Abnormal Foot Morphology Among Children with Obesity and the Potential Implications for Public Health

Introduction Promoting physical activity is a key component of all childhood obesity intervention programs. Unfortunately, physical activity puts greater strain on the musculoskeletal system. Children with obesity have been shown to have foot instability and gait abnormalities, which may result in overuse injuries that might interfere with exercise and physical activities. Methods We assessed the foot morphology and gait of 40 children with body mass index (BMI) ≥97.3 percentile (11.4 ± 1.4 yr; 75% girls; 17 White, 5 Black, 18 Hispanic) who enrolled in a 2-wk residential summer camp program. A visual assessment and a pressure mapping MatScan were done, and each child was rated for risk of lower-extremity musculoskeletal pain. Lower-extremity musculoskeletal pain during the first 2 d of camp was recorded. Body weight and height of each child were measured prior to and after the 2-wk camp. Results Pronation was diagnosed in 93% of the children. Abducted gait, pes planus, and genu valgum were each present in half of the children. Approximately 73% of children reported lower extremity pain. Prediction of risk showed substantial agreement (kappa = 0.624, P < 0.01) with pain. Significant improvements ( P < 0.001) in body weight (−3.6 kg), BMI (−1.53 kg·m −2 ), BMI percentile (−0.37), and BMI z -scores (−0.235) were detected in the cohort, with no significant differences based on the presence or absence of pain. Conclusions We hypothesize that treating abnormal foot morphology and gait with supportive shoes, accommodative insoles, and/or prescription orthotics might present an effective approach to prevent pain and overuse injuries and thereby encourage and maintain physical activity among children with obesity.