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The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight
Nili Steinberg1, Alon Eliakim2, Liav Elbaz3
1The Wingate College of Physical Education and Sport Sciences, Wingate Institute, Netanya, Israel. knopp@wincol.ac.il.
Insights
Childhood obesity negatively impacts Achilles tendon structure, but a 6-month multidisciplinary program improved tendon characteristics in overweight children. This intervention positively altered fiber types and cross-sectional area, suggesting benefits for pediatric obesity management.
Area of Science:
- Pediatric Endocrinology
- Sports Medicine
- Biomedical Engineering
Background:
- Childhood obesity is linked to orthopedic issues and physical activity limitations.
- The specific effects of obesity on tendon structure and the impact of interventions remain largely unknown.
Purpose of the Study:
- To investigate how a 6-month multidisciplinary obesity management program influences Achilles tendon structure in overweight/obese children.
- To compare tendon structure changes between overweight/obese children and normal-weight controls.
Main Methods:
- Ultrasound tissue characterization was used to analyze Achilles tendon structure (fiber types, cross-sectional area) in 25 overweight/obese children and 27 controls over 6 months.
- Anthropometric measurements, including BMI, were recorded at baseline, 3 months, and 6 months.
Main Results:
- The overweight group showed a significant decrease in BMI post-intervention (p=.002).
- Intervention led to decreased echo type I and III fibers, and increased echo type II fibers and cross-sectional area in the overweight group.
- Pre-intervention, overweight children had poorer tendon structure (lower echo type II, higher echo type III) compared to controls.
Conclusions:
- Overweight/obese children exhibit altered Achilles tendon structure compared to normal-weight peers.
- A 6-month multidisciplinary obesity management program positively modifies Achilles tendon structure in children.
- The intervention improved tendon fiber composition and cross-sectional area, suggesting a beneficial effect on musculoskeletal health.
Abstract:
The effects of childhood obesity on tendon structure and its relation to physical activity are barely known. We aimed to investigate the influence of a 6-month multidisciplinary childhood obesity management program (which included dietary intervention and an exercise program) on Achilles tendon structure in overweight/obese children. Twenty-five overweight/obese children (overweight group) who participated in a 6-month multidisciplinary childhood obesity program, and 27 normal-weight controls were examined for anthropometric measurements and for Achilles tendon structure (using ultrasound tissue characterization to capture a three-dimensional structure of four echo type fibers and the cross-sectional area) at baseline, 3, and 6 months. The BMI of the overweight group significantly decreased from the pre- to the post-intervention period, (p = .002, η2 = .229), yet among the control group, the BMI significantly increased (p = .002, η2 = .222). Interactions (pre-post × group) showed a significant decrease in the prevalence of echo type I and in echo type III fibers and a significant increase in the prevalence of echo type II fibers and in the cross-sectional area along the intervention. No significant changes in echo type fibers were found in the control group along the 6 months.Conclusion: At pre-intervention, the overweight group had significantly "worse" tendon structure, with a lower prevalence of echo type II fiber and a higher prevalence of echo type III fibers compared with the control group. Following the 6-month intervention, the tendon structure of the overweight group was "positively" changed, with reduced echo type III fibers and increased echo type II fibers. What is Known: • Physical activity and weight reduction programs are efficient for obese children. • Obese children tend to suffer orthopedic problems and pain during physical activity. What is New: • Pre-intervention, obese children had 'worse' tendon structure compared to controls. • Following 6-month program, tendon structure of obese children 'positively' changed.
