Esfandiari Elham, Kamyab Mojtaba, Yazdi Hamid Reza, Sanjari Mohammad Ali, Navvab Motlagh Fatemeh
Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran.
Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
Med J Islam Repub Iran. 2019 Dec 30;33:157. doi: 10.34171/mjiri.33.157. eCollection 2019.
Lateral wedge insole (LWI) aims to reduce loading on medial compartment of tibiofemoral joint in mild knee osteoarthritis (KOA). This effect may be augmented by concomitant use of subtalar strap to fix the ankle joint. Moreover, longitudinal arch support embedded in insoles can cause foot comfort and may be beneficial for people with KOA. Therefore, this study aimed to assess the immediate effect of LWI with an arch support with and without a subtalar strap on the kinetics and kinematics of walking in mild KOA. A convenient sample of 17 individuals with mild KOA (Kellgren and Lawrence grade II), aged ≥ 40 years were assessed in 3 conditions: without the insole; LWI; and LWI with a subtalar strap, where an arch support was embedded in all insoles. The primary outcomes were external knee adduction moment and angular impulse. The secondary outcomes were hip flexion and adduction moments, knee flexion angle, ankle eversion moment, and walking speed. The repeated measurements ANOVA was used to compare the primary and secondary outcomes between the conditions using SPSS. Significance level was set at 0.05. LWI and a subtalar strap can significantly increase the knee flexion angle at 0%-15% of the stance phase compared to no insole (p<0.001). No other changes were observed (p=0.142). LWI with an arch, with or without a subtalar strap, cannot impose any immediate changes on the kinetics and kinematics of lower limb joints during walking in people with mild KOA.
外侧楔形鞋垫（LWI）旨在减轻轻度膝关节骨关节炎（KOA）患者胫股关节内侧间室的负荷。同时使用距下带固定踝关节可能会增强这种效果。此外，鞋垫中嵌入的纵弓支撑可提高足部舒适度，对KOA患者可能有益。因此，本研究旨在评估带有纵弓支撑且有或没有距下带的LWI对轻度KOA患者步行时动力学和运动学的即时影响。对17名年龄≥40岁的轻度KOA患者（Kellgren和Lawrence分级为II级）进行了便利抽样，在3种条件下进行评估：不使用鞋垫；使用LWI；使用带有距下带的LWI，所有鞋垫均嵌入纵弓支撑。主要结局指标为膝关节外展力矩和角冲量。次要结局指标为髋关节屈曲和内收力矩、膝关节屈曲角度、踝关节外翻力矩和步行速度。使用SPSS软件，采用重复测量方差分析比较各条件之间的主要和次要结局指标。显著性水平设定为0.05。与不使用鞋垫相比，LWI和距下带可使站立期0%-15%时的膝关节屈曲角度显著增加（p<0.001）。未观察到其他变化（p=0.142）。对于轻度KOA患者，带有或不带有距下带的带纵弓LWI在步行过程中不会对下肢关节的动力学和运动学产生任何即时改变。
