Bone and Joint Center, Palo Alto VA, Palo Alto, California, USA.
J Orthop Res. 2010 Jul;28(7):873-9. doi: 10.1002/jor.21077.
This study tested the effects of variable-stiffness shoes on knee adduction moment, pain, and function in subjects with symptoms of medial compartment knee osteoarthritis over 6 months. Patients were randomly and blindly assigned to a variable-stiffness intervention or constant-stiffness control shoe. The Western Ontario and McMaster Universities (WOMAC) score served as the primary outcome measure. Joint loading, the secondary outcome measure, was assessed using the external knee adduction moment. Peak external knee adduction moment, total WOMAC, and WOMAC pain scores were assessed at baseline and after 6 months. The total WOMAC and WOMAC pain scores for the intervention group were reduced from baseline to 6 months (p = 0.017 and p = 0.002, respectively), with no significant reductions for the control group. There was no difference between groups in magnitude of the reduction in total WOMAC (p = 0.50) or WOMAC pain scores (p = 0.31). The proportion of patients achieving a clinically important improvement in pain was greater in the intervention group than in the control group (p = 0.012). The variable-stiffness shoes reduced the peak knee adduction moment (-6.6% vs. control, p < 0.001) in the 34 intervention subjects at 6 months. The adduction moment reduction significantly improved (p = 0.03) from the baseline reduction. The constant-stiffness control shoe increased the peak knee adduction moment (+6.3% vs. personal, p = 0.004) in the 26 control subjects at 6 months. The results of this study showed that wearing the variable-stiffness shoe lowered the adduction moment, reduced pain, and improved functionality after 6 months of wear. The lower adduction moment associated with wearing this shoe may slow the rate of progression of osteoarthritis after long-term use.
本研究旨在测试在患有内侧间室膝骨关节炎症状的受试者中，6 个月内不同硬度的鞋子对膝关节内收力矩、疼痛和功能的影响。患者被随机、盲法分配到可变硬度干预组或固定硬度对照组的鞋子中。WOMAC（西部安大略省和麦克马斯特大学）评分作为主要的结果测量指标。关节负荷，作为次要的结果测量指标，使用膝关节外内收力矩进行评估。在基线和 6 个月时评估峰值膝关节外内收力矩、总 WOMAC 和 WOMAC 疼痛评分。干预组的总 WOMAC 和 WOMAC 疼痛评分从基线到 6 个月时降低（p = 0.017 和 p = 0.002），而对照组则没有明显降低。两组之间在总 WOMAC（p = 0.50）或 WOMAC 疼痛评分（p = 0.31）降低的幅度上没有差异。与对照组相比，干预组达到疼痛改善临床重要程度的患者比例更大（p = 0.012）。在 6 个月时，34 名干预组患者的峰值膝关节内收力矩降低（与对照组相比，-6.6%，p < 0.001）。与基线相比，内收力矩的降低有显著改善（p = 0.03）。在 6 个月时，26 名对照组患者的峰值膝关节内收力矩增加（与个人相比，+6.3%，p = 0.004）。本研究的结果表明，穿着可变硬度的鞋子在 6 个月的穿着后降低了内收力矩，减轻了疼痛，改善了功能。这种鞋子降低了内收力矩，可能会减缓长期使用后骨关节炎的进展速度。
