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Kinsella R, Nasser A, Menz HB, Pizzari T, Collins NJ, Semciw AI. Effects of foot orthoses and footwear interventions on impairments and quality of life in people with hip pain: A systematic review. Musculoskeletal Care 2023; 21:1529-1550. [PMID: 37823790 DOI: 10.1002/msc.1826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Foot orthoses and footwear interventions are advocated for the management of lower limb musculoskeletal conditions including the hip, but much of the research is focused on knee disorders. The aim of this systematic review was to synthesise the literature that investigates the use of foot orthoses or footwear in people with hip-related pain. METHODS MEDLINE, EMBASE, CINAHL, AMED and SPORTDiscus were searched from inception to March 2023. Randomised controlled trials (RCT), cohort and pre-post studies reporting on footwear and foot orthoses interventions, in participants with hip-related pain, were eligible for inclusion. Outcomes included pain, physical function, and quality of life (QoL). Effect sizes were calculated where sufficient data were available. Reporting quality was assessed using the Cochrane Risk of Bias Tool (Rob-2) and the Joanna Briggs Institute Checklist. The overall quality of evidence was rated according to the Grading of Recommendations, Assessment, Development, and Evaluations framework. RESULTS Of the seven included studies (n = 266 participants), there was one RCT, one cohort and five single-group pre-post designs. Interventions included customised and non-customised arch supports, heel lifts, and footwear modifications, used in the following hip conditions: trochanteric pain, non-specific hip pain, hip osteoarthritis, and leg length dysfunction following total hip arthroplasty. Meta-analysis was possible for outcomes in two studies, demonstrating moderate improvement in pain following foot orthoses use. Overall certainty of evidence ranged from very low to low. CONCLUSION Single-group pre-post study designs describe positive relationships between foot orthoses and footwear use and improvements in hip pain, function, and QoL. However, these results were not supported by the only available RCT. Given this is a relatively inexpensive and non-invasive treatment approach, further rigorous studies are warranted.
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Affiliation(s)
- Rita Kinsella
- Department of Surgery, St Vincent's Hospital, Faculty Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Anthony Nasser
- Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Hylton B Menz
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Tania Pizzari
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Natalie J Collins
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Adam I Semciw
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Melbourne, Victoria, Australia
- Department of Allied Health, Northern Hospital, Melbourne, Australia
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Kayll SA, Hinman RS, Bryant AL, Bennell KL, Rowe PL, Paterson KL. Do biomechanical foot-based interventions reduce patellofemoral joint loads in adults with and without patellofemoral pain or osteoarthritis? A systematic review and meta-analysis. Br J Sports Med 2023:bjsports-2022-106542. [PMID: 36898768 DOI: 10.1136/bjsports-2022-106542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To evaluate the effects of biomechanical foot-based interventions (eg, footwear, insoles, taping and bracing on the foot) on patellofemoral loads during walking, running or walking and running combined in adults with and without patellofemoral pain or osteoarthritis. DESIGN Systematic review with meta-analysis. DATA SOURCES MEDLINE, CINAHL, SPORTdiscus, Embase and CENTRAL. ELIGIBILITY CRITERIA FOR SELECTING STUDIES English-language studies that assessed effects of biomechanical foot-based interventions on peak patellofemoral joint loads, quantified by patellofemoral joint pressure, reaction force or knee flexion moment during gait, in people with or without patellofemoral pain or osteoarthritis. RESULTS We identified 22 footwear and 11 insole studies (participant n=578). Pooled analyses indicated low-certainty evidence that minimalist footwear leads to a small reduction in peak patellofemoral joint loads compared with conventional footwear during running only (standardised mean difference (SMD) (95% CI) = -0.40 (-0.68 to -0.11)). Low-certainty evidence indicated that medial support insoles do not alter patellofemoral joint loads during walking (SMD (95% CI) = -0.08 (-0.42 to 0.27)) or running (SMD (95% CI) = 0.11 (-0.17 to 0.39)). Very low-certainty evidence indicated rocker-soled shoes have no effect on patellofemoral joint loads during walking and running combined (SMD (95% CI) = 0.37) (-0.06 to 0.79)). CONCLUSION Minimalist footwear may reduce peak patellofemoral joint loads slightly compared with conventional footwear during running only. Medial support insoles may not alter patellofemoral joint loads during walking or running and the evidence is very uncertain about the effect of rocker-soled shoes during walking and running combined. Clinicians aiming to reduce patellofemoral joint loads during running in people with patellofemoral pain or osteoarthritis may consider minimalist footwear.
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Affiliation(s)
- Samual A Kayll
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adam L Bryant
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick L Rowe
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Souto LR, Serrão PRMDS, Pisani GK, Tessarin BM, da Silva HF, Machado EDM, de Oliveira Sato T, Serrão FV. Immediate effects of hip strap and foot orthoses on self-reported measures and lower limb kinematics during functional tasks in individuals with patellofemoral osteoarthritis: protocol for a randomised crossover clinical trial. Trials 2022; 23:746. [PMID: 36064729 PMCID: PMC9446757 DOI: 10.1186/s13063-022-06676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Elevated patellofemoral joint stress has been associated with patellofemoral osteoarthritis (PFOA). Changes in lower limb kinematics, such as excessive femoral adduction and internal rotation and excessive rearfoot eversion during the stance phase of functional activities, may increase patellofemoral stress. There is a lack of studies that assess the effects of interventions for controlling femur and subtalar joint movements during functional activities on self-reported measures in individuals with PFOA. Thus, the primary aim of the study is to determine the immediate effects of the hip strap and foot orthoses during level-ground walking and the single-leg squat test on self-reported outcomes. The secondary aim is to investigate whether the hip strap and foot orthoses result in the kinematic changes that these devices are purported to cause. Methods Twenty-nine individuals with PFOA aged 50 years or older will take part in the study. The main outcome is pain intensity. The secondary outcomes are other self-reported measures (global rating of change, acceptable state of symptoms, ease of performance, and confidence) and lower limb kinematics (peak femoral adduction and internal rotation, and peak rearfoot eversion). These outcomes will be assessed during functional tasks performed under three conditions: (i) control condition, (ii) hip strap intervention, and (iii) foot orthoses intervention. To investigate whether these interventions result in the lower limb kinematic changes that they are purported to cause, three-dimensional kinematics of the femur and rearfoot will be captured during each task. Linear mixed models with two fixed factors will be used to test associations between the interventions (control, hip strap, and foot orthoses) and conditions (level-ground walking and single-leg squat test) as well as interactions between the interventions and conditions. Discussion To the best of the authors’ knowledge, this is the first study to evaluate the immediate effects of the hip strap and foot orthoses on self-reported measures and lower limb kinematics during functional tasks in individuals with PFOA. The findings of this study will enable future trials to investigate the effects of these interventions in rehabilitation programmes. Trial registration ClinicalTrials.gov NCT04332900. Registered on 3 April 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06676-0.
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Affiliation(s)
- Larissa Rodrigues Souto
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil.
| | | | - Giulia Keppe Pisani
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Bruna Mariana Tessarin
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Hygor Ferreira da Silva
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Eliane de Morais Machado
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Tatiana de Oliveira Sato
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Fábio Viadanna Serrão
- Department of Physical Therapy, Federal University of São Carlos, Rod. Washington Luís, Km 235, São Carlos, SP, CEP 13565-905, Brazil
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Lin W, Kang H, Dai Y, Niu Y, Yang G, Niu J, Li M, Wang F. Early patellofemoral articular cartilage degeneration in a rat model of patellar instability is associated with activation of the NF-κB signaling pathway. BMC Musculoskelet Disord 2021; 22:90. [PMID: 33461534 PMCID: PMC7814603 DOI: 10.1186/s12891-021-03965-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 01/11/2021] [Indexed: 01/11/2023] Open
Abstract
Background Patellar instability (PI) often increases the possibility of lateral patellar dislocation and early osteoarthritis. The molecular mechanism of early articular cartilage degeneration during patellofemoral osteoarthritis (PFOA) still requires further investigation. However, it is known that the NF-κB signaling pathway plays an important role in articular cartilage degeneration. The aim of this study was to investigate the relationship between the NF-κB signaling pathway and patellofemoral joint cartilage degeneration. Methods We established a rat model of PI-induced PFOA. Female 4-week-old Sprague-Dawley rats (n = 120) were randomly divided into two groups: the PI (n = 60) and control group (n = 60). The distal femurs of the PI and control group were isolated and compared 4, 8, and 12 weeks after surgery. The morphological structure of the trochlear cartilage and subchondral bone were evaluated by micro-computed tomography and histology. The expression of NF-κB, matrix metalloproteinase (MMP)-13, collagen X, and TNF-ɑ were evaluated by immunohistochemistry and quantitative polymerase chain reaction. Results In the PI group, subchondral bone loss and cartilage degeneration were found 4 weeks after surgery. Compared with the control group, the protein and mRNA expression of NF-κB and TNF-ɑ were significantly increased 4, 8, and 12 weeks after surgery in the PI group. In addition, the markers of cartilage degeneration MMP-13 and collagen X were more highly expressed in the PI group compared with the control group at different time points after surgery. Conclusions This study has demonstrated that early patellofemoral joint cartilage degeneration can be caused by PI in growing rats, accompanied by significant subchondral bone loss and cartilage degeneration. In addition, the degeneration of articular cartilage may be associated with the activation of the NF-κB signaling pathway and can deteriorate with time as a result of PI.
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Affiliation(s)
- Wei Lin
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Huijun Kang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Yike Dai
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Yingzhen Niu
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Guangmin Yang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Jinghui Niu
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Ming Li
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China
| | - Fei Wang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, China.
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Tan JM, Crossley KM, Munteanu SE, Collins NJ, Hart HF, Donnar JW, Cleary G, O’Sullivan IC, Maclachlan LR, Derham CL, Menz HB. Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis. J Foot Ankle Res 2020; 13:57. [PMID: 32967701 PMCID: PMC7509922 DOI: 10.1186/s13047-020-00426-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot and ankle characteristics are associated with patellofemoral pain (PFP) and may also relate to patellofemoral osteoarthritis (PFOA). A greater understanding of these characteristics and PFOA, could help to identify effective targeted treatments. OBJECTIVES To determine whether foot and ankle characteristics are associated with knee symptoms and function in individuals with PFOA. METHODS For this cross-sectional study we measured weightbearing ankle dorsiflexion range of motion, foot posture (via the Foot Posture Index [FPI]), and midfoot mobility (via the Foot Measurement Platform), and obtained patient-reported outcomes for knee symptoms and function (100 mm visual analogue scales, Anterior Knee Pain Scale [AKPS], Knee injury and Osteoarthritis Outcome Score, repeated single step-ups and double-leg sit-to-stand to knee pain onset). Pearson's r with significance set at p < 0.05 was used to determine the association between foot and ankle charateristics, with knee symptoms and function, adjusting for age. RESULTS 188 participants (126 [67%] women, mean [SD] age of 59.9 [7.1] years, BMI 29.3 [5.6] kg/m2) with symptomatic PFOA were included in this study. Lower weightbearing ankle dorsiflexion range of motion had a small significant association with higher average knee pain (partial r = - 0.272, p < 0.001) and maximum knee pain during stair ambulation (partial r = - 0.164, p = 0.028), and lower scores on the AKPS (indicative of greater disability; partial r = 0.151, p = 0.042). Higher FPI scores (indicating a more pronated foot posture) and greater midfoot mobility (foot mobility magnitude) were significantly associated with fewer repeated single step-ups (partial r = - 0.181, p = 0.023 and partial r = - 0.197, p = 0.009, respectively) and double-leg sit-to-stands (partial r = - 0.202, p = 0.022 and partial r = - 0.169, p = 0.045, respectively) to knee pain onset, although the magnitude of these relationships was small. The amount of variance in knee pain and disability explained by the foot and ankle characteristics was small (R2-squared 2 to 8%). CONCLUSIONS Lower weightbearing ankle dorsiflexion range of motion, a more pronated foot posture, and greater midfoot mobility demonstrated small associations with worse knee pain and greater disability in individuals with PFOA. Given the small magnitude of these relationships, it is unlikely that interventions aimed solely at addressing foot and ankle mobility will have substantial effects on knee symptoms and function in this population. TRIAL REGISTRATION The RCT was prospectively registered on 15 March 2017 with the Australia and New Zealand Clinical Trials Registry ( ANZCTRN12617000385347 ).
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Affiliation(s)
- Jade M. Tan
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Kay M. Crossley
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Shannon E. Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Natalie J. Collins
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Australia
| | - Harvi F. Hart
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
- Department of Physical Therapy, Faculty of Health Sciences, Collaborative Training Program in Musculoskeletal Health Research, and Bone and Joint Institute, Western University, London, N6A 3K7 Canada
| | - Joel W. Donnar
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Gearoid Cleary
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Australia
| | - Isobel C. O’Sullivan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Australia
| | - Liam R. Maclachlan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Australia
| | - Catherine L. Derham
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Hylton B. Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
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Immediate effects of foot orthoses on gait biomechanics in individuals with persistent patellofemoral pain. Gait Posture 2020; 77:20-28. [PMID: 31955047 DOI: 10.1016/j.gaitpost.2019.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The efficacy of foot orthoses in reducing patellofemoral pain (PFP) is well documented; however, the mechanisms by which foot orthoses modulate pain and function are poorly understood. RESEARCH QUESTION This within-subject study investigated the immediate effects of foot orthoses on lower limb kinematics and angular impulses during level walking and stair ambulation in individuals with persistent PFP. METHODS Forty-two participants with persistent PFP (≥3 months duration) underwent quantitative gait analysis during level walking, stair ascent and stair descent while using: (i) standard running sandals (control); and (ii) standard running sandals fitted with prefabricated foot orthoses. Hip, knee, and ankle joint kinematics and angular impulses were calculated and statistically analyzed using paired t-tests (p < 0.05). RESULTS Relative to the control condition, foot orthoses use was associated with small but significant decreases in maximum ankle inversion angles during walking (mean difference [95% confidence interval]: -1.00° [-1.48 to -0.53]), stair ascent (-1.06° [-1.66 to -0.45]) and stair decent (-0.94° [-1.40 to -0.49]). Foot orthoses were also associated with decreased ankle eversion impulse during walking (-9.8Nms/kg [-12.7 to -6.8]), and decreased ankle dorsiflexion and eversion impulse during stair ascent (-67.6Nms/kg [-100.7 to -34.6] and -17.5Nms/kg [-23.6 to -11.4], respectively) and descent (-50.4Nms/kg [-77.2 to -23.6] and -11.6Nms/kg [-15.6 to -7.5], respectively). Ankle internal rotation impulse decreased when participants ascended stairs with foot orthoses (-3.3Nms/kg [-5.4 to -1.3]). Limited changes were observed at the knee and hip. SIGNIFICANCE In individuals with persistent PFP, small immediate changes in kinematics and angular impulses - primarily at the ankle - were observed when foot orthoses were worn during walking or stair ambulation. The clinical implications of these small changes, as well as the longer-term effects of foot orthoses on lower limb biomechanics, are yet to be determined.
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Immediate effects of foot orthoses on lower limb biomechanics, pain, and confidence in individuals with patellofemoral osteoarthritis. Gait Posture 2020; 76:51-57. [PMID: 31731134 DOI: 10.1016/j.gaitpost.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/02/2019] [Accepted: 10/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot orthoses are a recommended treatment for patellofemoral (PF) pain and a number of lower limb osteoarthritic (OA) conditions. However, their mechanism of effect is poorly understood. RESEARCH QUESTION To compare the immediate effects of foot orthoses and flat inserts on lower limb biomechanics, knee pain and confidence in individuals with PFOA. METHODS Twenty-one participants (14 females; mean ± SD age 58 ± 8 years) with PFOA underwent three-dimensional motion analysis during level-walking, stair ascent, and stair descent under three footwear conditions: (i) their own shoes; (ii) prefabricated foot orthoses; and (iii) flat shoe inserts. Participants reported their average levels of knee pain and confidence after each task. Data were analysed with repeated-measures analysis of variance (ANOVA), effect sizes (partial eta squared), and Bonferroni post-hoc tests. RESULTS During level-walking, there was a significant main effect of foot orthoses on peak ankle dorsiflexion angle (F2 = 0.773, p < 0.001, ƞ2 = 0.773) and peak ankle external dorsiflexion moment (F2 = 0.356, p = 0.046, ƞ2 = 0.356). Foot orthoses decreased the peak ankle dorsiflexion angle compared to the flat insert and shoe conditions, and decreased the peak ankle external dorsiflexion moment relative to flat inserts. During stair descent, there was a significant main effect of foot orthoses on peak ankle external dorsiflexion moment (F2 = 0.823, p = 0.006, ƞ2 = 0.738), with a trend towards lower peak dorsiflexion moment for foot orthoses compared to the flat insert and shoe conditions. No significant main effects were observed during stair ascent. No other lower limb biomechanical changes were observed across all three conditions. Knee pain and confidence scores were not significantly different across the three conditions. SIGNIFICANCE Prefabricated foot orthoses altered sagittal plane biomechanics of the ankle during level-walking and stair descent in individuals with PFOA. Further research is required to determine whether these changes are clinically beneficial.
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Tan JM, Menz HB, Crossley KM, Munteanu SE, Hart HF, Middleton KJ, Smith AJ, Collins NJ. The efficacy of foot orthoses in individuals with patellofemoral osteoarthritis: a randomised feasibility trial. Pilot Feasibility Stud 2019; 5:90. [PMID: 31338205 PMCID: PMC6625074 DOI: 10.1186/s40814-019-0469-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 06/21/2019] [Indexed: 11/22/2022] Open
Abstract
Background Foot orthoses have the potential to be an efficacious treatment for patellofemoral osteoarthritis (PFOA) but have not been evaluated in clinical trials in this population. This study aimed to determine the: (i) feasibility of conducting a randomised controlled trial (RCT) investigating the efficacy of foot orthoses in individuals with PFOA; and (ii) effects of foot orthoses versus flat shoe inserts on pain, function, and knee-related quality of life (QOL). Methods This 6-week, single-blinded pilot RCT randomly allocated participants with PFOA to receive foot orthoses or flat inserts. The primary outcome of feasibility was determined via the following parameters: one participant recruited per week, 20% (35 h/week) adherence to the intervention, 50% log book completion rate, and < 20% drop-out, with results reported using descriptive statistics. Secondary outcomes included average and maximum pain severity (100 mm visual analogue scale), Anterior Knee Pain Scale, and Knee injury and Osteoarthritis Outcome Score, analysed using analysis of covariance. Results Twenty-six participants (16 women; mean (SD) age of 60 (8) years) with PFOA were recruited. All feasibility parameters were exceeded, with three participants recruited per week, > 20% (37.2 [9.8] hours/week) adherence to the intervention, 69.2% (18/26) log-book completion, and 3.8% (1/26) drop-outs. The most common adverse events were arch irritation and shoe fit issues, which were more common in the foot orthoses group (67.9% versus 32.1%). There was a trend for the foot orthoses group to report larger improvements in average and maximum pain than the flat insert group, with the mean difference for maximum knee pain severity (21.9 mm, 95% CI − 2.1 to 46.0) exceeding the minimal clinically important difference (15 mm). The estimated sample size for a full-scale RCT is 160 participants. Suggestions to improve study design include a greater number of face-to-face follow-up appointments, a larger variety of foot orthoses to reduce rates of adverse events, and increasing follow-up time to determine long-term efficacy. Conclusion This study supports the feasibility of a full-scale RCT to determine the efficacy of foot orthoses versus flat inserts in individuals with PFOA. Trial registration The trial protocol was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR number: 12616001287426).
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Affiliation(s)
- Jade M Tan
- 1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Hylton B Menz
- 1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Kay M Crossley
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Shannon E Munteanu
- 1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Harvi F Hart
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,4The Wolf Orthopaedic Biomechanics Laboratory, University of Western Ontario, London, Ontario N6A 3K7 Canada
| | - Kane J Middleton
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,3Discipline of Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Anne J Smith
- 5School of Physiotherapy and Exercise Science, Curtin University, Perth, 6102 Australia
| | - Natalie J Collins
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,6School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Australia
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Xu R, Wang Z, Ren Z, Ma T, Jia Z, Fang S, Jin H. Comparative Study of the Effects of Customized 3D printed insole and Prefabricated Insole on Plantar Pressure and Comfort in Patients with Symptomatic Flatfoot. Med Sci Monit 2019; 25:3510-3519. [PMID: 31079137 PMCID: PMC6528551 DOI: 10.12659/msm.916975] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There are many shortcomings in traditional prefabricated rehabilitation insoles for symptomatic flatfoot patients. This study investigated the effects of customized 3-dimensional (3D) printed insoles on pressure and comfort of the plantar foot in symptomatic flatfoot patients. MATERIAL AND METHODS Eighty patients with bilateral flatfoot participated in this study. At week 0, patients were randomly assigned into 1 of 2 groups. In the control group, the patients wore standardize shoes with prefabricated insoles; and in the experimental group the patients wore standardize shoes and customized insoles. The Footscan® system recorded peak pressure, peak force, and peak contact area in 10 areas of the sole at weeks 0 and at week 8. Patients used visual analogue scale scores at week 0 and at week 8 to assess overall comfort of insoles. RESULTS At week 0, compared with the control group, the peak pressure in the metatarsal was significantly lower in the experimental group (P<0.05) while the peak pressure in the mid-foot was significantly higher than the control group (P<0.05). At week 8, in the experimental group, the peak pressures in the mid-foot were significantly higher than the control group (P<0.05). The comfort scores (measured by pain scale) reported by the experimental group were significantly lower than those reported by the control group (P<0.05). CONCLUSIONS Customized 3D printed insoles reduced the pressure on the metatarsals by distributed it over the mid-foot area, thus reduced the damage from symptomatic flatfoot. Customized 3D printed insoles were more effective than prefabricated insoles and offered better comfort for patients with symptomatic flatfoot.
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Affiliation(s)
- Rui Xu
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital Of Jilin University, Changchun, Jilin, China (mainland)
| | - Zhenxiao Ren
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Tingjian Ma
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Zhe Jia
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Shuyan Fang
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Hui Jin
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Collins NJ, Tan JM, Menz HB, Russell TG, Smith AJ, Vicenzino B, Munteanu SE, Hinman RS, Haines TP, Hart HF, Patterson BE, Cleary G, Donnar JW, Maclachlan LR, Crossley KM. The FOOTPATH study: protocol for a multicentre, participant- and assessor-blind, parallel group randomised clinical trial of foot orthoses for patellofemoral osteoarthritis. BMJ Open 2019; 9:e025315. [PMID: 31005917 PMCID: PMC6500302 DOI: 10.1136/bmjopen-2018-025315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Patellofemoral (PF) osteoarthritis (OA) is a common and burdensome subgroup of knee OA, with very little evidence for effective treatments. Prefabricated foot orthoses are an affordable and accessible intervention that have been shown to reduce PF pain in younger adults. Similarities between PF pain and PFOA, as well as our pilot work, suggest that foot orthoses may also be an effective intervention for PFOA. The primary objective of this study is to compare the 3 month efficacy of prefabricated foot orthoses and flat shoe inserts in people with PFOA, on knee pain severity. METHODS AND ANALYSIS The FOOTPATH Study (FOot OrThoses for PAtellofemoral osteoarTHritis) is a multicentre, randomised, participant- and assessor-blinded superiority trial with two parallel groups, a 3 month observation period (pre-randomisation) and 12 month follow-up. 160 participants with a clinical diagnosis of PFOA will be recruited from three sites in Australia, and randomised to one of two groups (prefabricated foot orthoses or flat shoe inserts). The primary outcome is worst knee pain severity during a self-nominated aggravating activity in the previous week (100 mm visual analogue scale) at 3 months, with a secondary endpoint at 12 months. Secondary outcomes include global rating of change, symptoms, function, health-related quality of life, kinesiophobia, self-efficacy and use of co-interventions for knee pain. Blinded, intention-to-treat analyses of primary and secondary patient-reported outcomes will be performed, as well as economic analyses. ETHICS AND DISSEMINATION Ethical approval has been granted by La Trobe University's Human Ethics Committee and The University of Queensland's Medical Research Ethics Committee. Study outcomes will be disseminated via peer-reviewed journals, conference presentations targeting a range of healthcare disciplines and an open access website with clinician resources. TRIAL REGISTRATION NUMBER ANZCTRN12617000385347; Pre-results.
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Affiliation(s)
- Natalie J Collins
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Jade M Tan
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Hylton B Menz
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Trevor G Russell
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Anne J Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Bill Vicenzino
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Shannon E Munteanu
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Terry P Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Harvi F Hart
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- School of Physical Therapy and Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Brooke E Patterson
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Gearoid Cleary
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Joel W Donnar
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Liam R Maclachlan
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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11
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Bei M, Tian F, Liu N, Zheng Z, Cao X, Zhang H, Wang Y, Xiao Y, Dai M, Zhang L. A Novel Rat Model of Patellofemoral Osteoarthritis Due to Patella Baja, or Low-Lying Patella. Med Sci Monit 2019; 25:2702-2717. [PMID: 30979862 PMCID: PMC6476235 DOI: 10.12659/msm.915018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Patella baja, or patella infera, consists of a low-lying patella that results in a limited range of motion, joint pain, and crepitations. Patellofemoral joint osteoarthritis (PFJOA) is a subtype OA of the knee. This study aimed to develop a reproducible and reliable rat model of PFJOA. Material/Methods Three-month-old female Sprague-Dawley rats (n=24) included a baseline group (n=8) that were euthanized at the beginning of the study. The sham group (n=8), and the patella ligament shortening (PLS) group (n=8) were euthanized and evaluated at ten weeks. The PLS model group (n=8) underwent insertion of a Kirschner wire under the patella tendon to induce patella baja. At ten weeks, the sham group and the PLS group were compared using X-ray imaging, macroscopic appearance, histology, immunohistochemistry, TUNEL staining for apoptosis, and micro-computed tomography (micro-CT). The patella height was determined using the modified Insall-Salvati (MIS) ratio. Results The establishment of the rat model of patella baja in the PLS group at ten weeks was confirmed by X-ray. In the PLS group, patella volume, sagittal length, and cross-sectional area were significantly increased compared with the sham group. The PFJ showed typical lesions of OA, confirmed macroscopically and histologically. Compared with the sham group, in the rat model of PFJOA, there was increased cell apoptosis, and immunohistochemistry showed increased expression of biomarkers of osteoarthritis, compared with the sham group. Conclusions A rat model of PFJOA was developed that was confirmed by changes in cartilage and subchondral bone.
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Affiliation(s)
- Mingjian Bei
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Faming Tian
- Meical Research Center, North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Ning Liu
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Zhiyuan Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Xuehui Cao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Hongfei Zhang
- Meical Research Center, North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Yudan Wang
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Yaping Xiao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China (mainland)
| | - Muwei Dai
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Liu Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, China (mainland).,Department of Orthopedic Surgery, Meitan General Hospital, Beijing, China (mainland)
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12
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Jafarnezhadgero A, Madadi-Shad M, Alavi-Mehr SM, Granacher U. The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet: A randomized controlled trial. PLoS One 2018; 13:e0205187. [PMID: 30300405 PMCID: PMC6177172 DOI: 10.1371/journal.pone.0205187] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/30/2018] [Indexed: 12/23/2022] Open
Abstract
Background Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet. Methods Thirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected. Results Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group. Conclusions The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.
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Affiliation(s)
- AmirAli Jafarnezhadgero
- Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | | | - Seyed Majid Alavi-Mehr
- Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- * E-mail:
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13
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Abstract
OBJECTIVES Taking into account that the role of orthoses in patients with knee osteoarthritis (OA) is unclear and controversial, the purpose of this article is to review recent literature with the aim of answering the following question: What is the current role of orthoses in the treatment of knee OA? METHODS A Cochrane Library and PubMed (MEDLINE) search related to the role of orthoses in knee OA was performed. RESULTS Unloader braces decrease the adduction moment of the knee. In patients with varus medial compartment knee OA bracing is beneficial for pain, stiffness, function and quality of life (low grade of evidence). Lateral wedge arch support insoles seem not to decrease knee load. Lateral wedge insoles appear inefficacious at attenuating structural changes in patients with medial knee OA. CONCLUSIONS The ideal option for an orthosis in patients with knee OA keeps on indeterminate, and long-run inferences are lacking.
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Moyne-Bressand S, Dhieux C, Decherchi P, Dousset E. Effectiveness of Foot Biomechanical Orthoses to Relieve Patients' Knee Pain: Changes in Neural Strategy After 9 Weeks of Treatment. J Foot Ankle Surg 2018; 56:1194-1204. [PMID: 29079236 DOI: 10.1053/j.jfas.2017.05.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Indexed: 02/03/2023]
Abstract
Knee pain is one of the most common lower leg complaints. It is often treated with plantar orthoses to provide cushioning and correct locomotion, imbalances of the foot, and postural deficits. However, the published scientific data are poor concerning the mechanisms involved in pain reduction after wearing foot orthoses, and, to the best of our knowledge, no trial has investigated the mid-term effectiveness. The aim of the present study was to evaluate the effectiveness of foot orthoses according to sound biomechanical principles in the treatment of knee pain. Attention was mainly focused on changes in the central control strategies. Fifteen subjects were included in the protocol. The patients with knee pain were compared with healthy participants (control group) exhibiting no knee pain. In the patients with knee pain, pain perception, dynamic analysis of the gait, stabilometry, the soleus Hoffmann reflex at rest and during voluntary contraction, and V-wave were measured before and 3, 6, and 9 weeks after wearing orthoses. In the control group (n = 5), the same parameters were recorded at 0, 3, 6, and 9 weeks, but the subjects had not worn orthoses. In the patient group (n = 10), the results indicated that pain had significantly decreased from the third week onward, although the parameters of gait and stabilometry remained unchanged. From the sixth week, the soleus Hoffmann reflex during voluntary contraction wave was significantly reduced, suggesting an increase in motoneuronal presynaptic inhibition by non-nociceptive afferents. The V-wave amplitude increased throughout the 9 weeks of the experiment, suggesting a progressive increase in corticospinal and/or extrapyramidal descending pathway inputs, probably due to pain reduction. In the control group, no change was observed throughout the experimental sessions. Our data indicated that foot orthoses relieved patients' knee pain and reduced the descending motor inhibition. Changes in spinal modulation could contribute to a better quality of life. However, this treatment failed to change the altered gait, despite changes in spinal and supraspinal modulation.
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Affiliation(s)
- Sébastien Moyne-Bressand
- Podiatrist, Aix-Marseille Université, Centre National de la Recherche Scientifique, L'Institut des Sciences du Mouvement Etienne-Jules Marey est une Unité Mixte de Recherche (UMR 7287), Equipe "Plasticité des Systèmes Nerveux et Musculaire" (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, Marseille, France
| | - Carole Dhieux
- Podiatrist, Aix-Marseille Université, Centre National de la Recherche Scientifique, L'Institut des Sciences du Mouvement Etienne-Jules Marey est une Unité Mixte de Recherche (UMR 7287), Equipe "Plasticité des Systèmes Nerveux et Musculaire" (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, Marseille, France
| | - Patrick Decherchi
- Professor, Aix-Marseille Université, Centre National de la Recherche Scientifique, L'Institut des Sciences du Mouvement Etienne-Jules Marey est une Unité Mixte de Recherche (UMR 7287), Equipe "Plasticité des Systèmes Nerveux et Musculaire" (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, Marseille, France.
| | - Erick Dousset
- Assistant Professor, Aix-Marseille Université, Centre National de la Recherche Scientifique, L'Institut des Sciences du Mouvement Etienne-Jules Marey est une Unité Mixte de Recherche (UMR 7287), Equipe "Plasticité des Systèmes Nerveux et Musculaire" (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, Marseille, France
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15
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Inverted Rearfoot posture in subjects with coexisting patellofemoral osteoarthritis in medial knee osteoarthritis: an exploratory study. J Foot Ankle Res 2018; 11:17. [PMID: 29760787 PMCID: PMC5941454 DOI: 10.1186/s13047-018-0261-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/26/2018] [Indexed: 11/16/2022] Open
Abstract
Background While abnormal rearfoot posture and its relationship to patellofemoral (PF) pain has been thoroughly discussed in the literature, its relationship to patellofemoral osteoarthritis (PFOA) has not been determined. This study aimed to examine whether rearfoot posture is associated with a higher prevalence of radiographic PFOA in a compartment-specific manner in patients with medial tibiofemoral osteoarthritis (TFOA). Methods Participants from orthopedic clinics (n = 68, age 56–90 years, 75.0% female), diagnosed with radiographic medial TFOA (Kellgren/Lawrence [K/L] grade ≥ 2) were included in this study. The presence of PFOA and static rearfoot posture were evaluated using a radiographic skyline view and a footprint automatic measurement apparatus, respectively. The relationship between rearfoot posture and PFOA was examined using analysis of covariance and propensity score-adjusted logistic regression analysis. Results On average, patients with coexisting PFOA and medial TFOA (n = 39) had an inverted calcaneus 3.1° greater than those with isolated medial TFOA (n = 29). Increased calcaneus inverted angle was significantly associated with a higher probability of the presence of medial PFOA (odds ratio: 1.180, 95% confidence interval: [1.005, 1.439]; p = 0.043). Calcaneus inverted angle was not associated with higher odds of lateral PFOA presence based on the adjusted values. Conclusions The presence of an inverted rearfoot was associated with PFOA. Although these findings do not clearly indicate a biomechanical link between rearfoot posture and PFOA, this study shed light on the potential relationship between altered rearfoot posture and PFOA, as can be seen between rearfoot abnormality and PF pain.
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Induction of osteoarthritis by injecting monosodium iodoacetate into the patellofemoral joint of an experimental rat model. PLoS One 2018; 13:e0196625. [PMID: 29698461 PMCID: PMC5919651 DOI: 10.1371/journal.pone.0196625] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/16/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to investigate the histopathological changes in the patellofemoral joint using a rat model of osteoarthritis that was induced using monosodium iodoacetate, and to establish a novel model of patellofemoral osteoarthritis in a rat model using histopathological analysis. Sixty male rats were used. Osteoarthritis was induced through a single intra-articular injection of monosodium iodoacetate in both knee joints. Animals were equally divided into two experimental groups based on the monosodium iodoacetate dose: 0.2 mg and 1.0 mg. Histopathological changes in the articular cartilage of the patellofemoral joint and the infrapatellar fat pad were examined at 3 days, 1 week, 2 weeks, 4 weeks, 8 weeks, and 12 weeks after the monosodium iodoacetate injection. In the 1.0-mg group, the representative histopathological findings of osteoarthritis were observed in the articular cartilage of the patellofemoral joint over time. Additionally, the Osteoarthritis Research Society International scores of the patellofemoral joint increased over time. The synovitis scores of the infrapatellar fat pad in both groups were highest at 3 days, and then the values decreased over time. The fibrosis score of the infrapatellar fat pad in the 1.0-mg group increased with time, whereas the fibrosis score in the 0.2-mg group remained low. Representative histopathological findings of osteoarthritis were observed in the articular cartilage of the patellofemoral joint in a rat model of osteoarthritis induced using monosodium iodoacetate. With appropriate selection, this model may be regarded as an ideal patellofemoral osteoarthritis model.
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Wyndow N, Crossley KM, Vicenzino B, Tucker K, Collins NJ. A single-blinded, randomized, parallel group superiority trial investigating the effects of footwear and custom foot orthoses versus footwear alone in individuals with patellofemoral joint osteoarthritis: a phase II pilot trial protocol. J Foot Ankle Res 2017; 10:19. [PMID: 28450898 PMCID: PMC5405497 DOI: 10.1186/s13047-017-0200-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patellofemoral joint osteoarthritis is a common condition, yet information regarding conservative management is lacking. Foot orthoses are an effective intervention for improving pain and function in younger individuals with patellofemoral pain and may be effective in those with patellofemoral osteoarthritis. This pilot study will seek to establish the feasibility of a phase III randomised controlled trial to investigate whether foot orthoses worn in prescribed motion controlled footwear are superior to prescribed motion control footwear alone in the management of patellofemoral osteoarthritis. METHODS/DESIGN This phase II pilot clinical trial is designed as a randomized, single-blind, parallel group, two arm, superiority trial. The trial will recruit 44 participants from Queensland and Tasmania, Australia. Volunteers aged 40 years and over must have clinical symptoms and radiographic evidence of patellofemoral osteoarthritis to be eligible for inclusion. Those eligible will be randomized to receive either foot orthoses and prescribed motion control shoes, or prescribed motion control shoes alone, to be worn for a period of 4 months. The feasibility of a phase III clinical trial will be evaluated by assessing factors such as recruitment rate, number of eligible participants, participant compliance with the study protocol, adverse events, and drop-out rate. A secondary aim of the study will be to determine completion rates and calculate effect sizes for patient reported outcome measures such as knee-related symptoms, function, quality of life, kinesiophobia, self-efficacy, general and mental health, and physical activity at 2 and 4 months. Primary outcomes will be reported descriptively while effect sizes and 95% confidence intervals will be calculated for the secondary outcome measures. Data will be analysed using an intention-to-treat principle. DISCUSSION The results of this pilot trial will help determine the feasibility of a phase III clinical trial investigating whether foot orthoses plus motion control footwear are superior to motion control footwear alone in individuals with patellofemoral osteoarthritis. A Phase III clinical trial will help guide footwear and foot orthoses recommendations in the clinical management of this disorder. TRIAL REGISTRATION Retrospectively registered with the Australian New Zealand Clinical Trials Registry: ACTRN12615000002583. Date registered: 07/01/15.
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Affiliation(s)
- Narelle Wyndow
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072 QLD Australia
| | - Kay M. Crossley
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, 3086 VIC Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072 QLD Australia
| | - Kylie Tucker
- School of Biomedical Sciences, The University of Queensland, St Lucia, 4072 QLD Australia
| | - Natalie J. Collins
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072 QLD Australia
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