Lower Extremity Biomechanics, Pediatric Obesity
Conditions
Keywords
Gait Analysis, Knee Adduction Moment, Physiotherapy, Obesity
Brief summary
Childhood obesity is one of the most critical and accelerating health challenges throughout the world. It is a major risk factor for developing varus/valgus misalignments of the knee joint. The combination of misalignment at the knee and excess body mass may result in increased joint stress and damage to articular cartilage. A training programme, which aims at developing a more neutral alignment of the trunk and lower limbs during movement tasks may be able to reduce knee loading during locomotion. Despite the large number of guidelines for muscle strength training and neuromuscular exercises that exists, most are not specifically designed to target the obese children and adolescent demographic. The purpose of this study is to evaluate a training programme which combines strength and neuromuscular exercises specifically designed to the needs and limitations of obese children and adolescents and analyse the effects of the training programme from a biomechanical and clinical point of view.
Interventions
OTHERStrength and neuromuscular exercise programme
12 weeks strength and neuromuscular exercise programme for the lower extremity
Sponsors
University of Vienna
Medical University of Vienna
Danube University Krems
St. Pölten University of Applied Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Male or female * Age: 10 -18 years * BMI greater than the 97th percentile * Availability: can participate in two exercises session per week for a period of 12 weeks
Exclusion criteria
* Present syndromes * Chronic joint diseases, osteoarthritic surgery or * Neuro-motor diseases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall peak external frontal knee moment and impulse | Baseline and 12 weeks | Assessed by 3D gait analysis during walking |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Physical examination | Baseline and 12 weeks | Changes of function and strength of the targeted muscle groups will be assessed by a physical therapist. Therefore, a hand-dynamometer to investigate differences in muscle strength will be used. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | Baseline and 12 weeks | The Austria-German version of the Knee Injury and Osteoarthritis Outcome Score will be used to assess the participants' opinion about their knee. |
| Gait pattern | Baseline and 12 weeks | Kinematics and external joint moments for the sagittal and frontal plane for hip, knee and ankle joints as well as spatio-temporal parameters will be assessed by 3D gait analysis during walking and stair climbing. |
| Adherence to the training programme | Participants will be followed for the duration of the intervention (12 weeks) | Adherence will be considered as the percentage of actually completed sessions during the intervention period among the number of intended exercise sessions. |
| Ratings of knee related pain | Participants will be followed for the duration of the intervention (12 weeks) | Ratings of knee related pain will be assessed using a 7-point ordinal scale. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cardiopulmonary testing | Baseline and 12 weeks | The influence of the training programme on aerobic fitness will be assessed by submitting the participants to a symptom-limited cardiopulmonary exercise testing on a cycle ergometer. |
| Anthropometric measures | Baseline and 12 weeks | The anthropometric evaluation will include the measurement of height, weight, waist circumference, hip circumference, waist-to-hip ratio and calculation of the body mass index. |
| Body Composition | Baseline and 12 weeks | Body composition parameters will include, fat mass, fat free mass, total body water, body cell mass, extracellular mass and lean body mass. |
| Nutritional status | Baseline and 12 weeks | The nutritional status will be assessed using the 24-hour recall method. This method records the daily, self-reported consumption of food-intake. In combination with a standardized nutritional food programme (EBISpro) the intake of macro- and micronutrients will be estimated. |
| Psychological status | Baseline and 12 weeks | The AD-EVA test inventory as well as the Child Behavior Checklist (CBCL/4 -18 ) will be used to determine the psychological status of the participants. |
| Blood samples | Baseline and 12 weeks | Quantification of routine blood sampling in obese patients and growth hormones and inflammation will be performed from venous blood samples in the Laboratory of the Department of Pediatrics and Adolescent Medicine at the Medical University of Vienna. |
Countries
Austria
Outcome results
None listed