Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea.
Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea.
Knee. 2021 Jun;30:305-313. doi: 10.1016/j.knee.2021.04.018. Epub 2021 May 18.
Varus alignment of the knee is a risk factor for developing knee osteoarthritis. Recently, voluntary shifting the plantar pressure distribution medially (medial foot loading) during gait has been found to reduce knee adduction angle during stance, which may lower the joint load. However, it is not yet known whether such effect would persist after long-term self-practice. This study aimed to determine whether medial foot loading can be an effective self-care protocol for reducing the knee adduction angle.
Eight subjects with asymptomatic varus knee alignment were trained on medial foot loading once in a laboratory, then carried out as self-practice for 8 weeks outside the laboratory. Spatiotemporal gait parameters and lower limb joint kinematics data were collected during natural walking prior to the training (baseline walking), during the practice session immediately after the initial training (trained walking), and during natural walking after the self-practice period (post-practice walking).
Participants walked significantly faster after the self-practice period with longer step length compared with the baseline. The knee adduction angle at initial contact, maximum angle during stance, and mean angle during a gait cycle were significantly decreased during both the trained and post-practice walking compared with baseline. The 8-week self-practice caused larger decrements in the three angles than the single training, but no significant differences were found between the two conditions.
Self-practice of medial foot loading walking could be an effective gait strategy to reduce the knee adduction angle. The effect could be sustained for individuals with asymptomatic varus knee alignment.
膝关节内翻是发展为膝骨关节炎的一个风险因素。最近，人们发现，在行走过程中，自愿将足底压力分布向内侧转移（内侧足加载），可以减少支撑期的膝关节内收角，从而降低关节负荷。然而，目前尚不清楚这种效果是否会在长期自我练习后持续存在。本研究旨在确定内侧足加载是否可以作为一种有效的自我护理方案，以减少膝关节内收角。
8 名无症状膝关节内翻的受试者在实验室中接受了一次内侧足加载训练，然后在实验室外进行了 8 周的自我练习。在训练前（基线行走）、初次训练后的练习期间（训练行走）和自我练习后进行自然行走期间（练习后行走），采集了时空步态参数和下肢关节运动学数据。
与基线相比，参与者在自我练习后行走速度明显加快，步长也更长。在初始接触、支撑期最大角度和步态周期平均角度时，膝关节内收角在训练和练习后行走时均明显低于基线。与单次训练相比，8 周的自我练习使这三个角度的降幅更大，但两种情况下无显著差异。
内侧足加载行走的自我练习可能是一种有效的步态策略，可以减少膝关节内收角。对于无症状膝关节内翻的个体，这种效果可以持续存在。
