Effects of integrative neuromuscular training on the gait biomechanics of children with overweight and obesity

Abstract

Objective To analyze whether 13 weeks of integrative neuromuscular training can benefit spatiotemporal and kinematic parameters of gait in children with overweight/obesity. Methods This is a non‐randomized controlled trial. Fifty children (10.77 ± 1.24 years, 31 girls) with overweight/obesity were allocated to an exercise group (EG) (n = 25) that carried out a 13‐week exercise program based on fundamental movement skills, strength activities and aerobic training, and a control group (CG) (n = 25) that followed their normal lifestyle. Spatiotemporal (i.e., cadence, stance and support times, step length, and stride width) and kinematic (i.e., hip, pelvis, knee, and ankle angles) parameters were evaluated under laboratory conditions through a 3D analysis. ANCOVA was used to test raw and z‐score differences between the EG and CG at post‐exercise, adjusting for pre‐exercise values. Results The EG maintained their baseline stance and single‐limb support times while the CG increased them during walking (groups’ difference: 3.1 and 1.9 centiseconds). The EG maintained baseline maximum foot abduction angle during the stance phase whereas the CG showed an increase (groups’ difference: 3.9º). Additional analyses on kinematic profiles demonstrated that the EG walked with similar pelvic tilt and ankle abduction angles at post‐exercise, while the CG increased the pelvic anterior tilt in the whole stance phase (mean groups’ difference: 7.7º) and the ankle abduction angles in early‐ and mid‐stance phases (mean groups’ difference: 4.6º). No changes were observed in the rest of spatiotemporal and kinematic parameters. Conclusions The integrative neuromuscular training stopped the progression of some biomechanical alterations during walking in children with overweight/obesity. These findings could contribute to preventing common movement‐derived musculoskeletal disorders in this population, as well as preserving an optimal mechanical efficiency during walking.

The usefulness of Integrative Neuromuscular Training to counteract obesity: a narrative review

“…On the same line of evidence, the center of pressure sway area and velocity [ 30 ], combined the maximum force sustained by the medio-lateral forefoot, the lower limb angle, pelvic tilt and the plumb-tragus alignment significantly improved ( p < 0.05) thanks to neuromotor exercises whose aim was to preserve an optimal spine position, self-awareness of movement patterns, core muscles stabilization and muscular strength [ 31 , 33 ]. Functional performance has also been shown to improve with INT intervention, with five studies reporting a significant increase in the Functional Movement Screen total score [ 38 , 39 , 42 ] and single scores in the Hurdle Step ( p = 0.0036), Active Straight Leg Raise ( p = 0.0003) and Deep Squat ( p = 0.004) movement patterns [ 32 , 42 ]. Moreover, also Santanasto and colleagues demonstrated a significant amelioration in functional capacity after an INT protocol using the Short Physical Performance Battery, with scores increasing from 9.7 at baseline to 10.3 arbitrary units at the end of the intervention period in older people with obesity [ 49 ].…”