Effect of high and low-supportive footwear on female tri-planar knee moments during single limb landing

Timothy A Sayer,Adam L Bryant,Rana S Hinman,Karine Fortin,Kim L Bennell,Kade L Paterson

doi:10.1186/s13047-018-0294-x

Timothy A Sayer, Adam L Bryant + Show 4 more

Open Access

https://doi.org/10.1186/s13047-018-0294-x

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Abstract

BackgroundHigher landing-related external knee joint moments at later stages of female pubertal development likely contribute to a higher incidence of non-contact anterior cruciate ligament (ACL) injury. Athletic footwear may provide a potential strategy to alter higher knee moments.MethodsThirty-one late/post-pubertal girls (Tanner stage IV-V, menarche and growth spurt attained) performed a single limb drop lateral jump in three footwear conditions (barefoot, low support shoes and high support shoes), in which peak knee abduction moment (KAbM), flexion moment (KFM) and internal rotation moments (KIRM) were measured. Repeated measures ANOVA and ANCOVA were used to test for a main effect of footwear with and without foot posture index (FPI) as a covariate (p < 0.05) with post-hoc test carried out via Fisher’s Least Significant Difference (LSD).ResultsA main effect of footwear condition was observed for peak KFM (p < 0.05), but not KAbM or KIRM, in both unadjusted and adjusted models. Post-hoc analysis demonstrated that both high- and low-support shoes increased peak KFM compared with barefoot (p < 0.001).ConclusionOur findings indicate commercially available high- and low-supportive footwear increase peak KFM, but do not effect KAbM or KIRM while landing among late/post-pubertal girls. This suggests that these styles of footwear are inadequate at reducing higher knee moments in an at-risk cohort.

Highlights

Higher landing-related external knee joint moments at later stages of female pubertal development likely contribute to a higher incidence of non-contact anterior cruciate ligament (ACL) injury
Post-hoc results revealed that both adjusted and unadjusted results were identical, with the high-support shoe exhibiting higher peak Knee flexion moment (KFM) (MD = 0.44, 95% Confidence interval (CI) 0.36 to 0.53 N·m/kg, p < 0.001, Table 2) than the barefoot condition
Results for the low-support shoe were identical for both adjusted and unadjusted foot posture index (FPI) whereby higher peak KFM (MD = 0.36, 95% CI 0.25 to 0.48 N·m/kg, p < 0.001) was observed compared to barefoot

Summary

Introduction

Higher landing-related external knee joint moments at later stages of female pubertal development likely contribute to a higher incidence of non-contact anterior cruciate ligament (ACL) injury. Adolescence is an important stage in the context of female musculoskeletal development, as it typically involves a rapid influx of estrogen and growth factors, commonly referred to as puberty. Modifying medial and lateral support features of a shoe can influence the resultant frontal (i.e., KAbM) and transverse plane (i.e., KIRM) moments [11,12,13,14,15,16] which may be important in the context of ACL injury, given that combined valgus and rotation increases ACL strain [17]. High-supportive shoes commonly feature a medial post, increased longitudinal shoe stiffness and midfoot rotational stability to minimize excessive foot pronation during activity, whilst low-supportive shoes do not contain such features and allow natural pronation to occur [18]

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