Abstract
Previous studies investigating the effect of excessive weight on the foot have commonly been cross-sectional; therefore, it is still unclear how the foot function gradually changes with the increased body mass that is physiologically gained over time. This study aimed to use a load transfer method to identify the mechanism of how the foot function changed with the increased excessive body mass over two years. Taking normal weight as the baseline, fifteen children became overweight or obese (group 1), and fifteen counterparts maintained normal weight (group 0) over the two years. Barefoot walking was assessed using a Footscan® plate system. A load transfer method was used based upon the relative force–time integral (FTI) to provide an insight into plantar load transference as children increased in weight. Significantly increased FTIs were found at the big toe (BT), medial metatarsal (MM), lateral metatarsal (LM), and lateral heel (HL) in group 1, while at BT, MM, medial heel (HM), and HL in group 0. Foot load showed a posterior to anterior transferal from midfoot (2.5%) and heel (7.0%) to metatarsal and big toe in group 1. The control group, however, shifted the loading within the metatarsal level from LM to HM (4.1%), and equally relieved weight from around the midfoot (MF) (3.0%) to BT, MM, HM and HL. Earlier weight loss intervention is required to prevent further adverse effects on foot functions caused by excessive weight-bearing.
Highlights
Excessive body mass is known to be strongly associated with the development of musculoskeletal disorders, lower extremity postural deformities, and altered walking characteristics for children [1,2,3,4]
As the foot structure is in the process of development in children, childhood obesity may undermine the foot structure and foot function and further lead to the redistribution of foot loadings [5,6,7,8]
The gain of excessive body mass led to different load transferences compared to normal-weighted children
Summary
Excessive body mass is known to be strongly associated with the development of musculoskeletal disorders, lower extremity postural deformities, and altered walking characteristics for children [1,2,3,4]. Previous studies investigating the effect of increased weight on the plantar pressures and foot structural changes in children have commonly been cross-sectional [9,10,11,12]; obese/overweight children are compared with those of normal weight, but the temporal relationship of pathologic development on foot function with the increased excessive body mass is unknown. It is necessary to figure out how the foot function gradually changes with the increased excessive body mass that is physiologically gained over time. It is notable that with the increase in excessive body mass, distinctions exist between physiologic and pathologic development in children. A longitudinal study is needed to evaluate pathologic development with the gain of excessive body mass
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