title: Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent.
abstract: OBJECTIVE
  Previous studies indicate that flexible footwear, which mimics the biomechanics of walking barefoot, results in decreased knee loads in patients with knee osteoarthritis (OA) during walking. However, the effect of flexible footwear on other activities of daily living, such as descending stairs, remains unclear. Our objective was to evaluate the influence of inexpensive and minimalist footwear (Moleca) on knee adduction moment (KAM) during stair descent of elderly women with and without knee OA.
  
  
  METHODS
  Thirty-four elderly women were equally divided into an OA group and a control group (CG). Stair descent was evaluated in barefoot condition, while wearing the Moleca, and while wearing heeled shoes. Kinematics and ground reaction forces were measured to calculate KAM by using inverse dynamics.
  
  
  RESULTS
  The OA group experienced a higher KAM during midstance under the barefoot condition (233.3%; P = 0.028), the Moleca (379.2%; P = 0.004), and heeled shoes (217.6%; P = 0.007). The OA group had a similar knee load during early, mid, and late stance with the Moleca compared with the barefoot condition. Heeled shoes increased the knee loads during the early-stance (versus barefoot [16.7%; P < 0.001] and versus the Moleca [15.5%; P < 0.001]), midstance (versus barefoot [8.6%; P = 0.014] and versus the Moleca [9.5%; P = 0.010]), and late-stance phase (versus barefoot [10.6%; P = 0.003] and versus the Moleca [9.2%; P < 0.001]). In the CG, the Moleca produced a knee load similar to the barefoot condition only during the early-stance phase.
  
  
  CONCLUSIONS
  Besides the general foot protection, the inexpensive and minimalist footwear contributes to decreasing knee loads in elderly women with OA during stair descent. The loads are similar to the barefoot condition and effectively decreased when compared with heeled shoes.
authors.affiliation: School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. icnsacco@usp.br
authors.forename: I C N
authors.initials: IC
authors.lastname: Sacco
authors.forename: F
authors.initials: F
authors.lastname: Trombini-Souza
authors.forename: M K
authors.initials: MK
authors.lastname: Butugan
authors.forename: A C
authors.initials: AC
authors.lastname: Pássaro
authors.forename: A C
authors.initials: AC
authors.lastname: Arnone
authors.forename: R
authors.initials: R
authors.lastname: Fuller
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009989:Orthotic Devices; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D012775:Shoes; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology*