Visual feedback gait re-training in overweight children can reduce excessive tibial acceleration during walking and running: An experimental intervention study

Abstract

BackgroundBeing overweight may increase the risk for developing stress fracture, as overweight adults and children were reported to have greater pressure peaks and rates under the heel during walking when compared with their normal-weight counterparts. Biofeedback gait retraining was shown to reduce ground impact magnitude in adults but not yet in children. Research questionThe study examined whether overweight children have greater tibia peak positive acceleration (PPA) at ground impact during fast walking and running compared to healthy weight children, and whether visual feedback gait retraining program can be used to reduce PPA in overweight children. MethodsTwenty five overweight and 12 healthy weight children participated in the study. Overweight children were randomly assigned into either feedback group or control no-feedback group of 8 sessions training program over 2-weeks. Tibia PPA at ground impact output from a wearable inertial sensor attached to the tibia was the feedback displayed on a monitor placed in front of the treadmill during walking and running. ResultsCompared to healthy weight children, overweight participants showed significant greater PPA values in running (p < 0.05), but not in fast walking. Feedback group significantly reduced PPA by 16% (p < 0.01), and these changes persisted at the 1-month follow-up. SignificanceTibia PPA may be used in evaluating overweight children as a risk assessment to potential injuries due to high ground impact during running. Gait retraining using real-time feedback of tibia PPA may be useful in rehabilitation programs to reduce ground impact in overweight children.