Biomechanical variations in children who are overweight and obese during high‐impact activities: A systematic review and meta‐analysis

Abstract

Summary Youth who are obese or overweight demonstrate evidence of poor lower extremity joint health and alterations in gait characteristics compared with youth who are healthy weight. However, there is no consensus if altered movement patterns are still present during high‐impact activities. The purpose of this review was to determine if spatiotemporal and kinematic and kinetic variables during high‐impact activities were significantly different between youth who are overweight and obese compared with youth who are healthy weight. An electronic search of five databases was conducted, and a meta‐analysis and qualitative evidence synthesis was performed to determine the level of evidence, analyzing three tasks: running, jumping, and hopping. The findings of this review include the following: (1) overweight/obese (OW/OB) had higher stance phase time during running, (2) OW/OB had decreased hip flexion angles during running and stationary running, (3) OW/OB had decreased knee flexion angles during landing phase of jumping and hopping, and (4) OW/OB had increased hip abduction moments during running and jumping. These altered kinematic and kinetic variables at the hip and knee may result in mechanical inefficiency with high‐impact activities, as well as potentially increased risk of joint degradation and poor joint health into adulthood.

Leveraging the construct of physical literacy to promote physical activity for youth with obesity – A qualitative analysis of physical therapists’ perceptions

“…Through use of a physical literacy lens, participants in our study emphasized how the emotions and beliefs related to physical activity are critical to an individual's activity behavior and thus, need to be assessed. While youth with obesity demonstrate deficiencies in the physical domain that need to be considered [ 8 , 33 , 34 ], strategies described in our study focus primarily on the affective, cognitive, and behavioral domains. Overwhelmingly, the participants referred to the critical actions of engaging the patient in open, non-judgmental conversations, and taking the time to understand what experiences and factors may influence inactivity.…”

Pivot from Pain to Productive: Conversations about Weight Management in Youth with Obesity

“…Youth with obesity also may experience more fatigue and higher perceived exertion that make physical activity feel more challenging and uncomfortable (5,7). Neuromusculoskeletal (NMS) impairments, physical complications, biomechanical differences, and physical deconditioning can all impede functional movement, physical activity, and enjoyment (5,8,9).…”

Increased hip flexion gait as an exercise modality for individuals with obesity

“…During running, obesity has been associated with alterations of dynamic knee loading, higher tibia peak positive acceleration at ground impact, and higher average and instantaneous vertical ground reaction force loading rates that have been shown to increase the risk of injury in the knees in individuals with obesity (Harding et al 2016;Tirosh et al 2019). When compared with healthy-weight individuals, individuals with obesity have altered kinematic and kinetic variables at the hip and knee that may result in mechanical inefficiencies, higher joint moments, and ground reaction forces; potentially increasing the risk of joint degradation and poor joint health (Bowser and Roles 2021;Spech et al 2022).…”