Achilles Tendon Tissue Structure in Children with Overweight and Children with Obesity

Area of Science:

• Pediatric Orthopedics
• Biomedical Engineering
• Sports Medicine

Background:

• Childhood obesity is a growing concern with potential musculoskeletal implications.
• The Achilles tendon's structural integrity may be affected by excess weight.
• Understanding these changes is crucial for injury prevention in children.

Purpose of the Study:

• To compare Achilles tendon structure in children with overweight/obesity versus normal weight.
• To identify specific structural differences using advanced imaging techniques.
• To determine if Body Mass Index (BMI) percentile correlates with tendon abnormalities.

Main Methods:

• Ultrasound Tissue Characterization (UTC) was used to analyze Achilles tendon fiber structure (echo-types) and cross-sectional area.
• Participants included 22 children with obesity, 10 with overweight, and 44 with normal weight.
• Body Mass Index percentile (BMI%) was calculated for all participants.

Main Results:

• Children with normal weight showed a higher percentile of echo-type II fibers and lower percentiles of echo-types III and IV compared to overweight/obese children.
• A significantly lower cross-sectional area of the Achilles tendon was observed in normal-weight children.
• A BMI percentile cutoff of 75% accurately distinguished between "affected" (BMI% ≥ 75%) and "unaffected" (BMI% < 75%) tendon structures.

Conclusions:

• Achilles tendon integrity, assessed by UTC, differs significantly between normal-weight and overweight/obese children.
• Children with a BMI percentile of 75% or higher already present with altered Achilles tendon structure.
• These structural changes may increase the risk of Achilles tendon injuries in overweight and obese children, necessitating tailored exercise programs.