Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 Sao Paulo, Brazil.
Gait Posture. 2011 May;34(1):126-30. doi: 10.1016/j.gaitpost.2011.03.026. Epub 2011 May 4.
Recent literature has highlighted that the flexibility of walking barefoot reduces overload in individuals with knee osteoarthritis (OA). As such, the aim of this study was to evaluate the effects of inexpensive, flexible, non-heeled footwear (Moleca) as compared with a modern heeled shoes and walking barefoot on the knee adduction moment (KAM) during gait in elderly women with and without knee OA. The gait of 45 elderly women between 60 and 70 years of age was evaluated. Twenty-one had knee OA graded 2 or 3 according to Kellgren and Lawrence's criteria, and 24 who had no OA comprised the control group (CG). The gait conditions were: barefoot, Moleca, and modern heeled shoes. Three-dimensional kinematics and ground reaction forces were measured to calculate KAM by inverse dynamics. For both groups, the Moleca provided peak KAM and KAM impulse similar to barefoot walking. For the OA group, the Moleca reduced KAM even more as compared to the barefoot condition during midstance. On the other hand, the modern heeled shoes increased this variable in both groups. Inexpensive, flexible, and non-heeled footwear provided loading on the knee joint similar to a barefoot gait and significant overload decreases in elderly women with and without knee OA, compared to modern heeled shoes. During midstance, the Moleca also allowed greater reduction in the knee joint loads as compared to barefoot gait in elderly women with knee OA, with the further advantage of providing external foot protection during gait.
最近的文献强调，赤脚行走的灵活性可减少膝骨关节炎（OA）患者的关节负荷。因此，本研究旨在评估廉价、灵活、无跟的鞋子（Moleca）与现代高跟鞋以及赤脚行走相比，对有膝 OA 和无膝 OA 的老年女性在行走时膝关节内收力矩（KAM）的影响。评估了 45 名 60-70 岁的老年女性的步态。21 名女性根据 Kellgren 和 Lawrence 的标准被评为 2 级或 3 级膝 OA，24 名无 OA 的女性为对照组（CG）。步态条件为：赤脚、Moleca 和现代高跟鞋。使用三维运动学和地面反作用力来通过反向动力学计算 KAM。对于两个组，Moleca 提供的峰值 KAM 和 KAM 冲量与赤脚行走相似。对于 OA 组，Moleca 在中足期的 KAM 比赤脚行走时更小。另一方面，现代高跟鞋在两组中均增加了该变量。与现代高跟鞋相比，廉价、灵活且无跟的鞋子为膝关节提供的负荷与赤脚行走相似，并且在有和没有膝 OA 的老年女性中均显著降低了关节负荷。在中足期，与赤脚行走相比，Moleca 还允许 OA 老年女性的膝关节负荷更大程度地降低，并且在行走时还具有提供外部足部保护的额外优势。
