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

Authors

Nili Steinberg, Alon Eliakim, Liav Elbaz, Michal Pantanowitz, Aviva Zeev, Dan Nemet

Publisher

Phys Occup Ther Pediatr. 2020;40(3):330-344.

Publishing detail

PMID: 31591918

Abstract

Aim: To investigate differences in Achilles tendon structure between children with overweight/obesity and children with normal weight.

Methods: Twenty-two children with obesity, 10 children with overweight, and 44 children with normal weight participated in the study. BMI% was calculated. The Achilles tendon was examined using ultrasound tissue characterization (UTC) imaging to capture a three-dimensional structure of four echo-type fibers and a cross-sectional area.

Results: A significantly higher percentile of echo-types II, a lower percentile of echo-types III and IV, and a lower cross-sectional area were found for children with normal weight compared with children with overweight/obesity (p < .05). Following a piecewise linear regression model according to tendon structure, a BMI percentile of 75% was found to be the most accurate cutoff point of the children into the “unaffected” (BMI% <75%) and “affected” tendon structure groups (BMI% ≥ 75%), as the children with BMI%≥75% already had an Achilles tendon structure similar to that of the children with overweight/obesity.

Conclusions: Tendon integrity as examined with UTC differs between children with obesity and children with normal weight. Children with a BMI percentile of ≥75 already demonstrate a different tendon structure pattern compared with children with BMI percentile of <75. This may put children with obesity at a greater risk of injury and should be addressed when applying an exercise program for children with overweight/obesity.