OBESITY / CLINICAL RESEARCH
Influence of childhood overweight and obesity on foot and lower limb pain in a population of primary school children
More details
Hide details
1
Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Instituto de Investigacion Biomedica de Malaga (IBIMA), Malaga, Spain
2
Hospital Universitario Virgen de la Victoria, Unidad de Hospitalización de Salud Mental, Campus de Teatinos, Malaga, Spain
3
Primary Health Care Centre Arroyo de la Miel (Benalmadena), Health District Costa del Sol, Malaga, Spain
4
Department of Physiotherapy, University of Seville, Sevilla, Spain
5
Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
6
Department of Nursing, Frailty and Cognitive Impairment Organized Group (FROG), C/Jaume Roig SN, University of Valencia, Valencia, Spain
7
Primary Health Care Centre San Miguel (Torremolinos), Health District Costa del Sol, Malaga, Spain
Submission date: 2020-06-02
Final revision date: 2020-06-16
Acceptance date: 2020-06-21
Online publication date: 2020-07-08
Publication date: 2026-04-30
Corresponding author
Emmanuel Navarro-Flores
Department of Nursing
Frailty and Cognitive
Impairment Organized
Group (FROG)
C/Jaume Roig SN
University of Valencia
Valencia, Spain
Arch Med Sci 2026;22(2):695-701
KEYWORDS
TOPICS
ABSTRACT
Introduction:
In childhood, juvenile obesity affects the functional characteristics of the lower limb, predisposing children to pain, discomfort and musculoskeletal comorbidities. This cross-sectional descriptive study analyses the relationship between childhood overweight/obesity and foot/lower limb pain in a population of primary school children.
Material and methods:
The study population consisted of 150 children aged 9–12 years recruited at a primary school in Malaga (Spain). None had pathologic feet. Anthropometric and demographic data were compiled by questionnaire and by personal interview. Among other variables, the foot posture index was calculated and knee alignment was measured. In the statistical analysis, the dependent variables considered were foot and lower limb pain, and the predictor variables were age, sex, body mass index, sports activity, foot posture index and knee alignment. A descriptive analysis of these variables was performed, together with an association analysis (using the c2 test) and a multivariate analysis (using binary logistic regression).
Results:
In the study sample, 47.3% were girls, 15.3% were overweight and 12.7% obese. The overall prevalence of foot pain was 10.7% and that of lower limb pain, 27.3%. Of the study variables analyzed, the only ones significantly related to both foot pain and lower limb pain were overweight and obesity.
Conclusions:
Overweight and obesity are the main factors related to pain in the feet and lower limbs in primary school children.
REFERENCES (35)
1.
Mollo Tangara JC, Valdivie Rojas N. 2. V17N1_a10. Rev Científica Cienc Médica 2014; 17: 37-42.
2.
Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obes Rev Suppl 2004; 5 Suppl 1: 4-104.
3.
Onís M De, Onyango AW, Borghi E, Siyam A, Siekmann J. Investigación El desarrollo de un patrón de crecimiento de la OMS para los niños y adolescentes en edad escolar. 2007; 043497: 660-7.
4.
Reynoso-Sánchez LF, Flores JRH, García-Dávila M, et al. Cortisol y estrés-recuperación durante un periodo competitivo en jugadores de balonmano. Rev Psicol del Deport 2017; 26: 125-31.
5.
Rubio AM, Moreno AMS, Martínez Rubio A, Soto Moreno AM. Plan Integral de Obesidad Infantil de Andalucía 2007-2012. 2006.
6.
Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, Ramos-Carrera N, Lázaro-Masedo S. Prevalencia de obesidad general y obesidad abdominal en la población adulta española (25-64 años) 2014-2015: estudio ENPE. Rev Esp Cardiol 2016; 69: 579-87.
7.
Tsiros MD, Coates AM, Howe PRC, Grimshaw PN, Buckley JD. Obesity: the new childhood disability? Obes Rev 2011; 12: 26-36.
8.
Shultz SP, Browning RC, Schutz Y, Maffeis C, Hills AP. Childhood obesity and walking: guidelines and challenges. Int J Pediatr Obes 2011; 6: 332-41.
9.
McMillan AG, Pulver AME, Collier DN, Williams DSB. Sagittal and frontal plane joint mechanics throughout the stance phase of walking in adolescents who are obese. Gait Posture 2010; 32: 263-8.
10.
Gijon-Nogueron G, Montes-Alguacil J, Martinez-Nova A, Alfageme-Garcia P, Cervera-Marin JA, Morales-Asencio JM. Overweight, obesity and foot posture in children: a cross-sectional study. J Paediatr Child Health 2017; 53: 33-7.
11.
Dawe EJC, Davis J. Anatomy and biomechanics of the foot and ankle. Orthop Trauma 2011; 25: 279-86.
12.
López López D, Bouza Prego M de LÁ, Requeijo Constenla A, Saleta Canosa JL, Bautista Casasnovas A, Tajes FA. The impact of foot arch height on quality of life in 6-12 year olds. Colomb Medica 2014; 45: 168-72.
13.
Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, López-López D, et al. Slow velocity of the center of pressure and high heel pressures may increase the risk of Sever’s disease: a case-control study. BMC Pediatr 2018; 18: 357.
14.
Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg 2014; 12: 1500-24.
15.
Palomo-López P, López-López D, Becerro-De-Bengoa-Vallejo R, et al. Concurrent validity of the foot health status questionnaire and study short form 36 for measuring the health-related quality of life in patients with foot problems. Medicine 2019; 55: 750.
16.
Redmond AC, Crane YZ, Menz HB. Normative values for the Foot Posture Index. J Foot Ankle Res 2008; 1: 6.
17.
Brzeziński M, Czubek Z, Niedzielska A, Jankowski M, Kobus T, Ossowski Z. Relationship between lower-extremity defects and body mass among polish children: a cross-sectional study. BMC Musculoskelet Disord 2019; 20: 84.
18.
Rerucha CM, Dickison C, Baird DC. Lower extremity abnormalities in children. Am Fam Physician 2017; 96: 226-33.
19.
Dobbe AM, Gibbons PJ. Common paediatric conditions of the lower limb. J Paediatr Child Health 2017; 53: 1077-85.
20.
Gijon-Nogueron G, Martinez-Nova A, Alfageme-Garcia P, Montes-Alguacil J, Evans AM. International normative data for paediatric foot posture assessment: a cross-sectional investigation. BMJ Open 2019; 9: e023341.
21.
Holt GR. Declaration of Helsinki – The World’s Document of Conscience and Responsibility. South Med J 2014; 107: 407-7.
22.
Smith SM, Sumar B, Dixon KA. Musculoskeletal pain in overweight and obese children. Int J Obes 2014; 38: 11-5.
23.
Bout-Tabaku S, Briggs MS, Schmitt LC. Lower extremity pain is associated with reduced function and psychosocial health in obese children pediatrics. Clin Orthop Relat Res 2013; 471: 1236-44.
24.
Butterworth PA, Landorf KB, Smith SE, Menz HB. The association between body mass index and musculoskeletal foot disorders: a systematic review. Obes Rev 2012; 13: 630-42.
25.
Yan SH, Zhang K, Tan GQ, Yang J, Liu ZC. Effects of obesity on dynamic plantar pressure distribution in Chinese prepubescent children during walking. Gait Posture 2013; 37: 37-42.
26.
Brady SRE, Mamuaya BB, Cicuttini F, et al. Body composition is associated with multisite lower body musculoskeletal pain in a community-based study. J Pain 2015; 16: 700-6.
27.
Maciałczyk-Paprocka K, Stawińska-Witoszyńska B, Kotwicki T, et al. Prevalence of incorrect body posture in children and adolescents with overweight and obesity. Eur J Pediatr 2017; 176: 563-72.
28.
Gonçalves De Castro G, De M, Santos F, et al. Sobrepeso e obesidade infantil: fatores predisponentes para alterações ortopédicas Overweight and obesity in children: predisposing factors for orthopedic alterations. Fisioter Bras 2017; 18: 426-58.
29.
Mahaffey R, Morrison SC, Bassett P, Drechsler WI, Cramp MC. The impact of body fat on three dimensional motion of the paediatric foot during walking. Gait Posture 2016; 44: 155-60.
30.
Carvalho BKG, Penha PJ, Penha NLJ, Andrade RM, Ribeiro AP, João SMA. The influence of gender and body mass index on the FPI-6 evaluated foot posture of 10- to 14-year-old school children in São Paulo, Brazil: a cross-sectional study. J Foot Ankle Res 2017; 10: 1.
31.
Walsh TP, Butterworth PA, Urquhart DM, et al. Increase in body weight over a two-year period is associated with an increase in midfoot pressure and foot pain. J Foot Ankle Res 2017; 10: 4-11.
32.
Kuryliszyn-Moskal A, Hryniewicz A, Bagiński N, Moskal-Jasińska D, Dzięcioł-Anikiej Z, Dzięcioł J. Foot static disturbances and clinical features in overweight patients with rheumatoid arthritis. Arch Med Sci 2023; 19: 1774-80.
33.
Eker Y, Kaygısız B. The effect of pain severity on balance, postural stability and fall risk in patients with shoulder pathologies. Arch Med Sci 2021; 17: 390-6.
34.
Będzichowska A, Przekora J, Stapińska-Syniec A, et al. Frequency of infections caused by ESBL-producing bacteria in pediatric ward – single center five-year observation. Arch Med Sci 2019; 15: 688-93.
35.
Ramos Galván J, Tovaruela Carrión N, López López D, González Elena ML. Strategies to promote podiatric health, after 10 years. Atencion Primaria 2016; 48: 67-8.