Wang S, Mo S, Chung RCK, et al. - Researchers aimed at investigating if and how foot progression angle (FPA) modification affects the first and second peaks of external knee adduction moment (EKAM) and knee adduction angular impulse (KAAI) in individuals with and without medial knee osteoarthritis (OA) during level walking.

• PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and SPORTDiscus yielded 16 studies comparing FPA modification (toe-in or toe-out gait) interventions to lower EKAM and/or KAAI with natural walking.

• More than 85% of included patients were graded with Kellgren/Lawrence grade II–IV knee OA.

• Biomechanical effects of FPA modification differed between individuals with and without medial knee OA.

• In healthy individuals, there appeared greater effectiveness of both toe-in and toe-out gait in lowering EKAM and KAAI when compared with natural walking.

• In patients with mild-to-severe knee OA, reduction in EKAM and KAAI may occur with toe-out gait.

• Insufficient data were available from patients with early-stage knee OA, suggesting the necessity for future research.