The effects of using a lateral wedge insole on knee loading during ascending and descending stairs

Alshawabka, A

Abstract

Introduction: Stair climbing demands, compared to walking on level ground, a greater
range of motion in the lower extremity accompanied by about six times more load on the
knee joint. Consequently, pain while stair climbing is the first complaint in patients with
knee osteoarthritis (OA). The use of lateral wedge insoles aims to decrease medial knee
compartment loading by reducing the peak external knee adduction moment (EKAM)
during walking. The purpose of this study .was to assess the biomechanical effects of
wearing lateral wedge insoles on EKAM during stair climbing in elders with and without
knee OA.
Methods: Thirty healthy subjects (21 females, 9 males) and eight patients with medial
knee OA (5 females, 3 males) participated in the study. Subjects performed five trials of
step-over-step stairs ascent and descent. Three conditions were investigated: (1) Barefoot
(2) Standard shoe (3) Standard shoe with a lateral wedge insole. Kinematic and kinetic
data were collected for the lower extremity using a motion capture system (QTM ) and
two force plates (AMTI force platform stairway). Repeated measures ANOVA and
Friedman's ANOVA were used for statistical analysis.
Results: During stairs ascent and descent, a lateral wedge insole significantly (p<0.05)
reduced the EKAM's 1 st peak in early stance, 2 nd peak in the late stance, the trough in mid
stance, and the knee adduction angular impulse for both knee OA and healthy subjects as
compared to standard shoe and barefoot conditions (e.g., 1 st peak in lateral wedge
condition for OA patients (ascent: (0.37±0.02 Nm/Kg, descent: 0.33±0.05 Nm/Kg),
standard shoe condition (ascent: 0.39±0.03 Nm/Kg, descent: 0.37±0.06 Nm/Kg) and
barefoot condition (ascent: (0.40±0.03 Nm/Kg, descent: 0.39 ±0.07 Nm/Kg)).
Additionally, there was significantly greater range of ankle/subtalar joint complex eversion
with a lateral wedge insole (p<0.05) than in standard shoe and barefoot conditions.
Conclusion: Lateral wedge insoles consistently reduced the overall magnitude of EKAM,
which has been strongly correlated to decreased medial knee compartment loading. These
results support that lateral wedge insoles might be useful in decreasing pain level in
patients with medial knee OA during ascending and descending stairs.

Citation

Alshawabka, A. The effects of using a lateral wedge insole on knee loading during ascending and descending stairs. (Dissertation). University of Salford

• Thesis Type: Dissertation
• Deposit Date: Jul 27, 2021
• Award Date: Apr 1, 2012