Steven Robbins, MD, Edward Waked, PhD, Nicholas Krouglicof, PhD

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Vertical impact increase in middle age may explain idiopathic weight-bearing joint osteoarthritis Steven Robbins, MD, Edward Waked, PhD, Nicholas Krouglicof, PhD Archives of Physical Medicine and Rehabilitation Volume 82, Issue 12, Pages 1673-1677 (December 2001) DOI: 10.1053/apmr.2001.26255 Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 1 Schematic representation of testing set-up for impact measurement. Subjects stepped down onto the force platform and balanced on 1 foot after contact with the platform. Subjects were tested barefoot, with gaze straight and arms at side on landing. Archives of Physical Medicine and Rehabilitation 2001 82, 1673-1677DOI: (10.1053/apmr.2001.26255) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 2 Mean impact for each of the 20 trials as a function of age group, for barefoot and footwear conditions. Impact values were stabilized at trial 10. Trial 20 was used for the statistical analysis. Archives of Physical Medicine and Rehabilitation 2001 82, 1673-1677DOI: (10.1053/apmr.2001.26255) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 3 Mean impact for barefoot and footwear conditions as a function of age group. Archives of Physical Medicine and Rehabilitation 2001 82, 1673-1677DOI: (10.1053/apmr.2001.26255) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 4 Scatter plot of impact versus age for the barefoot condition. The plot shows complete separation in terms of impact between groups of more and less than 50 years of age, indicating that abruptness of onset and uniformity of impact increase in middle age. Archives of Physical Medicine and Rehabilitation 2001 82, 1673-1677DOI: (10.1053/apmr.2001.26255) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 5 Scatter plot of impact versus age for the footwear condition. Footwear strongly influences stability, hence impact and its influence varies in relation to shoe sole thickness, hardness, and resiliency. Impact was more variable when subjects wore shoes than when barefoot. Archives of Physical Medicine and Rehabilitation 2001 82, 1673-1677DOI: (10.1053/apmr.2001.26255) Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions