(1991)

There are more references available in the full text version of this article.

Cited by (12)

Biomechanical characteristics of lower limb gait waveforms: Associations with body fat in children
2018, Gait and Posture
Citation Excerpt :
Greater understanding of the biomechanical impact on childhood obesity is important to fully understand the impact of musculoskeletal structure and function, to inform rehabilitation strategies for obesity related joint and soft-tissue dysfunction, and prevent musculoskeletal co-morbidities. The impact of childhood obesity on clinical gait characteristics has been documented; obese children are reported to walk slower, with a greater base of support and longer stance phase duration [6,7]. To date, five studies have described associations between childhood obesity and three-dimensional (3D) kinematic/kinetic changes in the lower limb [8–12] with conflicting findings.
Childhood obesity is associated with musculoskeletal dysfunction and altered lower limb biomechanics during gait. Few previous studies have explored relationships between childhood obesity measured by body fat and lower limb joint waveform kinematics and kinetics.
What is the association between body fat and hip, knee and ankle joint angles and moments during gait and in 7 to 11 year-old boys?
Fifty-five boys participated in the study. Body fat was measured by air displacement plethysmography. Hip, knee and ankle 3D waveforms of joint angles and moments were recorded during gait. Principle component analysis was used to reduce the multidimensional nature of the waveform into components representing parts of the gait cycle. Multiple linear regression analysis determined the association between the components with body fat.
Higher body fat predicted greater hip flexion, knee flexion and knee internal rotation during late stance and greater ankle external rotation in late swing/early stance. Greater hip flexion and adduction moments were found in early stance with higher body fat. In mid-stance, greater knee adduction moments were associated with high body fat. Finally, at the ankle, higher body fat was predictive of greater internal rotation moments.
The study presents novel information on relationships between body fat and kinematic and kinetic waveform analysis of paediatric gait. The findings suggest altered lower limb joint kinematics and kinetics with high body fat in young boys. The findings may help to inform research in to preventing musculoskeletal comorbidities and promoting weight management.
Effects of obesity on the biomechanics of stair-walking in children
2011, Gait and Posture
Citation Excerpt :
However, only few studies investigated the interrelation of these factors during dynamic activities in obese persons and particularly in obese children. The few studies on kinematic and kinetic indices of obese subjects’ movement reported differences in movement strategy between normal and obese subjects for rising from a chair [11,12] and for level-gait [13–21]. Additional trunk movement in the preparation phase of rising from a seated position indicated that obese children experience a greater difficulty in performing this movement [11].
Anthropometric characteristics, particularly body mass, are important factors in the development and progression of varus/valgus angular deformities of the knee and have long-term implications including increased risk of osteoarthritis. However, information on how excessive body weight affects the biomechanics of dynamic activities in children is limited. The purpose of this study was to test the hypothesis that during stair-walking lower extremity joint moments normalized to body mass in obese children are greater than those in normal-weight children. Eighteen obese children (10.5 ± 1.5 years, 148 ± 10 cm, 56.6 ± 8.4 kg) and 17 normal-weight children (10.4 ± 1.3 years, 143 ± 9 cm, 36.7 ± 7.5 kg) were recruited. A Vicon system and two AMTI force plates were used to record and analyze the kinematics and kinetics of ascending and descending stairs. Significant differences in spatio-temporal, kinematic and kinetic parameters during ascending and descending stairs between obese and normal-weight children were detected. For stair ascent, greater hip abduction moments (+23%; p = 0.001) and greater knee extension moments (+20%; p = 0.008) were observed. For stair descent, smaller hip extension moment (−52%; p = 0.031), and greater hip flexion moments (+25%; p = 0.016) and knee extension moments (+15%, p = 0.008) were observed for obese subjects. To date, it is unclear if and how the body may adapt to greater joint moments in obese children. Nevertheless, these differences in joint moments may contribute to a cumulative overloading of the joint through adolescence into adulthood, and potentially result in a greater risk of developing knee and hip osteoarthritis.
The role of vision in obese and normal-weight children's gait control
2011, Gait and Posture
Citation Excerpt :
Further increasing this base of support could result in excessive medial–lateral excursion of the centre of mass (COM) and take away from propelling the body forward in the most efficient way. While previous research reported that OB children generally walk slower along with a decreased cadence and shortened stride length [7–10], similar group differences for these spatiotemporal gait parameters did not reach significance level in this study. Although our outcome is in agreement with Nantel et al. [11], research findings on self-selected walking speed in OB versus NW children are not conclusive at this point in time.
Previous research has suggested that perceptual-motor difficulties may account for obese children's lower motor competence; however, specific evidence is currently lacking. Therefore, this study examined the effect of altered visual conditions on spatiotemporal and kinematic gait parameters in obese versus normal-weight children. Thirty-two obese and normal-weight children (11.2 ± 1.5 years) walked barefoot on an instrumented walkway at constant self-selected speed during LIGHT and DARK conditions. Three-dimensional motion analysis was performed to calculate spatiotemporal parameters, as well as sagittal trunk segment and lower extremity joint angles at heel-strike and toe-off. Self-selected speed did not significantly differ between groups. In the DARK condition, all participants walked at a significantly slower speed, decreased stride length, and increased stride width. Without normal vision, obese children had a more pronounced increase in relative double support time compared to the normal-weight group, resulting in a significantly greater percentage of the gait cycle spent in stance. Walking in the DARK, both groups showed greater forward tilt of the trunk and restricted hip movement. All participants had increased knee flexion at heel-strike, as well as decreased knee extension and ankle plantarflexion at toe-off in the DARK condition. The removal of normal vision affected obese children's temporal gait pattern to a larger extent than that of normal-weight peers. Results suggest an increased dependency on vision in obese children to control locomotion. Next to the mechanical problem of moving excess mass, a different coupling between perception and action appears to be governing obese children's motor coordination and control.
Temporal parameters of the foot roll-over during walking: Influence of obesity and sarcopenic obesity on postmenopausal women
2010, Maturitas
The purpose of this study was to establish a reference dataset for temporal parameters on postmenopausal women during walking and to explore the effect of obesity and sarcopenic obesity on the same parameters.
Based on plantar pressure data collected from 239 postmenopausal women, the initial contact, final contact, time to peak pressure and the duration of contact at the 10 anatomical areas of the foot considered were measured. Body composition was evaluated by octopolar bioimpedance.
Non-obese and non-sarcopenic started with heel contact followed by a latero-medial contact of the metatarsals and finally the hallux (the sarcopenic obese group ended in the toes 2–5). After heel off, the forefoot started to push off at the lateral metatarsals, followed by a more central push off and finally over the hallux (the sarcopenic obese group presented a greater oscillation in the metatarsals). The stance phase was divided into four distinct phases: initial contact (22.30%), forefoot contact (19.98%), foot flat (13.40%) and forefoot push off (44.32%). Sarcopenic obese spent more time in the forefoot contact phase (relative and absolute) and less time in the initial contact phase (%).
These findings provide a reliable and representative reference dataset for temporal characteristics of foot roll-over during walking of postmenopausal women. Sarcopenic obesity affects significantly the temporal characteristics of foot roll-over during walking in this population. Such findings are of concern to clinicians interested in the promotion of activity to reduce obesity and gain or maintain muscle, since sarcopenic obesity affects normal walking, which might increase injuries.
Core stabilization exercises impact on balance and foot pressure distribution in overweight children: A randomized controlled trial protocol
2020, Revista Pesquisa em Fisioterapia
Kinematic analysis on gait of overweight and obese primary school children during level walking
2014, Yiyong Shengwu Lixue/Journal of Medical Biomechanics

View all citing articles on Scopus

View full text

Short communicationThe influence of body mass on the temporal parameters of peripubescent gait

Introduction

Section snippets

Methods

Data analysis

Results

Discussion

Conflict of interest

First page preview

Arch Phys Med Rehabil

Gait Posture

Gait asymmetry in obese children

Neuro-Orthopedics

Short communication
The influence of body mass on the temporal parameters of peripubescent gait