Asymmetric shoe height induces reactive changes in gait kinematics but not kinetics in healthy young adults

Sumire D Sato; Maia Schlechter; Mark Price; Wouter Hoogkamer

doi:10.1016/j.gaitpost.2023.05.027

Asymmetric shoe height induces reactive changes in gait kinematics but not kinetics in healthy young adults

Gait Posture. 2023 Jul:104:70-76. doi: 10.1016/j.gaitpost.2023.05.027. Epub 2023 Jun 1.

Authors

Sumire D Sato¹, Maia Schlechter², Mark Price³, Wouter Hoogkamer⁴

Affiliations

¹ Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, USA. Electronic address: sumiresato@ufl.edu.
² Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA; Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
³ Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA; Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA.
⁴ Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA.

PMID: 37327557
DOI: 10.1016/j.gaitpost.2023.05.027

Abstract

Background: Footwear interventions are a potential avenue to correct walking asymmetry in neurologic populations, such as stroke. However, the motor learning mechanisms that underlie the changes in walking imposed by asymmetric footwear are unclear.

Research question: The objectives of this study were to examine symmetry changes during and after an asymmetric shoe height intervention in (1) vertical impulse and (2) spatiotemporal gait parameters and (3) joint kinematics, in healthy young adults METHODS: Eleven healthy young adults (3 males, 8 females; 21.2 ± 3.1 years old) participated in this study. Participants walked on an instrumented treadmill at 1.3 m/s for four conditions: (1) a 5-minute familiarization with equal shoe height, (2) a 5-minute baseline with equal shoe height, (3) a 10-minute intervention, where participants walked with asymmetric shoe height with a 10 mm shoe insert in one shoe, and (4) a 10-minute post-intervention, where participants walked with equal shoe height. Asymmetry in kinetics and kinematics were used to identify changes during intervention and aftereffects, a hallmark of feedforward adaptation RESULTS: Participants did not alter vertical impulse asymmetry (p = 0.667) nor stance time asymmetry (p = 0.228). During the intervention, step time asymmetry (p = 0.003) and double support asymmetry (p < 0.001) were greater compared to baseline. Leg joint asymmetry during stance (Ankle plantarflexion: p < 0.001; Knee flexion: p < 0.001; Hip extension: p = 0.011) was greater during the intervention compared to baseline. However, changes in spatiotemporal gait variables and joint mechanics did not demonstrate aftereffects.

Significance: Our results show that healthy human adults change gait kinematics, but not weight-bearing symmetry with asymmetrical footwear. This suggests that healthy humans prioritize maintaining vertical impulse by changing their kinematics. Further, the changes in gait kinematics are short-lived, suggesting feedback-based control, and a lack of feedforward motor adaptations.

Keywords: Adaptation; Asymmetry; Biomechanics; Footwear; Locomotion.

MeSH terms

Adolescent
Adult
Biomechanical Phenomena
Female
Gait*
Humans
Lower Extremity
Male
Shoes*
Walking
Young Adult