Full length articleEffects of different movement modes on plantar pressure distribution patterns in obese and non-obese Chinese children
Introduction
Pediatric obesity is growing at a staggering rate [1]. Twelve percent of Chinese children are overweight according to a study from the Chinese Center for Disease Control and Prevention [2]. An investigation showed that the city of Beijing has the highest overweight rate for children and adolescents in China at 20% [3].
The excessive body weight may cause enormous health risks such as hypertension, diabetes, and cardiovascular diseases [4] as well as diseases associated with musculoskeletal system dysfunction [5]. Excessive weight affects children’s normal development of bones, muscles and joints [6], and may cause shorter step length, slower speed and weaker stability etc. compared with normal weight children [7], [8], [9].
The gait studies of obese children with small samples by Hills and Parker in 1991 [7] and 1992 [10] demonstrated that the step length, cadence, and gait cycle of obese children under three walking speeds were all different from those of non-obese children. Studies on the impact of obesity on children’s foot structure and plantar pressure distribution suggested that overweight in preschool children led to anatomical changes and differences of plantar pressure distribution such as higher peak value of plantar pressure distribution, larger contact area of the arch and foot axis angle etc. [9], [11], [12], [13], [14]. The most of previous studies on gait characteristics of obese children during walking showed that gait of obese children tended to be not favorable compared to non-obese children.
Walking, slow running (jogging) and fast running often occur in daily life, Physical Education Class, and Physical Fitness Test for children. Running is one of the most popular forms of exercise that contributes to sustained health and physical fitness [15]. Running consumes significantly more calories than walking, so obese children are encouraged to run whenever it is possible. As a form of running at a slow or leisurely pace, jogging is more often chosen for losing weight [16], [17] because of less effort and intensity than fast running. However, long-distance running led to the increased relative load and mean area under the MLA (medial longitudinal arch) that may alter lower limb loading and increase the risk of running-related injuries [18]. Nagel et al. found that long distance runners showed increased peak pressure of the metatarsal bones during running [19]. Van etc. also reported that the long distance runners were prone to sustain metatarsal stress fractures [20]. Jogging is also associated with increased risk of incurring lower limb injuries [21] and numerous overuse injuries have been reported in immature adolescent distance runners [22], [23]. Ho et al. examined the effect of changes in speed and incline slope on plantar pressure distribution of the foot during treadmill jogging for healthy young females, and found that the peak pressures of heel, the medial and lateral arch, central forefoot and lateral forefoot increased significantly with the increase of speed. The maximum pressures of heel, the medial forefoot, and hallux and toes reduced significantly and the maximum pressures of lateral arch increased significantly as the jogging slope increased [24].
The most of previous studies focused on adults and adolescents, especially elite runners. Few studies were on regular primary school children. It is an important issue for obese children in primary schools to choose the appropriate form of exercise to fight obesity. The purpose of this study was to compare plantar pressure distribution characteristics of obese and non-obese children during natural walking, jogging and fast running, and evaluate biomechanical effects of those exercises on obese children.
Section snippets
Participants
Forty children: 20 obese (mean ± standard deviation; age: 10.69 ± 2.11 years; height: 1.51 ± 0.11m; weight: 65.15 ± 14.22 kg; BMI: 28.13 ± 3.40 kg/m2) and 20 non-obese (age: 11.02 ± 1.01 years; height: 1.48 ± 0.07m; weight: 38.57 ± 6.09 kg; BMI: 17.44 ± 1.57 kg/m2) from Yulin Primary School in Fengtai District, Beijing, China participated in the study. There were no significant differences for ages and heights between two groups (p = 0.93, p = 0.46). All subjects signed the informed consent form. The study was approved by
Subphases during foot-ground contact
There were no significant differences between left and right foot for subphases during three movements for both groups.
There were no significant differences in duration of the heel strike phase between the two groups during three movements (walking: p = 0.92, jogging: p = 0.12, running: p = 0.71). Obese group showed significantly longer midstance phase (walking: 52.45% ± 10.22%, running: 49.88% ± 6.60%) and shorter propulsion phase (walking: 42.37% ± 8.26%, running: 47.82% ± 6.53%) than non-obese group
Discussion
This study investigated the characteristics of plantar pressure distribution for elementary students during their natural walking, jogging and running by using high frequency digital sampling technique for precise and comprehensive measurements. It has been reported that a detailed registration and analysis of foot-to-ground interaction could produce a detailed pressure image of the entire foot sole through high frequency digital sampling techniques [26].
The longer midstance phase duration is
Conclusions
In conclusion, the plantar pressure distribution during three movements changed differently between two groups. The peak pressures under most plantar regions and AIs for obese children during jogging are the largest among three movements. Because jogging causes more biomechanical burden on the feet of obese children compared with walking and running, obese children perhaps should not consider jogging as regular exercise in order to avoid possible lower extremity injury in the long-term.
Conflict of interest
The authors have no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.
Fund support
Beijing Natural Science Foundation of China (Grant 7152018), The Importation and Development of High-Caliber Talents Project of Beijing Municipal Institutions of China (Grant CIT&TCD201404177), The major project of Beijing Municipal Science and Technology Commission of China (Grant Z151100003715001), Natural Science Foundation Program and Scientific Research Key Program of Beijing Municipal Commission of Education of China (Grant KZ201310025010) and Research Fund for the Doctoral Program of
Acknowledgments
The authors would like to thank for financial support provided by the Beijing Natural Science Foundation of China, The major project of Beijing Municipal Science and Technology Commission of China, The Importation and Development of High-Caliber Talents Project of Beijing Municipal Institutions of China, Natural Science Foundation Program and Scientific Research Key Program of Beijing Municipal Commission of Education of China and Research Fund for the Doctoral Program of Higher Education of
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