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Updated: May 10, 2026
Using Gold-standard Gait Analysis Methods to Assess Experience Effects on Lower-limb Mechanics During Moderate High-heeled Jogging and Running
Published on: September 14, 2017
Effect of specific gait modifications on medial knee loading, metabolic cost and perception of task difficulty
Lydia K Caldwell1, Lloyd L Laubach, Joaquin A Barrios
1Health and Sport Science, University of Dayton, 300 College Park, Dayton, OH 45469, USA. caldwelll1@udayton.edu
Background:
The metabolic cost and cognitive demand of altering natural gait have not been well studied. The purpose of this investigation was to assess three modified patterns - toe out, ipsilateral trunk lean and a medial weight shift at the foot - on the basis of 1) medial knee joint load reduction, 2) metabolic cost of performance and 3) subject perception of task difficulty.
Methods:
12 healthy individuals underwent 3 dimensional motion analysis and metabolic testing to assess the gait mechanics and energy expenditure of natural gait and the three experimental gait patterns, performed to a self-selected moderate degree. Walking speed was controlled. Perceived workload was assessed using the NASA Task Load Index.
Findings:
Trunk lean significantly reduced first peak knee adduction moment (↓32%, P<0.001) as well as KAM impulse (↓35%, P<0.001), but was costly in terms of energy expenditure (↑11%, P<0.001) and perceived workload (↑1178%, P<0.001). A moderate toe-out pattern significantly reduced the second peak knee adduction moment (↓32%, P<0.001) and KAM impulse (↓14%, P=0.026), but had no effect on the first peak. Conversely, toe-out was least demanding in terms of additional energy expenditure (↑2%, P=0.001) and perceived workload (↑314%, P=0.001). Medial shift did not reduce knee adduction moment.
Interpretation:
The prioritization of joint load reduction versus additional metabolic and cognitive demands could play a substantial role in the clinical decision making process of selecting a modified gait pattern.
