Short communication| Volume 41, P77-81, January 2017

Relationship between body composition and vertical ground reaction forces in obese children when walking


      • Impact force during gait is positively related with body weight in obese children.
      • Impact force during gait is negatively with lean mass in obese children.
      • Propulsive rate is positively related with lean mass in obese children.
      • Body composition is an important factor to prevent high impact forces during gait.



      Obesity is now a serious worldwide challenge, especially in children. This condition can cause a number of different health problems, including musculoskeletal disorders, some of which are due to mechanical stress caused by excess body weight. The aim of this study was to determine the association between body composition and the vertical ground reaction force produced during walking in obese children.


      Sixteen children participated in the study, six females and ten males [11.5 (1.2) years old, 69.8 (15.5) kg, 1.56 (0.09) m, and 28.36 (3.74) kg/m2 of body mass index (BMI)]. Total weight, lean mass and fat mass were measured by dual-energy X-ray absorptiometry and vertical forces while walking were obtained by a force platform. The vertical force variables analysed were impact and propulsive forces, and the rate of development of both. Multiple regression models for each vertical force parameter were calculated using the body composition variables as input.


      The impact force regression model was found to be positively related to the weight of obese children and negatively related to lean mass. The regression model showed lean mass was positively related to the propulsive rate. Finally, regression models for impact and propulsive force showed a direct relationship with body weight.


      Impact force is positively related to the weight of obese children, but lean mass helps to reduce the impact force in this population. Exercise could help obese persons to reduce their total body weight and increase their lean mass, thus reducing impact forces during sports and other activities.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Arens R.
        • Muzumdar H.
        Childhood obesity and obstructive sleep apnea syndrome.
        J. Appl. Physiol. 1985; 108 (Bethesda Md. 2010 Feb): 436-444
      1. Centers for Disease Control and Prevention. Body Mass Index (BMI), Percentile Calculator for Child and Teen. Available from:

        • Chen C.T.
        • Burton-Wurster N.
        • Lust G.
        • Bank RA
        • Tekoppele J.M.
        Compositional and metabolic changes in damaged cartilage are peak-stress, stress-rate, and loading-duration dependent.
        J. Orthop. Res. 1999 Nov; 17: 870-879
        • Chomentowski P.
        • Dubé J.J.
        • Amati F.
        • Stefanovic-Racic M.
        • Zhu S.
        • Toledo F.G.S.
        • et al.
        Moderate exercise attenuates the loss of skeletal muscle mass that occurs with intentional caloric restriction-induced weight loss in older, overweight to obese adults.
        J. Gerontol. A Biol. Sci. Med. Sci. 2009 May; 64: 575-580
        • Danaei G.
        • Ding E.L.
        • Mozaffarian D.
        • Taylor B.
        • Rehm J.
        • Murray C.J.L.
        • et al.
        The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors.
        PLoS Med. 2009 Apr 28; 6e1000058
        • DE Sousa A.L.
        • Calçadas Dias Gabriel R.E.
        • Faria A.M.
        • Aragão F.R.
        • Rodrigues Moreira M.H.
        Behavior of temporal parameters of the ground reactive forces for the walking of postmenopausal women.
        Acta Bioeng. Biomech. 2015; 17 (Wroc Univ Technol.): 119-127
        • Frederick E.C.
        • Hagy J.L.
        Factors affecting peak vertical ground reaction forces in running.
        Int. J. Sport Biomech. 1986 Feb 1; 2: 41-49
        • Glass N.A.
        • Torner J.C.
        • Frey Law L.A.
        • Wang K.
        • Yang T.
        • Nevitt M.C.
        • et al.
        The relationship between quadriceps muscle weakness and worsening of knee pain in the MOST cohort: a 5-year longitudinal study.
        Osteoarthr. Cartil. 2013 Sep; 21: 1154-1159
        • Griffiths L.J.
        • Parsons T.J.
        • Hill A.J.
        Self-esteem and quality of life in obese children and adolescents: a systematic review.
        Int. J. Pediatr. Obes. 2010 Aug; 5: 282-304
        • Grotle M.
        • Hagen K.B.
        • Natvig B.
        • Dahl F.A.
        • Kvien T.K.
        Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up.
        BMC Musculoskelet. Disord. 2008; 9: 132
        • Hills A.P.
        • Hennig E.M.
        • Byrne N.M.
        • Steele J.R.
        The biomechanics of adiposity–structural and functional limitations of obesity and implications for movement.
        Obes. Rev. 2002 Feb; 3: 35-43
        • Kim J.-E.
        • Hsieh M.-H.
        • Soni B.K.
        • Zayzafoon M.
        • Allison D.B.
        Childhood obesity as a risk factor for bone fracture: a mechanistic study.
        Obesity (Silver Spring). 2013 Jul; 21: 1459-1466
        • l'Allemand-Jander D.
        Clinical diagnosis of metabolic and cardiovascular risks in overweight children: early development of chronic diseases in the obese child.
        Int. J. Obes. 2005; (2010 Dec): S32-S36
        • Lurbe E.
        • Carvajal E.
        • Torro I.
        • Aguilar F.
        • Alvarez J.
        • Redon J.
        Influence of concurrent obesity and low birth weight on blood pressure phenotype in youth.
        Hypertension. 2009 Jun; 53: 912-917
        • Lythgo N.
        • Wilson C.
        • Galea M.
        Basic gait and symmetry measures for primary school-aged children and young adults. II: walking at slow, free and fast speed.
        Gait Posture. 2011 Jan; 33: 29-35
        • Mauch M.
        • Grau S.
        • Krauss I.
        • Maiwald C.
        • Horstmann T.
        Foot morphology of normal, underweight and overweight children.
        Int. J. Obes. 2005; 32 (2008 Jul): 1068-1075
        • Messier S.P.
        • Ettinger W.H.
        • Doyle T.E.
        • Morgan T.
        • James M.K.
        • O'Toole M.L.
        • et al.
        Obesity: effects on gait in an osteoarthritic population.
        J. Appl. Biomech. 1996 May 1; 12: 161-172
        • Messier S.P.
        • Gutekunst D.J.
        • Davis C.
        • DeVita P.
        Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis.
        Arthritis Rheum. 2005 Jul; 52: 2026-2032
        • Messier S.P.
        • Beavers D.P.
        • Loeser R.F.
        • Carr J.J.
        • Khajanchi S.
        • Legault C.
        • et al.
        Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat.
        Med. Sci. Sports Exerc. 2014; 46: 1677
        • Øiestad B.E.
        • Juhl C.B.
        • Eitzen I.
        • Thorlund J.B.
        Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis.
        Osteoarthr. Cartil. 2015 Feb; 23: 171-177
        • Pamukoff D.N.
        • Lewek M.D.
        • Blackburn J.T.
        Greater vertical loading rate in obese compared to normal weight young adults.
        Clin. Biomech. (Bristol, Avon). 2016 Feb 23; 33: 61-65
        • Paulis W.D.
        • Silva S.
        • Koes B.W.
        • van Middelkoop M.
        Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review.
        Obes. Rev. 2014 Jan; 15: 52-67
        • Radin E.L.
        • Paul I.L.
        • Rose R.M.
        Role of mechanical factors in pathogenesis of primary osteoarthritis.
        Lancet Lond. Engl. 1972 Mar 4; 1: 519-522
        • Radin E.L.
        • Parker H.G.
        • Pugh J.W.
        • Steinberg R.S.
        • Paul I.L.
        • Rose R.M.
        Response of joints to impact loading. 3. Relationship between trabecular microfractures and cartilage degeneration.
        J. Biomech. 1973 Jan; 6: 51-57
        • Radin E.L.
        • Burr D.B.
        • Caterson B.
        • Fyhrie D.
        • Brown T.D.
        • Boyd R.D.
        Mechanical determinants of osteoarthrosis.
        Semin. Arthritis Rheum. 1991 Dec; 21: 12-21
        • Radin E.L.
        • Yang K.H.
        • Riegger C.
        • Kish V.L.
        • O'Connor J.J.
        Relationship between lower limb dynamics and knee joint pain.
        J. Orthop. Res. 1991 May; 9: 398-405
        • Schipplein O.D.
        • Andriacchi T.P.
        Interaction between active and passive knee stabilizers during level walking.
        J. Orthop. Res. 1991 Jan; 9: 113-119
        • Segal N.A.
        • Glass N.A.
        • Torner J.
        • Yang M.
        • Felson D.T.
        • Sharma L.
        • et al.
        Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort.
        Osteoarthr. Cartil. 2010 Jun; 18: 769-775
        • Sharma L.
        • Dunlop D.D.
        • Song J.
        • Hayes K.W.
        Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
        Ann. Intern. Med. 2003; 138: 613-619
        • Singh A.S.
        • Mulder C.
        • Twisk J.W.R.
        • van Mechelen W.
        • Chinapaw M.J.M.
        Tracking of childhood overweight into adulthood: a systematic review of the literature.
        Obes. Rev. 2008 Sep; 9: 474-488
        • Smith S.M.
        • Sumar B.
        • Dixon K.A.
        Musculoskeletal pain in overweight and obese children.
        Int. J. Obes. 2005; 38 (2014 Jan): 11-15
        • Stovitz S.D.
        • Pardee P.E.
        • Vazquez G.
        • Duval S.
        • Schwimmer J.B.
        Musculoskeletal pain in obese children and adolescents.
        Acta Paediatr. 1992; 97 (Oslo Nor. 2008 Apr): 489-493
        • Syed I.Y.
        • Davis B.L.
        Obesity and osteoarthritis of the knee: hypotheses concerning the relationship between ground reaction forces and quadriceps fatigue in long-duration walking.
        Med. Hypotheses. 2000 Feb; 54: 182-185
        • Taylor E.D.
        • Theim K.R.
        • Mirch M.C.
        • Ghorbani S.
        • Tanofsky-Kraff M.
        • Adler-Wailes D.C.
        • et al.
        Orthopedic complications of overweight in children and adolescents.
        Pediatrics. 2006 Jun; 117: 2167-2174
        • Thorpe D.E.
        • Dusing S.C.
        • Moore C.G.
        Repeatability of temporospatial gait measures in children using the GAITRite electronic walkway.
        Arch. Phys. Med. Rehabil. 2005 Dec; 86: 2342-2346