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Menz HB, Bonanno DR. Footwear comfort: a systematic search and narrative synthesis of the literature. J Foot Ankle Res 2021; 14:63. [PMID: 34876192 PMCID: PMC8650278 DOI: 10.1186/s13047-021-00500-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To provide a narrative synthesis of the research literature pertaining to footwear comfort, including definitions, measurement scales, footwear design features, and physiological and psychological factors. METHODS A systematic search was conducted which yielded 101 manuscripts. The most relevant manuscripts were selected based on the predetermined subheadings of the review (definitions, measurement scales, footwear design features, and physiological and psychological factors). A narrative synthesis of the findings of the included studies was undertaken. RESULTS The available evidence is highly fragmented and incorporates a wide range of study designs, participants, and assessment approaches, making it challenging to draw strong conclusions or implications for clinical practice. However, it can be broadly concluded that (i) simple visual analog scales may provide a reliable overall assessment of comfort, (ii) well-fitted, lightweight shoes with soft midsoles and curved rocker-soles are generally perceived to be most comfortable, and (iii) the influence of sole flexibility, shoe microclimate and insoles is less clear and likely to be more specific to the population, setting and task being performed. CONCLUSION Footwear comfort is a complex and multifaceted concept that is influenced not only by structural and functional aspects of shoe design, but also task requirements and anatomical and physiological differences between individuals. Further research is required to delineate the contribution of specific shoe features more clearly, and to better understand the interaction between footwear features and individual physiological attributes.
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Affiliation(s)
- Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia
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Fukuchi CA, Lewinson RT, Worobets JT, Stefanyshyn DJ. Effects of Lateral and Medial Wedged Insoles on Knee and Ankle Internal Joint Moments During Walking in Healthy Men. J Am Podiatr Med Assoc 2016; 106:411-418. [PMID: 28033056 DOI: 10.7547/15-077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Wedged insoles have been used to treat knee pathologies and to prevent injuries. Although they have received much attention for the study of knee injury, the effects of wedges on ankle joint biomechanics are not well understood. This study sought to evaluate the immediate effects of lateral and medial wedges on knee and ankle internal joint loading and center of pressure (CoP) in men during walking. METHODS Twenty-one healthy men walked at 1.4 m/sec in five footwear conditions: neutral, 6° (LW6) and 9° (LW9) lateral wedges, and 6° (MW6) and 9° (MW9) medial wedges. Peak internal knee abduction moments and angular impulses, internal ankle inversion moments and angular impulses, and mediolateral CoP were analyzed. Analysis of variance with post hoc analysis and Pearson correlations were performed to detect differences between conditions. RESULTS No differences in internal knee joint loading were found between neutral and any of the wedge conditions. However, as the wedge angle increased from medial to lateral, the internal ankle inversion moment (LW6: P = .020; LW9: P < .001; MW6: P = .046; MW9: P < .001) and angular impulse (LW9: P = .012) increased, and the CoP shifted laterally (LW9: P < .001) and medially (MW9: P < .001) compared with the neutral condition. CONCLUSIONS Neither lateral nor medial wedges were effective in altering internal knee joint loading during walking. However, the greater internal ankle inversion moment and angular impulse observed with lateral wedges could lead to a higher risk of ankle injury. Thus, caution should be taken when lateral wedges need to be prescribed.
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Affiliation(s)
- Claudiane A. Fukuchi
- Neuroscience and Cognition Program, Federal University of ABC, São Bernardo do Campo, Brazil
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Ryan T. Lewinson
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Program, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Jay T. Worobets
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Darren J. Stefanyshyn
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Program, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
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Lewinson RT, Worobets JT, Stefanyshyn DJ. Calculation of external knee adduction moments: a comparison of an inverse dynamics approach and a simplified lever-arm approach. Knee 2015; 22:292-7. [PMID: 26006770 DOI: 10.1016/j.knee.2015.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/17/2015] [Accepted: 04/06/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The external knee adduction moment (EKAM) is often studied in knee osteoarthritis research. This study compared EKAMs between two methods of calculation: a method that only requires ground reaction force and knee position data (i.e. lever-arm), and an inverse dynamics link-segment method. METHODS Sixteen participants walked while wearing a control shoe with and without a six millimeter lateral wedge insole. Peak EKAMs between the lever-arm and inverse dynamics methods were compared for the control condition, and the %change in moment induced by the lateral wedge was compared between methods. RESULTS When comparing EKAMs between methods, no correlation was found (r=0.24, p=0.36); peak EKAMs with the lever-arm method (26.0Nm) were significantly lower than EKAMs with the inverse dynamics method (40.2Nm, pb0.001); and Bland-Altman plots showed poor agreement between methods. When assessing the %change in moment with a lateral wedge, a moderate correlation was found (r=0.55, p=0.03) between methods; Bland-Altman plots showed moderate agreement between methods; and the lever-arm method (-6.4%) was not significantly different from the inverse dynamics method (-11.4%, p=0.09); however, the two methods produced opposite results 31% of the time. CONCLUSION The lever-arm method cannot estimate peak EKAMs, and can only approximate the %change in moment induced by a lateral wedge; however, the error rate was 31%. Therefore, the lever-arm method is not recommended for use in its current form. CLINICAL RELEVANCE This study may help guide the development of a fast and simple method for determining EKAMs for individuals with knee osteoarthritis.
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Affiliation(s)
- Ryan T Lewinson
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Jay T Worobets
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Darren J Stefanyshyn
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
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Lewinson RT, Wiley JP, Humble RN, Worobets JT, Stefanyshyn DJ. Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial. PLoS One 2015; 10:e0134461. [PMID: 26230399 PMCID: PMC4521888 DOI: 10.1371/journal.pone.0134461] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/30/2015] [Indexed: 11/18/2022] Open
Abstract
Objective Determine if a change in internal knee abduction angular impulse (KAAI) is related to pain reduction for runners with patellofemoral pain (PFP) by comparing lateral and medial wedge insole interventions, and increased KAAI and decreased KAAI groups. Design Randomized controlled clinical trial (ClinicalTrials.gov ID# NCT01332110). Setting Biomechanics laboratory and community. Patients Thirty-six runners with physician-diagnosed PFP enrolled in the trial, and 27 were analyzed. Interventions Runners with PFP were randomly assigned to either an experimental 3 mm lateral wedge or control 6 mm medial wedge group. Participants completed a biomechanical gait analysis to quantify KAAIs with their assigned insole, and then used their assigned insole for six-weeks during their regular runs. Usual pain during running was measured at baseline and at six-week follow-up using a visual analog scale. Statistical tests were performed to identify differences between wedge types, differences between biomechanical response types (i.e. increase or decrease KAAI), as well as predictors of pain reduction. Main Outcome Measures Percent change in KAAI relative to neutral, and % change in pain over six weeks. Results Clinically meaningful reductions in pain (>33%) were measured for both footwear groups; however, no significant differences between footwear groups were found (p = 0.697). When participants were regrouped based on KAAI change (i.e., increase or decrease), again, no significant differences in pain reduction were noted (p = 0.146). Interestingly, when evaluating absolute change in KAAI, a significant relationship between absolute % change in KAAI and % pain reduction was observed (R2 = 0.21; p = 0.030), after adjusting for baseline pain levels. Conclusion The greater the absolute % change in KAAI during running, the greater the % reduction in pain over six weeks, regardless of wedge type, and whether KAAIs increased or decreased. Lateral and medial wedge insoles were similar in effectiveness for treatment of PFP. Clinical Relevance Altering KAAI should be a focus of future PFP research. Lateral wedges should be studied further as an alternative therapy to medial wedges for management of PFP. Trial Registration ClinicalTrials.gov NCT01332110
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Affiliation(s)
- Ryan T. Lewinson
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Program, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - J. Preston Wiley
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - R. Neil Humble
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jay T. Worobets
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Darren J. Stefanyshyn
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Program, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
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Lewinson RT, Collins KH, Vallerand IA, Wiley JP, Woodhouse LJ, Reimer RA, Worobets JT, Herzog W, Stefanyshyn DJ. Reduced knee joint loading with lateral and medial wedge insoles for management of knee osteoarthritis: a protocol for a randomized controlled trial. BMC Musculoskelet Disord 2014; 15:405. [PMID: 25467955 PMCID: PMC4265477 DOI: 10.1186/1471-2474-15-405] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 11/27/2014] [Indexed: 11/21/2022] Open
Abstract
Background Knee osteoarthritis (OA) progression has been linked to increased peak external knee adduction moments (KAMs). Although some trials have attempted to reduce pain and improve function in OA by reducing KAMs with a wedged footwear insole intervention, KAM reduction has not been specifically controlled for in trial designs, potentially explaining the mixed results seen in the literature. Therefore, the primary purpose of this trial is to identify the effects of reduced KAMs on knee OA pain and function. Methods/design Forty-six patients with radiographically confirmed diagnosis medial knee OA will be recruited for this 3 month randomized controlled trial. Recruitment will be from Alberta and surrounding areas. Eligibility criteria include being between the ages of 40 and 85 years, have knee OA primarily localized to the medial tibiofemoral compartment, based on the American College of Rheumatology diagnostic criteria and be classified as having a Kellgren-Lawrence grade of 1 to 3. Patients will visit the laboratory at baseline for testing that includes dual x-ray absorptiometry, biomechanical testing, and surveys (KOOS, PASE activity scale, UCLA activity scale, comfort visual analog scale). At baseline, patients will be randomized to either a wedged insole group to reduce KAMs, or a waitlist control group where no intervention is provided. The survey tests will be repeated at 3 months, and response to wedged insoles over 3 months will be evaluated. Discussion This study represents the first step in systematically evaluating the effects of reduced KAMs on knee OA management by using a patient-specific wedged insole prescription procedure rather than providing the same insole to all patients. The results of this trial will provide indications as to whether reduced KAMs are an effective strategy for knee OA management, and whether a personalized approach to footwear insole prescription is warranted. Trial registration NCT02067208. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-405) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ryan T Lewinson
- Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada.
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Sole CC, Milosavljevic S, Sole G, Sullivan SJ. Patterns of mediolateral asymmetry in worn footwear. FOOTWEAR SCIENCE 2014. [DOI: 10.1080/19424280.2014.913694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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