Immediate efficacy of laterally wedged insoles with arch support on walking in persons with bilateral medial knee osteoarthritis

Hsiu-Chen Yeh; Li-Fei Chen; Wei-Chun Hsu; Tung-Wu Lu; Lin-Fen Hsieh; Hao-Ling Chen

doi:10.1016/j.apmr.2014.06.014

Immediate efficacy of laterally wedged insoles with arch support on walking in persons with bilateral medial knee osteoarthritis

Arch Phys Med Rehabil. 2014 Dec;95(12):2420-7. doi: 10.1016/j.apmr.2014.06.014. Epub 2014 Jul 4.

Authors

Hsiu-Chen Yeh¹, Li-Fei Chen², Wei-Chun Hsu³, Tung-Wu Lu⁴, Lin-Fen Hsieh⁵, Hao-Ling Chen⁶

Affiliations

¹ School of Occupational Therapy, National Taiwan University, Taipei City, Taiwan, ROC; Department of Physical Medicine and Rehabilitation, Taoyuan Armed Forces General Hospital, Taoyuan County, Taiwan, ROC.
² Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan, ROC.
³ Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei City, Taiwan, ROC.
⁴ Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan, ROC; Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei City, Taiwan, ROC.
⁵ Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan, ROC; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC.
⁶ School of Occupational Therapy, National Taiwan University, Taipei City, Taiwan, ROC. Electronic address: hlchen@ntu.edu.tw.

PMID: 25007708
DOI: 10.1016/j.apmr.2014.06.014

Abstract

Objective: To investigate the immediate efficacy of laterally wedged insoles with arch support (LWAS) on gait in persons with bilateral medial knee osteoarthritis (OA).

Design: A prospective case-control intervention study.

Setting: A gait laboratory with a 6-camera motion analysis system and 2 forceplates.

Participants: Fifteen women with bilateral medial knee OA and 15 healthy control subjects (N=30).

Interventions: LWAS.

Main outcome measures: Subjective knee pain and objective biomechanical indices, namely, joint angles and moments in the frontal plane, frontal plane ground reaction force and lever arm, as well as medial/lateral center of mass and center of pressure during gait.

Results: When wearing the LWAS, knee pain during gait in persons with medial knee OA decreased (P=.01). Peak internal knee abductor moments were also reduced (P<.001) with increasing foot progression angles, laterally shifted center of pressure, and a shortened frontal plane lever arm (all P<.05). However, ankle invertor moments were increased (P<.05) when wearing the LWAS.

Conclusions: Although peak internal knee abductor moment and knee pain were immediately reduced during gait when wearing the LWAS, increased ankle invertor moments were found, suggesting that the LWAS should be used with caution. Strengthening and monitoring the condition of the ankle invertor muscles may be necessary if the LWAS is used as an intervention for persons with bilateral medial knee OA.

Keywords: Biomechanical phenomena; Gait; Knee; Orthoses; Osteoarthritis; Rehabilitation.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Ankle / physiopathology
Biomechanical Phenomena
Case-Control Studies
Female
Foot Orthoses*
Gait / physiology*
Humans
Knee Joint / physiopathology
Middle Aged
Muscle, Skeletal / physiopathology
Musculoskeletal Pain / etiology
Musculoskeletal Pain / rehabilitation
Osteoarthritis, Knee / complications
Osteoarthritis, Knee / physiopathology
Osteoarthritis, Knee / rehabilitation*
Prospective Studies
Walking / physiology*