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Lan Z, Yang Y, Wang H, Guo X, Wu Z, Jin Q. Impact of Prevention Strategies on Quality of Life in Patients with Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials. World Neurosurg 2024; 182:159-164.e4. [PMID: 37995990 DOI: 10.1016/j.wneu.2023.11.065] [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: 07/17/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To evaluate the impact of prevention strategies on the quality of life in patients with osteoarthritis (OA) through a comprehensive analysis of randomized controlled trials (RCTs). METHODS A systematic search was conducted in multiple electronic databases, including Cochrane Library, PubMed, Embase, and ClinicalTrials.gov, up to June 10th, 2023. Eligible studies were RCTs assessing the effectiveness of prevention strategies in adult patients diagnosed with OA, with validated instruments used to measure quality of life outcomes. A total of 10 RCTs met the inclusion criteria and were included in the meta-analysis. The analyzed prevention strategies encompassed enhanced exercise, education, or a combination of both. The quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS The pooled results revealed a significant improvement in the quality of life of OA patients who underwent enhanced exercise or education compared to control groups (standardized mean difference = 0.44, 95% confidence interval 0.08-0.8). However, the overall quality of evidence was graded as low according to the Grading of Recommendations Assessment, Development and Evaluation assessment. CONCLUSIONS This meta-analysis provides evidence that prevention strategies, particularly enhanced exercise or education, have a positive impact on the quality of life in patients with OA. Despite the observed benefits, the overall quality of evidence is limited, highlighting the need for larger, well-designed trials to strengthen the evidence base. These findings underscore the importance of implementing effective prevention strategies in the management of OA to improve patient outcomes and enhance their quality of life. Further research is warranted to optimize the selection and implementation of prevention strategies for OA patients.
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Affiliation(s)
- Zhibin Lan
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Yang Yang
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Hui Wang
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xuefang Guo
- Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, China
| | - Zhiqiang Wu
- Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, China
| | - Qunhua Jin
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China.
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Channasanon S, Praewpipat B, Duangjinda N, Sornchalerm L, Tesavibul P, Paecharoen S, Tanodekaew S. 3D-printed medial arch supports of varying hardness versus a prefabricated arch support on plantar pressure: A 1-month randomized crossover study in healthy volunteers. Prosthet Orthot Int 2023; 47:210-217. [PMID: 36037286 DOI: 10.1097/pxr.0000000000000178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 06/01/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Foot orthoses are commonly used as a noninvasive treatment to relieve foot pain. The custom full-length insoles with various materials and designs have been studied for their effectiveness in reducing plantar pressure. However, few studies have been conducted with respect to custom medial arch support on the relationships between material hardness and measured plantar pressure and level of comfort. OBJECTIVES To evaluate the effects of the hardness of custom medial arch supports on plantar pressure and comfort perception. STUDY DESIGN Randomized crossover study. METHODS Two custom silicone medial arch supports of varying hardness (A and B) were fabricated using 3D printing technology and tested in 12 healthy volunteers against a commercially prefabricated arch support (C). The volunteers wore three medial arch supports in a random order, one month for each arch support with 3-4 days of washout period before wearing the next one. The plantar pressure was measured and analyzed according to each foot zone: forefoot, midfoot, and hindfoot, comparing before intervention, immediately after intervention, and 1 month after intervention. The comfort perception was assessed by collecting volunteer feedback with a questionnaire after using each medial arch support. RESULTS After 1-month intervention, both 3D-printed and prefabricated medial arch supports demonstrated significantly higher average pressure in the midfoot ( P < 0.001), whereas significantly lower average pressure in the forefoot ( P < 0.001) and hindfoot ( P = 0.014, 0.026, and 0.018 for A, B, and C, respectively), compared with those before intervention. There were no significant differences in plantar pressure distribution between the 3D-printed and prefabricated medial arch supports. However, the 3D-printed medial arch supports resulted in better comfort than the prefabricated arch support. CONCLUSIONS The material hardness had no apparent effect on plantar pressure distribution. The three medial arch supports showed reducing plantar heel pressure. Further research is needed to investigate the potential effect of 3D-printed silicone medial arch supports on reducing foot pain in patients.
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Affiliation(s)
- Somruethai Channasanon
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Bongkoch Praewpipat
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Nitkamon Duangjinda
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Lertchai Sornchalerm
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Passakorn Tesavibul
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Siranya Paecharoen
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Siriporn Tanodekaew
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
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Hsu WC, Chou LW, Chiu HY, Hsieh CW, Hu WP. A Study on the Effects of Lateral-Wedge Insoles on Plantar-Pressure Pattern for Medial Knee Osteoarthritis Using the Wearable Sensing Insole. SENSORS (BASEL, SWITZERLAND) 2022; 23:84. [PMID: 36616681 PMCID: PMC9824433 DOI: 10.3390/s23010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Patients with knee osteoarthritis have a unique plantar-pressure pattern during walking, and lateral-wedge insoles are one of the treatment options. Participants were randomly assigned to either the lateral-wedge insole group or the ordinary insole group. The Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and plantar-pressure test scores were evaluated at the baseline and at 20 weeks. Plantar pressure data were collected using a pressure insole with 89 sensing locations. In the ordinary insole group, the function and total WOMAC scores decreased significantly (function score, 24.8 (baseline) to 16.5 (week 20); total score, 34.9 (baseline) to 24.6 (week 20)). During walking, the transverse width of the center of pressure as a percentage of foot width (%Trans) significantly increased in the ordinary insole group (baseline, 6.3%; week 20, 14.8%). In addition, the values of partial foot pressure as a percentage of body weight (%PFP) on the forefoot (baseline, 30.3%; week 20, 39.2%) and heel (baseline, 28.1%; week 20, 16.9%) also increased significantly in the ordinary insole group. Significant group-by-time interaction effects were observed for partial foot pressure per body weight in the forefoot (p = 0.031) and heel (p = 0.024). In the ordinary insole group, the plantar pressure on the heel significantly decreased (p = 0.011) and that on the forefoot significantly increased (p = 0.023). In contrast, plantar pressure remained stable in all regions in the lateral-wedge insole group. Thus, lateral-wedge insoles may protect against plantar pressure deterioration in patients with knee osteoarthritis.
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Affiliation(s)
- Wei-Ching Hsu
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City 41354, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Taichung City 41354, Taiwan
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Taichung City 41354, Taiwan
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung City 40402, Taiwan
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung City 40402, Taiwan
| | - Hsiao-Yen Chiu
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City 41354, Taiwan
| | - Chang-Wei Hsieh
- Department of Computer Science & Information Engineering, Asia University, Taichung City 41354, Taiwan
| | - Wen-Pin Hu
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City 41354, Taiwan
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Cheng J, Zeng Q, Lai J, Zhang X. Effects of arch support doses on the center of pressure and pressure distribution of running using statistical parametric mapping. Front Bioeng Biotechnol 2022; 10:1051747. [DOI: 10.3389/fbioe.2022.1051747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022] Open
Abstract
Insoles with an arch support have been used to address biomechanical risk factors of running. However, the relationship between the dose of support and running biomechanics remains unclear. The purpose of this study was to determine the effects of changing arch support doses on the center of pressure (COP) and pressure mapping using statistical parametric mapping (SPM). Nine arch support variations (3 heights * 3 widths) and a flat insole control were tested on fifteen healthy recreational runners using a 1-m Footscan pressure plate. The medial-lateral COP (COPML) coordinates and the total COP velocity (COPVtotal) were calculated throughout the entirety of stance. One-dimensional and two-dimensional SPM were performed to assess differences between the arch support and control conditions for time series of COP variables and pressure mapping at a pixel level, respectively. Two-way ANOVAs were performed to test the main effect of the arch support height and width, and their interaction on the peak values of the COPVtotal. The results showed that the COPVtotal during the forefoot contact and forefoot push off phases was increased by arch supports, while the COP medial-lateral coordinates remained unchanged. There was a dose-response effect of the arch support height on peak values of the COPVtotal, with a higher support increasing the first and third valleys but decreasing the third peak of the COPVtotal. Meanwhile, a higher arch support height shifted the peak pressure from the medial forefoot and rearfoot to the medial arch. It is concluded that changing arch support doses, primarily the height, systematically altered the COP velocities and peak plantar pressure at a pixel level during running. When assessing subtle modifications in the arch support, the COP velocity was a more sensitive variable than COP coordinates. SPM provides a high-resolution view of pressure comparisons, and is recommended for future insole/footwear investigations to better understand the underlying mechanisms and improve insole design.
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Gómez Carrión Á, Atín Arratibe MDLÁ, Morales Lozano MR, Martínez Rincón C, Martínez Sebastián C, Saura Sempere Á, Nuñez-Fernandez A, Sánchez-Gómez R. Changes in the Kinematics of Midfoot and Rearfoot Joints with the Use of Lateral Wedge Insoles. J Clin Med 2022; 11:jcm11154536. [PMID: 35956151 PMCID: PMC9369829 DOI: 10.3390/jcm11154536] [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: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 01/27/2023] Open
Abstract
The lateral wedge insole (LWI) is a typical orthopedic treatment for medial knee osteoarthritis pain, chronic ankle instability, and peroneal tendon disorders. It is still unknown what the effects are in the most important joints of the foot when using LWIs as a treatment for knee and ankle pathologies. Objectives: The aim of this study was to determine the influence of LWIs on the position of the midfoot and rearfoot joints by measuring the changes using a tracking device. Methods: The study was carried out with a total of 69 subjects. Movement measurements for the midfoot were made on the navicular bone, and for the rearfoot on the calcaneus bone. The Polhemus system was used, with two motion sensors fixed to each bone. Subjects were compared by having them use LWIs versus being barefoot. Results: There were statistically significant differences in the varus movement when wearing a 4 mm LWI (1.23 ± 2.08°, p < 0.001) versus the barefoot condition (0.35 ± 0.95°), and in the plantarflexion movement when wearing a 4 mm LWI (3.02 ± 4.58°, p < 0.001) versus the barefoot condition (0.68 ± 1.34°), in the midfoot. There were also statistically significant differences in the valgus movement when wearing a 7 mm LWI (1.74 ± 2.61°, p < 0.001) versus the barefoot condition (0.40 ± 0.90°), and in the plantar flexion movement when wearing a 4 mm LWI (2.88 ± 4.31°, p < 0.001) versus the barefoot condition (0.35 ± 0.90°), in the rearfoot. Conclusions: In the navicular bone, a varus, an abduction, and plantar flexion movements were generated. In the calcaneus, a valgus, an adduction, and plantar flexion movements were generated with the use of LWIs.
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The effect of arch-support insole on knee kinematics and kinetics during a stop-jump maneuver. Prosthet Orthot Int 2022; 46:368-373. [PMID: 35315830 DOI: 10.1097/pxr.0000000000000103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 01/04/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Anterior cruciate ligament injuries commonly occur during sports that involve sudden stops or direction changes. Although athletes often use arch-support insoles in competition and training, little is known about the effect of foot insoles on knee biomechanics and jump take-off performances. OBJECTIVE This study aimed to investigate the effects of arch-support insoles on knee kinematics and kinetics during the stop-braking phase and the subsequent jump take-off performances. STUDY DESIGN That is a quasi-experimental study, repeated-measures design. METHODS Twenty male healthy recreational university basketball athletes performed stop-jump with maximum effort in both arch-support and flat insole conditions. Paired t -tests were performed on knee kinetics and kinematics and jump performance variables to determine whether there were significant differences between insole conditions. RESULTS Wearing arch-support insoles experienced larger ground reaction forces (GRFs), loading rates of peak vertical and posterior GRFs, peak knee adduction and rotation moments, and knee flexion angular velocity than the flat insoles ( P < 0.05). CONCLUSIONS The increased GRFs and knee loading in arch-support insoles are indicative of a higher risk of anterior cruciate ligament injuries. The findings could be insightful to the knee mechanics that are related to performance and injury potential during stop-jump maneuvers.
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Tse CTF, Ryan MB, Dien J, Scott A, Hunt MA. An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs. J Foot Ankle Res 2021; 14:55. [PMID: 34615545 PMCID: PMC8493692 DOI: 10.1186/s13047-021-00493-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration. Methods In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot were divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. Results Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. Conclusions Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00493-5.
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Affiliation(s)
- Calvin T F Tse
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada.,Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.,Kintec Footlabs Inc, Surrey, BC, Canada
| | - Michael B Ryan
- Kintec Footlabs Inc, Surrey, BC, Canada.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Jason Dien
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada
| | - Alex Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Michael A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada. .,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
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Effects of taping techniques on arch deformation in adults with pes planus: A meta-analysis. PLoS One 2021; 16:e0253567. [PMID: 34214104 PMCID: PMC8253385 DOI: 10.1371/journal.pone.0253567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate effects of taping techniques on arch deformation in adults with pes planus. Methods The following databases were searched up to March 2020, including Web of Science, Pubmed, EBSCO, CNKI and Cochrane Library. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. In addition, Cochrane scale was used to evaluate the quality of research. Results Navicular height for three antipronation taping techniques significantly increased immediately post tape compared with baseline (mean difference = 4.86 mm, 95% CI = 2.86–6.87 mm, Z = 4.75, p < 0.001). The highest increase was observed in Augmented low-Dye (ALD). Modified low-Dye (MLD) was second only to ALD (p<0.001). Navicular height after walking for 10 min was much higher than baseline (p<0.001), with MLD decreased smaller than ALD. Conclusions ALD was the most effective taping technique for controlling foot arch collapse immediately post tape compared with baseline, followed by MLD. By contrast, MLD could possibly performed better than ALD in maintaining immediate navicular height after walking for 10 min. Low-Dye could make resting calcaneal stance position closer to neutral position. Although positive effects of Navicular sling, low-Dye and Double X taping interventions were observed, they could not maintain this immediate navicular height effect after a period of higher intensity weight-bearing exercise.
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Hunt MA, Charlton JM, Felson DT, Liu A, Chapman GJ, Graffos A, Jones RK. Frontal plane knee alignment mediates the effect of frontal plane rearfoot motion on knee joint load distribution during walking in people with medial knee osteoarthritis. Osteoarthritis Cartilage 2021; 29:678-686. [PMID: 33582238 DOI: 10.1016/j.joca.2021.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the nature of differences in the relationship between frontal plane rearfoot kinematics and knee adduction moment (KAM) magnitudes. DESIGN Cross-sectional study resulting from a combination of overground walking biomechanics data obtained from participants with medial tibiofemoral osteoarthritis at two separate sites. Statistical models were created to examine the relationship between minimum frontal plane rearfoot angle (negative values = eversion) and different measures of the KAM, including examination of confounding, mediation, and effect modification from knee pain, radiographic disease severity, static rearfoot alignment, and frontal plane knee angle. RESULTS Bivariable relationships between minimum frontal plane rearfoot angle and the KAM showed consistent negative correlations (r = -0.411 to -0.447), indicating higher KAM magnitudes associated with the rearfoot in a more everted position during stance. However, the nature of this relationship appears to be mainly influenced by frontal plane knee kinematics. Specifically, frontal plane knee angle during gait was found to completely mediate the relationship between minimum frontal plane rearfoot angle and the KAM, and was also an effect modifier in this relationship. No other variable significantly altered the relationship. CONCLUSIONS While there does appear to be a moderate relationship between frontal plane rearfoot angle and the KAM, any differences in the magnitude of this relationship can likely be explained through an examination of frontal plane knee angle during walking. This finding suggests that interventions derived distal to the knee should account for the effect of frontal plane knee angle to have the desired effect on the KAM.
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Affiliation(s)
- M A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia: Vancouver, BC, Canada.
| | - J M Charlton
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
| | - D T Felson
- Department of Rheumatology, Boston University School of Medicine, Boston, MA, USA; NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester, UK; Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
| | - A Liu
- School of Health and Society, University of Salford: Manchester, UK.
| | - G J Chapman
- School of Sport and Health Sciences, University of Central Lancashire: Preston, UK.
| | - A Graffos
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
| | - R K Jones
- School of Health and Society, University of Salford: Manchester, UK.
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Whittaker GA, Munteanu SE, Roddy E, Menz HB. Measures of Foot Pain, Foot Function, and General Foot Health. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:294-320. [PMID: 33091250 DOI: 10.1002/acr.24208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Glen A Whittaker
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, Chesterfield, UK, School of Primary, Community and Social Care, Keele University, Keele, UK, and Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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Esfandiari E, Kamyab M, Yazdi HR, Sanjari MA, Navvab Motlagh F. The effect of a lateral wedge insole and a subtalar strap on gait parameters in knee osteoarthritis. Med J Islam Repub Iran 2020; 33:157. [PMID: 32280663 PMCID: PMC7137820 DOI: 10.34171/mjiri.33.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Lateral wedge insole (LWI) aims to reduce loading on medial compartment of tibiofemoral joint in mild knee osteoarthritis (KOA). This effect may be augmented by concomitant use of subtalar strap to fix the ankle joint. Moreover, longitudinal arch support embedded in insoles can cause foot comfort and may be beneficial for people with KOA. Therefore, this study aimed to assess the immediate effect of LWI with an arch support with and without a subtalar strap on the kinetics and kinematics of walking in mild KOA.
Methods: A convenient sample of 17 individuals with mild KOA (Kellgren and Lawrence grade II), aged ≥ 40 years were assessed in 3 conditions: without the insole; LWI; and LWI with a subtalar strap, where an arch support was embedded in all insoles. The primary outcomes were external knee adduction moment and angular impulse. The secondary outcomes were hip flexion and adduction moments, knee flexion angle, ankle eversion moment, and walking speed. The repeated measurements ANOVA was used to compare the primary and secondary outcomes between the conditions using SPSS. Significance level was set at 0.05.
Results: LWI and a subtalar strap can significantly increase the knee flexion angle at 0%-15% of the stance phase compared to no insole (p<0.001). No other changes were observed (p=0.142).
Conclusion: LWI with an arch, with or without a subtalar strap, cannot impose any immediate changes on the kinetics and kinematics of lower limb joints during walking in people with mild KOA.
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Affiliation(s)
- Elham Esfandiari
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran.,Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran
| | - Hamid Reza Yazdi
- Department of Orthopedic Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sanjari
- Department of Basic Rehabilitation Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Fukaya T, Mutsuzaki H, Nakano W, Mori K. Characteristics of frontal plane lower limb movement during walking in patients with knee osteoarthritis of varying severity. J Orthop Surg (Hong Kong) 2020; 27:2309499019848085. [PMID: 31117881 DOI: 10.1177/2309499019848085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This study aimed to investigate the effect of knee joint structural destruction on frontal plane hip and ankle joint kinematics and kinetics during the stance phase of walking in patients with differing severities of knee osteoarthritis (KOA). METHODS An early KOA group consisted of eight subjects with bilateral knee Kellgren-Lawrence (KL) scale scores of 1 or 2. An established KOA group comprised nine subjects (18 knees) with KL scores of 3 or 4. To measure walking, the data were obtained using the motion analysis system and force plates. From the ground reaction force data, the stance phase of gait was divided into five periods. RESULTS In the established KOA group, the hip joint was significantly abducted, and the knee joint had significantly greater varus positioning during the stance phase. In addition, in the established KOA group, a significant knee abductor moment was observed during the stance phase. In contrast, in the early KOA group, the ankle joint showed a significant inversion moment during the stance phase, but in the established KOA group, the ankle joint moment was very small. CONCLUSIONS The structural destruction of the knee joint in the frontal plane in patients with the established KOA changes the movement of the hip and the moment of the ankle.
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Affiliation(s)
- Takashi Fukaya
- 1 Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Ibaraki, Japan
| | - Hirotaka Mutsuzaki
- 2 Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Wataru Nakano
- 1 Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Ibaraki, Japan
| | - Koichi Mori
- 3 Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Ferreira V, Simões R, Gonçalves RS, Machado L, Roriz P. The optimal degree of lateral wedge insoles for reducing knee joint load: a systematic review and meta-analysis. Arch Physiother 2019; 9:18. [PMID: 31890292 PMCID: PMC6921534 DOI: 10.1186/s40945-019-0068-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 11/08/2019] [Indexed: 12/17/2022] Open
Abstract
Background Lateral wedge insoles are traditionally used to reduce the adduction moment that crosses the knee during walking in people with medial knee osteoarthritis. However, the best degree to reduce knee joint load is not yet well established. Methods Electronic databases were searched from their inception until May 2017. Included studies reported on the immediate biomechanical effects of different degrees of lateral wedge insoles during walking in people with knee osteoarthritis. The main measures of interest relating to the biomechanics were the first and second peak of external knee adduction moment and knee adduction angular impulse. For the comparison of the biomechanical effects of different degrees of insoles, the studies were divided in three subgroups: insoles with a degree higher than 0° and equal to or lower than 5°; insoles higher than 5° and equal to or lower than 9°; and insoles higher than 9°. Eligible studies were pooled using random-effects meta-analysis. Results Fifteen studies with a total of 415 participants met all eligibility criteria and were included in the final review and meta-analysis. The overall effect suggests that lateral wedge insoles resulted in a statistically significant reduction in the first peak (standardized mean difference [SMD] -0.25; 95% confidence interval [CI] -0.36, - 0.13; P < 0.001), second peak (SMD -0.26 [95% CI -0.48, - 0.04]; P = 0.02) and knee adduction angular impulse (SMD -0.17 [95% CI -0.31, - 0.03]; P = 0.02). The test of subgroups found no statistically significant differences. Conclusion Systematic review and meta-analysis suggests that lateral wedge insoles cause an overall slight reduction in the biomechanical parameters. Higher degrees do not show higher reductions than lower degrees. Prior analysis of biomechanical parameters may be a valid option for selecting the optimal angle of wedge that best fits in knee osteoarthritis patients with the lowest possible degree.
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Affiliation(s)
- Vitor Ferreira
- 1School of Health Sciences, ESSUA - School of Health, Edificio 30, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Rita Simões
- Santa Casa da Misericórdia da Mealhada, Aveiro, Portugal
| | - Rui Soles Gonçalves
- 3Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal University of Coimbra, Centre for Health Studies and Research, Coimbra, Portugal
| | - Leandro Machado
- CIF2D, LABIOMEP, Faculdade de Desporto da Universidade do Porto, Coimbra, Portugal
| | - Paulo Roriz
- CIDESD-ISMAI, INESC-TEC, LABIOMEP, Coimbra, Portugal
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14
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Bratke G, Bruggemann GP, Willwacher S, Mählich D, Trudeau MB, Rohr E, Weir G, Maintz D, Hamill J. Does footwear affect articular cartilage volume change after a prolonged run? Scand J Med Sci Sports 2019; 30:332-338. [PMID: 31605631 DOI: 10.1111/sms.13576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/25/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate knee intra-articular cartilage volume changes after a prolonged running bout in three footwear conditions. Twelve participants performed 75-minute running bouts in the three footwear conditions. Before and after each running bout, magnetic resonance imaging (MRI) scans were obtained using a high-resolution 3.0 Tesla MRI. Three-dimensional reconstruction of the cartilage plates of the patella, the femur, and the tibia was created to quantify cartilage volume change due to the 75-minute running bout. Three-dimensional biomechanical data were also collected using an integrated motion capture and force treadmill system. There were no statistically significant differences among shoe conditions for all anatomical regions. However, significant cartilage volume reductions at all anatomical sites were observed after the 75-minute running bout in each footwear condition. These data suggest that the intra-articular knee cartilage undergoes a significant reduction in cartilage volume during a prolonged run that may indicate an increase in joint loading. There was a considerable variation in cartilage volume between participants across footwear conditions indicating an individual cartilage volume response to footwear. An individualistic approach to footwear recommendations may help in minimizing this change in cartilage.
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Affiliation(s)
- Grischa Bratke
- Institute for Diagnostic and Interventional Radiology, University Hospital, Cologne, Germany
| | - Gert-Peter Bruggemann
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | - Daniela Mählich
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | | | - Eric Rohr
- Brooks Running Inc, Seattle, WA, USA
| | - Gillian Weir
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, University Hospital, Cologne, Germany
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
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15
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Lewinson RT, Madden R, Killick A, Wannop JW, Preston Wiley J, Lun VMY, Patel C, LaMothe JM, Stefanyshyn DJ. Foot structure and knee joint kinetics during walking with and without wedged footwear insoles. J Biomech 2018; 73:192-200. [PMID: 29673934 DOI: 10.1016/j.jbiomech.2018.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 10/01/2017] [Accepted: 04/01/2018] [Indexed: 11/19/2022]
Abstract
The relationship between static foot structure characteristics and knee joint biomechanics during walking, or the biomechanical response to wedged insoles are currently unknown. In this study, 3D foot scanning, dual X-ray absorptiometry and gait analysis methods were used to determine structural parameters of the foot and assess their relation to knee joint loading and biomechanical response to wedged insoles in 30 patients with knee osteoarthritis. In multiple linear regression models, foot fat content, height of the medial longitudinal arch and static hind foot angle were not associated with the magnitude of the knee adduction moment (R2 = 0.24, p = 0.060), knee adduction angular impulse (R2 = 0.21, p = 0.099) or 3D resultant knee moment (R2 = 0.23, p = 0.073) during gait. Furthermore, these foot structure parameters were not associated with the patients' biomechanical response to medial or lateral wedge footwear insoles (all p < 0.01). These findings suggest that static foot structure is not associated with gait mechanics at the knee, and that static foot structure alone cannot be utilized to predict an individual's biomechanical response to wedged footwear insoles in patients with knee osteoarthritis.
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Affiliation(s)
- Ryan T Lewinson
- Biomedical Engineering Program, Schulich School of Engineering, University of Calgary, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada; Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Canada.
| | - Ryan Madden
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
| | - Anthony Killick
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
| | - John W Wannop
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
| | - J Preston Wiley
- Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Canada
| | - Victor M Y Lun
- Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Canada
| | - Chirag Patel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Canada
| | - Jeremy M LaMothe
- Section of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, Canada
| | - Darren J Stefanyshyn
- Biomedical Engineering Program, Schulich School of Engineering, University of Calgary, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
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Schiphof D, van den Driest JJ, Runhaar J. Osteoarthritis year in review 2017: rehabilitation and outcomes. Osteoarthritis Cartilage 2018; 26:326-340. [PMID: 29330103 DOI: 10.1016/j.joca.2018.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 12/14/2017] [Accepted: 01/02/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to describe studies examining rehabilitation for people with osteoarthritis (OA) and to summarize findings from selected key systematic reviews (SRs) and randomized controlled trials (RCTs). DESIGN A systematic search was performed using Pubmed, Embase and Cochrane databases from April 1st 2016 to May 15th 2017 using the terms 'osteoarthritis', 'randomized controlled trial', and 'systematic review'. Inclusion criteria were: clinically or radiologically diagnosed patients with OA, rehabilitation treatment, RCT or SRs. A selection of the included studies is discussed based on study quality and perceived importance to the field; including those that are innovative, inform the direction of the field or generate controversy. Methodological quality of the included studies was assessed using the PEDro-scale for RCTs and the Amstar guideline for SRs. RESULTS From 1211 articles, 80 articles met the eligibility criteria including 21 SRs and 61 RCTs. The median of the methodological quality of the SRs and RCTs was 7 (2-9) and 6 (3-10), respectively. The studies were grouped into several themes, covering the most important rehabilitation fields. CONCLUSIONS Striking is the small number of studies investigating another joint (18%) than the knee (82%). Exercise is the most common treatment evaluated and should be accompanied with education to effectuate a behavioural change in physical activity of people with OA. No new insights in the field of braces (or orthoses) and in the field of acupuncture were found.
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Affiliation(s)
- D Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - J J van den Driest
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - J Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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