Effects of Laterally Wedged Insoles on Knee and Subtalar Joint Moments

doi:10.1016/j.apmr.2004.09.033

Archives of Physical Medicine and Rehabilitation

Volume 86, Issue 7, July 2005, Pages 1465-1471

https://doi.org/10.1016/j.apmr.2004.09.033 Get rights and content

Abstract

Kakihana W, Akai M, Nakazawa K, Takashima T, Naito K, Torii S. Effects of laterally wedged insoles on knee and subtalar joint moments.

Objective

To assess the biomechanic effects of wearing a lateral wedge on the knee joint varus moment during gait in elders with and without knee osteoarthritis (OA).

Design

Crossover design whereby subjects walked under 2 different insole conditions: a 0° control wedge and a 6° lateral wedge.

Setting

A gait laboratory with 3-dimensional motion analysis and force platform equipment.

Participants

Thirteen healthy subjects and 13 knee patients with OA.

Interventions

Not applicable.

Main Outcome Measures

Frontal plane angles and moments at the knee and subtalar joints, ground reaction forces, and center of pressure. Moments were derived by using a 3-dimensional inverse dynamics model of the lower extremity.

Results

The 6° lateral wedge significantly reduced knee joint varus moment and increased subtalar joint valgus moment in both groups when compared with no wedge. All patients had a greater knee joint varus moment with a similar subtalar joint valgus moment compared with the people without OA. There were diverse, sometimes reversed effects with the insole among the patients.

Conclusions

The 6° lateral wedge did not consistently reduce the knee joint varus moment in patients with knee OA. The biomechanic indications and limitations of laterally wedged insoles should be confirmed by a larger study.

Section snippets

Participants

After informed consent was obtained, 26 elderly women (13 healthy elders, 13 osteoarthritic patients with a varus deformity of the knee) participated in the experiments. There were no statistically significant differences in age, height, and weight (table 1). OA patients were recruited through public advertisements in local community programs about knee OA in the area around the National Rehabilitation Center. The inclusion criteria for OA patients were: 50 years of age or older, knee pain for

Results

The effects of wearing lateral wedged insoles on the knee and subtalar joint moments during stance phase were evident in each insole condition in both the healthy elders and the OA patients (fig 2, table 2). The knee joint varus moment was significantly smaller for insole W compared with insole N (a 10.4% reduction for the healthy elders, a 5.6% reduction for the OA patients; P<.001), whereas the subtalar joint valgus moment was significantly greater for insole W compared with insole N (a 27.7%

Discussion

Our study examined the kinematic and kinetic factors of a 6° lateral wedge insole (insole W) on the knee joint varus moment in healthy elders and in OA patients. The knee joint varus moment was significantly smaller, whereas the subtalar joint valgus moment was significantly greater with insole W compared with insole N (0° wedge) in both the healthy elders and the OA patients. With insole W, this finding correlated with a more lateral shift in the location of the COP during the stance phase.

Conclusions

Generally, patients with OA had significant differences in knee joint biomechanics during walking when compared with age-matched healthy elders. As compared with insole N (0° wedge), insole W (6° wedge) significantly reduced the knee joint varus moment and increased the subtalar joint valgus moment during gait. These results of insole W also correlated with a lateral shift in the location of the COP during stance phase. With respect to the 2 OA patients who had an increase in the knee joint

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Original articleEffects of Laterally Wedged Insoles on Knee and Subtalar Joint Moments

Abstract

Objective

Design

Setting

Participants

Interventions

Main Outcome Measures

Results

Conclusions

Section snippets

Participants

Results

Discussion

Conclusions

Suppliers

Clin Biomech (Bristol, Avon)

J Biomech

J Biomech

Clinical evaluation of the treatment of osteoarthritic knees using a newly designed wedged insole

Clin Orthop

The mechanics of treatment of the osteoarthritic knee with a wedged insole

Clin Orthop

Conservative treatment of genu valgus and varum with medial/lateral heel wedges

Indiana Med

Treatment of osteoarthritis of the knee with heel wedges

Int Orthop

Use of lateral heel and sole wedges in the treatment of medial osteoarthritis of the knee

Orthop Rev

The effect of wedged insoles on the thrust of osteoarthritic knees

Int Orthop

Effect of a novel insole on the subtalar joint of patients with medial compartment osteoarthritis of the knee

J Rheumatol

Original article
Effects of Laterally Wedged Insoles on Knee and Subtalar Joint Moments