871
Moderate-Heeled Shoes and Knee Joint Torques Relevant to
the Development and Progression of Knee Osteoarthritis
D. Casey Kerrigan, MD, MS, Jennifer L. Johansson, MS, Mary G. Bryant, MD, Jennifer A. Boxer, BA,
Ugo Della Croce, PhD, Patrick O. Riley, PhD
ABSTRACT. Kerrigan DC, Johansson JL, Bryant MG,
Boxer JA, Della Croce U, Riley PO. Moderate-heeled shoes
and knee joint torques relevant to the development and pro-
gression of knee osteoarthritis. Arch Phys Med Rehabil 2005;
86:871-5.
Objective: To determine if women’s dress shoes with heels
of just 1.5in (3.8cm) in height increases knee joint torques,
which are thought to be relevant to the development and/or
progression of knee osteoarthritis (OA) in both the medial and
patellofemoral compartments.
Design: Randomized controlled trial.
Setting: A 3-dimensional motion analysis gait laboratory.
Participants: Twenty-nine healthy young women (age,
26.7⫾5.0y) and 20 healthy elderly adult women (age,
75.3⫾6.5y).
Interventions: Not applicable.
Main Outcome Measures: Peak external varus knee torque
in early and late stance and prolongation of flexor knee torque
in early stance. Three-dimensional data on lower-extremity
torques and motion were collected during walking while (1)
wearing shoes with 1.5-in high heels and (2) wearing control
shoes without any additional heel. Data were plotted and qual-
itatively compared; major peak values and timing were statis-
tically compared between the 2 conditions using paired t tests.
Results: Peak knee varus torque during late stance was
statistically significantly greater with the heeled shoes than
with the controls, with increases of 14% in the young women
and 9% in the elderly women. With the heeled shoes, the early
stance phase knee flexor torque was significantly prolonged, by
19% in the young women and by 14% in elderly women. Also,
the peak flexor torque was 7% higher with the heeled shoe in
the elderly women.
Conclusions: Even shoes with moderately high heels (1.5in)
significantly increase knee torques thought to be relevant in the
development and/or progression of knee OA. Women, partic-
ularly those who already have knee OA, should be advised
against wearing these types of shoes.
Key Words: Biomechanics; Gait; Kinetics; Knee; Osteoar-
thritis; Rehabilitation; Shoes; Women.
© 2005 by American Congress of Rehabilitation Medicine
and the American Academy of Physical Medicine and
Rehabilitation
From the Department of Physical Medicine and Rehabilitation, University of
Virginia, Charlottesville, VA (Kerrigan, Bryant, Boxer, Della Croce, Riley); Spaul-
ding Rehabilitation Hospital, Boston, MA (Johansson); and Department of Biomed-
ical Sciences, University of Sassari, Sassari, Italy (Della Croce).
Supported by the Ellison Foundation and by the Public Health Service (grant no.
NIH HD01351).
No party having a direct interest in the results of the research supporting this article
has or will confer a benefit on the author(s) or on any organization with which the
author(s) is/are associated.
Reprint requests to D. Casey Kerrigan, MD, MS, Dept of Physical Medicine and
Rehabilitation, University of Virginia School of Medicine, 545 Ray C Hunt Dr,
Charlottesville, VA 22908, e-mail: dck7b@virginia.edu.
0003-9993/05/8605-9141$30.00/0
doi:10.1016/j.apmr.2004.09.018
HE POSSIBILITY THAT different types of shoe wear
T contribute to the development and/or progression of knee
osteoarthritis (OA) deserves consideration, because shoe wear
is a potentially controllable and easily modifiable factor for this
prevalent and disabling disease.1,2 We3 previously found that
stiletto high-heeled shoes with heels averaging 2.5in (6.35cm)
in height exaggerate knee external varus and flexor torques
during walking—torques that are thought to be relevant to the
development and/or progression of knee OA. Specifically, we
showed an increase in varus torque during walking with high-
heeled shoes. This increase implies exaggerated compressive
forces through the medial aspect of the knee,4-6 the typical
tibiofemoral site for knee OA.7 An increased varus torque is
likely to be clinically significant, given animal data showing
that increasing knee varus torque leads to degenerative changes
in the knee’s medial compartment.8 Because repetitive loading
is believed to be an important etiologic factor in the develop-
ment of OA, and walking is by far the most common daily
activity causing the greatest force about the knee,6 an increase
in varus torque is likely to be important.
Similarly, we showed a prolongation of the knee flexor
torque in early to midstance, implying increased work of the
quadriceps muscles,4,9,10 increased strain through the patella
tendon, and increased pressure across the patellofemoral
joint.11 During walking, the increased strain that occurs
through the patella tendon, with its associated patellofemoral
pressures, may be important with respect to the development of
degenerative joint changes within the patellofemoral compart-
ment. A study12 comparing women’s wide-based high-heeled
shoes with narrow-based high-heeled shoes (each with an av-
erage heel height of 2.8in [7.1cm]) found that both types of
shoes exaggerated the knee varus torques (by an increase of
26%) and the sagittal torques (by an increase in peak torque of
30%).
Having learned that shoes with heels averaging 2.5 to 2.8in
in height significantly increase knee joint torques, we hypoth-
esized that even moderately high heels would increase these
knee joint torques for the reasons noted previously3,12: that the
shoe’s heel so compromises foot and ankle kinetics that bio-
mechanic compensations to maintain stability and forward
progression during walking must occur at the knee. Many
women, both young and old, continue to wear shoes with
moderately high heels that are less than 2in (5.1cm) high, in the
belief that these are sensible shoes. In fact, it is typically
recommended that shoes with heels less than 2in are safe to
wear.13,14 We have observed in our clinical experience that
even women who already have knee OA often wear dress shoes
with heels (that are typically wide) that are slightly less than
2in high. We hypothesized that dress shoes with heels only
1.5in (3.8cm) high significantly increase the same knee joint
torques believed to be relevant to the development and/or
progression of knee OA. To test our hypothesis, we used
standard 3-dimensional gait analysis techniques, commonly
used in gait laboratories, to evaluate joint torques and motion at
the knee.12,15-20
Arch Phys Med Rehabil Vol 86, May 2005
872 MODERATE-HEELED SHOES AND KNEE JOINT TORQUES, Kerrigan
Fig 1. Custom shoes, size 9, with (A) moderate heel (1.5-in heel height) and (B) no heel (control).
METHODS
Healthy, able-bodied young (age, 18 –35y) and elderly (age,
⬎65y) women were studied. We posted fliers to recruit sub-
jects from the general population. Subjects had to be accus-
tomed to walking while wearing shoes with 1.5-in heels and
not suffer from musculoskeletal, cardiac, or pulmonary disease.
The study protocol was approved by both the institutional
review board where the data were collected and by the insti-
tutional review board where the data were analyzed. Written
informed consent was obtained from each subject. Each subject
was asked to walk at her comfortable walking speed across a
10-m gait laboratory walkway under 2 conditions: with 1.5-in–
heeled shoes and with control shoes, the order of which was
randomized.
Both the heeled and control shoes were custom-made by
Lerness Shoes.a The heeled shoes (fig 1A) had a consistent
1.5-in heel height across all sizes, and the control shoes (fig 1B)
had zero heel height. All shoes had an identical upper and
midsole design. Although we previously found no difference in
effect of knee torques between wide- and narrow-heeled
shoes,12 we decided to use a shoe with a wide heel in this study,
because this style is conventionally believed to be especially
sensible and is commonly worn by both young adult and
elderly women. Subjects were fitted with test shoes by the
study staff based on the subject’s self-reported size. The sub-
jects practiced walking with each test shoe to assure adequate
fit and comfort and to become accustomed to the shoe.
Knee joint torque data in 3 planes (sagittal, coronal, trans-
verse) were collected bilaterally, over 3 trials, for each of the 2
conditions. The procedures are based on standard techniques
reported elsewhere.3,12,15,16,19,21,22 We used a 6-camera video-
based motion analysis system (Vicon 512 system)b to measure
the 3-dimensional position of 15-mm diameter markers, at 120
frames per second. Markers were attached to the following
bony landmarks on the pelvis and lower extremities during
walking: the bilateral anterior and posterior superior iliac
spines, lateral femoral condyles, lateral malleoli, and forefeet.
Additional markers attached to lateral wands were placed over
the midfemur and midshank. Ground reaction forces were
measured synchronously with the motion analysis data using 2
staggered force platformsc imbedded in the walkway. Joint
torques in each plane were calculated by a commercially avail-
able full-inverse dynamic model.b Accordingly, joint torque
calculations were based on 3 things: (1) the mass and inertial
characteristics of each lower-extremity segment, (2) the de-
rived linear and angular velocities and accelerations of each
lower-extremity segment, and (3) the ground reaction force and
joint center position estimates. Joint torques, normalized for
body weight and overall barefoot height, were reported in
Arch Phys Med Rehabil Vol 86, May 2005
newton meters per kilogram meters (Nm/kg-m). Sagittal knee
joint angle motion was also studied and was reported in de-
grees.
Knee joint torque and sagittal plane motion data were
graphed over the walking cycle (0%–100%). Averaged torque
values (in the sagittal, coronal, and transverse planes) and
motion values (in the sagittal plane) for each subject for both
conditions were obtained from 3 trials (average of both right
and left lower extremities, providing an average of 6 values for
each condition). We used a Student paired t test for both the
young group and the elderly group to compare knee torque and
motion values between the 2 conditions. Specifically, in the
coronal plane, we examined peak knee varus torques in both
early and late stance phases. We also examined prolongation of
the sagittal flexor knee torque, calculating the time from initial
contact until the sagittal torque became extensor as a percent-
age of the gait cycle. Although the peak knee varus torques and
the timing of the knee flexor torque were our main variables of
interest, we also evaluated the peak knee flexor torque during
early stance, peak internal rotation torque, and peak knee
flexion in stance and in swing. Applying a Bonferroni adjust-
ment for the use of multiple t tests, 3 variables in 2 groups, we
defined statistical significance at P less than .008 (.05/6).
RESULTS
A total of 50 subjects, 30 healthy young women and 20
healthy elderly subjects, were assessed and found eligible for
the study. One young subject was excluded from the final
analysis because of technical problems with her data set. Fur-
ther, 1 young and 3 elderly subjects were not included in the
analysis of knee flexor torque prolongation. Thus, most of the
results reflect the analysis of data from 29 young and 20 elderly
subjects, with a subgroup of 28 young and 17 elderly women
for the analysis of knee flexor torque prolongation. The young
women averaged (mean ⫾ standard deviation [SD]) 26.7⫾5.0
years in age, 1.65⫾0.06m in height, and 58.7⫾8.99kg in body
mass. The elderly women averaged 75.3⫾6.5 years in age,
1.60⫾0.07m in height, and 63.4⫾13.3kg in body mass. There
was no significant difference in walking speed between the
heeled-shoe and control-shoe conditions for either the young
women (1.32⫾0.13m/s and 1.32⫾0.12m/s, respectively;
P⫽.990) or the elderly adult women (1.25⫾0.15m/s and
1.25⫾0.16m/s, respectively; P⫽.768). The elderly women
walked more slowly in both conditions, as would be expected,
but the differences were not significant (control shoe, P⫽.069;
heeled shoe, P⫽.089).
The torque values (mean ⫾ SD) and P values for compari-
sons between heeled and control shoes, for young adult and
elderly women, are listed in table 1. Graphs of the coronal
 MODERATE-HEELED SHOES AND KNEE JOINT TORQUES, Kerrigan 873

Table 1: Knee Torque Parameters

Young Women Elderly Women

Parameters Heeled Shoes Control Shoes P* Heeled Shoes Control Shoes P*

Peak varus torque, early stance (Nm/kg-m) 0.33⫾0.07 0.32⫾0.06 .021 0.33⫾0.07 0.31⫾0.07 .001
Peak varus torque, late stance (Nm/kg-m) 0.25⫾0.05 0.22⫾0.05 ⬍.001 0.25⫾0.05 0.23⫾0.05 ⬍.001
Flexor torque prolongation (% gait cycle) 31⫾4.4 26⫾3.8 ⬍.001 33⫾3.3 29⫾4.4 ⬍.001
Peak flexor torque, early stance (Nm/kg-m) 0.28⫾0.11 0.28⫾0.11 .490 0.31⫾0.10 0.29⫾0.11 .007
Peak internal rotation torque (Nm/kg-m) 0.11⫾0.02 0.11⫾0.02 .104 0.10⫾0.03 0.10⫾0.03 .319

NOTE. Values are mean ⫾ SD.

*Applying a Bonferroni adjustment for multiple tests; P⬍.008 is significant.

(varus) knee torque with heeled and control shoes, averaged
over the gait cycle, are illustrated in figure 2A (young women)
and figure 2B (elderly women). Similarly, graphs of the sagittal
knee (flexor and extensor) torque with heeled and control shoes
are illustrated in figure 3A (young women) and 3B (elderly
women). The peak knee varus torque in late stance was signif-
icantly greater for the heeled shoe compared with the control
shoe for both the young and elderly women. The rate of
occurrence of increased late stance knee varus torque was quite
high, with 24 of 29 young and 16 of 20 elderly subjects. The
early stance peak knee varus torque was not significantly
higher in either group when the Bonferroni adjustment was
applied. Although the increase in early stance varus torque was
not significant, 22 young subjects and 16 elderly subjects
showed an increase in this peak value. Twenty-six of 29 young
subjects and 19 of 20 elderly subjects showed an increase in
either the early stance (not significantly increased) or late
stance (significantly increased) peak knee varus torque when
wearing heels. In 21 young and 14 elderly subjects, both varus
torque peaks increased with heels.
In 1 young woman and 3 elderly women, the sagittal knee
torque remained flexed with the heeled shoe throughout the
entire stance period. These subjects were excluded from the
analysis of flexor torque prolongation, because an appropriate
value for crossover time could not be assigned. For the remain-
ing subjects, the sagittal knee flexor torque was prolonged with
heeled shoes in both the young and elderly women.
Among the other variables evaluated there were some inci-
dental findings of interest. The peak sagittal knee flexor torque

Fig 2. Knee varus torque during walking plotted over an averaged Fig 3. Knee sagittal torque during walking plotted over an averaged
gait cycle. Effect of moderate-heeled shoe (solid line) versus control gait cycle. Effect of moderate-heeled shoe (solid line) versus control
shoe (dotted line) in (A) young women and (B) elderly women. shoe (dotted line) in (A) young women and (B) elderly women.

Arch Phys Med Rehabil Vol 86, May 2005

874 MODERATE-HEELED SHOES AND KNEE JOINT TORQUES, Kerrigan
was significantly greater for the heeled shoe than for the control
shoe for the elderly women but not for the young. No signif-
icant differences existed in peak internal rotation torque in late
stance in either group. Knee flexion angle in early stance was
greater with the heeled shoe in the elderly women (16°⫾5° vs
14°⫾6°, P⫽.003) but not in the young women (15°⫾4° vs
15°⫾4°, P⫽.758). Peak knee flexion angle in swing was re-
duced with the heeled shoe in both young women (59°⫾3° vs
63°⫾3°, P⬍.001) and elderly women (57°⫾4° vs 61°⫾4°,
P⬍.001).
DISCUSSION
As hypothesized, the late stance peak varus knee torque
increased significantly with moderately high heels of 1.5in in
both young adult and elderly women. There was no significant
increase in the early stance peak knee varus torque, but an
increase occurred in over half the subjects in both groups. The
late stance varus torque was increased, with a magnitude of
increase compared with the control shoe of 14% in the young
women and 9% in the elderly women. Although in prior studies
with higher heels (2.5- and 2.8-in height) we found 23% and
26% increases in both early and late stance peak knee varus
moments, the increases found here with moderate-heeled shoes
are still clinically notable. Often an aim of rehabilitation in
patients with medial knee OA is to reduce the knee varus
torque, to reduce the medial compartment loading. For in-
stance, a lateral shoe wedge is often prescribed for patients
with medial compartment OA and has been reported to help
reduce symptoms of knee OA.23,24 We25 showed that a 5°
lateral shoe wedge reduces knee varus torque by a significant
5% and 7% in early and late stance, respectively. Crenshaw
et al26 similarly found in subjects with no knee OA that a lateral
shoe wedge reduces knee varus torque by approximately 7%.
This amount of change is of similar magnitude to what we
found in this study, albeit in an opposite direction.
Also as hypothesized, we found a significant prolongation of
the early external knee flexor torque. Although the heeled
shoes were associated with prolongation of the knee flexor
torque throughout the entire stance period in 1 young woman
and 3 elderly women, the characteristic early peak knee flexor
torque was prolonged by 19% and 14% in the remaining young
and elderly women, respectively. Further, in the elderly women
the heeled shoe was associated with a significant 7% increase
in peak knee flexor torque. Although the magnitudes are
smaller, these findings are similar to those we found previ-
ously: with stiletto 2.5-in high-heeled shoes knee flexor torque
is prolonged but there is no increase in the peak torque,3 and
with the narrow and wide 2.8-in high-heeled shoes peak torque
is both prolonged and increased.12
The current study is the first on the effects of shoes on knee
biomechanics that has included a group of elderly women with
ages similar to those with knee OA. The heeled shoes had
essentially the same effect in the elderly women as in the young
adult women, with 2 additional effects in the elderly women.
One was the increase in peak knee flexor torque, already noted
above. The second was an increase in peak knee flexion in
stance, which is likely related to the increased knee flexor
torque. Although the reason for these age-related differences is
not clear, it is clear that overall, the elderly women’s knee
biomechanics were affected by the heeled shoes to the same
degree as the younger women, if not more so.
As was observed with the higher-heeled shoes, we found in
this study no changes in internal rotation torque. Also as
observed with the higher-heeled shoes, we found here a reduc-
tion in peak knee flexion in swing in both the young and elderly
women. Because speed can affect the magnitude of both joint
Arch Phys Med Rehabil Vol 86, May 2005
motion and torques,27 it is important to note that even though
subjects chose their own comfortable walking speeds, they
tended to walk at similar speeds with the heeled and control
shoes.
The methods used in this study are considered to be the best,
most technologically advanced, noninvasive techniques avail-
able to assess biomechanics during walking. Nevertheless, a
limitation of our study, and of noninvasive gait analysis in
general, is that we must infer rather than measure directly the
joint contact forces from the measured net joint torques. Bio-
mechanic modeling has shown that differences in net knee
varus torques are the major determinants of differences in
medial and lateral compartment contact forces.4 Similarly, the
knee extension torque determines patellofemoral contact
forces. Thus, it is appropriate that these torques, rather than the
net joint forces, become the focus in looking for the cause of
medial compartment and patellofemoral joint OA. However,
the development of new procedures that directly assess joint
forces about the patellofemoral interface and medial compart-
ment of the knee would be useful in at least corroborating the
joint torque information obtained using current methods.
This study is the first to use a standard shoe for all subjects
to wear, rather than relying on the shoes that the subjects
normally wore. This approach allowed us to construct and use
a control shoe with no heel. (In previous studies, we used
barefoot walking as the control.) The advantage of the design
in our study was that we could evaluate more purely the effect
of the added heel. We28 previously showed that men’s sneakers
and dress shoes with an average 0.5-in heel do not, in men,
exaggerate knee joint torques compared with walking barefoot.
Thus, it is likely that shoes with heels up to 0.5in high do not
significantly affect knee joint torques in women; however, it is
unknown what effect of heels between 0.5 and 1.5in high may
have on knee joint torques. Moreover, it is unclear what type of
relation exists between heel height and knee torques at higher
heel heights. Future study should include varying heel heights
across a wide range using a controlled shoe design. This
approach would show whether a relation, linear or otherwise,
exists between heel height and knee torques. Such a study
would require special fabrication of shoes over a range of heel
heights, controlled for design of everything except heel height.
This is an expensive and time-consuming endeavor, requiring
different lasts to be made for each heel height. Nonetheless,
knowing the precise relation between heel height and knee joint
torques would allow proper epidemiologic studies to evaluate
the effect of heel height on the predisposition for knee OA.
Having precise biomechanic data to guide epidemiologic stud-
ies is essential, because women tend to wear shoes with vary-
ing heel heights that likely have varying effects on knee joint
torques. Future epidemiologic studies also must consider the
length of time and conditions under which different heel
heights are worn.
CONCLUSIONS
Shoes with heels 1.5in high significantly increase peak ex-
ternal varus knee torque in late stance and prolong knee flexor
torque in early to midstance. These are the same knee joint
torques believed to be related to the development and/or pro-
gression of knee OA. Our findings show that even moderately
high-heeled shoes cause alterations in knee joint torques that
are similar to those caused by women’s dress shoes with heel
heights averaging 2.5 and 2.8in. Women, particularly those
who already have knee OA, should be advised against wearing
these types of shoes.
 MODERATE-HEELED SHOES AND KNEE JOINT TORQUES, Kerrigan
References
1. Guccione AA, Felson DT, Anderson JJ. Defining arthritis and
measuring functional status in elders: methodological issues in the
study of disease and physical disability. Am J Public Health
1990;80:945-9.
2. Verbrugge LM. Women, men, and osteoarthritis. Arthritis Care
Res 1995;8:212-20.
3. Kerrigan DC, Todd MK, Riley PO. Knee osteoarthritis and high-
heeled shoes. Lancet 1998;351:1399-401.
4. Schipplein OD, Andriacchi TP. Interaction between active and
passive knee stabilizers during level walking. J Orthop Res 1991;
9:113-9.
5. Sharma L, Hurwitz DE, Thonar EJ, et al. Knee adduction moment,
serum hyaluronan level, and disease severity in medial tibiofemo-
ral osteoarthritis. Arthritis Rheum 1998;41:1233-40.
6. Morrison JB. The mechanics of the knee joint in relation to normal
walking. J Biomech 1970;3:51-61.
7. Windsor RE, Insall JN. Surgery of the knee. In: Sledge CB, Ruddy
S, Harris ED, Kelley WN, editors. Arthritis surgery. Philadelphia:
WB Saunders; 1994. p 794-817.
8. Ogata K, Whiteside LA, Lesker PA, Simmons DJ. The effect of
varus stress on the moving rabbit knee joint. Clin Orthop 1977;
Nov-Dec(129):313-8.
9. Winter DA. The biomechanics and motor control of human gait:
normal, elderly and pathological. 2nd ed. Waterloo (ON): Univ
Waterloo Pr; 1991.
10. Perry J. Gait analysis: normal and pathological function. Thoro-
fare: Slack; 1992.
11. Reilly DT, Martens M. Experimental analysis of the quadriceps
muscle force and patello-femoral joint reaction force for various
activities. Acta Orthop Scand 1972;43:126-37.
12. Kerrigan DC, Lelas JL, Karvosky ME. Women’s shoes and knee
osteoarthritis [letter]. Lancet 2001;357:1097-8.
13. Your podiatric physician talks about women’s feet. Information
from the American Podiatric Medical Association. Available at:
http://www.apma.org/topics/womens.htm. Accessed September
27, 2004.
14. Ebbeling CJ, Hamill J, Crussemeyer JA. Lower extremity me-
chanics and energy cost of walking in high-heeled shoes. J Orthop
Sports Phys Ther 1994;19:190-6.
15. Kadaba MP, Ramakrishnan HK, Wootten ME, Gainey J, Gorton G,
Cochran GV. Repeatability of kinematic, kinetic, and electromyo-
graphic data in normal adult gait. J Orthop Res 1989;7:849-60.
875
16. Winter DA. Biomechanics and motor control of human move-
ment. 2nd ed. New York: John Wiley & Sons; 1990.
17. Gage JR. Gait analysis. An essential tool in the treatment of
cerebral palsy. Clin Orthop 1993;May(288):126-34.
18. Kerrigan DC, Glenn MB. An illustration of clinical gait laboratory
use to improve rehabilitation management. Am J Phys Med Re-
habil 1994;73:421-7.
19. Meglan D, Todd F. Kinetics of human locomotion. In: Rose J,
Gamble JG, editors. Human walking. 2nd ed. Baltimore: Williams
& Wilkins; 1994. p 73-99.
20. O’Connell PG, Siegel KL, Kepple TM, Stanhope SJ, Gerber LH.
Forefoot deformity, pain, and mobility in rheumatoid and nonar-
thritic subjects. J Rheumatol 1998;25:1681-6.
21. Kerrigan DC, Riley PO, Nieto TJ, Croce UD. Knee joint torques:
a comparison between women and men during barefoot walking.
Arch Phys Med Rehabil 2000;81:1162-5.
22. Kadaba MP, Ramakrishnan HK, Wootten ME. Measurement of
lower extremity kinematics during level walking. J Orthop Res
1990;8:383-92.
23. Sasaki T, Yasuda K. Clinical evaluation of the treatment of
osteoarthritic knees using a newly designed wedged insole. Clin
Orthop 1987;Aug(221):181-7.
24. Yasuda K, Sasaki T. The mechanics of treatment of the osteoar-
thritic knee with a wedged insole. Clin Orthop 1987;Feb(215):
162-72.
25. Kerrigan DC, Lelas JL, Goggins J, Merriman GJ, Kaplan RJ,
Felson DT. Effectiveness of a lateral-wedge insole on knee varus
torque in patients with medial knee osteoarthritis. Arch Phys Med
Rehabil 2002;83:889-93.
26. Crenshaw SJ, Pollo FE, Calton EF. Effects of lateral-wedged
insoles on kinetics at the knee. Clin Orthop 2000;Jun(375):185-92.
27. Lelas J, Merriman G, Riley P, Kerrigan D. Predicting peak kine-
matic and kinetic parameters from gait speed. Gait Posture 2003;
17:106-12.
28. Kerrigan DC, Lelas JL, Karvosky ME, Riley PO. Men’s shoes and
knee joint torques relevant to the development and progression of
knee osteoarthritis. J Rheumatol 2003;30:529-33.
Suppliers
a. Lerness Shoes, 2155 SW 8th St, Miami, FL 33135.
b. Oxford Metrics Ltd, 14 Minns Estate, West Way, Oxford OX2 0JB,
UK.
c. Advanced Mechanical Technology Inc, 176 Waltham St, Water-
town, MA 02472.
Arch Phys Med Rehabil Vol 86, May 2005