Esfandiari Elham, Kamyab Mojtaba, Yazdi Hamid Reza, Foroughi Nasim, Sanjari Mohammad Ali
Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran.
Department of Orthopedic Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Geriatr Orthop Surg Rehabil. 2013 Dec;4(4):127-32. doi: 10.1177/2151458513512327.
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.
膝关节骨关节炎（OA）的矫形干预旨在减少膝关节内侧间室的机械负荷，并可能减轻作为最重要代偿性步态策略的躯干向外侧倾斜。外侧楔形鞋垫是一种已知的用于膝关节OA的矫形干预措施。然而，文献中尚未探讨在楔形鞋垫上增加距下带是否能提高其效果。
比较带和不带距下带的外侧楔形鞋垫对膝关节OA患者躯干向外侧倾斜的影响。
本研究纳入了23名年龄超过40岁、根据美国风湿病学会标准诊断为单膝内侧间室I级或II级OA的患者。患者通过临床检查诊断为OA，并通过X线片确诊。使用三维运动测量系统收集3种不同情况下的步态数据：（1）不使用鞋垫；（2）使用外侧楔形鞋垫；（3）使用外侧楔形鞋垫和距下带。在步态周期的站立期和中间站立点比较3种测试条件对躯干向外侧倾斜的即时影响。
基于实验室坐标系，这3种条件对膝关节OA患者在步态周期、站立期和中间站立点时的躯干向外侧倾斜均无显著影响。
本研究结果表明，带和不带距下带的外侧楔形鞋垫对膝关节OA患者的躯干向外侧倾斜均无即时影响。然而，外侧楔形鞋垫对这些患者躯干向外侧倾斜的长期影响需要进一步研究。
