Department of Physiotherapy, College of Applied Medical Sciences, University of Hail, Saudi Arabia.
Gait Posture. 2022 Feb;92:103-109. doi: 10.1016/j.gaitpost.2021.11.018. Epub 2021 Nov 24.
For individuals with knee osteoarthritis (OA), stair negotiation is a challenging task and the first task during which they report pain due to the high knee loading required. The use of lateral wedge insole (LWI) has been found to reduce loading in patients with OA but not to reduce pain, whereas the use of knee sleeve has been shown to result in good pain reduction. Understanding the effect of combining LWI and knee sleeve use on healthy individuals before testing on individuals with knee OA is an important step.
The current study aimed to evaluate the effect of combining the use of LWI and knee sleeve and compare the results with the application of each treatment separately and with the control condition.
This randomised cross-over study included 17 healthy participants who underwent 3D gait analysis. Participants performed ascending and descending stair activities with the following four treatment conditions: five-degree LWI, off-the-shelf knee sleeve, both LWI and knee sleeve and control condition. External knee adduction moment (EKAM) and knee frontal plane range of motion (ROM) were evaluated as primary outcomes. Repeated measure ANOVA or the Friedman test was selected based on meeting the assumption followed by multiple pairwise comparisons with Bonferroni correction.
In general, the use of LWI reduced the first peak EKAM significantly (p < 0.001) compared to the control condition in stir ascending (12% reduction) but not in stair descending (p > 0.05). Interestingly, knee sleeve use did not result in any reduction in the first peak EKAM compared to the control or any other condition. However, knee sleeve use led to a significant reduction in the knee frontal plane ROM during stair descending. The combined treatment was not superior to the LWI use when compared to control in the EKAM reduction.
Combined knee sleeve and LWI use was not superior to LWI use alone in reducing the knee loading, but it may be beneficial for individuals with knee OA since it helped in reduction of the knee frontal plane ROM during stair descending. Importantly, the effect of LWI use or any other treatment must be investigated for each different activity, and the results found in one activity must not be generalised across other activities.
对于膝骨关节炎（OA）患者来说，上下楼梯是一项具有挑战性的任务，也是他们首先报告因膝关节高负荷而感到疼痛的任务。使用外侧楔形鞋垫（LWI）已被发现可减少 OA 患者的负荷，但不能减轻疼痛，而使用膝套已被证明可有效减轻疼痛。在对膝 OA 患者进行测试之前，了解 LWI 和膝套联合使用对健康个体的影响是重要的一步。
本研究旨在评估联合使用 LWI 和膝套的效果，并将结果与单独应用每种治疗方法的结果以及与对照条件进行比较。
这是一项随机交叉研究，纳入了 17 名健康参与者，他们接受了 3D 步态分析。参与者进行了上下楼梯活动，有以下四种治疗条件：5 度 LWI、现成的膝套、LWI 和膝套联合以及对照条件。评估了外部膝关节内收力矩（EKAM）和膝关节额状面运动范围（ROM）作为主要结果。基于满足假设，选择重复测量方差分析或 Friedman 检验，然后进行多重两两比较和 Bonferroni 校正。
一般来说，与对照条件相比，LWI 在楼梯上升时显著降低了第一峰值 EKAM（p<0.001；12%的降低），但在楼梯下降时没有（p>0.05）。有趣的是，与对照或其他任何条件相比，膝套的使用并没有导致第一峰值 EKAM 的任何降低。然而，膝套的使用导致在楼梯下降时膝关节额状面 ROM 显著减小。与对照相比，联合治疗在 EKAM 降低方面并不优于 LWI 单独使用。
与单独使用 LWI 相比，联合使用膝套和 LWI 并不能降低膝关节负荷，但对于膝 OA 患者可能是有益的，因为它有助于在楼梯下降时减少膝关节额状面 ROM。重要的是，必须针对每种不同的活动来研究 LWI 或任何其他治疗的效果，并且在一项活动中发现的结果不能推广到其他活动。
