Article

Anterior knee pain (AKP) is a common injury among runners and effectively treated
with posted insoles and foot orthotics. While clinically effective, the
underlying biomechanical mechanisms that bring about these improvements remain
debatable. Several methodological factors contribute to the inconsistent
biomechanical findings, including errors associated with removing and reattaching
markers, inferring foot motion from markers placed externally on a shoe, and
redefining segmental coordinate systems between conditions. Therefore, the
purpose of this study was to evaluate the influence of medially posted insoles on
lower extremity kinematics in runners with and without AKP while trying to limit
the influence of these methodological factors. Kinematics of 16 asymptomatic and
17 runners with AKP were collected while running with and without insoles.
Reflective markers were attached to the surface of the calcaneus and kept in
place (as opposed to detached) between conditions, eliminating the error
associated with reattaching markers and redefining segmental coordinate systems.
Using these methods, no significant interactions between insole and injury and
the main effect of injury were detected (p>0.05); therefore, means were pooled
across injury. Insoles, on average, reduced peak eversion by 3.6 degrees (95%
confidence interval -2.9 degrees to -4.3 degrees ), peak eversion velocity by
53.2 degrees /s (95% confidence interval -32.9 to -73.4) and eversion range of
motion by 1.33 (95% confidence interval -0.8 to -1.9). However, while insoles
systematically reduced eversion variables, they had small influences on the
transverse plane kinematics of the tibia or knee, indicating that they may bring
about their clinical effect by influencing other variables.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS