The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight and o
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ORIGINAL ARTICLE
The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight and obesity Nili Steinberg 1 & Alon Eliakim 2 & Liav Elbaz 1 & Michal Pantanowitz 1,2 & Aviva Zeev 1 & Dan Nemet 2 Received: 7 December 2019 / Revised: 8 May 2020 / Accepted: 11 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
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.
Keywords Achilles tendon . Children . Obesity . Ultrasound
Communicated by Gregorio Paolo Milani * Nili Steinberg [email protected]
Aviva Zeev [email protected] Dan Nemet [email protected]
Alon Eliakim [email protected] Liav Elbaz [email protected]
1
The Wingate College of Physical Education and Sport Sciences, Wingate Institute, Netanya, Israel
Michal Pantanowitz [email protected]
2
Child Health and Sport Center, Pediatric Department, Meir Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Eur J Pediatr
Abbreviations BMI Body ma
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