Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis
Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis
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DOI：
10.1053/apmr.2002.33225
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发表时间：
2002-07-01
影响因子：
4.3
通讯作者：
Felson, DT
中科院分区：
文献类型：
--
作者：
Kerrigan, DC;Lelas, JL;Felson, DT
目的：为了测试膝关节骨性关节炎患者在行走过程中，与不使用鞋垫和穿着相同材料和平均厚度的非楔形对照鞋垫相比，倾斜50度或100度的外侧楔形鞋垫是否能显著降低膝关节内翻扭矩。（2）用5度侧楔与无楔的3.175-mm（1/8-in）均匀厚度对照鞋垫进行比较;（3）用100度侧楔与无楔的6.35-mm（1/4-in）均匀厚度对照鞋垫进行比较。15例患者的临床和影像学骨关节炎的内侧间室的1 kne.Interventions：不适用。主要成果措施：峰值外膝关节内翻扭矩在步态的立场期间。收集有关下肢关节扭矩和运动的数据，并通过方差分析比较使用不同鞋垫和楔子的膝关节扭矩。虽然个人的反应各不相同，但作为一个群体，与不穿鞋垫和穿3.175-mm和6.35-mm非楔形鞋垫行走相比，5 °和10 °侧楔形鞋垫行走时膝内翻扭矩显著降低。与无鞋垫相比，5 °楔形物使膝内翻扭矩峰值降低约6%，10 °楔形物使峰值降低约8%。虽然没有显着差异的条件之间的步行速度，10度楔形和6.35毫米的控制鞋垫与不同程度的uncomfortab.Conclusion：楔形鞋垫是有效的，在步行过程中减少内翻扭矩超出理论上可以解释的步行速度或缓冲效果降低鞋垫。这些数据表明，楔形鞋垫是生物力学有效的，并应减少内侧膝关节骨关节炎的人内侧间室的负荷。虽然5度楔形的影响较小，但穿在自己的鞋子里可能比10度楔形更舒适。
Objectives: To test whether a lateral-wedged insole, inclined at 5degrees or 10degrees, significantly reduces knee varus torque during walking in patients with knee osteoarthritis compared with both using no insole and with wearing nonwedged control insoles of the same material and average thickness.Design: Patients with medial knee osteoarthritis were studied while they walked wearing their comfortable shoes (1) without an insole; (2) with a 5degrees lateral wedge compared with a nonwedged, 3.175-mm (1/8-in) even-thickness control insole; and (3) with a 100 lateral wedge compared with a nonwedged 6.35-mm (1/4-in) even-thickness control insole.Setting: A gait laboratory with 3-dimensional motion analysis and force platform equipment.Participants: Fifteen patients with clinical and radiographic osteoarthritis of the medial compartment of 1 knee.Interventions: Not applicable.Main Outcome Measures: Peak external knee varus torques during the stance period of gait. Data regarding lower-extremity joint torques and motions were collected, and knee joint torques using the different insoles and wedges were compared by analysis of variance.Results: Although responses varied among individuals, as a group, both the 5degrees and 10degrees lateral-wedge insoles significantly reduced the knee varus torque during walking compared with walking with no insole and walking with nonwedged 3.175-mm and 6.35-mm control insoles Compared with no insole, the 5degrees wedge reduced the peak knee varus torque values by about 6% and the 10degrees wedge reduced the peaks by about 8%. Although there were no significant differences in speed of walking between the conditions, the 10degrees wedge and 6.35-mm control insoles were associated with varying degrees of discomfort.Conclusion: Both wedge insoles are effective in reducing the varus torque during walking beyond what theoretically could be explained by a reduced walking speed or cushioning effect from the insole. These data imply that wedged insoles are biomechanically effective and should reduce loading of the medial compartment in persons with medial knee osteoarthritis. Although the effect of the 5degrees wedge was smaller, it may be more comfortable than the 10degrees wedge to wear inside one's own shoes.