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Posted: December 31, 2010

Special Shoes Could Help Reduce Knee Loads

Arthritic Knees

Aging adults often encounter knee pain from osteoarthritis that can eventually lead to knee replacement surgery. To slow that process and ease the pain, researchers suggest a pair of special mobility shoes.

The use of special mobility shoes can help ease knee pain and slow disease progression in people with osteoarthritis, according to research presented recently at the annual scientific meeting of the American College of Rheumatology in Atlanta.

Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage -- the cushioning material at the end of long bones -- and causes changes in the structures around the joint.

These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.

"Forces on the knee joint during walking have been shown to be related to pain, severity and progression of knee osteoarthritis," said Dr. Najia Shakoor, associate professor of medicine at Rush University in Chicago and lead investigator in the study. "Therefore, researchers currently investigate strategies to reduce these forces or loads on the knee joint in hopes of preventing progression of the disease."

Testing the Strategies

Shakoor's study recently tested these strategies, more specifically, by studying how the use of mobility shoes -- flat and flexible shoes, created specifically for this research, that allow natural foot mobility and provide sufficient support for the foot -- can affect knee OA, even on seniors whose walking is more like shuffling.

At the beginning of the study, researchers used a special camera system and a force plate to determine gait in 16 participants, who were all diagnosed with knee OA through X-rays and based on symptoms, while they walked in their own shoes, in mobility shoes, and barefoot.

After this initial evaluation, participants were instructed to wear the mobility shoes a minimum of six hours per day, six days a week for six months. To determine the progression of each participant, researchers performed the same gait analysis that was performed at the beginning of the study at six, 12 and 24 weeks.

Easy on the Knees

Overall, researchers determined that mobility shoes, in comparison to conventional shoes, led to significantly decreased knee loads in the participants. Additionally, they found that longer-term use of the mobility shoes led to even better outcomes in participants, noting a reduction in knee load that increased from 3.7% at the beginning of the study to 9.4% after six weeks, and to 18% at six months.

Finally, researchers found that after 24 weeks of wearing mobility shoes, participants experienced an adaptation in their gait (with a knee load reduction of 11%) even when wearing conventional shoes. This led researchers to believe that the use of mobility shoes could create beneficial neuromuscular and behavioral changes in how people with OA walk.

"This study showed that specialized footwear was beneficial in reducing knee loads substantially over six months," Shakoor said. "It is also the first study to show that chronic use of a mechanical, knee-load reducing intervention could lead to favorable alterations in the way participants walk, even once the intervention is removed.”

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