Pediatric Obesity: Implications for Fall Injuries

Sayegh, Rockan; Bradley, Darlene; Vaca, Federico E.

doi:10.1016/j.jen.2009.12.009

Cited by 2 publications

(4 citation statements)

References 29 publications

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“…Decreased tactile sensitivity has been implicated in adverse postural outcomes in children with obesity . Decreased plantar cutaneous sensation adversely impacted critical movement performance determinants like leg stiffness regulation during hopping .…”

Section: Introductionmentioning

confidence: 99%

Obesity, but not overweight, is associated with plantar light touch sensation in children aged 8 to 16 years: A cross‐sectional study

Ajisafe

Gilson

Garcia

et al. 2020

Obesity Science & Practice

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Summary Objective Increased foot‐ground contact loading engenders adaptive glabrous skin thickening and can decrease mechanoreceptor acuity and alter plantar cutaneous sensation. There has not been any research on whether overweight and obesity are similarly associated with normal plantar cutaneous sensation scores in children. This study investigated the associations between normal plantar cutaneous sensation scores and weight status (i.e., healthy weight, overweight, and obesity) in a sample of youth. Methods Plantar sensation was tested among 122 participants aged 8 to 16 years (10.3 ± 1.8 years; 140.0 ± 11.2 cm; 44.2 ± 16.0 kg) across the forefoot, midfoot, and rearfoot using Semmes‐Weinstein pressure aesthesiometry (0.07 g and 0.4 g monofilaments). Weight status was determined using the Centers for Disease Control and Prevention growth charts. Age‐ and sex‐adjusted models were used to explore the relationships between normal plantar sensation scores and weight status. Significant two‐tailed tests were set at p < .05. Results Only obesity was inversely associated with normal plantar sensation scores on the left (β = −.241; p = .009) and right (β = −.222; p = .018) forefeet, left (β = −.322; p = .001) and right (β = −.253; p = .007) midfeet, and left (β = −.286; p = .002) and right (β = −.228; p = .014) wholefeet (relative to healthy weight) when using the 0.07 g monofilament. There was no association between obesity and plantar sensation when using the 0.4 g monofilament. Conclusions Obesity is associated with diminished light touch plantar sensation. Considering previously reported higher mechanical loading and the fact that Merkel cells and the Aβfibers that innervate them are superficial to the hypodermis, adaptive glabrous skin thickening (rather than fat pad thickness) may underlie this association. Contrary to previous suggestions, overweight is not associated with decreased plantar cutaneous sensation.

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Section: Introductionmentioning

confidence: 99%

Obesity, but not overweight, is associated with plantar light touch sensation in children aged 8 to 16 years: A cross‐sectional study

Ajisafe

Gilson

Garcia

et al. 2020

Obesity Science & Practice

View full text Add to dashboard Cite

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“…Previous studies underlined the linear association between obesity and fall risk, that is, greater obesity relates to greater falling risk (Himes & Reynolds, 2012;Mitchell et al, 2014;Rosenblatt & Grabiner, 2012). In particular, balance impairment, poor postural stability and lack of coordination, resulting from excessive body fat accumulation, are reported to be strictly related to the greater falling risk in the obese population (Sayegh et al, 2010). Moreover, due to the fact that obese subjects usually fall with more impact related to their dimension, this population is at higher risk for T A B L E 1 Characteristics of the study sample and those of the sub-groups of fallers, non-fallers, high-risk, and low-risk for falling severe injuries due to falls (Rosenblatt & Grabiner, 2012;Sayegh et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…In this respect, it is well-known that obesity causes many functional physical limitations which frequently reduce the ability to perform common daily routine activities (Bray et al, 2016). Impairment in balance and coordination, as a consequence of abnormal fat distribution and inadequate postural stability, seem to be related to a greater falling risk in the obese population (Sayegh et al, 2010). In addition, due to the fact that obese individuals usually fall with more impact related to their body dimension, this population is at higher risk for severe injuries due to falls (Rosenblatt & Grabiner, 2012;Sayegh, et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…Impairment in balance and coordination, as a consequence of abnormal fat distribution and inadequate postural stability, seem to be related to a greater falling risk in the obese population (Sayegh et al, 2010). In addition, due to the fact that obese individuals usually fall with more impact related to their body dimension, this population is at higher risk for severe injuries due to falls (Rosenblatt & Grabiner, 2012;Sayegh, et al, 2010). For all the above reasons, in-hospital fall prevention, especially in the pediatric obese population, is fundamental to avoid accidents and to guarantee the safety of patients.…”

Section: Introductionmentioning

confidence: 99%

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Use of a Pediatric Obesity Fall‐risk Scale (POFS) in 301 hospitalized obese children and adolescents

Tamini

Cicolini

Porcu

et al. 2021

Specialist Pediatric Nursing

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Purpose: Falls are a significant safety risk in hospitalized patients, but little evidence regarding their significance in obese children are available to date. Aim of the study was to determine whether the Pediatric Obesity Fall-risk Scale (POFS) is able to discriminate between hospitalized obese pediatric patients at high or low risk of falling, to evaluate its sensitivity and specificity and to analyze if the risk factors considered were actually related to the falling event.Design and Methods: The sample consisted of 301 children and adolescents hospitalized for a body weight reduction program. In this 12-month study, 14.6% of patients experienced a fall during hospitalization, the fall rate per 1000 patient days being 5.33 for the first and 4.36 for the second 6-month of the year. The components of the POFS included chronological age, history of falls, body mass index standard deviation score (BMI-SDS), and the ability to maintain equilibrium.Results: No differences were observed between fallers and nonfallers as far as BMI and BMI-SDS are concerned. Compared with patients who did not fall, those who fell were significantly younger and shorter and their weights were lower. The POFS identified 85 patients with high and 216 with low falling risk, the two subgroups being comparable for BMI and BMI-SDS. Compared with patients with low fall-risk, those with high fall-risk were significantly younger and shorter and their weights were lower. The sensitivity of the POFS was 61.4%, while the specificity was 77.4%. The positive predictive value of the POFS was 31.8%, while the negative predictive value was 92.1%. The analyses of each POFS component did not show significant differences between fallers and nonfallers in terms of BMI-SDS and equilibrium test. Compared with patients who did not fall, those who fell were significantly younger, experienced a fall during the 3 months prior the admission in hospital and their total POFS score was higher.Practice Implications: Preventing falls in hospitalized obese pediatric patients is challenging due to the markedly increased risk of this population and specific fall-risk assessment tools are required to early identify patients who needs more care, attention, and specific nursing/medical interventions.

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Pediatric Obesity: Implications for Fall Injuries

Cited by 2 publications

References 29 publications

Obesity, but not overweight, is associated with plantar light touch sensation in children aged 8 to 16 years: A cross‐sectional study

Obesity, but not overweight, is associated with plantar light touch sensation in children aged 8 to 16 years: A cross‐sectional study

Use of a Pediatric Obesity Fall‐risk Scale (POFS) in 301 hospitalized obese children and adolescents

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