Abdulhadi H M, Kerrigan D C, LaRaia P J
Harvard Medical School Department of Physical Medicine and Rehabilitation, Boston, MA 02114, USA.
Arch Phys Med Rehabil. 1996 Jul;77(7):670-2. doi: 10.1016/s0003-9993(96)90006-4.
Evaluate the effect of a contralateral shoe-lift on the oxygen cost of walking with an artificially immobilized knee.
A prospective quantitative evaluation of oxygen cost of walking under varying conditions. Subjects walked (1) normally (N), (2) with one knee immobilized (1), (3) with one knee immobilized and with a one-half-inch shoe-lift applied to the contralateral shoe (I1/2"L), and (4) with one knee immobilized and with a one-inch shoe-lift (I1"L).
Exercise physiology laboratory.
Ten able-bodied subjects without known cardiopolmonary or musculoskeletal problems.
Breath-by-breath oxygen consumption measurements in mL/kg/m.
Oxygen cost on average was 20% more with the knee immobilized (I) compared to normal (N) (mean difference = .0298 +/- .0245mL/kg/m, p = .002). Oxygen cost was significantly less (11% versus 20% above that of normal walking) with the half-inch shoe-lift (mean difference between I1/2" and I = .0167 +/- .0138mL/kg/m, p = .002). Similarly, oxygen cost was significantly less (12% versus 20% above that of normal walking) with the one-inch shoe-lift (mean difference between I1"L and I = .0142 +/- .0116, p = .002).
This study demonstrates that a subject with an immobilized knee requires less energy to walk with a contralateral shoe-lift and provides scientific evidence for prescribing a shoe-lift in patients with an immobilized knee as a result of knee joint fusion, knee immobilization as a result of casting or orthotics, or spastic paretic stiff-legged gait associated with upper motor neuron disease.
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