Wide step width reduces knee abduction moment of obese adults during stair negotiation

An increased likelihood of developing obesity-related knee osteoarthritis may be associated with increased peak internal knee abduction moments (KAbM). Increases in step width (SW) may act to reduce this moment. The purpose of this study was to determine the effects of increased SW on knee biomechanics during stair negotiation of healthy-weight and obese participants.

Participants (24: 10 obese and 14 healthy-weight) used stairs and walked over level ground while walking at their preferred speed in two different SW conditions - preferred and wide (200% preferred). A 2 × 2 (group × condition) mixed model analysis of variance was performed to analyze differences between groups and conditions (p < 0.05).

Increased SW increased the loading-response peak knee extension moment during descent and level gait, decreased loading-response KAbMs, knee extension and abduction range of motion (ROM) during ascent, and knee adduction ROM during descent. Increased SW increased loading-response peak mediolateral ground reaction force (GRF), increased peak knee abduction angle during ascent, and decreased peak knee adduction angle during descent and level gait. Obese participants experienced disproportionate changes in loading-response mediolateral GRF, KAbM and peak adduction angle during level walking, and peak knee abduction angle and ROM during ascent.

Increased SW successfully decreased loading-response peak KAbM. Implications of this finding are that increased SW may decrease medial compartment knee joint loading, decreasing pain and reducing joint deterioration. Increased SW influenced obese and healthy-weight participants differently and should be investigated further.