The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis : a randomised trial

Jones, R; Chapman, GJ; Parkes, M; Forsythe, L; Felson, D

Abstract

Many conservative treatments exist for medial knee osteoarthritis (OA) which aims to reduce the external knee adduction moment (EKAM). The objective of this study was to determine the difference between different shoes and lateral wedge insoles on EKAM, knee adduction angular impulse (KAAI), external knee flexion moment, pain, and comfort when walking in individuals with medial knee OA. Seventy individuals with medial knee OA underwent three-dimensional walking gait analysis in five conditions
(barefoot, control shoe, typical wedge, supported wedge, and mobility shoe) with pain and comfort recorded concurrently. The change in EKAM, KAAI, external knee flexion moment, pain, and comfort were assessed using multiple linear regressions and pairwise comparisons. Compared with the control shoe, lateral wedge insoles and barefoot walking significantly reduced early stance EKAM and KAAI. The mobility shoe showed no effect. A significant reduction in latter stance EKAM was seen in the lateral wedge insoles compared to the other conditions, with only the barefoot condition reducing the external knee flexion moment. However, the mobility
shoe showed significant immediate knee pain reduction and improved comfort scores. Different lateral wedge insoles show comparable reductions in medial knee loading and in our study, the mobility shoe did not affect medial loading.

• Journal Article Type: Article
• Acceptance Date: May 13, 2015
• Online Publication Date: May 19, 2015
• Publication Date: May 19, 2015
• Deposit Date: Jun 17, 2015
• Publicly Available Date: Jul 23, 2019
• Journal: Journal of Orthopaedic Research
• Print ISSN: 0736-0266
• Electronic ISSN: 1554-527X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Issue: 11
• Pages: 1646-1654
• DOI: https://doi.org/10.1002/jor.22947
• Publisher URL: http://dx.doi.org/10.1002/jor.22947
• Related Public URLs: http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1554-527X
• Additional Information: Funders : Arthritis Research UK Special Strategic Award;Arthritis Research UK Centre of Excellence in Epidemiology;SILK (ISRCTN);National Institutes of Health (NIH); Projects : Developing New Treatments for Knee Osteoarthritis; Grant Number: 18676; Grant Number: 20380; Grant Number: 83706683; Grant Number: AR47785