Lower extremity pain is associated with reduced function and psychosocial health in obese children.

BACKGROUND: Childhood obesity is associated with reduced quality of life, physical fitness, and a higher prevalence of lower extremity (LE) pain; however, it is unclear whether and how these factors are related. QUESTIONS/PURPOSES: For this study we asked if obese children with LE pain (LE+) had higher BMI-Z scores, lower physical function and psychosocial health, and lower physical fitness compared with obese children without LE pain (LE-). We determined the association of BMI-Z score with physical function, psychosocial health, or physical fitness in obese children.
METHODS: Medical charts of 183 obese children were reviewed. Recorded data included anthropometrics, demographics, reports of musculoskeletal pain, Pediatric Quality of Life (PedsQL)-Physical Function score, PedsQL-Psychosocial Health score, and physical fitness levels. Data from 175 individuals were included in the analysis, with 51 in the LE+ group and 124 in the LE- group. Statistical analysis included Mann-Whitney U tests and Spearman's rank order correlations.
RESULTS: Between the LE+ and LE- groups, BMI-Z and physical fitness scores were not different. The LE+ group scored worse on the PedsQL-Physical Function scale (LE+: 72.4 [17.1], LE-: 79.5 [15.0]) and PedsQL-Psychosocial Health scale (LE+: 70.0 [16.1], LE-: 75.8 [16.3]). BMI-Z scores negatively correlated with PedsQL-Physical Function scores, PedsQL-Psychosocial Health scores, and physical fitness scores.
CONCLUSIONS: Our findings indicate that LE pain should be considered in the evaluation and management of children who are obese. LEVEL OF EVIDENCE: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.