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01-12-2013 | Research | Uitgave 1/2013 Open Access

Journal of Foot and Ankle Research 1/2013

Investigation of the biomechanical effect of variable stiffness shoe on external knee adduction moment in various dynamic exercises

Journal of Foot and Ankle Research > Uitgave 1/2013
Jee Chin Teoh, Jin Huat Low, Ying Bena Lim, Victor Phyau-Wui Shim, Jaeyoung Park, Seung-Bum Park, Sang Jun Park, Taeyong Lee
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Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-6-39) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JC, JH and TY designed the study. JC, JH and BL conducted the experiment and the statistical analysis. JC drafted the manuscript with assistance from JH, BL, VPWS, SB, SJ and TY. All authors reviewed and approved the final manuscript.



The growing ageing population and high prevalence of knee osteoarthritis (OA) in athletes across nations have created a strong demand for improved non-invasive therapeutic alternatives for knee OA. The aim of this study is to investigate the effect of the variable stiffness shoe (VSS), a new non-invasive therapeutic approach, on external knee adduction moment (EKAM) in various dynamic exercises. EKAM is believed to have positive correlation with the progression and development of knee OA.


Thirty young participants (16 male and 14 female; age 22.6 ± 1.9 years) from National University of Singapore were enrolled in this study. The tested activities were walking, running, drop-landing, and lateral hopping. All the dynamic exercises were recorded simultaneously by the 8-camera VICON Motion Systems (Oxford Metric, UK) with a sampling rate of 100 Hz.


The results showed that the EKAM was reduced in all the dynamic exercises with the use of VSS. The VSS produced significant reductions in the peak EKAM during walking (4.97%, p = 0.039), running (11.15%, p = 0.011), drop-landing (11.18%, p = 0.038) and lateral hopping (17.34%, p = 0.023) as compared to the control shoe.


The reduction of EKAM with the use of VSS in various dynamic exercises demonstrates its potential in delaying the onset and the progression of knee OA in early stage of knee OA patients.

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