ArticlesVertical impact increase in middle age may explain idiopathic weight-bearing joint osteoarthritis☆,☆☆
Section snippets
Subjects
Subjects consisted of 36 consecutive patients from an internal medicine practice who met admission criteria regarding age group and mobility. By a priori design, subjects were divided into 6 age groups, with 6 subjects per group. None had conditions affecting their balance and ability to walk, such as severe stability problems and advanced weight-bearing joint osteoarthritis. The mean age and body mass of each age group are listed in table 1.Empty Cell Empty Cell Empty Cell
Testing procedure
Written consent was obtained according to guidelines of the Helsinki Declaration. The testing procedure called for subjects to perform 20 consecutive footfall impacts while barefoot and while wearing their own shoes. The details of shoe construction were not recorded—any inference about the effect of specific shoe types is impossible because of the variability of materials and construction methods in the shoes worn. Subjects were required to step forward from a perch, fall to a surface 4.5cm
Steady-state impact
Steady-state impact was achieved in both footwear and barefoot conditions by trial 10, with post hoc testing indicating no differences thereafter (F1,35 = .33, p = .56). Because the average of trials 11 to 20 was not significantly different from trial 20 for both footwear and barefoot conditions, the last trial was selected for statistical analysis (fig 2).
Discussion
Results indicate that impact when men step remains constant until age 50, at which time it rises 13.3% (p < .001) on average for barefoot individuals, and this increase remains relatively unchanged into later years. This is consistent with our hypothesis. The abruptness of the rise seems remarkable, considering that the age of 50 separated barefoot subjects into high and low impact groups without a single exceptional case. This impact upsurge coincides temporally with the development of
Conclusion
This report is the first to identify that a sharp increase in impact forces during locomotion occurs at approximately age 50. It is probably the result of postural adjustments from instability caused by a decline in plantar tactile sensibility that is inherent with aging. These results suggest that improving stability in older groups may have a moderating effect on impact forces. This may delay the beginning of, or slow the progression, of weight-bearing joint osteoarthritis. Low levels of
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Reprint requests to Steven Robbins, MD, 800 Rene Levesque W, Ste 1540, Montreal, Que H3B 1X9 Canada, e-mail: [email protected].