Análise da influência de um calçado flexível e desprovido de salto sobre a mecânica da marcha e a carga articular de indivíduos com osteoartrite de joelho / Influence of flexible footwear and without heel on the gait mechanics and joint loading in individuals with knee osteoarthritis

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

The literature has been given evidences that the use of flexible and non-heeled footwear that reproduces the kinematic and kinetic characteristics of barefoot gait may reduce the joint loads and the progression of the knee osteoarthritis (OA). The purpose of this study was to evaluate and compare the influence of the acute use of flexible, non-heeled and inexpensive footwear (Moleca®), with a modern heeled shoe and barefoot condition on the lower limb kinetic and kinematic patterns during gait in elderly women with and without knee OA. The gait of 45 elderly women was evaluated: 21 with OA grade 2 or 3 (OAG) according to Kellgren and Lawrence´s criteria and 24 asymptomatic control group (CG) between 60 and 75 years. Vertical and horizontal ground reaction force, ankle, knee and hip sagittal angular variation were acquired in the follow conditions: barefoot, Moleca® and heeled shoe. Knee adduction moments and angular impulse were also calculated by inverse dynamics. Comparisons intergroups and inter-conditions were performed by two-way ANOVAs, and the three gait conditions were within factors. In both groups, the acute use of Moleca® produced ankle sagittal angular variation similar to barefoot condition. In the sagittal plane, the use of Moleca® and heeled shoe generated an increased knee range of motion and increased knee final flexion in both groups. In the OAG, the heeled shoe imposed an increased hip flexion compared to the barefoot condition. In both groups, the heeled shoe and Moleca® increased the 1st vertical force peak in comparison to barefoot condition. Moreover, the magnitude of this variable was even greater when using the heeled shoe compared to the Moleca®. In the OAG, the acute use of Moleca® provided greater attenuation of the vertical force in midstance. Also in the OAG, the Moleca® provided greater capacity of deceleration and acceleration in comparison to the heeled shoe. In both groups, the Moleca® provided joint loads to the knee medial compartment similar to barefoot gait. Moleca®, however, was even more effective than barefoot gait in reducing the knee loads during midstance. We conclude that flexible, nonheeled and inexpensive footwear (Moleca®), in elderly women with knee OA, due to the association of the lower limb kinematics and ground reaction force characteristics, provides loads on the knee joint similar to barefoot gait and a significant reduction of overloads in comparison to the heeled shoe. The Moleca® also allows, in some gait support phases, a greater reduction in the knee joint load compared to the barefoot gait; however, with the advantage of providing external protection to the feet during gait.

ASSUNTO(S)

marcha gait joelho osteoartrite knee calçado osteoarthritis shoe

ACESSO AO ARTIGO

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