Department of Orthotics & Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Physiotherapy, School of Rehabilitation Sciences, Rehabilitation Research Centre, Iran University of Medical Sciences, Tehran, Iran.
Disabil Rehabil. 2022 Dec;44(26):8501-8508. doi: 10.1080/09638288.2021.2019841. Epub 2022 Jan 11.
This study aimed to compare a biaxial ankle-foot orthosis (AFO) with a lateral wedge insole in terms of the biomechanical and clinical outcomes in individuals with knee osteoarthritis.
A cross-over randomized design was used where 31 individuals (25 females and six males, mean age of 52.19 ± 4.12 years) with knee osteoarthritis wore each intervention for two weeks with two weeks washout period. Three-dimensional kinematic and kinetic data and clinical outcomes were collected to evaluate the effects of each intervention on knee adduction moment (KAM), pain, stiffness, and function.
Both orthoses significantly improved pain by 17 and 22%, function by 11 and 14%, the first peak KAM by 15.7 and 19.2%, the second peak KAM by 10.4 and 16.7%, and KAM impulse by 14.8 and 22.2%, respectively. However, the biaxial AFO significantly reduced the KAM and improved function compared to the lateral wedge insole ( < 0.01).
The results of this study have shown that both orthoses have a potential role in the conservative management of medial knee osteoarthritis. The biaxial AFO proved statistically better at improving function and KAM; though these differences do not seem to be clinically significant.IMPLICATION FOR REHABILITATIONOrthotic interventions have been reported to be effective in the management of medial knee osteoarthritis.Lateral wedge insole and biaxial ankle-foot orthosis (AFO) are effective in the improvement of pain, function, and knee adduction moment (KAM) in people with medial knee osteoarthritis.The biaxial AFO, compared with lateral wedge insole, contributes to statistically more improvement of function and KAM. However, these differences do not seem to be clinically significant.
本研究旨在比较双侧踝足矫形器（AFO）与外侧楔形鞋垫在膝骨关节炎患者中的生物力学和临床效果。
采用交叉随机设计，31 名（25 名女性和 6 名男性，平均年龄 52.19±4.12 岁）膝骨关节炎患者佩戴每种干预措施两周，洗脱期为两周。收集三维运动学和动力学数据以及临床结果，以评估每种干预措施对膝内收力矩（KAM）、疼痛、僵硬和功能的影响。
两种矫形器均显著改善疼痛 17%和 22%，功能改善 11%和 14%，第一峰值 KAM 减少 15.7%和 19.2%，第二峰值 KAM 减少 10.4%和 16.7%，KAM 冲量减少 14.8%和 22.2%。然而，双侧 AFO 与外侧楔形鞋垫相比，显著降低 KAM 并改善功能（ < 0.01）。
本研究结果表明，两种矫形器在治疗内侧膝骨关节炎的保守治疗中都具有潜在的作用。双侧 AFO 在改善功能和 KAM 方面的效果优于统计学意义；尽管这些差异似乎没有临床意义。
矫形器干预措施已被报道对内侧膝骨关节炎的管理有效。外侧楔形鞋垫和双侧踝足矫形器（AFO）在改善内侧膝骨关节炎患者的疼痛、功能和膝内收力矩（KAM）方面都有效。与外侧楔形鞋垫相比，双侧 AFO 在功能和 KAM 的改善方面有统计学上的更大改善。然而，这些差异似乎没有临床意义。
