B Horsak1, C Schwab2, A Baca3, S Greber-Platzer4, A Kreissl4, S Nehrer5, M Keilani6, R Crevenna6, A Kranzl7, B Wondrasch2. 1. St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria. Electronic address: brian.horsak@fhstp.ac.at. 2. St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria. 3. University of Vienna, Department of Biomechanics, Kinesiology and Computer Science in Sport, Vienna, Austria. 4. Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna, Austria. 5. Danube-University Krems, Center for Regenerative Medicine and Orthopedics, Krems, Austria. 6. Medical University of Vienna, Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna, Austria. 7. Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Vienna, Austria.
Abstract
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).
RCT Entities:
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).
Authors: Luis Diego Méndez-Hernández; Esther Ramírez-Moreno; Rosario Barrera-Gálvez; María Del Consuelo Cabrera-Morales; Josefina Reynoso-Vázquez; Olga Rocío Flores-Chávez; Lizbeth Morales-Castillejos; Nelly Del Socorro Cruz-Cansino; Reyna Cristina Jiménez-Sánchez; José Arias-Rico Journal: Children (Basel) Date: 2022-07-01
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