Osteoarthritis and Cartilage 

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Copyright © 2007 Osteoarthritis Research Society International Published by Elsevier Ltd.

Foot progression angle and the knee adduction moment: a cross-sectional investigation in knee osteoarthritis1

D.J. Rutherford M.Sc. (P.T.), , Physiotherapist, C.L. Hubley-Kozey Ph.D., ,  ,  , Professor, K.J. Deluzio Ph.D., §, Associate Professor, W.D. Stanish M.D. , Professor and M. Dunbar M.D., Ph.D.,  , Assistant Professor
School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
School of Biomedical Engineering, Faculty of Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
 Department of Surgery, Division of Orthopaedics, Dalhousie University, Halifax, Nova Scotia, Canada
§Department of Mechanical Engineering, Queens University, Kingston, Ontario, Canada
Received 8 June 2007;  accepted 27 November 2007.  Available online 7 January 2008.



To test the hypothesis that an association exists between the characteristics of the knee adduction moment and foot progression angle (FPA) in asymptomatic individuals and those with mild to moderate and severe knee osteoarthritis (OA).


Fifty asymptomatic individuals, 46 patients with mild to moderate and 44 patients with severe knee OA were recruited. Maximum knee adduction moment during late stance and principal component analysis (PCA) were used to describe the knee adduction moment captured during gait. Multiple regression models were used for each of the three group assignments to analyze the association between the independent variables and the knee adduction moment.


FPA explained a significant amount of the variability associated with the shape of the knee adduction moment waveform for the asymptomatic and mild to moderate groups (P < 0.05), but not for the severe group (P > 0.05). Walking velocity alone explained significant variance associated with the shape of the knee adduction moment in the severe OA group (P < 0.05).


A toe out FPA was associated with altered knee adduction moment waveform characteristics, extracted using PCA, in asymptomatic individuals and those with mild to moderate knee OA only. These findings are directly implicated in medial knee compartment loading. This relationship was not evident in those with severe knee OA.

Key words: Knee osteoarthritis; Foot progression angle; Gait analysis; Knee adduction moment; Principal component analysis

1Funding source: Canadian Institutes of Health Research, Nova Scotia Health Research Foundation.
 Address correspondence and reprint requests to: Dr Cheryl L. Hubley-Kozey, School of Physiotherapy, Dalhousie University, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 3J5. Tel: 1-902-494-2635; Fax: 1-902-494-1941.

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Osteoarthritis and Cartilage 

Article in Press, Corrected Proof

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