Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis
Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis
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DOI：
10.1016/j.gaitpost.2017.06.009
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发表时间：
2017-09-01
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;Tanimoto, Kenji;Shinkoda, Koichi
外侧楔形鞋垫（LWI）适用于膝关节内侧骨关节炎患者，以减少膝关节外收力矩（KAM）。然而，LWI 的生物力学效应在某些患者中有限。本研究的目的是调查 LWI 的生物力学效应是否取决于个体足部的排列方式，并检查穿着 LWI 时 KAM 的变化与足部和踝关节生物力学变化之间的关系。二十一名患者参与了这项研究。根据足部姿势指数（FPI）将他们分为正常或异常足部组。所有患者均被要求在赤足和 LWI 条件下进行正常步态。使用三维运动分析系统记录第一和第二KAM、膝内收角脉冲(KAAI)、压力中心位移和膝地面反作用力杠杆臂。此外，还评估了足部和踝部额面运动学参数。正常足组中，与赤足条件下相比，LWI条件下的第一KAM显着降低。相比之下，异常足组的两种情况下的第一 KAM 没有显着差异。在正常足组中，后足外翻的减少与第一 KAM 的减少密切相关。这些研究结果表明，评估个体足部的排列有助于确保内侧膝骨关节炎患者得到充分的鞋垫治疗，并且在正常脚穿着 LWI 时，站立阶段早期后足外翻的减少与第一 KAM 的减少有显着关系。
Lateral wedge insoles (LWIs) are prescribed for patients with medial knee osteoarthritis to reduce the external knee adduction moment (KAM). However, the biomechanical effects of LWIs are limited in some patients. The purpose of this study was to investigate whether the biomechanical effects of LWIs depend on individual foot alignment and to examine the relationship between change in KAM and changes in foot and ankle biomechanics when wearing LWIs. Twenty-one patients participated in this study. They were categorized into normal or abnormal foot groups based on the foot posture index (FPI). All patients were requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record 1st and 2nd KAM, knee adduction angular impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm. Furthermore, the foot and ankle frontal plane kinematic parameters were evaluated. The 1st KAM was significantly reduced under the LWI condition compared to that under the barefoot condition in the normal foot group. In contrast, there was no significant difference in 1st KAM between both conditions in the abnormal foot group. Decreased rear foot eversion strongly correlated with reduction in the 1st KAM in the normal foot group. These findings suggested that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with medial knee osteoarthritis and that decreased rear foot eversion during the early stance phase is significantly involved in the reduction of 1st KAM when wearing LWIs with normal feet.