Foot alignments influence the effect of knee adduction moment with lateral wedge insoles during gait
Foot alignments influence the effect of knee adduction moment with lateral wedge insoles during gait
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DOI：
10.1016/j.gaitpost.2016.08.011
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发表时间：
2016-09-01
期刊：
影响因子：
2.4
通讯作者：
Shinkoda, Koichi
中科院分区：
文献类型：
--
作者：
Sawada, Tomonori;Tokuda, Kazuki;Shinkoda, Koichi
侧楔鞋垫（LWIs）减少峰值外膝内收力矩（KAM）。然而，在某些个体中，LWIs的功效是有限的，因为它们不能降低KAM。缺乏预期LWI反应的可能解释是足部排列的变化。本研究的目的是评估lwi的即时生物力学效应是否依赖于步态中个人足部的排列。15名健康成年人参加了这项研究。使用足部姿势指数将他们的脚分为正常、内旋和外旋。随后，所有受试者被要求在赤脚和LWI条件下表现正常的步态。使用三维运动分析系统记录了运动学和动力学数据，包括峰值KAM、KAM冲量（KAAI）、压力位移中心和膝地反作用力杠杆臂（KLA）。此外，还评估了后脚、踝关节、膝关节和髋关节的下肢前平面运动学参数。各足部间KAM和KAAI峰均无显著性差异。与正常足组相比，LWI条件下的KAM峰值明显降低。峰值KAM的降低与更侧向的压力中心和降低的KLA相关。此外，KLA降低与髋关节内收减少相关。LWIs显著降低了正常足部的峰值KAM，这表明LWIs的生物力学效应因不同的足部排列而异。我们的研究结果表明，评估个体足部对齐有助于确保对膝骨关节炎患者进行适当的鞋垫治疗。(C) 2016 Elsevier B.V.版权所有
Lateral wedge insoles (LWIs) reduce the peak external knee adduction moment (KAM). However, the efficacy of LWIs is limited in certain individuals for whom they fail to decrease KAM. Possible explanations for a lack of desired LWI response are variations in foot alignments. The purpose of this study was to evaluate whether the immediate biomechanical effects of LWIs depend on individual foot alignments during gait. Fifteen healthy adults participated in this study. Their feet were categorized as normal, pronated, and supinated using the foot posture index. All subjects were subsequently requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record the kinematic and kinetic data, included peak KAM, KAM impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm (KLA). Furthermore, lower limb frontal plane kinematic parameters at the rear foot, ankle, knee, and hip were evaluated. Among all feet, there was no significant difference in the peak KAM and KAAI between the conditions. In contrast, the peak KAM was significantly reduced under the LWI condition relative to the barefoot condition in the normal foot group. Reductions in the peak KAM were correlated with a more lateral center of pressure and reduced KLA. In addition, a reduced KLA was correlated with decreased hip adduction. LWIs significantly reduced the peak KAM in normal feet, indicating that biomechanical effects of LWIs vary between individual foot alignments. Our findings suggest that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with knee osteoarthritis. (C) 2016 Elsevier B.V. All rights reserved.