What is the Impact of Excessive Body Mass on the Biomechanical Walking Characteristics in 7 to 11 Year Old Children

Childhood obesity is associated with multiple health co-morbidities and various musculoskeletal disorders, affecting the lower limb and feet. Limited research has been undertaken which quantifies the impact of obesity on the function of the paediatric foot and lower limb. Furthermore, it is yet undetermined whether overweight children display similar functional changes as their obese counterparts. The primary aim of this research was to advance understanding on foot function and lower limb biomechanical movement characteristics in children; analysing differences between obese, overweight and normal weight children. Having determined the reliability of the measurement protocols, 100 children were recruited for assessment of body mass status and plantar foot loading. Following this, a sub-group of 45 children were recruited and three-dimensional gait analysis was undertaken. Plantar foot loading and lower limb temporal-spatial, kinematic and kinetic gait characteristics were analysed during barefoot level walking. Multiple regression was undertaken to determine relationships between body mass status, foot loading and lower limb gait biomechanics. Findings demonstrated that overweight and obese children displayed marked differences in foot loading and lower limb gait biomechanics when compared to normal weight children. The research identified that increased loading at the midfoot and 2nd- 5th metatarsals significantly predicted change in the kinematic and kinetic walking parameters at the hip and ankle in overweight and obese children. These findings provide evidence of an atypical biomechanical function of the foot and lower limb. This work advances understanding on the implications of excessive body mass on the functional characteristics of the paediatric foot and lower limb. This research identifies for the first time, differences in foot loading and lower limb gait biomechanics in overweight and obese children relative to those of normal weight. This work also provides important information as to the use of plantar pressure assessment in predicting change to the lower limb biomechanical movement characteristics of these children. This work underpins the need for further longitudinal work that further enhances our understanding on the consequences of excessive body mass on the foot and lower limb musculoskeletal and locomotor systems in children

The reliability of plantar pressure assessment during barefoot level walking in children aged 7-11 years

Background: Plantar pressure assessment can provide information pertaining to the dynamic loading of the foot, as well as information specific to each region in contact with the ground. There have been few studies which have considered the reliability of plantar pressure data and therefore the purpose of this study was to investigate the reliability of assessing plantar pressure variables in a group of typically developing children, during barefoot level walking. Methods: Forty-five participants, aged 7 to 11 years, were recruited from local primary and secondary schools in East London. Data from three walking trials were collected at both an initial and re-test session, taken one week apart, to determine both the within- and between-session reliability of selected plantar pressure variables. The variables of peak pressure, peak force, pressure-time and force-time integrals were extracted for analysis in the following seven regions of the foot; lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint, hallux and the lesser toes. Reliability of the data were explored using Intra Class Correlation Coefficients (ICC 3,1 and 3,2) and variability with Coefficients of Variation (CoV’s). Results: The measurements demonstrated moderate to good levels of within-session reliability across all segments of the foot (0.69-0.93), except the lesser toes, which demonstrated poor reliability (0.17-0.50). CoV’s across the three repeated trials ranged from 10.12-19.84% for each of the measured variables across all regions of the foot, except the lesser toes which demonstrated the greatest variability within trials (27.15-56.08%). The between-session results demonstrated good levels of reliability across all foot segments (0.79-0.99) except the lesser toes; with moderate levels of reliability reported at this region of the foot (0.58-0.68). The CoV’s between-sessions demonstrated that the midfoot (16.41-36.23%) and lesser toe region (29.64-56.61) demonstrated the greatest levels of variability across all the measured variables. Conclusions: These findings indicate that using the reported protocols, reliable plantar pressure data can be collected in children, aged 7 to 11 years in all regions of the foot except the lesser toes which consistently reported poor-to-moderate levels of reliability and increased variability

Foot loading patterns in normal weight, overweight and obese children aged 7 to 11 years

Background: Childhood obesity is thought to predispose to structural foot changes and altered foot function. Little is currently understood about whether similar changes occur in overweight children. The aim of this study was determine foot loading characteristics in obese, overweight and normal weight children aged 7 to 11 years during level walking. Methods: Dynamic plantar pressures were measured in 22 obese, 22 overweight and 56 normal weight children recruited from local primary and secondary schools in East London. Peak pressure, peak force, normalised peak force, pressure–time and force-time integrals were analysed at six regions of the plantar foot: lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint and hallux. A one-way ANOVA was used to test for significant differences in variables across the groups. Where differences existed Tukey post-hoc tests were used to ascertain the location of the difference. Results: Children who were obese and overweight demonstrated significantly (p<0.05) higher peak pressures and peak forces as well as significantly higher force-time and pressure–time integrals under the midfoot and 2nd-5th metatarsal regions. After normalisation of peak force, similar trends existed where the obese and overweight children demonstrated significantly (p<0.05) greater loading at the midfoot and 2nd-5th metatarsals. Conclusion: Findings from this study indicated that overweight children, as young as seven, displayed differences in foot loading during walking, when compared with normal weight children. These findings were consistent with loading patterns of children who were obese and suggest that early assessment and intervention may be required in overweight children to mitigate against the development of musculoskeletal complications associated with excessive body mass

Mini‐review: The Promise of Piezoelectric Polymers

Recent advances provide new opportunities in the field of polymer piezoelectric materials. Piezoelectric materials provide unique insights to the fundamental understanding of the solid state. In addition, piezoelectric materials have a wide range of applications, representing billions of dollars of commercial applications. However, inorganic piezoelectric materials have limitations that polymer ferroelectric materials can overcome, if certain challenges can be addressed. This mini-review is a practical summary of the current research and future directions in the investigation and application of piezoelectric materials with an emphasis on polymeric piezoelectric materials. We will assume that the reader is well versed in the subject of polymers, however, not as familiar with piezoelectric materials

Current Understanding of the Impact of Childhood Obesity on the Foot and Lower Limb

Childhood obesity has emerged in recent years as a major public health problem. As this continues to concern across local, national and international populations, and as our understanding of obesity advances, access to multi-disciplinary care and understanding of the complications is warranted. Recent findings have suggested that the musculoskeletal system is one of the multiple body systems compromised by obesity and that aberrant biomechanical function may be a precursor to the onset of musculoskeletal symptoms. This review will consider childhood obesity and its impact on the paediatric foot and lower limb through examination of literature on foot structure and biomechanics of gait. An overview of evidence-based management is out with the context of this review, however some recommendations for clinical practice will be proposed

The reliability of plantar pressure assessment during barefoot level walking in children aged 7-11 years

<p>Abstract</p> <p>Background</p> <p>Plantar pressure assessment can provide information pertaining to the dynamic loading of the foot, as well as information specific to each region in contact with the ground. There have been few studies which have considered the reliability of plantar pressure data and therefore the purpose of this study was to investigate the reliability of assessing plantar pressure variables in a group of typically developing children, during barefoot level walking.</p> <p>Methods</p> <p>Forty-five participants, aged 7 to 11 years, were recruited from local primary and secondary schools in East London. Data from three walking trials were collected at both an initial and re-test session, taken one week apart, to determine both the within- and between-session reliability of selected plantar pressure variables. The variables of peak pressure, peak force, pressure-time and force-time integrals were extracted for analysis in the following seven regions of the foot; lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint, hallux and the lesser toes. Reliability of the data were explored using Intra Class Correlation Coefficients (ICC 3,1 and 3,2) and variability with Coefficients of Variation (CoV's).</p> <p>Results</p> <p>The measurements demonstrated moderate to good levels of within-session reliability across all segments of the foot (0.69-0.93), except the lesser toes, which demonstrated poor reliability (0.17-0.50). CoV's across the three repeated trials ranged from 10.12-19.84% for each of the measured variables across all regions of the foot, except the lesser toes which demonstrated the greatest variability within trials (27.15-56.08%). The between-session results demonstrated good levels of reliability across all foot segments (0.79-0.99) except the lesser toes; with moderate levels of reliability reported at this region of the foot (0.58-0.68). The CoV's between-sessions demonstrated that the midfoot (16.41-36.23%) and lesser toe region (29.64-56.61) demonstrated the greatest levels of variability across all the measured variables.</p> <p>Conclusions</p> <p>These findings indicate that using the reported protocols, reliable plantar pressure data can be collected in children, aged 7 to 11 years in all regions of the foot except the lesser toes which consistently reported poor-to-moderate levels of reliability and increased variability.</p