BACKGROUND This narrative review aimed to synthesize current evidence and propose an integrated conceptual framework for preventing recurrent musculoskeletal injuries in obese adolescents. METHODS A narrative synthesis of peer-reviewed literature was conducted across multiple scientific databases, focusing on published studies that examined injury risk, reinjury, physical training, recovery, and lifestyle factors in adolescents with overweight or obesity. RESULTS The evidence indicates that obese adolescents exhibit reduced relative strength, impaired neuromuscular control, altered movement mechanics, and compromised recovery capacity, all of which contribute to elevated reinjury risk. Strength and neuromuscular training emerge as foundational components for enhancing load tolerance and movement efficiency. Technology-based monitoring tools offer opportunities to individualize load progression and detect early maladaptation, while recovery processes such as sleep and fatigue management critically influence tissue adaptation. Lifestyle and behavioral factors further shape injury risk by affecting physical activity patterns, adherence, and recovery behaviors. CONCLUSION Preventing recurrent musculoskeletal injuries in obese adolescents requires a systems-based, multidimensional approach that extends beyond traditional rehabilitation paradigms. Integrating physical training, monitoring technologies, recovery strategies, and lifestyle considerations within a unified framework may improve injury resilience and support sustainable participation in physical activity.
Purpose : It is well described that adolescents with obesity show a higher cost of walking (Cw) compared with their lean counterparts, but it remains unknown how the degree of obesity and adiposity impact this Cw in this population. The present study, a secondary analysis of the EBOY cohort (Energy Balance and Obesity in Youth), explores the influence of the degree of obesity and adiposity on the Cw in adolescents with obesity. Method : The Cw was assessed using indirect calorimetry, and body composition was measured by dual-energy X-ray absorptiometry. Participants were divided into tertiles based on their anthropometrics and body composition outcomes. Results : The present study shows a tertile effect for body weight, z -score of body mass index, fat-free mass, and fat mass (FM; in kilograms) on gross and net absolute Cw ( P < .001), while there was only a FM (in percenatage) tertile effect on net absolute Cw ( P = .045). Conclusion : Cw in weight stable adolescents suffering from obesity seems to be mainly under the influence of the mechanical load imposed by the increase of body weight, z -score of body mass index, fat-free mass, and FM in kilograms, while the effects of the percentage of FM appears to be less clear and remains to be further explored.
Purpose: To investigate associations of physical activity (PA) and sedentary time accumulated from childhood to adolescence with arterial stiffness and structure in adolescence. Method: Altogether 175 (83 girls) children participated in the study (average baseline age 7.6 [0.4] y). Physical activity energy expenditure, PA, and sedentary time were estimated using a combined accelerometer and heart rate monitor at baseline and 2-and 8-year follow-ups. Cumulative exposures were computed using area under the curves. Carotid-femoral pulse wave velocity and cardio-ankle vascular index were assessed using impedance cardiography, and carotid artery distensibility and carotid intima-media thickness was assessed using ultrasonography. Data were analyzed using linear regression models adjusted for age and sex and separately for systolic blood pressure, body fat percentage, and pubertal stage. Results: No statistically significant associations were found in the complete sample or in boys (P > .05). Higher cumulative PA energy expenditure (beta = -0.260; 95% CI, -0.495 to -0.025) and moderate to vigorous PA (beta = -0.341; 95% CI, -0.570 to -0.112) were associated with lower carotid-femoral pulse wave velocity, and higher cumulative moderate to vigorous PA (beta = -0.346; 95% CI, -0.573 to -0.118) was associated with lower cardio-ankle vascular index at 8 years in girls. Conclusion: In girls, higher PA, especially moderate to vigorous PA, may slow arterial stiffening, whereas boys may already be physically active beyond levels that yield further benefits.
Purpose : Childhood obesity is a major public health issue linked to long-term metabolic disorders. Although aerobic exercise is often emphasized, evidence suggests that resistance exercise may also improve body composition in youth who are overweight or obese. This study aims to examine the effects of resistance-based exercise programs on fat mass, lean mass, body fat percentage, body weight, and body mass index in children and adolescents who are overweight or obese and to identify potential moderators of these effects. Methods : Eight electronic databases and 3 gray literature databases were searched from inception to May 2025. Randomized controlled trials involving resistance-based exercise programs in children and adolescents classified as overweight or obese were included. Data were extracted independently in duplicate, and random-effects meta-analyses were performed. Results : Twenty-four trials (n = 846 participants) were included. Resistance exercise significantly reduced fat mass (−2.06 kg), body fat percentage (−2.1%), and body weight (−1.3 kg), and increased lean mass (+0.8 kg), with small-to-moderate effect sizes (standardized mean difference = −0.35 to 0.33; P < .05). No significant moderating effects of age, sex, duration, volume, or intensity were identified. Conclusions : Resistance exercise improves body composition in children and adolescents who are overweight or obese.
