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Development of balance in overweight and obese children from 7 to 14 years old
ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116
S61
Results: Results followed up to three months showed a significant improvement in gait pattern, both clinically (mean dorsiflexion pretreatment 0◦ post treatment 5◦ ) and instrumentally (Table 1). Statistical analysis did not find significant changes at the ankle kinematics although differences in the kinematic pattern in the three planes of the space is evident from graph in dorsiflexion peak timing during stance (Fig. 1)
age groups (7–8, 9–10, 11–12 and 13–14). An AMTI AccuSway Plus force plate at a frequency of 100 Hz was used to measure the anterior–posterior amplitude (COPap), medio-lateral amplitude (COPml), mean velocity (COPvel) and 95% area of the ellipse (COParea) for three trials (30 s) standing in comfortable feet apart and eyes open. Pearson correlation coefficient and ANOVA (Tukey
Discussion and conclusions: Although this study is limited by a small number of patients and the lack a control group, preliminary results on a very well selected and documented sample of children are encouraging on the positive effects of Botulinum Toxin on ankle-foot kinematics during stance and on compensative anteversion in the pelvis. Improvement is evident at three months post injection. It is reasonable to interpret this time as necessary for musculo-skeletal reorganization. This pilot study will be used to design a RCT with a control group treated with a standard program of exercise and AFO.
post-hoc test) were used for statistical analysis. Results: Obese group had significant (p < 0.01) greater sway for 13–14 year olds than normal weight and overweight groups only for COParea. There is no other significant difference between groups. Moderate correlations are found between age and balance variables for normal weight and overweight groups as shown in Table 1 while obese group had poorest correlation with no-significant values for COParea, COPml and COPap. COPvel showed stronger correlation with age than the other measures for all groups. Discussion and conclusions: As to be expected, balance becomes better as age increases. Similarly with other studies postural balance was measured during quiet double leg stance using natural base of support. This less challenging foot position might explain the absence of BMI group differences. Significantly lower motor coordination in overweight and obese children when compared to normal-weight children on more dynamic situations reported in some studies support this idea. According to our results balance improves from 7 to 14 year olds in a similar way as in normal weight, overweight and obese children for quiet standing double leg posture. It seems related more with age than with weight status.
References [1] Hirsch G, et al. Acta Paediatrica 2004;93(February (2)):196–9. [2] Caselli MA, et al. Clinics in Podiatric Medicine and Surgery 1988;5(July (3)):547–59.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.135 P11 Development of balance in overweight and obese children from 7 to 14 years old Ana C. De David, Marcella M. Barbacena
Table 1 Pearson’s coefficient correlation values between age and COP variables.
University Of Brasilia, Physical Education Faculty, Brasilia, Brazil Introduction: In addition to the metabolic and cardiac diseases, already well documented, obesity affects the musculoskeletal development and may have long-term implications during adulthood. Gait analysis in obese children has showed differences in double support, stance, and swing phases of the gait cycle and diminished dynamic stability when compared to healthy children [1]. However, it is not clear how being overweight and obesity affect the postural balance during childhood and early adolescence. Increased instability and major dependency on vision system have been reported [2,3]. On the other hand, some investigations have found no differences between normal-weight and obese children balance during the quiet standing posture. Therefore, the purpose of this study was to verify the association between postural balance and age (from 7 to 14 years old) in obese, overweight and normal weight children. Patients/materials and methods: The postural balance of 438 subjects (201 normal weight, 136 overweight and 101 obese) using Cole et al. [4] was assessed. They were divided into four
Normal-weight Overweight Obese *
(n = 201) (n = 136) (n = 101)
COP Vel
COP Area
COP ML
COP AP
−.40* −.51* −.37*
−.39* −.42* −.12
−.41* −.47* −.18
−.26* −.34* −.06
Correlation is significant at the 0.01 level (2-tailed).
References [1] McGraw B, et al. Archives of Physical Medicine and Rehabilitation 2000;81:484–9. [2] Hue O, et al. Gait & Posture 2007;26:32–8. [3] D’Hont E, et al. Gait & Posture 2011;33:179–84. [4] Cole TJ, et al. British Medical Journal 2000;320:1–6.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.136
S61
Results: Results followed up to three months showed a significant improvement in gait pattern, both clinically (mean dorsiflexion pretreatment 0◦ post treatment 5◦ ) and instrumentally (Table 1). Statistical analysis did not find significant changes at the ankle kinematics although differences in the kinematic pattern in the three planes of the space is evident from graph in dorsiflexion peak timing during stance (Fig. 1)
age groups (7–8, 9–10, 11–12 and 13–14). An AMTI AccuSway Plus force plate at a frequency of 100 Hz was used to measure the anterior–posterior amplitude (COPap), medio-lateral amplitude (COPml), mean velocity (COPvel) and 95% area of the ellipse (COParea) for three trials (30 s) standing in comfortable feet apart and eyes open. Pearson correlation coefficient and ANOVA (Tukey
Discussion and conclusions: Although this study is limited by a small number of patients and the lack a control group, preliminary results on a very well selected and documented sample of children are encouraging on the positive effects of Botulinum Toxin on ankle-foot kinematics during stance and on compensative anteversion in the pelvis. Improvement is evident at three months post injection. It is reasonable to interpret this time as necessary for musculo-skeletal reorganization. This pilot study will be used to design a RCT with a control group treated with a standard program of exercise and AFO.
post-hoc test) were used for statistical analysis. Results: Obese group had significant (p < 0.01) greater sway for 13–14 year olds than normal weight and overweight groups only for COParea. There is no other significant difference between groups. Moderate correlations are found between age and balance variables for normal weight and overweight groups as shown in Table 1 while obese group had poorest correlation with no-significant values for COParea, COPml and COPap. COPvel showed stronger correlation with age than the other measures for all groups. Discussion and conclusions: As to be expected, balance becomes better as age increases. Similarly with other studies postural balance was measured during quiet double leg stance using natural base of support. This less challenging foot position might explain the absence of BMI group differences. Significantly lower motor coordination in overweight and obese children when compared to normal-weight children on more dynamic situations reported in some studies support this idea. According to our results balance improves from 7 to 14 year olds in a similar way as in normal weight, overweight and obese children for quiet standing double leg posture. It seems related more with age than with weight status.
References [1] Hirsch G, et al. Acta Paediatrica 2004;93(February (2)):196–9. [2] Caselli MA, et al. Clinics in Podiatric Medicine and Surgery 1988;5(July (3)):547–59.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.135 P11 Development of balance in overweight and obese children from 7 to 14 years old Ana C. De David, Marcella M. Barbacena
Table 1 Pearson’s coefficient correlation values between age and COP variables.
University Of Brasilia, Physical Education Faculty, Brasilia, Brazil Introduction: In addition to the metabolic and cardiac diseases, already well documented, obesity affects the musculoskeletal development and may have long-term implications during adulthood. Gait analysis in obese children has showed differences in double support, stance, and swing phases of the gait cycle and diminished dynamic stability when compared to healthy children [1]. However, it is not clear how being overweight and obesity affect the postural balance during childhood and early adolescence. Increased instability and major dependency on vision system have been reported [2,3]. On the other hand, some investigations have found no differences between normal-weight and obese children balance during the quiet standing posture. Therefore, the purpose of this study was to verify the association between postural balance and age (from 7 to 14 years old) in obese, overweight and normal weight children. Patients/materials and methods: The postural balance of 438 subjects (201 normal weight, 136 overweight and 101 obese) using Cole et al. [4] was assessed. They were divided into four
Normal-weight Overweight Obese *
(n = 201) (n = 136) (n = 101)
COP Vel
COP Area
COP ML
COP AP
−.40* −.51* −.37*
−.39* −.42* −.12
−.41* −.47* −.18
−.26* −.34* −.06
Correlation is significant at the 0.01 level (2-tailed).
References [1] McGraw B, et al. Archives of Physical Medicine and Rehabilitation 2000;81:484–9. [2] Hue O, et al. Gait & Posture 2007;26:32–8. [3] D’Hont E, et al. Gait & Posture 2011;33:179–84. [4] Cole TJ, et al. British Medical Journal 2000;320:1–6.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.136