Effects of Childhood Obesity on Three-Dimensional Knee Joint Biomechanics During Walking

Abstract

Despite the increasing percentages of children who are overweight, few studies have investigated their gait patterns. The purpose of this study was to quantify the three-dimensional knee joint kinematics and kinetics during walking in children of varying body mass and to identify effects associated with obesity. Three-dimensional kinematics and kinetics were collected from children of normal weight and overweight during normal gait using surface-mounted infrared emitting diodes and a force plate. The overweight group walked with a significantly lower peak knee flexion angle during early stance, and no significant differences in peak internal knee extension moments were found between groups. However, the overweight group showed a significantly higher peak internal knee abduction moment during early stance. These data suggest that although overweight children may develop a gait adaptation to maintain a similar knee extensor load, they may not be able to compensate for alterations in the frontal plane, which may lead to increased medial compartment joint loads. Therefore, assuming that the development of varus angular deformities of the knee joint and, in the longer term, medial compartment osteoarthritis are influenced by cumulative stress, this study supports the understanding that childhood obesity may impart a greater risk for the development of these diseases.

Associations of the mechanical, anthropometric and gait contributors to the knee adduction moment during paediatric gait

“…Discussion: The contribution of greater fat mass to the KAM confirms previous findings on the effect of obesity on frontal plane knee loading during gait [2]. Greater external foot rotation may indicate reduced stability and has been reported in obese individuals and patients with osteoarthritis [3,4].…”

“…Introduction: The knee adduction moment (KAM) during gait has been proposed as an indirect measure of dynamic knee joint loading and has been reported to be higher in obese children [1,2]. The KAM is primarily calculated from the resultant ground reaction force (GRF) and the lever arm length, both of which can be manipulated through weight-loss or medical interventions [1].…”

Body size and walking cadence affect lower extremity joint power in children's gait

“…Greater attention has been paid to metabolic cost of activity compared to biomechanical consequences of obesity [12][13][14][15][16].…”

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

“…Gait analysis in overweight and obese 12-year-old children demonstrates very high joint forces of the type that are associated with knee OA severity and progression. 10 Aside from knee OA, only carpal tunnel syndrome (CTS) and low-back pain (LBP) have a strong association with obesity. In a number of case-control studies, obesity was strongly associated with CTS and was independent of diabetes mellitus as a risk factor.…”