Knee and ankle biomechanics with lateral wedges with and without a custom arch support in those with medial knee osteoarthritis and flat feet

Hatfield, Gillian L.; Cochrane, Christopher K.; Takacs, Judit; Krowchuk, Natasha M.; Chang, Ryan; Hinman, Rana S; Hunt, Michael A.

doi:10.1002/jor.23174

Cited by 45 publications

(41 citation statements)

References 36 publications

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“…For the purposes of the meta-analysis, unlike the KAM, the magnitudes of the ankle/subtalar eversion angle and moment were deemed to be relatively consistent between 20% and 80% of stance,16 and data were pooled from studies reporting overall peaks, mean values and values at the time of early and late stance KAM peaks (figure 3). In general, LWIs produce small-to-medium increases in ankle/subtalar eversion angles (SMD=−0.48, 95% CI: −0.91 to –0.06, I 2 =77%, p=0.03) and subsequently large increases in external ankle eversion moments (SMD=−0.84, 95% CI: −1.41 to –0.27, I 2 =77%, p=0.0003), however, large heterogeneity in each variable reduces the strength of the evidence.…”

Section: Resultsmentioning

confidence: 99%

The effects of shoe-worn insoles on gait biomechanics in people with knee osteoarthritis: a systematic review and meta-analysis

et al. 2017

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Objectives The effect of shoe-worn insoles on biomechanical variables in people with medial knee osteoarthritis has been studied extensively. The majority of research has focused specifically on the effect of lateral wedge insoles at the knee. The aim of this systematic review and meta-analysis was to summarise the known effects of different shoe-worn insoles on all biomechanical variables during level walking in this patient population to date. Methods Four electronic databases were searched to identify studies containing biomechanical data using shoe-worn insole devices in the knee osteoarthritis population. Methodological quality was assessed and a random effects meta-analysis was performed on biomechanical variables reported in three or more studies for each insole. Results Twenty-seven studies of moderate-to-high methodological quality were included in this review. The primary findings were consistent reductions in the knee adduction moment with lateral wedge insoles, although increases in ankle eversion with these insoles were also found. Conclusion Lateral wedge insoles produce small reductions in knee adduction angles and external moments, and moderate increases in ankle eversion. The addition of an arch support to a lateral wedge minimises ankle eversion change, and also minimises adduction moment reductions. The paucity of available data on other insole types and other biomechanical outcomes presents an opportunity for future research.

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Section: Resultsmentioning

confidence: 99%

The effects of shoe-worn insoles on gait biomechanics in people with knee osteoarthritis: a systematic review and meta-analysis

et al. 2017

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“…[49] The inclination angles of insoles ranged from 3 degrees [43] to 11 degrees [37] and the most common angle was 5 degrees. [21,44,46,52] With regard to the medial arch support, 5 used a custom design based on patient comfort, [16,21,23,42,43] and 3 studies used prefabricated arch supports. [37,45,52] The remaining study did not report these data.…”

Section: Resultsmentioning

confidence: 99%

“…Recent studies have tested the effect on EKAM of adding an arch support to the LWI during gait but showed inconsistent findings. [21,23,29,37–46] Some authors found a reduction in the EKAM during the stance phase of gait using a lateral wedge and an arch support. [21,39–42,44–46] However, in some patients, no reductions [23,28] or smaller reductions [46] on the EKAM were observed.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis

et al. 2017

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“…The study was approved by the Institution’s Clinical Research Ethics Board and all participants provided written informed consent. In contrast to information provided on the trials registry (Clinicaltrials.gov identifier: NCT02234895), gait biomechanics data were only collected at the initial baseline data collection session, rather than at all time points, and are presented elsewhere [24]. …”

Section: Methodsmentioning

confidence: 99%

Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study

Hunt

Takacs

Krowchuk

et al. 2017

Journal of Foot and Ankle Research

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BackgroundPronated foot posture is associated with many clinical and biomechanical outcomes unique to medial compartment knee osteoarthritis (OA). Though shoe-worn insole treatment, including lateral wedges, is commonly studied in this patient population, their effects on the specific subgroup of people with medial knee OA and concomitant pronated feet are unknown. The purpose of this study was to evaluate whether lateral wedge insoles with custom arch support are more beneficial than lateral wedge insoles alone for knee and foot symptoms in people with medial tibiofemoral knee osteoarthritis (OA) and pronated feet.MethodsTwenty-six people with pronated feet and symptomatic medial knee OA participated in a randomized crossover study comparing five degree lateral wedge foot insoles with and without custom foot arch support. Each intervention was worn for two months, separated by a two-month washout period of no insoles wear. Main outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function subscales, the revised short-form Foot Function Index (FFI-R) pain and stiffness subscales, and the timed stair climb test. Regression modeling was conducted to examine treatment, period, and interaction effects.ResultsTwenty-two participants completed the study, and no carryover or interaction effects were observed for any outcome. Significant treatment effects were observed for the timed stair climb, with greater improvements seen with the lateral wedges with arch support. Within-condition significant improvements were observed for WOMAC pain and physical function, as well as FFI-R pain and stiffness with lateral wedges with arch support use. More adverse effects were reported with the lateral wedges alone, while more people preferred the lateral wedges with arch support overall.ConclusionsAddition of custom arch support to a standard lateral wedge insole may improve foot and knee symptoms in people with knee OA and concomitant pronated feet. These preliminary findings suggest further research evaluating the role of shoe-worn insoles for treatment of this specific sub-group of people with knee OA is warranted.Trial registrationClinicaltrials.gov identifier: NCT02234895.

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Knee and ankle biomechanics with lateral wedges with and without a custom arch support in those with medial knee osteoarthritis and flat feet

Cited by 45 publications

References 36 publications

The effects of shoe-worn insoles on gait biomechanics in people with knee osteoarthritis: a systematic review and meta-analysis

The effects of shoe-worn insoles on gait biomechanics in people with knee osteoarthritis: a systematic review and meta-analysis

A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis

Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study

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