A profile of musculoskeletal problems in children with obesity
Aims: To determine the presence of musculoskeletal disorders which may influence physical activity in children with obesity.
Methods: Flexibility, balance and lower limb range of movement (ROM) were measured in a group of obese children. The presence of lower limb pain was assessed using a pain profile and visual analogue scale. Past history of lower limb injury was recorded. Static and dynamic balance was measured by timed single-leg stance (SLS) tests and intramalleolar gap indicated level of genu valgum (Knock knees).
Results: 18 children (mean BMI=32.47±6.15 Kg/m2, mean age=11.88±2.29 yrs) participated. 50% of subjects (boys=11%, girls=39%) had received care for lower limb injuries and 38.9% had previous lower limb fractures (boys=11.1%, girls=27.8%). 72.2% of the group (boys=33.3%, girls=38.9%) had lower limb pain at the time of examination with foot pain (50%) being the most common pain site followed by knee (11.1%) and thigh pain (11.1%). Mean hip ROM for boys and girls were; flexion 110°±9, 105°±17; abduction 55°±5, 44°±9; extension 26°±5, 23°±4; internal rotation 46°±9, 44°±10; external rotation 59°±13, 68°±7. Mean knee and ankle ROM were: flexion 135°±4,130°±9; hyperextension 3°±2, 2°±3; dorsiflexion 93°±3,91°±6 for boys and girls respectively. Mean intramalleolar gap was 7.36±2.7cm for boys and 9.41±3.4cm for girls. Mean hamstring and quadriceps length for boys and girls were: 43°±9, 121°±13 and, 44°±5, 114°±11. Mean static and dynamic balance measures were 17s±9, 9s±6 for boys and 24s±26, 15±12 for girls.
Conclusions: Currently there are no normative paediatric values available for lower limb ROM, balance or levels of flexibility for comparison however, obese children do present with a number of musculoskeletal signs and symptoms that may affect or limit their time spent in physical activity.