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The effect of different types of adapted footwear con-ditions on medial loading of the knee: implications for use by people with high risk of knee osteoarthritis

Keywords:

A.Yu. Aksenov - Ph. D. (Doctor of Philosophy) University of Salford; Assistant, Department of Biotechnical Systems, Saint-Petersburg Electrotechnical University «LETI» E-mail: a.aksenov@hotmail.com T.A. Klishkovskaya - Bachelor, Department of Biotechnical Systems, Saint-Petersburg Electrotechnical University «LETI» E-mail: tatianaklishkov@mail.ru


Lateral wedges have been suggested for treating patients with knee osteoarthrits, however, the effect of different footwear profiles on knee abduction moment have not been fully studied. This study investigates the effects of different rocker soles on kinetics of medial compartment of the knee of healthy subjects. Fifteen volunteer healthy subjects, age range 20–29 (mean 25.3 2.73) undertook a seies of gait laboratory trials with shoes adapted with specifically chosen outsole features. High street shoes were adapted with the test conditions which included shoes with five different heel heights (varying from a 1.5 cm to 5.5 cm heels), two heel profile conditions (curved and semi curved geels) three with varying apex angles (10, 15, and 20 deg.), barefoot and 3CR footwear condition. The baseline shoe was taken as being one with no heel curve, a heel height of 3.5 mm, an apex position of 62.5% of shoe length, and apex angle of 15 deg. and a stiff forepart to the shoe. Measurement and comparisons were taken of lower limb kinetics and kinematics (Qualysis, Sweden) during walking trials where the walking speed was controlled using timing gaits. Data were analysed using Visual3D (C-Motion). Results changes from the baseline shoe were taken as being at a level of significance of p < 0.05 Results: The shoe with 5.5 cm heel height significantly increased mean knee abduction moment during 50–100 % stance phase when compared to 1.5 cm heel (p=0.08). High heel shoe also increased knee abduction impulse (area under the curve) versus 1.5 cm, 3.5 cm heel, 10 toe angle and barefoot to significant level p<0.001. Ten degree of toe angle reduced mean knee abduction moment during 0–50 %of stance phase versus 20 and significantly reduced mean knee abduction moment during the late stance phase versus 15 and 20 toe angle footwear conditions respectively. Walking with the curved heel on the healthy subjects increased mean knee abduction moment during 0-50% on the stance phase when compared to the heel without curvature (p < 0.0009). The 3Cr condition which has slightly curved heel, elevated heel height (≈5 cm heel height) and increased toe angle (≈18) significantly loaded knee abduction moment during the whole stance phase and increased knee abduction impulse when compared to all footwear conditions. Walking with elevated heel height, curved heel and increased toe angle above 15 may significantly load medial part of the knee. Further study is required to investigate those changes on patients with high risk of knee osteoarthritis.
References:

 

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