title: Biomechanic effects of a contralateral shoe-lift on walking with an immobilized knee.
abstract: OBJECTIVE
  A previous study demonstrated that when one knee is artificially immobilized, a contralateral shoe-lift improves the oxygen cost of walking. This study was undertaken to evaluate the kinematic and kinetic effects associated with this shoe-lift.
  
  
  METHODS
  Motion analysis and force platform data were collected in subjects walking (1) normally, (2) with one knee immobilized, (3) with one knee immobilized and with a one-half-inch shoe-lift applied to the contralateral, nonimmobilized shoe, and (4) with a one-inch shoe-lift similarly applied. Kinematic and kinetic data from three trials of each condition were compared graphically and statistically using a repeated measures analysis of variance.
  
  
  METHODS
  A gait laboratory.
  
  
  METHODS
  Eight able-bodied subjects without known neurologic or musculoskeletal problems.
  
  
  METHODS
  Fifty-two peak kinematic and kinetic variables during various phases of the gait cycle.
  
  
  RESULTS
  Statistically significant differences (p < .05) between the normal and immobilized knee conditions were noted in 22 variables; however, significant differences between the immobilized knee conditions were found in only 4 variables. There were small improvements with the shoe-lifts toward normal in peak hip abduction, hip abduction at 20% to 30% of the gait cycle, and in peak knee extension moment on the nonimmobilized side. There was a small change away from normal in peak knee extension moment on the immobilized-side for the 1" shoe-lift.
  
  
  CONCLUSIONS
  Wearing a contralateral shoe-lift when one knee is immobilized is associated with only small changes in kinematic and kinetic parameters. The shoe-lift may slightly reduce the need for compensatory hip abduction and vaulting on the nonimmobilized side. Importantly, no adverse biomechanic effect from the shoe-lift was noted except for a slightly increased peak knee extension moment on the immobilized side found for the 1" but not the 1"/2 shoe-lift.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Kerrigan
authors.forename: H M
authors.initials: HM
authors.lastname: Abdulhadi
authors.forename: T A
authors.initials: TA
authors.lastname: Ribaudo
authors.forename: U
authors.initials: U
authors.lastname: Della Croce
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005684:Gait; D006801:Humans; D007103:Immobilization; D007700:Kinetics; D007719:Knee Joint / Q000502:physiology*; D012775:Shoes; D016138:Walking / Q000502:physiology*