Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent
Article first published online: 28 FEB 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 3, pages 368–374, March 2012
How to Cite
Sacco, I. C. N., Trombini-Souza, F., Butugan, M. K., Pássaro, A. C., Arnone, A. C. and Fuller, R. (2012), Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent. Arthritis Care Res, 64: 368–374. doi: 10.1002/acr.20690
- Issue published online: 28 FEB 2012
- Article first published online: 28 FEB 2012
- Accepted manuscript online: 10 NOV 2011 11:15AM EST
- Manuscript Accepted: 1 NOV 2011
- Manuscript Received: 18 AUG 2011
- National Council for Scientific and Technological Development (CNPq). Grant Number: 480209/2007-3
- Coordination for Improvement of Higher Education Personnel (CAPES)
- State of Sao Paulo Research Foundation (FAPESP). Grant Number: 2011/01640-8
Previous studies indicate that flexible footwear, which mimics the biomechanics of walking barefoot, results in decreased knee loads in patients with knee osteoarthritis (OA) during walking. However, the effect of flexible footwear on other activities of daily living, such as descending stairs, remains unclear. Our objective was to evaluate the influence of inexpensive and minimalist footwear (Moleca) on knee adduction moment (KAM) during stair descent of elderly women with and without knee OA.
Thirty-four elderly women were equally divided into an OA group and a control group (CG). Stair descent was evaluated in barefoot condition, while wearing the Moleca, and while wearing heeled shoes. Kinematics and ground reaction forces were measured to calculate KAM by using inverse dynamics.
The OA group experienced a higher KAM during midstance under the barefoot condition (233.3%; P = 0.028), the Moleca (379.2%; P = 0.004), and heeled shoes (217.6%; P = 0.007). The OA group had a similar knee load during early, mid, and late stance with the Moleca compared with the barefoot condition. Heeled shoes increased the knee loads during the early-stance (versus barefoot [16.7%; P < 0.001] and versus the Moleca [15.5%; P < 0.001]), midstance (versus barefoot [8.6%; P = 0.014] and versus the Moleca [9.5%; P = 0.010]), and late-stance phase (versus barefoot [10.6%; P = 0.003] and versus the Moleca [9.2%; P < 0.001]). In the CG, the Moleca produced a knee load similar to the barefoot condition only during the early-stance phase.
Besides the general foot protection, the inexpensive and minimalist footwear contributes to decreasing knee loads in elderly women with OA during stair descent. The loads are similar to the barefoot condition and effectively decreased when compared with heeled shoes.