title: Ipsilateral and contralateral foot pronation affect lower limb and trunk biomechanics of individuals with knee osteoarthritis during gait.
abstract: Lateral wedges have been suggested for the treatment of individuals with knee osteoarthritis, but it may have undesirable effects on the biomechanics of gait through increased foot pronation. This study investigated the effects of increased unilateral foot pronation on the biomechanics of individuals with knee osteoarthritis during gait.
  
  
  
  Biomechanical data of twenty individuals with knee osteoarthritis were collected while they walked in three conditions: i) flat sandals; ii) wedged sandal on the knee osteoarthritis limb and flat sandal on the healthy limb; and iii) flat sandal on the osteoarthritis and wedged sandal on the healthy limb. Knee pain and comfort were evaluated. Principal Component Analysis followed by ANOVA was implemented to identify differences between conditions.
  
  
  
  The wedged sandal on the osteoarthritis limb increased rearfoot eversion (P<0.001; ES=0.79); increased shank rotation range of motion (P<0.001; ES=0.70); reduced knee internal rotation moment (P<0.001; ES=0.83); reduced hip internal rotation moment (P=0.001; ES=0.66); increased ipsilateral trunk lean (P=0.031; ES=0.47); and increased trunk rotation range of motion (P=0.001; ES=0.69). Walking with the wedged sandal on the healthy limb increased hip (P=0.003; ES=0.61) and knee (P=0.002; ES=0.63) adduction moments. Individuals reported greater comfort walking with the flat sandals (P=0.004; ES=0.55).
  
  
  
  Increased unilateral foot pronation of the knee osteoarthritis and healthy limbs causes lower limb and trunk mechanical changes that may overload the knee and the lower back, such as increased knee adduction moment, shank rotation and trunk lateral lean. Foot motion of both lower limbs should be evaluated and care must be taken when suggesting lateral wedges for individuals with knee osteoarthritis.
authors.affiliation: Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901 Belo Horizonte, MG, Brazil. Electronic address: renanresende@hotmail.com.
authors.forename: Renan A
authors.initials: RA
authors.lastname: Resende
authors.affiliation: Wilfrid Laurier University, 75 University Avenue W, Waterloo, ON N2L 3C5, Canada. Electronic address: renata.kirkwood@gmail.com.
authors.forename: Renata N
authors.initials: RN
authors.lastname: Kirkwood
authors.affiliation: Queen's University, McLaughlin Hall, Faculty of Engineering and Applied Science, Department of Mechanical and Materials Engineering, Kingston, Ontario, Canada. Electronic address: kevin.deluzio@gmail.com.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Deluzio
authors.affiliation: Queen's University, McLaughlin Hall, Faculty of Engineering and Applied Science, Department of Mechanical and Materials Engineering, Kingston, Ontario, Canada. Electronic address: lizhassan@gmail.com.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hassan
authors.affiliation: Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901 Belo Horizonte, MG, Brazil. Electronic address: sergioteixeirafonseca@gmail.com.
authors.forename: Sérgio T
authors.initials: ST
authors.lastname: Fonseca
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D005528:Foot / Q000502:physiology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology; D025341:Principal Component Analysis; D011403:Pronation / Q000502:physiology*; D016059:Range of Motion, Articular; D012399:Rotation; D060726:Torso / Q000502:physiology*; D016138:Walking
keywords: Biomechanics; Foot pronation; Gait; Knee osteoarthritis; Lateral wedges