Factors of modern lifestyle influencing gait pattern alterations in elementary school children: a mini review

Development of gait in elementary school children represents a sensitive period of locomotor maturation; however, contemporary lifestyle factors such as heavy school backpack carriage, inappropriate footwear, and the increasing prevalence of overweight and obesity can disrupt normal biomechanical gait patterns and potentially compromise musculoskeletal health. This mini review synthesizes current evidence on how selected modern lifestyle factors influence gait biomechanics in elementary school-aged children (approximately 6-14 years). Based on a comprehensive review of 35 highly relevant studies, the evidence reveals that three primary lifestyle factors significantly alter children's gait biomechanics: backpack carriage, footwear characteristics, and childhood obesity. Backpack loads exceeding 10%-12% of body weight consistently produce alterations in spatiotemporal parameters, ground reaction forces, and postural control. Footwear design, particularly sole flexibility, heel elevation, and barefoot vs. shod conditions modifies foot kinematics, plantar pressure distribution, and joint mechanics. Childhood overweight and obesity induce substantial changes in gait velocity, stride characteristics, joint loading patterns, and plantar pressures. These findings have important implications for school health policies, footwear recommendations, and obesity prevention programs. The evidence underscores the need for multifaceted interventions addressing these modifiable lifestyle factors to promote healthy musculoskeletal development and prevent long-term locomotor dysfunction in children.