Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study

Abstract Background Knee ‘unloading’ footwear can reduce the external knee adduction moment in people with knee osteoarthritis, yet effects of these shoes on regional plantar forces are unknown. We evaluated the effects of unloading shoes on in-shoe regional plantar forces, and whether measures of f...

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Main Authors: Joyce A. C. van Tunen, Kade L. Paterson, Tim V. Wrigley, Ben R. Metcalf, Jonas B. Thorlund, Rana S. Hinman
Format: Article
Language:English
Published: BMC 2018-06-01
Series:Journal of Foot and Ankle Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13047-018-0278-x
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author Joyce A. C. van Tunen
Kade L. Paterson
Tim V. Wrigley
Ben R. Metcalf
Jonas B. Thorlund
Rana S. Hinman
author_facet Joyce A. C. van Tunen
Kade L. Paterson
Tim V. Wrigley
Ben R. Metcalf
Jonas B. Thorlund
Rana S. Hinman
author_sort Joyce A. C. van Tunen
collection DOAJ
description Abstract Background Knee ‘unloading’ footwear can reduce the external knee adduction moment in people with knee osteoarthritis, yet effects of these shoes on regional plantar forces are unknown. We evaluated the effects of unloading shoes on in-shoe regional plantar forces, and whether measures of foot posture and/or mobility moderate these effects in people with symptomatic knee osteoarthritis. Methods In this exploratory study 21 participants underwent testing while wearing knee unloading shoes (ASICS GEL-Melbourne OA) and conventional shoes in random order. Peak total forces were compared across conditions for: lateral heel, medial heel, lateral forefoot, and medial forefoot. Arch index, centre of pressure position and medial-lateral heel peak force ratio were also evaluated. Foot posture, foot mobility magnitude and navicular drop were separately added to the mixed linear model to investigate if these modified the effect of footwear on outcomes. Results Unloading shoes significantly increased lateral heel and lateral forefoot force (12.9 and 20.2% respectively, all P < 0.001), with concurrent decreases in the medial heel (8.9%, P = 0.001) and medial forefoot (9.9%, P = 0.005). Unloading shoes significantly shifted the centre of pressure anteriorly (4.7%, P < 0.001) and laterally (5.6%, P = 0.034), but did not affect the arch index (8.7%, P = 0.093). Foot posture, foot mobility magnitude and navicular drop did not moderate the effect of footwear on outcomes. Conclusion Compared to conventional shoes, unloading shoes caused a lateral shift in foot pressure and force patterns. Although these effects were not moderated by foot posture, FMM or navicular drop, variability in the individual increases in lateral heel force suggests participant characteristics other than foot posture may play a role. Trial registration ACTRN12613000851763. Registered 02 August 2013.
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spelling doaj.art-fc958a2a8bd942f0971ff0a4cac77e842024-02-02T10:40:50ZengBMCJournal of Foot and Ankle Research1757-11462018-06-011111810.1186/s13047-018-0278-xEffect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory studyJoyce A. C. van Tunen0Kade L. Paterson1Tim V. Wrigley2Ben R. Metcalf3Jonas B. Thorlund4Rana S. Hinman5Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern DenmarkCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of MelbourneCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of MelbourneCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of MelbourneResearch Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern DenmarkCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of MelbourneAbstract Background Knee ‘unloading’ footwear can reduce the external knee adduction moment in people with knee osteoarthritis, yet effects of these shoes on regional plantar forces are unknown. We evaluated the effects of unloading shoes on in-shoe regional plantar forces, and whether measures of foot posture and/or mobility moderate these effects in people with symptomatic knee osteoarthritis. Methods In this exploratory study 21 participants underwent testing while wearing knee unloading shoes (ASICS GEL-Melbourne OA) and conventional shoes in random order. Peak total forces were compared across conditions for: lateral heel, medial heel, lateral forefoot, and medial forefoot. Arch index, centre of pressure position and medial-lateral heel peak force ratio were also evaluated. Foot posture, foot mobility magnitude and navicular drop were separately added to the mixed linear model to investigate if these modified the effect of footwear on outcomes. Results Unloading shoes significantly increased lateral heel and lateral forefoot force (12.9 and 20.2% respectively, all P < 0.001), with concurrent decreases in the medial heel (8.9%, P = 0.001) and medial forefoot (9.9%, P = 0.005). Unloading shoes significantly shifted the centre of pressure anteriorly (4.7%, P < 0.001) and laterally (5.6%, P = 0.034), but did not affect the arch index (8.7%, P = 0.093). Foot posture, foot mobility magnitude and navicular drop did not moderate the effect of footwear on outcomes. Conclusion Compared to conventional shoes, unloading shoes caused a lateral shift in foot pressure and force patterns. Although these effects were not moderated by foot posture, FMM or navicular drop, variability in the individual increases in lateral heel force suggests participant characteristics other than foot posture may play a role. Trial registration ACTRN12613000851763. Registered 02 August 2013.http://link.springer.com/article/10.1186/s13047-018-0278-xKnee osteoarthritisFootUnloadingFootwearPressureForce
spellingShingle Joyce A. C. van Tunen
Kade L. Paterson
Tim V. Wrigley
Ben R. Metcalf
Jonas B. Thorlund
Rana S. Hinman
Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study
Journal of Foot and Ankle Research
Knee osteoarthritis
Foot
Unloading
Footwear
Pressure
Force
title Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study
title_full Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study
title_fullStr Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study
title_full_unstemmed Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study
title_short Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis – an exploratory study
title_sort effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis an exploratory study
topic Knee osteoarthritis
Foot
Unloading
Footwear
Pressure
Force
url http://link.springer.com/article/10.1186/s13047-018-0278-x
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