The effect of shoe design and lateral wedges on knee load and neuromuscular control in healthy subjects during walking

The increasing number of patients with developing osteoarthritis is accompanied by a growing scientific interest in non-operative early treatment strategies. It is generally believed that laterally wedged insoles can change the distribution of knee loading. However, the importance of footwear design/type on the effectiveness of lateral wedging has not been investigated so far. The Purpose of the present study was to explore alterations in knee loading due to lateral foot wedges in three different shoes. Methods: Thirteen healthy participants with no history of knee pain were tested using three-dimensional gait analysis. Barefoot walking, walking in a running shoe, an Oxford-type leather shoe, and a rocker shoe were analysed. The shoes were tested both with and without a 10-degree full-length laterally wedged insole. Results: There were significant shoe*wedge interactions on the first and second peak knee adduction moments. However, the variability of this moment between shoe designs was of similar magnitude as the effect of laterally wedged insoles. Only marginal changes in muscle activity for gastrocnemius when walking with the wedged Oxford shoe were revealed. Conclusion: Lateral wedging is effective regardless of shoe design. Differences between the three neutral walking conditions underline the importance of footwear choice in individuals. It is safe to apply lateral wedges without jeopardising muscular control during walking regardless of shoe type. Possible effects of altering neuromuscular control by shoe type needs further exploration in patient groups.