Previous reports show that encouraging overweight children to adhere to exercise programs is
difficult because of the greater cardiopulmonary and biomechanical strain associated primarily with
weight-bearing activity [14,15,22,46]. The discomfort associated with transporting an overweight
body may result in pain in the lower extremities, breathing difficulty, and premature fatigue,
especially in severe conditions of obesity [21,22]. In addition, there are emerging data to indicate
that childhood obesity impairs fundamental motor skills. This, combined with a higher-energy cost
of locomotion, alters the obese child’s perception of exercise difficulty. Therefore, obese children
may experience negative consequences to participation in activities considered appropriate for
normal-weight children. Although walking looks relatively easy, it is an extremely complex biomechanical
process [47]. The excess weight that overweight children carry may affect their gait
pattern and posture. Therefore, the child’s gait pattern and posture should also be considered because
overweight children experience more gait and postural problems compared with normal-weight
children [47]. Exercises to improve their gait pattern, posture, and balance should be considered
when prescribing a physical activity program to overweight children [30].
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