ABSTRACT
Recent literature has highlighted that the flexibility of walking barefoot reduces overload in individuals with knee osteoarthritis (OA). As such, the aim of this study was to evaluate the effects of inexpensive, flexible, non-heeled footwear (Moleca) as compared with a modern heeled shoes and walking barefoot on the knee adduction moment (KAM) during gait in elderly women with and without knee OA. The gait of 45 elderly women between 60 and 70 years of age was evaluated. Twenty-one had knee OA graded 2 or 3 according to Kellgren and Lawrence's criteria, and 24 who had no OA comprised the control group (CG). The gait conditions were: barefoot, Moleca, and modern heeled shoes. Three-dimensional kinematics and ground reaction forces were measured to calculate KAM by inverse dynamics. For both groups, the Moleca provided peak KAM and KAM impulse similar to barefoot walking. For the OA group, the Moleca reduced KAM even more as compared to the barefoot condition during midstance. On the other hand, the modern heeled shoes increased this variable in both groups. Inexpensive, flexible, and non-heeled footwear provided loading on the knee joint similar to a barefoot gait and significant overload decreases in elderly women with and without knee OA, compared to modern heeled shoes. During midstance, the Moleca also allowed greater reduction in the knee joint loads as compared to barefoot gait in elderly women with knee OA, with the further advantage of providing external foot protection during gait.
Subject(s)
Gait/physiology , Leg/physiopathology , Osteoarthritis, Knee/physiopathology , Shoes/economics , Aged , Analysis of Variance , Biomechanical Phenomena , Body Mass Index , Case-Control Studies , Female , Humans , Middle Aged , Statistics, Nonparametric , Weight-BearingABSTRACT
OBJECTIVES: To investigate plantar pressure distribution in individuals with and without Patellofemoral Pain Syndrome during the support phase of stair descent. DESIGN: Observational case-control study. PARTICIPANTS: 30 young adults with Patellofemoral Pain Syndrome and 44 matched controls. MAIN OUTCOME MEASURES: Contact area, peak pressure and pressure-time integral (Novel Pedar-X system) were evaluated in six plantar areas (medial, central and lateral rearfoot; midfoot; medial and lateral forefoot) during stair descent. RESULTS: Contact area was greater in the Patellofemoral Pain Syndrome Group at medial rearfoot (p = 0.019) and midfoot (p < 0.001). Subjects with Patellofemoral Pain Syndrome presented smaller peak pressures (p < 0.001). CONCLUSION: The pattern of plantar pressure distribution during stair descent in Patellofemoral Pain Syndrome subjects was different from controls. This seems to be related to greater medial rearfoot and midfoot support. Smaller plantar loads found in Patellofemoral Pain Syndrome subjects during stair descent reveal a more cautious motor pattern in a challenging task.
