Effect Of Lateral Wedge Insole Research Articles

The Immediate Effect of Lateral Wedge Insoles, With and Without a Subtalar Strap, on the Lateral Trunk Lean Motion in Patients With Knee Osteoarthritis

Orthotic interventions for knee osteoarthritis (OA) aim to reduce mechanical loading on the medial compartment of the knee and may lessen the lateral trunk lean as the most important compensatory gait strategy. The lateral wedge insole is a known orthotic intervention for knee OA. However, the question whether the addition of a subtalar strap to the wedge improves its effect has not been addressed in the literature. To compare the effects of lateral wedge insoles, with and without a subtalar strap, on the lateral trunk lean in patients with knee OA. Twenty-three patients aged over 40 years, with grade I or II OA of the medial compartment of one knee, based on the American College of Rheumatology criteria, were included in this study. The patients were diagnosed with OA based on a clinical examination, and the diagnosis was confirmed with radiographs. A 3-dimensional motion measurement system was used to collect the gait data for 3 different conditions: (1) with no insole, (2) with a lateral wedge insole, and (3) with a lateral wedge insole and a subtalar strap. The immediate effect of the 3 test conditions on the lateral trunk lean was compared during a gait cycle a stance phase and at the point of midstance. Based on the laboratory coordinate system, the 3 conditions had no significant effect on the lateral trunk lean during a gait cycle and a stance phase and at the point of midstance in patients with knee OA. The results of this study demonstrated that the lateral wedge insoles, with and without a subtalar strap, had no immediate effect on the lateral trunk lean in patients with knee OA. However, the long-term effect of lateral wedge insoles on the lateral trunk lean in these patients requires further investigation.

Peak knee adduction moment and impulse are not related to changes in self-reported pain or physical function over 12 months in individuals with medial knee osteoarthritis

Purpose: Dynamic joint loading is thought to be a major contributing factor to the development and progression of knee joint structural changes. The external knee adduction moment (KAM) during walking is a valid and reliable proxy for the load on the medial tibiofemoral compartment of the knee and is related to radiographic knee OA severity and risk of structural disease progression. However, no study has longitudinally examined the relationship between baseline KAM and changes in pain or physical function in a cohort with knee OA. The purpose of this study was to examine the relationship between peak KAM and KAM impulse with changes in self-reported pain and self-reported physical function over a 12-month period. Methods: Data from 141 individuals with medial knee OA (80 females, 61 males, age: 64.5±8.0yrs, BMI: 28.6±4.5m/kg2) who participated in a clinical trial were analyzed. The clinical trial showed no significant effect of lateral wedge insoles on pain or function compared to control insoles, thus data from treatment groups were pooled for this analysis. All participants underwent baseline three-dimensional gait analysis, and completed baseline and follow-up self-report measures of pain and function. Peak KAM and the KAM impulse were determined via gait analysis (8-camera VICON, 3 AMTI force plates). Pain and physical function at baseline and at 12 months were evaluated using a) The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and b) numeric rating scales (NRS) to rate average overall weekly pain, average weekly pain when walking and average restriction to daily activities. Paired t-tests were used to examine changes in pain and function over 12-months in the whole cohort. Initially, unadjusted linear regression models were performed to examine the relationships between peak KAM (independent variable and change in self-reported pain and function (dependent variables). Models were repeated adjusting for a) age, sex, and body mass index and b) with the additional covariate of treatment group. All analyses were repeated using KAM impulse as the independent variable. Results: Baseline and follow-up self-reported pain and function scores are reported in Table 1. The cohort showed a small but significant improvement in WOMAC pain and function scores (Table 1). Neither peak KAM nor KAM impulse were associated with changes in self-reported WOMAC pain or function (Table 2). Similar to WOMAC scores, the NRS scores also significantly improved over time (Table 1). However, these improvements were less than the minimal clinically important differences. Neither peak KAM nor KAM impulse were associated with changes in self-report NRS pain or activity restrictions (Table 2). Conclusions: We found no relationship between parameters of the KAM and change in self-reported pain and function over 12-months in our cohort. Future research targeting those who exhibit worsening of pain and function over time, longer follow-up duration and incorporating performance-based measures of physical function is warranted.Table 1Baseline and follow-up self-reported pain and function scoresBaselineFollow-upMean Difference (95%CI)p-valueWOMAC Pain (0-20)7.2 (2.9)6.3 (3.3)0.9 (0.4, 1.4)0.001WOMAC Function (0-68)23.7 (11.1)20.2 (12.2)3.5 (1.8, 5.1)<0.001Average weekly pain when walking (0-10)4.3 (2.1)3.1 (2.4)1.2(0.8, 1.5)<0.001Average weekly pain (0-10)4.2 (1.9)3.1(2.2)1.1(0.7, 1.4)<0.001Average weekly restriction to activities (0-10)3.8 (2.3)3.1 (2.5)0.7 (0.4, 1.1)<0.001Lower scores indicate less pain/better function Open table in a new tab Table 2Relationship between KAM and changes in self-reported pain and functionUnivariate analysisMultivariate analysis*Multivariate analysis**Regression coefficient (95% CI)p-valueRegression coefficient (95% CI)p-valueRegression coefficient (95% CI)p-valueWOMAC PainPeak Knee Adduction Moment (Nm/BW*ht%)Knee Adduction Moment Impulse (Nm.s/BW*ht)-0.11 (-0.62, 0.41)-0.51 (-1.85, 0.83)0.680.45-0.08 (-0.62, 0.47)-0.55 (-1.93, 0.82)0.780.43-0.06 (-0.61, 0.48)-0.53 (-1.92, 0.85)0.810.45WOMAC FunctionPeak Knee Adduction Moment (Nm/BW*ht%)Knee Adduction Moment Impulse (Nm.s/BW*ht)0.53 (-1.14, 2.20)0.79 (-3.57, 5.15)0.530.720.48 (-1.29, 2.25)1.02 (-3.47, 5.51)0.590.650.50 (-1.29, 2.28)1.06 (-3.46, 5.58)0.580.64Average weekly pain when walkingPeak Knee Adduction Moment (Nm/BW*ht%)Knee Adduction Moment Impulse (Nm.s/BW*ht)0.22 (-0.17, 0.61)0.51 (-0.52, 1.53)0.270.330.24 (-0.18, 0.65)0.58 (-0.47, 1.63)0.260.290.24 (-0.17, 0.66)0.60 (-0.46, 1.65)0.250.26Average weekly painPeak Knee Adduction Moment (Nm/BW*ht%)Knee Adduction Moment Impulse (Nm.s/BW*ht)0.07 (-0.32, 0.45)0.07 (-0.83, 1.06)0.740.890.13 (-0.27, 0.54)0.18 (-0.83, 1.20)0.520.720.15 (-0.26, 0.55)0.21 (-0.81, 1.23)0.480.68Average weekly restriction to activitiesPeak Knee Adduction Moment (Nm/BW*ht%)Knee Adduction Moment Impulse (Nm.s/BW*ht)0.17 (-0.20, 0.54)0.21 (-1.18, 0.76)0.270.330.22 (-0.17, 0.61)0.33 (-0.66, 1.33)0.260.510.23 (-0.16, 0.62)0.35 (0.65, 1.35)0.250.49* adjusted for age, gender, body mass index** adjusted for age, gender, body mass index, treatment group Open table in a new tab

외측웨지인솔이 대퇴절단자의 무릎내전모멘트에 미치는 영향

The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with 5° and 10° lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial

Objective To assess the effect of lateral wedge insoles compared with flat control insoles on improving symptoms and slowing structural disease progression in medial knee osteoarthritis.Design Randomised controlled trial.Setting Community...

Comparison of the Effects of 3-Point Valgus Knee Support and Lateral Wedge Insoles in Medial Compartment Knee Osteoarthritis

There are many opinions and controversies regard the effect of lateral wedge insoles and valgus stress 3point knee braces in treatment of medial compartment knee osteoarthritis (OA). In this study we compared the effect of lateral wedge insoles and 3 point knee supports in treatment of medial compartment knee OA. Sixty patients (35-65 years), with knee pain and genu varum and moderate to severe medial compartment DJD were divided into three groups. The first group received a custom molded 3 point valgus stress knee support. Lateral wedge insoles were applied for the second group and the third group served as control. All groups were followed for 9 months according to pain severity, walking distance, and radiologic changes. Pain reduced significantly in both lateral wedge and knee brace groups compared to control group with more significant reduction in the brace group. The walking distance was significantly longer only in the brace group. There was more pronounced effect of brace in patients with severe DJD in walking distance compared to moderate DJD, but not in severity of pain. Three point valgus stress knee support had more significant effect on pain reduction, walking distance and also radiologic improvement of patients with moderate to severe medial compartment DJD compared to lateral wedge insoles and could even reverse radiologic findings.

The Effects of Lateral Wedge Insole in the Management of Patients with Varus Osteoarthritis of the Knee.

Although insufficient evidence supports the application of lateral wedge insole (LWI) as a non-operative treatment for medial/varus osteoarthritis of the knee joint, objective evaluation of its effects on pain, stiffness and functional disability is limited. The purpose of the study therefore was to determine the effect of LWI on the functional disability and symptoms resulting from the medial/varus osteoarthritis of the knee. Fifty (50) out of 76 patients referred for physiotherapy with diagnosis of varus osteoarthritis of the knee joint participated in this study. The 50 subjects were randomly assigned into 2 groups of 25 patients each. Group A (Experimental), were treated with thermal therapy, massage and LWI. Group B (Control), were treated with thermal therapy and massage only. The outcome measures included knee pain, knee stiffness and functional disability. These parameters were statistically analysed pre and post treatment. Results established a significant difference (p

The effect of lateral wedge insole on rotational movement for osteoarthritic knee

The effect of lateral wedge insole on rotational movement for osteoarthritic knee