Association between the levels of physical activity and plantar pressure in 6-14-year-old children

Altered gait patterns during arch important development period in children with persistent obesity: An experimental longitudinal study

BACKGROUND

Obesity can cause structural changes and functional adjustments in growing children's feet. However, there is a lack of continuous observation of changes in feet in children with persistent obesity during important developmental periods. This makes it challenging to provide precise preventive measures.

OBJECTIVE

This study aimed to investigate the effects of persistent obesity on gait patterns in children at an important stage in the formation of a robust foot arch.

METHODS

The Footscan® plantar pressure system was used for 3 checks over two years. A total of 372 children aged 7-8 years participated in the study, and gait data from 33 children who maintained normal weight and 26 children with persistent obesity were finally selected. Repeated measures ANOVA or Friedman's test were used for longitudinal comparisons. Independent-Sample t-tests or the Mann-Whitney-Wilcoxon tests were used for cross-sectional comparisons.

RESULTS

During the important period of development, children with persistent obesity did not exhibit a significant decrease in the arch index and had significantly higher values than the normal group in the third check. The persistently obese children showed increased load accumulation in the lateral rearfoot, first metatarsophalangeal joints, and the great toe regions. Children with persistent obesity had significantly greater medial-lateral displacements in the initial contact phase and forefoot contact phase than normal children in the first check. These differences diminished between the second and third checks.

SIGNIFICANCE

Persistent obesity during an important period of foot development leads to slow or abnormal development of arch structure and affects foot loading patterns with heel inverted and forefoot everted. Additionally, the development of gait stability is not limited by persistent obesity.

Influence of motor capacity of the lower extremity and mobility performance on foot plantar pressures in community-dwelling older women

Objectives

To investigate the associations of motor capacity of the lower extremity and mobility performance in daily physical activities with peak foot plantar pressures during walking among older women.

Methods

Using the data collected among 58 community-dwelling older women (68.66 ± 3.85 years), Pearson correlation and multiple linear regression analyses were performed to analyze the associations of motor capacity of the lower extremity (the 30-s chair stand test, the timed one-leg stance with eyes closed, and the Fugl-Meyer assessment of lower extremity), mobility performance in daily physical activities (the average minutes of moderate to vigorous physical activity every day and the metabolic equivalents), and foot plantar pressures (peak force and peak pressure) with the age and body fat percentage as covariates.

Results

(1) The motor capacity of the lower extremity has higher explanatory power for peak foot plantar pressures compared with the mobility performance in daily physical activities. (2) Higher body fat percentage was positively associated with peak force and pressure, while a lower score on the Fugl-Meyer assessment of lower extremity was negatively associated with both of them. (3) The metabolic equivalents were positively associated with the peak force, while the 30-s chair stand test was negatively associated with it.

Conclusions

Mobility performance in daily physical activities can be significant predictors for peak foot plantar pressures among older women. The significant predictor variables include the Fugl-Meyer assessment of lower extremity, the 30-s chair stand test, and metabolic equivalents.

Overweight and Obesity: Its Impact on Foot Type, Flexibility, Foot Strength, Plantar Pressure and Stability in Children from 5 to 10 Years of Age: Descriptive Observational Study

BACKGROUND

Overweight (OW) and childhood obesity (OB) may cause foot problems and affect one's ability to perform physical activities. The study aimed to analyze the differences in descriptive characteristics, foot type, laxity, foot strength, and baropodometric variables by body mass status and age groups in children and, secondly, to analyze the associations of the BMI with different physical variables by age groups in children.

METHODS

A descriptive observational study involving 196 children aged 5-10 years was conducted. The variables used were: type of foot, flexibility, foot strength and baropodometric analysis of plantar pressures, and stability by pressure platform.

RESULTS

Most of the foot strength variables showed significant differences between the normal weight (NW), OW and OB groups in children aged between 5 and 8. The OW and OB groups showed the highest level of foot strength. In addition, the linear regression analyses showed, in children aged 5 to 8 years, a positive association between BMI and foot strength (the higher the BMI, the greater the strength) and negative association between BMI and stability (lower BMI, greater instability).

CONCLUSIONS

Children from 5 to 8 years of age with OW and OB show greater levels of foot strength, and OW and OB children from 7 to 8 years are more stable in terms of static stabilometrics. Furthermore, between 5 and 8 years, having OW and OB implies having more strength and static stability.

Comparison of plantar pressure distribution in underweight, normal, overweight, and obese adolescents: A cross-sectional study evaluation of plantar pressure in adolescents

BACKGROUND

Repeated overload by body weight in the adolescents affects the foot structure.

OBJECTIVE

This study aimed to evaluate plantar pressure distribution in adolescents with different body mass indices during gait and standing.

STUDY DESIGN

This is a randomized, cross-sectional study.

METHODS

One hundred eighty-six adolescents between the ages of 8 and 15 years were included. The individuals were divided into groups according to body mass index (BMI). Plantar pressure distributions were examined during gait and standing. Surface areas, plantar pressures, forefoot-hindfoot load, surface amounts, and foot angles of the individuals were determined during gait and standing.

RESULTS

Significant differences were detected in left-right surfaces, maximum load quantities, average pressures, forefoot-hindfoot surface areas between static and dynamic plantar pressure distributions of underweight, normal, overweight, and obese adolescents (P < 001). Maximum, average pressure, right forefoot foot load, and foot angles increased in the obese group during standing as BMI increased; total surface areas, and loads in forefoot, hindfoot surface areas in right and left feet also increased in maximum and average pressures during gait (P < .05). No differences were detected between groups in foot angles during standing and gait (P > .05).

CONCLUSIONS

This study show that increased BMI causes increased plantar pressures during gait and standing, and weight gain would cause problems in adolescents.

Arch-related alteration in foot loading patterns affected by the increasing extent of body mass index in children: A follow-up study

BACKGROUND

A high load on children 's feet can cause arch deformation and negatively affect their normal development. Studies have yet to document how the foot arch varied with different body mass index (BMI) increments and its influence on foot loading patterns.

METHODS

Barefoot walking trails were conducted using a Footscan® plate system. A follow-up check was performed after twenty-four months. Participants were selected with an initial BMI between 14.5 kg/m² and 16.5 kg/m². Totally 75 participants were classified into groups 0-7 according to the BMI increment levels of 0-0.49 kg/m², 0.50-1.49 kg/m², 1.50-2.49 kg/m², 2.50-3.49 kg/m², 3.50-4.49 kg/m², 4.50-5.49 kg/m², 5.50-6.49 kg/m², 6.50-7.49 kg/m², respectively. Paired t-tests and effect sizes were used to compare the data.

RESULTS

The arch index significantly decreased when the BMI reached 20.8 kg/m². Significantly increased normalized maximum forces were found in the great toe and 1st MTPJ in groups 4-5. Meanwhile, the absence of significance showed under the 3rd-5th, midfoot, and rearfoot in those groups. The normalized maximum force increments under the 3rd-5th MTPJs, midfoot and rearfoot regions in groups 4-5 after the follow-up study were significantly decreased compared with the increments found in groups 0-3, followed by a sudden increase arising under those regions in group 6. It indicates a transition period that leads to alteration in gait pattern characteristics when BMI increases to 18.6-19.9 kg/m² (between group 3 and group 4). Group 6 displayed significantly increased peak pressure amplitudes under the great toe, 1st-3rd MTPJs, midfoot, and medial rearfoot compared to other groups.

SIGNIFICANCE

There was a transition period when the BMI of normal-weighted children increased to a certain extent and failed to reach the obesity level, resulting in changes in foot arch structure and loading patterns.

New Distinct Component Patterns for Plantar Pressure Variables by Using Principal Component Analysis

BACKGROUND

It is important to determine the plantar pressure distribution of schoolchildren by applying static and dynamic foot analyses using a pedobarography device. However, it is difficult to obtain clear interpretations from results that can be explained by a large number of plantar pressure variables. The aim of this study was to use principal component analysis (PCA) to predict the main components for reducing the size of big data sets, provide a practical overview, and minimize information loss on the subject of plantar pressure assessment in youths.

METHODS

In total, 112 schoolchildren were included in the study (mean ± SD: age, 10.58 ± 1.27 years; body mass index, 18.86 ± 4.33). During the research, a pedobarography device was used to obtain plantar pressure data. Each foot was divided into six anatomical regions and evaluated. Global and regional plantar pressure distributions, load and surface areas, pressure-time integrals, weight ratios, and geometric foot properties were calculated.

RESULTS

The PCA yielded ten principal components that together account for 81.88% of the variation in the data set and represent new and distinct patterns. Thus, 137 variables affecting the subject were reduced to ten components.

CONCLUSIONS

The numerous variables that affect static and dynamic plantar pressure distributions can be reduced to ten components by PCA, making the research results more concise and understandable.

The Impact of Overweight and Obesity on Plantar Pressure in Children and Adolescents: A Systematic Review

We aimed to synthesise the results of previous studies addressing the impact of overweight and obesity on plantar pressure in children and adolescents. An electronic search of scientific literature was conducted using PubMed, Cochrane and Scopus database, with keywords: “plantar pressure” AND “children” AND “obesity”; “plantar pressure” AND “adolescents” AND “obesity”, “plantar pressure” AND “children” AND “overweight”, “plantar pressure” AND “adolescents” AND “overweight”. Twenty-two articles were included in the review and the following data were recorded: authors, publication year, type of technology (systems, software) for the determination of plantar pressure, study characteristics. Most of the articles used dynamic plantar pressure determination with only four using static plantar pressure measurement. Using ultrasonography with static plantar pressure determination, the correlation between structural and functional changes in the feet of obese children. In overweight and obese children and adolescents, important findings were recorded: higher contact area, increased maximum force beneath the lateral and medial forefoot, increased pressure–time integral beneath the midfoot and 2nd–5th metatarsal regions. Significantly increased foot axis angle and significantly flatter feet were observed in obese subjects in comparison to their normal-weight counterparts. The obese children presented increased midfoot fat pad thickness, with decreased sensitivity of the whole foot and midfoot.