Video-analysis of the effect of different types of adapted shoes on knee adduction moment

Background. The effect of different footwear profiles on knee adduction moment have not been fully studied. Methods. Fifteen healthy volunteer subjects, age 25.3 (±2.73), undertook a series of gait laboratory trials with adapted shoes. Kinematic and kinetic data were collect using 16 Oqus 3+ cameras and the walking speed was controlled using timing gates. High street shoes were adapted to include five different heel heights (varying from a 1.5 cm to 5.5 cm heels), two heel profile conditions (curved and semi-curved heels), three varying apex angles (10, 15, and 20 degrees), and barefoot and 3CR footwear conditions. The baseline shoe had no heel curve, a heel height of 3.5cm, an apex position of 62.5% of the shoe length, an apex angle of 15 deg, and a rigid forepart of the shoe. Results. The shoe with 5.5 cm heel height significantly increased the mean knee adduction moment during 50%–100% of the stance phase compared to the 1.5 cm heel (p = 0.008). The high heel shoe also significantly increased knee adduction impulse (area under the curve) versus the 1.5, 2.5, and 3.5 cm heels, and the 10° toe angle and barefoot condition. Ten degrees of toe angle reduced mean knee adduction moment during 0%–50% of the stance phase versus 20° and significantly reduced mean knee adduction moment during the late stance phase versus 15° and 20° toe angle footwear conditions. Walking with the curved heel for the healthy subjects increased mean knee adduction moment during 0%–50% of the stance phase compared to the heel without curvature (p < 0.0009). Conclusion. Further study is required to investigate those changes in patients with high risk of knee osteoarthritis.