Skou Søren Thorgaard, Hojgaard Lea, Simonsen Ole H
Orthopaedic Surgery Research Unit, Aalborg Hospital-Aarhus University Hospital, Aalborg, Denmark.
J Am Podiatr Med Assoc. 2013 Jan-Feb;103(1):50-5. doi: 10.7547/1030050.
Knee osteoarthritis (KOA) is a prevalent degenerative disease in older adults. Treatment strategies, including insoles, focus on reducing pain and physical disability. In medial KOA, insoles have been studied extensively with conflicting results, possibly due to heterogeneity in outcome measures and the intervention. We sought to investigate the effect of custom-made laterally wedged insoles on pain, function, and quality of life in patients with medial KOA.
Fifty-one consecutive patients with medial KOA were prescribed custom-made insoles with arch support and a 5.0° to 8.7° lateral wedge. At follow-up, 42 of the 51 participants (22 men; mean age, 63 years; mean Kellgren-Lawrence, 3.4) participated. Retrospectively, participants were asked to rate the pain intensity in their affected knee before and after the intervention measured on a visual analog scale after 30 min of physical activity (primary outcome), at rest, at night, and after 50 m of walking. Additionally, they completed the Oxford Knee Score and the EQ-5D. The paired-samples t test was applied in the statistics.
The visual analog scale score after 30 min of physical activity was significantly reduced after the intervention (mean, 3.3 cm; 95% confidence interval, 2.1-4.5 cm; P < .001). The same significant changes were found in all of the secondary outcomes.
There was a significant reduction in pain and improvements in function and quality of life with custom-made laterally wedged insoles with arch support in older adults with mild-to-severe medial KOA. The customization of laterally wedged insoles may be essential for the effect in medial KOA.
膝关节骨关节炎(KOA)是老年人中一种常见的退行性疾病。包括鞋垫在内的治疗策略主要侧重于减轻疼痛和身体残疾。在内侧KOA中,对鞋垫进行了广泛研究,但结果相互矛盾,这可能是由于结局指标和干预措施存在异质性。我们旨在研究定制的外侧楔形鞋垫对内侧KOA患者疼痛、功能和生活质量的影响。
连续纳入51例内侧KOA患者,为其定制带有足弓支撑和5.0°至8.7°外侧楔形的鞋垫。随访时,51名参与者中有42名(22名男性;平均年龄63岁;平均Kellgren-Lawrence分级为3.4)参与。回顾性地,要求参与者在体育活动30分钟后(主要结局)、休息时、夜间以及行走50米后,使用视觉模拟量表对干预前后患膝的疼痛强度进行评分。此外,他们还完成了牛津膝关节评分和EQ-5D量表。统计分析采用配对样本t检验。
干预后,体育活动30分钟后的视觉模拟量表评分显著降低(平均值为3.3厘米;95%置信区间为2.1 - 4.5厘米;P <.001)。所有次要结局指标均出现了同样显著的变化。
对于轻度至重度内侧KOA的老年人,定制的带有足弓支撑的外侧楔形鞋垫可显著减轻疼痛,并改善功能和生活质量。外侧楔形鞋垫的定制对于内侧KOA的治疗效果可能至关重要。