Medial Unloader Braces and Lateral Heel Wedges Do not Alter Gait Biomechanics in Healthy Young Adults

in Journal of Sport Rehabilitation
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Context: Orthotic devices such as medial unloader knee braces and lateral heel wedges may limit cartilage loading following trauma or surgical repair. However, little is known regarding their effects on gait biomechanics in young, healthy individuals who are at risk of cartilage injury during physical activity due to greater athletic exposure compared with older adults. Objective: Determine the effect of medial unloader braces and lateral heel wedges on lower-extremity kinematics and kinetics in healthy, young adults. Design: Cross-sectional crossover design. Setting: Laboratory setting. Patients: Healthy, young adults who were recreationally active (30 min/d for 3 d/wk) between 18 and 35 years of age, who were free from orthopedic injury for at least 6 months, and with no history of lower-extremity orthopedic surgery. Interventions: All subjects completed normal over ground walking with a medial unloader brace at 2 different tension settings and a lateral heel wedge for a total of 4 separate walking conditions. Main Outcome Measures: Frontal plane knee angle at heel strike, peak varus angle, peak internal knee valgus moment, and frontal plane angular impulse were compared across conditions. Results: The medial unloader brace at 50% (−2.04° [3.53°]) and 100% (−1.80° [3.63°]) maximum load placed the knee in a significantly more valgus orientation at heel strike compared with the lateral heel wedge condition (−0.05° [2.85°]). However, this difference has minimal clinical relevance. Neither of the orthotic devices altered knee kinematics or kinetics relative to the control condition. Conclusions: Although effective in older adults and individuals with varus knee alignment, medial unloader braces and lateral heel wedges do not influence gait biomechanics in young, healthy individuals.

Goodwin is with the Department of Physical Therapy Education, Elon University, Elon, NC. Creighton, Spang, and Blackburn are with the Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Pietrosimone and Blackburn are with Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Pietrosimone and Blackburn are also with the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Goodwin (fgoodwin@elon.edu) is corresponding author.
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