Madden Elizabeth G, Kean Crystal O, Wrigley Tim V, Bennell Kim L, Hinman Rana S
1Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, AUSTRALIA; 2School of Human, Health, and Social Sciences, Central Queensland University, Rockhampton, Queensland, AUSTRALIA; and 3School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, AUSTRALIA.
Med Sci Sports Exerc. 2015 Jan;47(1):128-35. doi: 10.1249/MSS.0000000000000384.
This study evaluated the immediate effects of rocker-soled shoes on parameters of the knee adduction moment (KAM) and pain in individuals with knee osteoarthritis (OA).
Three-dimensional gait analysis was performed on 30 individuals (mean (SD): age, 61 (7) yr; 15 (50%) male) with radiographic and symptomatic knee OA under three walking conditions in a randomized order: i) wearing rocker-soled shoes (Skechers Shape-ups), ii) wearing non-rocker-soled shoes (ASICS walking shoes), and iii) barefoot. Peak KAM and KAM angular impulse were measured as primary indicators of knee load distribution. Secondary measures included the knee flexion moment (KFM) and knee pain during walking.
Peak KAM was significantly lower when wearing the rocker-soled shoes compared with that when wearing the non-rocker-soled shoes (mean difference (95% confidence interval), -0.27 (-0.42 to -0.12) N·m/BW × Ht%; P < 0.001). Post hoc tests revealed no significant difference in KAM impulse between rocker-soled and non-rocker-soled shoe conditions (P = 0.13). Both peak KAM and KAM impulse were significantly higher during both shoe conditions compared with those during the barefoot condition (P < 0.001). There were no significant differences in KFM (P = 0.36) or knee pain (P = 0.89) between conditions.
Rocker-soled shoes significantly reduced peak KAM when compared with non-rocker-soled shoes, without a concomitant change in KFM, and thus may potentially reduce medial knee joint loading. However, KAM parameters in the rocker-soled shoes remained significantly higher than those during barefoot walking. Wearing rocker-soled shoes did not have a significant immediate effect on walking pain. Further research is required to evaluate whether rocker-soled shoes can influence symptoms and progression of knee OA with prolonged wear.
本研究评估了摇摆底鞋对膝关节骨关节炎(OA)患者膝关节内收力矩(KAM)参数和疼痛的即时影响。
对30名经影像学检查确诊且有症状的膝关节OA患者(平均(标准差):年龄61(7)岁;15名(50%)男性)进行三维步态分析,在三种行走条件下按随机顺序进行:i)穿着摇摆底鞋(斯凯奇塑身鞋),ii)穿着非摇摆底鞋(亚瑟士步行鞋),iii)赤脚行走。测量峰值KAM和KAM角冲量作为膝关节负荷分布的主要指标。次要测量指标包括膝关节屈曲力矩(KFM)和行走时的膝关节疼痛。
与穿着非摇摆底鞋相比,穿着摇摆底鞋时的峰值KAM显著降低(平均差值(95%置信区间),-0.27(-0.42至-0.12)N·m/BW×Ht%;P<0.001)。事后检验显示,摇摆底鞋和非摇摆底鞋条件下的KAM冲量无显著差异(P=0.13)。与赤脚条件相比,两种鞋类条件下的峰值KAM和KAM冲量均显著更高(P<0.001)。不同条件下的KFM(P=0.36)或膝关节疼痛(P=0.89)无显著差异。
与非摇摆底鞋相比,摇摆底鞋显著降低了峰值KAM,且KFM无相应变化,因此可能潜在地减少膝关节内侧关节负荷。然而,摇摆底鞋的KAM参数仍显著高于赤脚行走时。穿着摇摆底鞋对行走疼痛没有显著的即时影响。需要进一步研究以评估摇摆底鞋长期穿着是否会影响膝关节OA的症状和进展。