Hunter J Bennett1, Guangping Shen2, Harold E Cates3, Songning Zhang4. 1. Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA. 2. Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN, USA. 3. Tennessee Orthopaedic Clinics, Knoxville, TN, USA. 4. Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN, USA. Electronic address: szhang@utk.edu.
Abstract
BACKGROUND: Increased peak external knee adduction moments exist for individuals with knee osteoarthritis and varus knee alignments, compared to healthy and neutrally aligned counterparts. Walking with increased toe-in or increased step width have been individually utilized to successfully reduce 1st and 2nd peak knee adduction moments, respectfully, but have not previously been combined or tested among all alignment groups. The purpose of this study was to compare toe-in only and toe-in with wider step width gait modifications in individuals with neutral, valgus, and varus alignments. METHODS: Thirty-eight healthy participants with confirmed varus, neutral, or valgus frontal-plane knee alignment through anteroposterior radiographs, performed level walking in normal, toe-in, and toe-in with wider step width gaits. A 3×3 (group×intervention) mixed model repeated measures ANOVA compared alignment groups and gait interventions (p<0.05). RESULTS: The 1st peak knee adduction moment was reduced in both toe-in and toe-in with wider step width compared to normal gait. The 2nd peak adduction moment was increased in toe-in compared to normal and toe-in with wider step width. The adduction impulse was also reduced in toe-in and toe-in with wider step width compared to normal gait. Peak knee flexion and external rotation moments were increased in toe-in and toe-in with wider step width compared to normal gait. CONCLUSION: Although the toe-in with wider step width gait seems to be a viable option to reduce peak adduction moments for varus alignments, sagittal, and transverse knee loadings should be monitored when implementing this gait modification strategy.
BACKGROUND: Increased peak external knee adduction moments exist for individuals with knee osteoarthritis and varus knee alignments, compared to healthy and neutrally aligned counterparts. Walking with increased toe-in or increased step width have been individually utilized to successfully reduce 1st and 2nd peak knee adduction moments, respectfully, but have not previously been combined or tested among all alignment groups. The purpose of this study was to compare toe-in only and toe-in with wider step width gait modifications in individuals with neutral, valgus, and varus alignments. METHODS: Thirty-eight healthy participants with confirmed varus, neutral, or valgus frontal-plane knee alignment through anteroposterior radiographs, performed level walking in normal, toe-in, and toe-in with wider step width gaits. A 3×3 (group×intervention) mixed model repeated measures ANOVA compared alignment groups and gait interventions (p<0.05). RESULTS: The 1st peak knee adduction moment was reduced in both toe-in and toe-in with wider step width compared to normal gait. The 2nd peak adduction moment was increased in toe-in compared to normal and toe-in with wider step width. The adduction impulse was also reduced in toe-in and toe-in with wider step width compared to normal gait. Peak knee flexion and external rotation moments were increased in toe-in and toe-in with wider step width compared to normal gait. CONCLUSION: Although the toe-in with wider step width gait seems to be a viable option to reduce peak adduction moments for varus alignments, sagittal, and transverse knee loadings should be monitored when implementing this gait modification strategy.
Authors: Guangping Shen; Songning Zhang; Hunter J Bennett; James C Martin; Scott E Crouter; Eugene C Fitzhugh Journal: J Sports Sci Med Date: 2018-05-14 Impact factor: 2.988
Authors: Iván Nacher Moltó; Juan Pardo Albiach; Juan José Amer-Cuenca; Eva Segura-Ortí; Willig Gabriel; Javier Martínez-Gramage Journal: Sensors (Basel) Date: 2020-11-12 Impact factor: 3.576