Immediate and long-term efficacy of laterally-wedged insoles on persons with bilateral medial knee osteoarthritis during walking

نویسندگان

  • Wei-Chun Hsu
  • You-Cai Jhong
  • Hao-Ling Chen
  • Yi-Jia Lin
  • Li-Fei Chen
  • Lin-Fen Hsieh
چکیده

BACKGROUND The current study aimed to investigate the immediate and long-term effects of laterally-wedged (LW) insoles on the knee loadings, the knee abductor moment (KAM) in particular, and the compensatory changes at other lower limb joints in patients with bilateral medial knee osteoarthritis during level walking with and without LW insoles. METHODS Older adults with bilateral medial knee OA (age 66 ± 5.3 years; height 156 ± 4.9 cm; mass 60 ± 5.1 kg; leg length 83.72 ± 3.64 cm) were studied using computerized gait analysis initially (Baseline) and 6 weeks after using LW insoles (Follow-up) during barefoot walking and walking with LW insoles (7° of lateral inclination, with medial arch support). The three-dimensional angles and internal moments at the lower limb joints, as well as the ground reaction forces, were obtained using a motion analysis system and two forceplates. Key features of all the variables were compared using paired t tests for immediate effects (barefoot vs. LW) and for long-term effects (Baseline vs. Follow-up). The symptomatic severity (WOMAC Index) was also evaluated (Baseline vs. Follow-up). RESULTS The KAM with LW insoles at Baseline was significantly reduced when compared to the barefoot condition (p < 0.05), suggesting that the LW insoles were effective in reducing unfavorable loadings at the knee immediately upon wearing the insoles. After 6 weeks of wearing LW insoles (Follow-up), no significant changes were found in most of the biomechanical variables, including KAM (p > 0.05), when compared to Baseline with LW insoles. However, a specific gait adaptation with reduced knee loading was revealed when walking without LW insoles, i.e., for the barefoot condition (p < 0.05). CONCLUSIONS After long-term use of LW insoles, the pain and physical function were improved with decreased peak KAM. A specific gait adaptation with reduced KAM was also found when walking without LW insoles. These results indicate a positive long-term effect in persons with bilateral medial knee OA, both as an orthosis to assist walking, and as a treatment intervention to facilitate gait adaptations in favor of reduced KAM.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Long term effects of laterally wedged insoles on knee frontal plane biomechanics in patients with medial knee osteoarthritis

Address correspondence to: Dr. Fzt. Senem Güner Ankara University, Department of Prosthetics and Orthotics, Vocational School of Health Care Professions, Fatih Street 197/A, 06290 Keçiören/Gazino, Ankara, Türkiye E-mail: [email protected] Purpose: The aim of this study was to examine the effects of laterally wedged insoles to treat knee osteoarthritis on frontal plane mechanics and knee varu...

متن کامل

Redistribution of knee stress using laterally wedged insole intervention: Finite element analysis of knee-ankle-foot complex.

BACKGROUND Laterally wedged insoles are widely applied in the conservative treatment for medial knee osteoarthritis. Experimental studies have been conducted to understand the effectiveness of such an orthotic intervention. However, the information was limited to the joint external loading such as knee adduction moment. The internal stress distribution is difficult to be obtained from in vivo e...

متن کامل

The Influence of Wedged Insoles on Knee and Ankle Moments and Angular Impulses during Walking

High frontal plane knee joint angular impulse has been associated with patellofemoral pain syndrome (PFPS) and knee osteoarthritis (OA) [1,2]. Interventions that reduce frontal plane knee joint loading may provide clinical benefits. Wedged insoles have widely been proposed as one form of such an intervention. It has been shown that a laterally wedged insole can effectively decrease the peak fro...

متن کامل

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

BACKGROUND Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA), there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical fu...

متن کامل

The Effects of Unloader Knee Orthosis and Lateral Wedge Insole in Patients with Mild and Moderate Knee Osteoarthritis (OA)

Objectives: Patients suffering from mild to moderate knee osteoarthritis may be treated with unloader knee orthoses or laterally wedged insoles. The aim of this study was to identify and compare the effects of two orthoses in these patients. Methods: 56 patients with medial compartment knee OA were evaluated when wearing an unloader knee orthosis and insoles with a 6° lateral wedge which wer...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 14  شماره 

صفحات  -

تاریخ انتشار 2015