Effects of a lower extremity exercise program on gait biomechanics and clinical outcomes in children and adolescents with obesity: A randomized controlled trial.


Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
05 2019
Historique:
received: 30 07 2018
revised: 25 02 2019
accepted: 26 02 2019
pubmed: 10 3 2019
medline: 12 7 2019
entrez: 10 3 2019
Statut: ppublish

Résumé

Research highlights the detrimental effects of obesity on gait biomechanics and the accompanied risk of lower-extremity skeletal malalignments, increased joint stress, pain and discomfort. Individuals with obesity typically show increased knee valgus angles combined with an increased step width. Accompanying muscular dysfunctions impede their ability to compensate for these alterations, especially in the frontal plane. To date, no studies are available, which evaluated the potential effects of an exercise program (EP) in reducing these unfavorable biomechanical changes. Is a 12-week EP, which includes hip abductor and knee extensor strength exercises and fosters dynamic knee alignment, effective in positively altering gait biomechanics in children and adolescents with obesity? This study was a randomized controlled trial having children and adolescents with obesity assigned to an EP (n = 19) or control (n = 16) group. Pain, self-rated knee function, muscle strength and 3D gait analysis during walking and stair climbing were evaluated. Results indicate that the EP was able to increase muscular strength especially in the hip abductors. In addition, children from the EP group walked with less maximum hip adduction and reduced pelvic drop during weight acceptance at follow-up. No changes were present in self-rated knee function, pain or discomfort. Even though effects were small, results indicate that an EP is an effective short-term possibility to counteract the progressive development of biomechanical malalignments of the lower extremity. Clinical parameters indicated that the program was feasible. Nonetheless, low adherence highlights the need to develop more attractive programs. CLINICAL TRIALS REG. NO: clinicaltrials.gov (NCT02545764).

Sections du résumé

BACKGROUND
Research highlights the detrimental effects of obesity on gait biomechanics and the accompanied risk of lower-extremity skeletal malalignments, increased joint stress, pain and discomfort. Individuals with obesity typically show increased knee valgus angles combined with an increased step width. Accompanying muscular dysfunctions impede their ability to compensate for these alterations, especially in the frontal plane. To date, no studies are available, which evaluated the potential effects of an exercise program (EP) in reducing these unfavorable biomechanical changes.
RESEARCH QUESTIONS
Is a 12-week EP, which includes hip abductor and knee extensor strength exercises and fosters dynamic knee alignment, effective in positively altering gait biomechanics in children and adolescents with obesity?
METHODS
This study was a randomized controlled trial having children and adolescents with obesity assigned to an EP (n = 19) or control (n = 16) group. Pain, self-rated knee function, muscle strength and 3D gait analysis during walking and stair climbing were evaluated.
RESULTS
Results indicate that the EP was able to increase muscular strength especially in the hip abductors. In addition, children from the EP group walked with less maximum hip adduction and reduced pelvic drop during weight acceptance at follow-up. No changes were present in self-rated knee function, pain or discomfort.
SIGNIFICANCE
Even though effects were small, results indicate that an EP is an effective short-term possibility to counteract the progressive development of biomechanical malalignments of the lower extremity. Clinical parameters indicated that the program was feasible. Nonetheless, low adherence highlights the need to develop more attractive programs. CLINICAL TRIALS REG. NO: clinicaltrials.gov (NCT02545764).

Identifiants

pubmed: 30851623
pii: S0966-6362(18)31334-1
doi: 10.1016/j.gaitpost.2019.02.032
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02545764']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

122-129

Informations de copyright

Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

Auteurs

B Horsak (B)

St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria. Electronic address: brian.horsak@fhstp.ac.at.

C Schwab (C)

St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria.

A Baca (A)

University of Vienna, Department of Biomechanics, Kinesiology and Computer Science in Sport, Vienna, Austria.

S Greber-Platzer (S)

Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna, Austria.

A Kreissl (A)

Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna, Austria.

S Nehrer (S)

Danube-University Krems, Center for Regenerative Medicine and Orthopedics, Krems, Austria.

M Keilani (M)

Medical University of Vienna, Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna, Austria.

R Crevenna (R)

Medical University of Vienna, Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna, Austria.

A Kranzl (A)

Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Vienna, Austria.

B Wondrasch (B)

St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria.

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