title: Contralateral shoe-lift: effect on oxygen cost of walking with an immobilized knee.
abstract: OBJECTIVE
  Evaluate the effect of a contralateral shoe-lift on the oxygen cost of walking with an artificially immobilized knee.
  
  
  METHODS
  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).
  
  
  METHODS
  Exercise physiology laboratory.
  
  
  METHODS
  Ten able-bodied subjects without known cardiopolmonary or musculoskeletal problems.
  
  
  METHODS
  Breath-by-breath oxygen consumption measurements in mL/kg/m.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Harvard Medical School Department of Physical Medicine and Rehabilitation, Boston, MA 02114, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Abdulhadi
authors.forename: D C
authors.initials: DC
authors.lastname: Kerrigan
authors.forename: P J
authors.initials: PJ
authors.lastname: LaRaia
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004734:Energy Metabolism / Q000502:physiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D007103:Immobilization / Q000009:adverse effects / Q000502:physiology*; D007717:Knee / Q000503:physiopathology*; D008297:Male; D009989:Orthotic Devices / Q000592:standards*; D010101:Oxygen Consumption; D016059:Range of Motion, Articular; D012775:Shoes / Q000592:standards*; D016138:Walking / Q000502:physiology*