Comparison of the effects of shoe orthotics on the replacement of center of pressure in patients with severe medial compartment knee osteoarthritis

Document Type : Original article

Authors

1 1. MSc in Physiotherapy. Dept. of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. Tehran. Iran

2 2. Professor of Physiotherapy, Dept. of Physiotherapy, Faculty of Rehabilitation Sciences, Physiotherapy research center, Shahid Beheshti University of Medical Sciences. Tehran. Iran

3 3. Associated professor of Statistics, Dept. of Basic Sciences, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. Tehran. Iran

4 4. PhD candidate of orthotics and prosthetics, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. Tehran. Iran

Abstract

Background and aim: Osteoarthritis of knee is the most common joint disorder, accounting for a large rate of disability in elderly that affected both genders equally. The patients with severe knee osteoarthritis complain of considerable pain and immobility and functional limitations. The medial compartment of the knee affected more often than lateral compartment. One of the conservative treatments proposed for this disorder is the lateral wedge insole. The aim of this study was to compare the effect of different insoles (in-shoe and out-shoe wedges) with the height of 7mm on the replacement of foot’s center of pressure in patients with severe medial knee osteoarthritis.
 Materials &Methods: 40 female patients with severe knee OA (severity of OA was 3, 4 in kallegrane & larense index, varus angle >182 and Mean age of 56.52±9.38) participated in this interventional study. The volunteers are evaluated at two positions included single limb stance and double limb stance during wearing seven different in-sole and out-sole wedges; in-shoe lateral heel wedge, in-shoe full length lateral wedge, in-shoe lateral heel wedge with medial arc support, in-shoe full length wedge with medial arc support, out-shoe lateral heel wedge, out-shoe full length lateral wedge and, without any wedge. Foot scan setting was used for evaluating and data collection. Repeated Measures ANOVA test was used to analyze the data.
Results: Different in-shoe and out-shoe wedges had different effects on the displacement of the center of pressure (P<0.0001). The comparison across different lateral wedges with height of 7mm suggested that out-shoe full length Lateral wedge has the most effect in lateralization of foot center of pressure followed by  in-shoe lateral heel wedge with medial arc support, in-shoe lateral heel wedge, in-shoe full length wedge and in-shoe full length wedge with medial arch support.
Conclusion: Among the investigated in-sole and out-sole wedges the lateral full length out-shoe wedge has the greatest effect on the lateral displacement of foot center of pressure.

Keywords

References

  1. Joern W M, Klaus U S, Peer E. The epidemiology, Etiology, Diagnosis, and Treatment of Osteoarthritis of the knee. Dtsch Arztebl Int. 2010; 107(9): 152-62
  2. Rahimi A. New findings in osteoarthritis (Arthrosis). 1st ed. Tehran. Sarmadi. 1385. p16-28. [In Persian]
  3. Baker K, Goggins J, Xie H, Szumowski K, LaValley M, Hunter DJ, Felson DT. A randomized crossover trial of a wedged insole for treatment of knee osteoarthritis. Arthritis & Rheumatism. 2007; 56(4): 1198–1203.
  4. Nester CJ, van der Linden ML, Bowker P. Effect of foot orthoses on the kinematics and kinetics of normal walking gait. Gait Posture. 2003; 17(2):180-7.
  5. Sharma L, Hurwitz DE, Thonar EJ, Sum JA, Lenz ME, Dunlop DD, Schnitzer TJ, n Kirwan-Mellis G, Andriacchi TP. Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheum.1998; 41(7):1233–40.
  6. Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ, Hubley-Kozey CL. Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels. J Biomech. 2008; 41(4):868-76.
  7. Hinman RS, Bowles KA, Bennell KL.Laterally wedged insoles in knee osteoarthritis: do biomechanical effects decline after one month of wear? BMC Musculoskelet Disord. 2009; 25(10):146.
  8. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis Rheum. 2000;43(9):1905-15.
  9. Tropp H, Odenrick P. Postural control in single-limb stance. Department of Clinical Neurophysiology. J Orthop Res. 1988; 6(6):833-9.
  10. Kakihana W, Akai M, Nakazawa K, Takashima T, Naito K, Torii S. Effects of laterally wedged insoles on knee and subtalar joint moments. Arch Phys Med Rehabil. 2005; 86(7):1465-71.
  11. Kakihana W, Akai M, Yamasaki N, Takashima T, Nakazawa K. Changes of joint moments in the gait of normal subjects wearing laterally wedged insoles. Am J Phys Med Retail? 2004; 83(4):273-8.
  12. Maly M, Culham E, Costigan P. Static and dynamic biomechanics of foot orthoses in people with medial compartment knee osteoarthritis. Clin Biomech (Bristol, Avon). 2002;17(8):603-10.
  13. Bartold SJ. The Role of Orthoses in the Treatment of Patellofemoral Pain in Runners. . Int Sport Med J. 2001; 2(1): 170-81.
  14. Lidtke R, Muehleman C, Case JP, Block JA. Relationship between plantar foot pressure and medial knee osteoarthritis.51st Annual meeting of the orthopaedic Research Society. Paper no: 1435.
  15. Lidtke R, Muehleman C, Block JA. Knee adduction moments in osteoarthritis are related to foot center of pressure.52nd Annual meeting of the orthopaedic Research Society. Paper no: 423.
  16. Divine JG, Hewett TE. Valgus bracing for degenerative knee osteoarthritis: relieving pain, improving gait, and increasing activity. Phys Sports med.2005; 33(2):40-6.
  17. Wu DD, Burr DB, Boyd RD, Radin EL. Bone and cartilage changes following experimental varus or valgus tibial angulation. J Orthop Res. 1990; 8(4):572–85.
  18. Kraemer WJ, Ratamess NA, Maresh CM,Anderson JA, Tiberio DP, Joyce ME. Effects of treatment with a cetylated fatty acid topical cream on static postural stability and plantar pressure distribution in patients with knee osteoarthritis. J Strength Cond Res.2005; 19(1):115-21.
  19. Kirkley A, Webster-Bogaert S, Litchfield R, Amendola A, MacDonald S, McCalden R. The effect of bracing on varus gonarthrosis. J Bone Joint Surg Am. 1999; 81(4):539-48.
  20. Davidson PL, Sanderson DJ, Loomer RL. Kinematics of valgus bracing for medial gonarthrosis: technical report. Clin Biomech(Bristol, Avon). 1998; 13(6):414-419.
  21. Shimada S, Kobayashi S, Wada M, Uchida K, Sasaki S,Kawahara H, Yayama T, Kitade I, Kamei K, Kubota M, Baba H .Effects of disease severity on response to lateral wedged shoe insole for medial compartment knee osteoarthritis. 2006; 87(11):1436-41.
The Scientific Journal of Rehabilitation Medicine
Volume 2, Issue 2 - Serial Number 2
July and August 2013
Pages 24-31

Files

History

  • Receive Date: 24 June 2012
  • Revise Date: 09 September 2012
  • Accept Date: 30 October 2012
  • First Publish Date: 22 June 2013

Share

How to cite

Statistics