title: Effect of rocker-soled shoes on parameters of knee joint load in knee osteoarthritis.
abstract: OBJECTIVE
  This study evaluated the immediate effects of rocker-soled shoes on parameters of the knee adduction moment (KAM) and pain in individuals with knee osteoarthritis (OA).
  
  
  METHODS
  Three-dimensional gait analysis was performed on 30 individuals (mean (SD): age, 61 (7) yr; 15 (50%) male) with radiographic and symptomatic knee OA under three walking conditions in a randomized order: i) wearing rocker-soled shoes (Skechers Shape-ups), ii) wearing non-rocker-soled shoes (ASICS walking shoes), and iii) barefoot. Peak KAM and KAM angular impulse were measured as primary indicators of knee load distribution. Secondary measures included the knee flexion moment (KFM) and knee pain during walking.
  
  
  RESULTS
  Peak KAM was significantly lower when wearing the rocker-soled shoes compared with that when wearing the non-rocker-soled shoes (mean difference (95% confidence interval), -0.27 (-0.42 to -0.12) N·m/BW × Ht%; P < 0.001). Post hoc tests revealed no significant difference in KAM impulse between rocker-soled and non-rocker-soled shoe conditions (P = 0.13). Both peak KAM and KAM impulse were significantly higher during both shoe conditions compared with those during the barefoot condition (P < 0.001). There were no significant differences in KFM (P = 0.36) or knee pain (P = 0.89) between conditions.
  
  
  CONCLUSIONS
  Rocker-soled shoes significantly reduced peak KAM when compared with non-rocker-soled shoes, without a concomitant change in KFM, and thus may potentially reduce medial knee joint loading. However, KAM parameters in the rocker-soled shoes remained significantly higher than those during barefoot walking. Wearing rocker-soled shoes did not have a significant immediate effect on walking pain. Further research is required to evaluate whether rocker-soled shoes can influence symptoms and progression of knee OA with prolonged wear.
authors.affiliation: 1Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, AUSTRALIA; 2School of Human, Health, and Social Sciences, Central Queensland University, Rockhampton, Queensland, AUSTRALIA; and 3School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, AUSTRALIA.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Madden
authors.forename: Crystal O
authors.initials: CO
authors.lastname: Kean
authors.forename: Tim V
authors.initials: TV
authors.lastname: Wrigley
authors.forename: Kim L
authors.initials: KL
authors.lastname: Bennell
authors.forename: Rana S
authors.initials: RS
authors.lastname: Hinman
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000503:physiopathology / Q000534:rehabilitation; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000534:rehabilitation; D012775:Shoes; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology