Article

There is contradictory evidence regarding whether the addition of
medial arch supports to laterally wedged insoles reduces knee adduction moment,
improves comfort, and reduces knee pain during the late stance phase of gait.
OBJECTIVES: To verify if such effects occur in participants with medial knee
osteoarthritis. STUDY DESIGN: Randomized single-blinded study. METHODS: Gait
analysis was performed on 18 patients affected by medial knee osteoarthritis.
Pain and comfort scores, frontal plane kinematics and kinetics of ankle, knee,
and hip were compared in four conditions: without foot orthosis, with foot
orthoses, with medial arch support, and with foot orthoses with medial arch
support and lateral wedge insoles with 6 degrees and 10 degrees inclination.
RESULTS: Lower-extremity gait kinetics were characterized by a significant
decrease, greater than 6%, in second peak knee adduction moment in laterally
wedged insole conditions compared to the other conditions ( p < 0.001; effect
size = 0.6). No significant difference in knee adduction moment was observed
between laterally wedged insole conditions. In contrast, a significant increase
of 7% in knee adduction moment during the loading response was observed in the
customized foot orthoses without lateral inclination condition ( p < 0.001;
effect size = 0.3). No difference was found in comfort or pain ratings between
conditions. CONCLUSION: Our study suggests that customized foot orthoses with a
medial arch support may only be suitable for the management of medial knee
osteoarthritis when a lateral wedge is included. Clinical relevance Our data
suggest that customized foot orthoses with medial arch support and a lateral
wedge reduce knee loading in patients with medial knee osteoarthritis (KOA). We
also found evidence that medial arch support may increase knee loading, which
could potentially be detrimental in KOA patients.

Langue : ANGLAIS