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UBC Theses and Dissertations

Examining lower leg biomechanics during toe-in and toe-out walking in people with medial compartment knee osteoarthritis Charlton, Jesse M.

Abstract

Introduction: Knee osteoarthritis is a common and painful disease, and is one of the leading causes of disability in Canada. It is thought that one of the primary causes of disease progression is excessive knee joint loading. Thus, conservative treatments have aimed to reduce knee joint load, predominantly targeting the knee adduction moment – a valid proxy of tibial joint load distribution. Toe-in and toe-out walking are two such strategies which have proven effective in the short term at reducing the knee adduction moment, but still require longer-term assessment and a more thorough understanding of the ancillary effects at joints other than the knee prior to clinical implementation. The ankle joint in particular may be subjected to altered biomechanics during toe-in and toe-out walking. Purpose: The purpose of this thesis was to examine ankle biomechanics during toe-in and toe-out foot rotations in those with medial compartment knee osteoarthritis. Methods: Fifteen individuals with medial compartment knee osteoarthritis were recruited. In a single session, participants were instructed to walk in four conditions guided by real-time biofeedback of performance: 1) toe-in (+10°), 2) neutral (0°), 3) toe-out (-10°) and 4) toe-out (-20°). Ankle kinematics, kinetics and muscle activity were examined during over-ground walking. Results: Toe-out walking exhibited an increase (p=0.011) in peak ankle eversion compared to toe-in walking, while toe-in walking exhibited an increase in ankle inversion at heel strike (p

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Attribution-NonCommercial-NoDerivatives 4.0 International