Influence of Internal and External Foot Rotation on Peak Knee Adduction Moments and Ankle Moments during Gait in Individuals with Knee Osteoarthritis: A Cross-Sectional Study

Abstract

The aim of the study was to verify the effects of foot progression angle (FPA) modification during walking on the internal moments of the ankle and knee joints in individuals with knee osteoarthritis (OA). Biomechanical changes such as increased knee adduction moment (KAM) during walking are known to be involved in the development and severity of knee OA. Although various FPA modifications during gait have been applied to reduce peak KAM, few studies have investigated the effects of applying toe-in or toe-out walking modifications for knee OA on peak KAM and three-dimensional (3D) moments of the ankle joint. Kinetic moment variables were acquired from 35 individuals with medial knee compartment OA. A 3D motion analysis system and two force platforms were used to acquire KAM and 3D moments of both ankle joints during gait. Visual3D was used to obtain final moment data for statistical processing. Repeated-measures analysis of variance with Bonferroni adjustment was used to compare kinetic and kinematic values for each FPA walking condition. There was a significant decrease (p < 0.01) in first peak KAM when walking with an internal rotation foot position compared to normal foot position walking. Also, there was a significant decrease (p < 0.01) in second peak KAM when walking with an external rotation foot position compared to normal foot position walking. Compared to a normal foot position, peak ankle inversion moment of the external rotation foot position walking showed a significant decrease (p < 0.05). There were no interactive effects between FPA condition and limb sides for any KAM values (p > 0.05). The results showed no significant increase in the ankle joint moment value during gait for FPA modification conditions. Thus, the clinical implications of this study suggest that modification of the FPA in patients with OA to reduce KAM does not negatively impact the 3D ankle moments.