Joint Impact of Lower Extremities in Obese and Overweight Children Jenny Patel and Benjamin Sweely Tickle College of Engineering November 16th, 2017
Impact
340 Million Children Aged 5-19 in 2016 World Health Organization (WHO)
Consequences Marymount University
Consequences Marymount University
How Childhood Obesity affects Joint Pain Consequences Marymount University
Overview Background Previous Studies Proposal
Defining Childhood Overweight and Obesity Body Mass Index Overweight: BMI > 25 Obese: BMI > 30 World Health Organization
Gait Comparison Studies
Elongation of Cycle Length Greater Midstance Duration Widened Bases of Support by having their toes-out to increase stability Foot Supination Calf Rotation
Increased Pelvic Obliquity Range of Motion Reduced Early Stance Knee Flexion Angles Lerner, Z. F., Shultz, S. P., Board, W. J., Kung, S., & Browning, R. C.
Comparison Lerner, Z. F., Shultz, S. P., Board, W. J., Kung, S., & Browning, R. C.
Increased Stress Pain Many studies report children experience lower extremity pain Hips, Knees, Ankles, Feet As weight increases, more pressure on joints and cartilages Sets up Soft Tissue for Inflammation
How do you Reduce the Stress?? Studies suggest exercise programs and nutrition guides
Reduce Joint Pain by Modifying Gait
Previous Studies Implications Singh 2016 Fatigue from cardiovascular activities leads to increase in joint moments This increase leads to problems performing physical activities
Previous Studies Real time wearable sensors Hanlon 2009 Force sensitive resistors and accelerometers Can be placed according to what needs to be measured Can give real time data that is useful to user
Previous Studies Gait Modification Reinbolt 2007 Nonsurgical approach as an alternative to surgery Can be done in various ways to affect different joints Gait modification -> Gait retraining
Proposed Research Subject Pool 40 Members Ages 9-12 Overweight or Obese Task Collect Data and Analyze for Stresses and Forces on joints Control - before modifications Gait Modification
Proposed Research Use motion capture and force plates to gather relative data Inverse dynamics package OpenSim Use data to make a proposed gait modification Examples that will be tested More toe-in stance More bend in knee during early stance phase
No modification, normal walking gait Sensors and force plates save data and compare to initial Final data is collected and compared to previous Initial Data Collection Modification 1 Data 2 Final Modification Resulting Data Participants walk with a more toe-in stance and higher knee flex Participants are asked to adjust their stance again based on Data 2
Proposal Future project: Use result from experiment to make a sensor package Sensor package can be worn during daily activities Links to phone for real time results and suggestions Suggestions on gait modification tips and other fun stuff
Questions?
References a. Lerner, Z. F., Shultz, S. P., Board, W. J., Kung, S., & Browning, R. C. (2014). Does adiposity affect muscle function during walking in children? Journal of Biomechanics, 47(12), 2975-2982. doi:10.1016/j.jbiomech.2014.07.006 a. Meron Rubinstein, Alon Eliakim, nili Steinberg, Dan Nemet, Moshe Ayalon, Aviva Zeev, Michal Pantaonwitz & Tamar Brosh (2017): Biomechanical characteristics of overweight and obese children during five different walking and running velocities, Footwear Science, DOI: 10.1080/19424280.2017.1363821 a. Browning, R., Kram, R., & Brynes, W. (2006). Effects of Obesity on the Biomechanics of Walking at different speeds. Medicine & Science in Sports & Exercise, 38 (Supplement). doi:10.1249/00005768-200605001-00896 a. Strutzenberger, G., Richter, A., Schneider, M., Mündermann, A., & Schwameder, H. (2011). Effects of obesity on the biomechanics of stair-walking in children. Gait & Posture, 34(1), 119-125. doi:10.1016/j.gaitpost.2011.03.025 a. Yan, S., W. Ren, X. Liang, & K. Zhang (2015). Gait characteristics of overweight and obese children with different ages. International Congress on Image and Signal Processing, 7, 493-498. doi:10.1109/bmei.2014.7002767 a. Lerner, Z.F., W.J. Board, & R.C. Browning (2016). Pediatric obesity and walking duration increase medial tibiofemoral compartment contact forces. Journal of Orthopaedic Research, 97-105. doi: 10.1002/jor.23028 a. Zachary F. Lerner, Raymond C. Browning (2015). Compressive and shear hip joint contact forces are affected by pediatric obesity during walking. Journal of Biomechanics, 49(9), 1547.
References H. Singh, B., Negatu, M., Francis, S., Janz, K., & Yack, H. (2016). Do fitness and fatigue affect gait biomechanics in overweight and obese children? Gait & Posture., 50, 190-195. doi: 10.1016/j.gaitpost.2016.09.006 I. Browning, R.C. (2012). Locomotion mechanics in obese adults and children. Current Obesity Report, 1, 152-159. J. Clark, K. N. (2004). Balance and Strength Training for Obese Individuals. ACSMs Health & Fitness Journal, 8(1), 14-20. doi:10.1097/00135124-200401000-00008 K. Fregly, B. J. (2011). Gait Modification to Treat Knee Osteoarthritis. HSS Journal, 8(1), 45-48. doi:10.1007/s11420-011-9229-9