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外侧楔形鞋垫治疗膝骨关节炎:佩戴一个月后生物力学效果会下降吗?

Laterally wedged insoles in knee osteoarthritis: do biomechanical effects decline after one month of wear?

机构信息

Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, Victoria, Australia.

出版信息

BMC Musculoskelet Disord. 2009 Nov 25;10:146. doi: 10.1186/1471-2474-10-146.

Abstract

OBJECTIVE

This study aimed to determine whether the effect of laterally wedged insoles on the adduction moment in knee osteoarthritis (OA) declined after one month of wear, and whether higher reported use of insoles was associated with a reduced effect on the adduction moment at one month.

METHODS

Twenty people with medial compartment OA underwent gait analysis in their own shoes wearing i) no insoles and; ii) insoles wedged laterally 5 degrees in random order. Testing occurred at baseline and after one month of use of the insoles. Participants recorded daily use of insoles in a log-book. Outcomes were the first and second peak external knee adduction moment and the adduction angular impulse, compared across conditions and time with repeated measures general linear models. Correlations were obtained between total insole use and change in gait parameters with used insoles at one month, and change scores were compared between high and low users of insoles using general linear models.

RESULTS

There was a significant main effect for condition, whereby insoles significantly reduced the adduction moment (all p < 0.001). However there was no significant main effect for time, nor was an interaction effect evident. No significant associations were observed between total insole use and change in gait parameters with used insoles at one month, nor was there a difference in effectiveness of insoles between high and low users of the insoles at this time.

CONCLUSION

Effects of laterally wedged insoles on the adduction moment do not appear to decline after one month of continuous use, suggesting that significant wedge degradation does not occur over the short-term.

摘要

目的

本研究旨在确定在佩戴外侧楔形鞋垫一个月后,其对膝骨关节炎(OA)患者的内收力矩的影响是否会减弱,以及报告的更高鞋垫使用率是否与一个月时内收力矩的降低效果相关。

方法

20 名内侧间室 OA 患者在穿着自己的鞋子时进行了步态分析,分别佩戴了 i)无鞋垫和 ii)随机 5 度外侧楔形鞋垫。测试分别在基线和佩戴鞋垫一个月后进行。参与者在日志中记录了鞋垫的日常使用情况。结果比较了不同条件和时间下的首次和第二次外膝内收力矩峰值和内收角冲量,并使用重复测量一般线性模型进行了比较。还获得了总鞋垫使用量与佩戴鞋垫一个月时步态参数变化之间的相关性,并使用一般线性模型比较了高鞋垫和低鞋垫使用者之间的变化分数。

结果

条件有显著的主效应,即鞋垫显著降低了内收力矩(均 p<0.001)。但是,时间没有显著的主效应,也没有明显的交互效应。佩戴鞋垫一个月时,总鞋垫使用量与佩戴鞋垫时步态参数的变化之间没有显著的相关性,高和低鞋垫使用者之间的鞋垫效果也没有差异。

结论

外侧楔形鞋垫对内收力矩的影响在连续使用一个月后似乎不会减弱,这表明在短期内不会发生显著的楔形降解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7837/2791095/e6fe971b025f/1471-2474-10-146-1.jpg

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