Biomedical Engineering Reference
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Fig. 5 A sample of the plantar pressure distribution during walking for an obese child (left) and
a non-obese prepubertal child (right), both aged 8 years
inadequate activity levels [
81
,
82
]. High levels of obesity can even limit an
individual's ability to perform the fundamental activity of walking [
83
,
84
]. It has
been postulated that the high pressures generated beneath the feet of obese adults
during walking can cause lower extremity pain and discomfort and may result in
musculoskeletal degeneration [
85
], which can be severe enough to reduce the level
of physical activity of obese individuals [
86
] (see
Sect. 4.3.2
). However, the effect
of high plantar pressures upon the developing feet of children is less well known.
As obese children generate significantly higher dynamic peak plantar pres-
sures compared to normal-weight children of a similar age, it has been suggested
that these high pressures may limit the amount and type of physical activity
obese children participate in. However, only one study could be found that
investigated whether higher plantar pressures were related to physical activity
levels in overweight and obese school-aged children [
87
]. The study investigated
a group of 73 overweight and obese children (aged 8.3 ± 1.1 years, 47 girls,
BMI z-score 2.7 ± 0.7) who participated in an obesity treatment trial that
combined physical activity skill-development and a dietary modification program
[
88
]. The children's physical activity was objectively measured using acceler-
ometers, and their plantar pressure was measured while the children walked over
a pressure platform. The authors found that children who generated greater
pressures beneath their forefoot and midfoot during walking had lower levels of
physical activity. Although statistically significant, the correlations between the
plantar pressures and physical activity levels were low. This warrants further
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