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Martinez-Rico M, Deschamps K, Gijon-Nogueron G, Ortega-Avila AB. Impact of in shoe and barefoot placed frontal wedges on plantar loading: A systematic review. Gait Posture 2022; 97:62-72. [PMID: 35901593 DOI: 10.1016/j.gaitpost.2022.07.233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 06/26/2022] [Accepted: 07/17/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE The main aim of this review is to report the effect of different types of in-shoe and barefoot wedges on the distribution of the plantar loading of the human foot. We hypothesise that frontal plane wedges modify this parameter. METHODS A systematic review was performed, using the PubMed, CINAHL, Prospero and Scopus databases, consulted from their date of first publication to May 2020. Only observational (cross-over studies), randomised controlled trials (RCTs) and quasi-experimental studies addressing the effects of in-shoe and barefoot frontal plane wedges on plantar loading were included. All articles were subjected to quality assessment, using the Newcastle-Ottawa scale for the observational (cross-over) studies, TREND for quasi-experimental studies and the Cochrane Collaboration's tool for the RCTs. RESULTS Eleven papers were included in the final review. Four were cross-over studies, other four were quasi-experimental studies and three were RCTs. These eleven studies included 320 patients, with ages ranging from 20 to 60 years. Regarding the risk of bias, most of the observational studies and RCTs had a moderate level of quality. CONCLUSIONS The results suggest that lateral wedges are more effective, producing a lateral shift of the centre of pressure and increasing the pressure. Regarding the impact on the peak impact force there seems to be less consensus among the published data.
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Affiliation(s)
- Magdalena Martinez-Rico
- Department of Nursing and Podiatry. University of Malaga, Spain; KULeuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Spoorwegstraat 12, 8200 Bruges, Belgium
| | - Kevin Deschamps
- KULeuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Spoorwegstraat 12, 8200 Bruges, Belgium; Department of Podiatry, Artevelde University College, Ghent, Belgium; Institut D'Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Brussels, Belgium
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Fischer AG, Ulrich B, Hoffmann L, Jolles BM, Favre J. Effect of lateral wedge length on ambulatory knee kinetics. Gait Posture 2018; 63:114-118. [PMID: 29729613 DOI: 10.1016/j.gaitpost.2018.04.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/23/2018] [Accepted: 04/26/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Lateral wedge insoles (LWI) were proposed to treat medial knee osteoarthritis through reductions of the ambulatory knee adduction moment (KAM). Limited attention was however paid to the LWI length, resulting in unclear understanding of its effect on KAM reductions. The knee flexion moment (KFM) was also shown to be important in knee osteoarthritis, but little is known about the effect of LWI length on it. RESEARCH QUESTION This study aimed to compare the KAM and KFM of healthy subjects walking with four different lengths of LWI, explicitly without LWI and with LWI below the hindfoot (HF), below the hindfoot and forefoot (HF + FF) and below the hindfoot, forefoot and hallux (HF + FF + HX) segments. METHODS Nineteen healthy participants (63% male; 24 ± 3 years old) walked in an instrumented gait lab with LWI of four different lengths. Repeated one-way ANOVAs and post-hoc t-tests were used to compare knee kinetics among LWI lengths. RESULTS The peak value of the KAM during the first half of stance and the KAM impulse differed with respect to the LWI length (p < 0.001). A length of at least HF + FF, but not necessarily longer, was needed to decrease both KAM parameters compared to walking without LWI. The LWI length had no effect on the peak value of the KFM during the first half of stance (p = 0.86). SIGNIFICANCE The results in this study could contribute to better selections of LWI for medial knee osteoarthritis and suggested that the length of the LWI could be a critical factor that should be considered in future research.
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Affiliation(s)
- Arielle G Fischer
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
| | - Baptiste Ulrich
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | | | - Brigitte M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
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Mine K, Nakayama T, Milanese S, Grimmer K. The effectiveness of braces and orthoses for patients with knee osteoarthritis: A systematic review of Japanese-language randomised controlled trials. Prosthet Orthot Int 2017; 41:115-126. [PMID: 27117012 DOI: 10.1177/0309364616640926] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Knee osteoarthritis is common. The evidence regarding the effectiveness of braces and orthoses for patients with knee osteoarthritis is inconclusive according to English-language literature. English-language reviews to date have not included Japanese-language studies. OBJECTIVES This study aimed to collect and synthesise Japanese-language randomised controlled trials investigating the effectiveness of braces and orthoses for patients with knee osteoarthritis. STUDY DESIGN Systematic review. METHODS Eight databases were systematically searched from inception to 29 July 2015. Only Japanese-language randomised controlled trials were included. Risk of bias was assessed using Physiotherapy Evidence Database scale. A meta-analysis was not appropriate due to the heterogeneity in the included studies. RESULTS Seven randomised controlled trials with low to high risks of bias were included. Six of seven included studies were conducted by the same author group. Limited evidence supported the positive effects of short-lever elastic knee braces to improve pain and functional disability in specific outcomes. No evidence was found to support the use of foot orthoses, such as laterally wedged insoles, medial arch support and metatarsal arch pad. CONCLUSION Our systematic review found no conclusive evidence about the effectiveness of any braces and orthoses for patients with medial knee osteoarthritis. Future Japanese-language studies should address methodological flaws exposed in this review and strengthen the international evidence base. Clinical relevance This is the first systematic review of Japanese-language randomised controlled trials investigating orthoses for patients with knee osteoarthritis. Clinicians can consider the use of short-lever elastic knee braces to improve specifically pain on squat or walking. Evidence found in this review does not support the use of foot orthoses.
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Affiliation(s)
- Koya Mine
- 1 International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia
| | - Takashi Nakayama
- 2 School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Steve Milanese
- 1 International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia
| | - Karen Grimmer
- 2 School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
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Baghaei Roodsari R, Esteki A, Aminian G, Ebrahimi I, Mousavi ME, Majdoleslami B, Bahramian F. The effect of orthotic devices on knee adduction moment, pain and function in medial compartment knee osteoarthritis: a literature review. Disabil Rehabil Assist Technol 2016; 12:441-449. [PMID: 26980073 DOI: 10.3109/17483107.2016.1151952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Knee braces and foot orthoses are commonly used to improve knee adduction moment, pain and function in subjects with knee osteoarthritis (OA). However, no literature review has been performed to compare the effects of foot orthoses and knee braces in this group of patients. Purpose The aim of this review was to evaluate the effects of foot orthoses and knee braces on knee adduction moment, pain and function in individuals with knee OA. Study design Literature review. Method The search strategy was based on the Population Intervention Comparison Outcome method. A search was performed in PubMed, Science Direct, Google Scholar and ISI web of knowledge databases using the PRISMA method and based on selected keywords. Thirty-one related articles were selected for final evaluation. Results The results of the analysis of these studies demonstrated that orthotic devices reduce knee adduction moment and also improve pain and function in individuals with knee OA. Conclusion Foot orthoses may be more effective in improving pain and function in subjects with knee OA. Both knee braces and foot orthoses reduce the knee adduction moment in knee OA and consequently patients typically do not need to use knee braces for a long period of time. Also, foot orthoses and knee braces may be more effective for medial compartment knee OA patients due to the fact that this treatment helps improve pain and function. Implications for Rehabilitation Knee braces and foot orthoses are commonly used for improving knee adduction moment, pain and function in subjects with knee osteoarthritis (OA). Orthotic devices can reduce knee adduction moment, pain and improve function in knee OA. The combined use of a knee braces and foot orthoses can provide more improvement in knee adduction moment, reduced pain and increased function.
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Affiliation(s)
- Roshanak Baghaei Roodsari
- a Department of Orthotics and Prosthetics , University of Social Welfare and Rehabilitation Sciences , Tehran , Islamic Republic of Iran
| | - Ali Esteki
- b Shahid Beheshti University of Medical Sciences , Tehran , Islamic Republic of Iran
| | - Gholamreza Aminian
- a Department of Orthotics and Prosthetics , University of Social Welfare and Rehabilitation Sciences , Tehran , Islamic Republic of Iran
| | - Ismaeil Ebrahimi
- c School of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran , Islamic Republic of Iran
| | - Mohammad Ebramim Mousavi
- a Department of Orthotics and Prosthetics , University of Social Welfare and Rehabilitation Sciences , Tehran , Islamic Republic of Iran
| | - Basir Majdoleslami
- a Department of Orthotics and Prosthetics , University of Social Welfare and Rehabilitation Sciences , Tehran , Islamic Republic of Iran
| | - Fatemeh Bahramian
- a Department of Orthotics and Prosthetics , University of Social Welfare and Rehabilitation Sciences , Tehran , Islamic Republic of Iran
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The Effect of Lateral Wedge and Medial Arch Support on Displacement of Ground Reaction Force in Patients with Knee Osteoarthritis. JOURNAL OF REHABILITATION 2016. [DOI: 10.20286/jrehab-170172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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de Campos GC, Rezende MU, Pasqualin T, Frucchi R, Bolliger R. Lateral wedge insole for knee osteoarthritis: randomized clinical trial. SAO PAULO MED J 2015; 133:13-9. [PMID: 25626851 PMCID: PMC10496616 DOI: 10.1590/1516-3180.2013.6750002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 02/14/2013] [Accepted: 12/03/2013] [Indexed: 12/27/2022] Open
Abstract
CONTEXT AND OBJECTIVE Optimal management of knee osteoarthritis requires a combination of pharmacological and non-pharmacological methods. The use of lateral wedge insoles to treat medial knee osteoarthritis is recommended, but there is still controversy about its efficacy. The purpose of this study was to ascertain whether the use of lateral wedge insoles can diminish pain and improve function in patients with medial knee osteoarthritis. DESIGN AND SETTING Prospective randomized trial conducted in a tertiary-level hospital. METHODS We prospectively enrolled 58 patients with medial knee osteoarthritis and randomized them to use either a lateral wedge insole with subtalar strapping (Group W), or a neutral insole with subtalar strapping (Group N - control). All the patients were instructed to use the insole for five to ten hours per day. A visual analogue pain scale, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Lequesne questionnaire were applied at baseline and at weeks 2, 8 and 24. RESULTS At weeks 8 and 24, both groups showed lower scores for WOMAC (P = 0,023 and P = 0,012 respectively). There were no statistically significant differences between the groups regarding the visual analogue pain scale, WOMAC or Lequesne results at any time evaluated. CONCLUSION The use of a lateral wedge insole with subtalar strapping improved the patients' symptoms and function but was not superior to placebo insoles.
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Affiliation(s)
| | - Marcia Uchôa Rezende
- MD, MSc, PhD. Head of Osteometabolic Disease Group, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Thiago Pasqualin
- MD. Medical Volunteer, Osteometabolic Disease Group, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Renato Frucchi
- MD. Medical Volunteer, Osteometabolic Disease Group, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Raul Bolliger
- MD, MSc, PhD. Attending Physician in Institute of Orthopedics and Traumatology, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
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Messier SP, Pater M, Beavers DP, Legault C, Loeser RF, Hunter DJ, DeVita P. Influences of alignment and obesity on knee joint loading in osteoarthritic gait. Osteoarthritis Cartilage 2014; 22:912-7. [PMID: 24857973 PMCID: PMC4108726 DOI: 10.1016/j.joca.2014.05.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 05/05/2014] [Accepted: 05/07/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the influences of frontal plane knee alignment and obesity on knee joint loads in older, overweight and obese adults with knee osteoarthritis (OA). METHODS Cross-sectional investigation of alignment and obesity on knee joint loads using community dwelling older adults (age ≥ 55 years; 27 kg m(-2) ≥ body mass or body mass index (BMI) ≤ 41 kg m(-2); 69% female) with radiographic knee OA that were a subset of participants (157 out of 454) enrolled in the Intensive Diet and Exercise for Arthritis (IDEA) clinical trial. RESULTS A higher BMI was associated with greater (P = 0.0006) peak knee compressive forces [overweight, 2411 N (2182, 2639), class 1 obesity, 2772 N (2602, 2943), class 2+ obesity, 2993 N (2796, 3190)] and greater (P = 0.004) shear forces [overweight, 369 N (322, 415), class 1 obesity, 418 N (384, 453), class 2+ obesity, 472 N (432, 513)], independent of alignment, and varus alignment was associated (P < 0.0001) with greater peak external knee adduction moments, independent of BMI [valgus, 18.7 Nm (15.1, 22.4), neutral, 27.7 Nm (24.0, 31.4), varus, 37.0 Nm (34.4, 39.7)]. CONCLUSION BMI and alignment were associated with different joint loading measures; alignment was more closely associated with the asymmetry or imbalance of loads across the medial and lateral knee compartments as reflected by the frontal plane external adduction moment, while BMI was associated with the magnitude of total tibiofemoral force. These data may be useful in selecting treatment options for knee OA patients (e.g., diet to reduce compressive loads or bracing to change alignment).
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Affiliation(s)
- S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA; Section on Gerontology and Geriatric Medicine, Wake Forest University, School of Medicine, USA.
| | - M Pater
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - D P Beavers
- Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - C Legault
- Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - R F Loeser
- Division of Rheumatology, Allergy and Immunology Thurston Arthritis Research Center, University of North Carolina-Chapel Hill, USA.
| | - D J Hunter
- Rheumatology Department, Northern Clinical School, University of Sydney, Sydney, Australia.
| | - P DeVita
- Department of Kinesiology, East Carolina University, Greenville, NC, USA.
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Huleatt JB, Campbell KJ, Laprade RF. Nonoperative treatment approach to knee osteoarthritis in the master athlete. Sports Health 2014; 6:56-62. [PMID: 24427443 PMCID: PMC3874223 DOI: 10.1177/1941738113501460] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Context: Middle-age and elderly participants in athletic activities frequently encounter the chronic disabling process of osteoarthritis. Knowledge of the treatment of knee osteoarthritis is needed to keep the master athlete active. Objective: This article reviews the current scientific evidence regarding recommendations for the maturing athlete, specifically discussing the strengths and weaknesses of dietary and lifestyle modifications, physical therapy, bracing, supplements, pharmacotherapies, and biologics in the management of knee osteoarthritis. Level of Evidence: Level 4. Conclusion: These treatment modalities can help keep the aging athlete active, which in itself plays an important role in reducing the symptoms of knee osteoarthritis.
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Parkes MJ, Maricar N, Lunt M, LaValley MP, Jones RK, Segal NA, Takahashi-Narita K, Felson DT. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis: a meta-analysis. JAMA 2013; 310:722-30. [PMID: 23989797 PMCID: PMC4458141 DOI: 10.1001/jama.2013.243229] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
IMPORTANCE There is no consensus regarding the efficacy of lateral wedge insoles as a treatment for pain in medial knee osteoarthritis. OBJECTIVE To evaluate whether lateral wedge insoles reduce pain in patients with medial knee osteoarthritis compared with an appropriate control. DATA SOURCES Databases searched include the Cochrane Central Register of Controlled Trials, EMBASE, AMED, MEDLINE, CINAHL Plus, ScienceDirect, SCOPUS, Web of Science, and BIOSIS from inception to May 2013, with no limits on study date or language. The metaRegister of Controlled Trials and the NHS Evidence website were also searched. STUDY SELECTION Included were randomized trials comparing shoe-based treatments (lateral heel wedge insoles or shoes with variable stiffness soles) aimed at reducing medial knee load, with a neutral or no wedge control condition in patients with painful medial knee osteoarthritis. Studies must have included patient-reported pain as an outcome. DATA EXTRACTION AND SYNTHESIS Trial data were extracted independently by 2 researchers using a standardized form. Risk of bias was assessed using the Cochrane Risk of Bias tool by 2 observers. Eligible studies were pooled using a random-effects approach. MAIN OUTCOME AND MEASURES Change in self-reported knee pain at follow-up. RESULTS Twelve trials met inclusion criteria with a total of 885 participants of whom 502 received lateral wedge treatment. The pooled standardized mean difference (SMD) suggested a favorable association with lateral wedges compared with control (SMD, -0.47; 95% CI, -0.80 to -0.14); however, substantial heterogeneity was present (I2 = 82.7%). This effect size represents an effect of -2.12 points on the 20-point Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scale. Larger trials with a lower risk of bias suggested a null association. Meta-regression analyses showed that higher effect sizes (unstandardized β, 1.07 [95% CI, 0.28 to 1.87] for trials using a no treatment control) were seen in trials using a no wedge treatment control group (n = 4 trials; SMD, -1.20 [95% CI, -2.09 to -0.30]) and lower effect sizes (unstandardized β, 0.26 [95% CI, 0.002 to 0.52] for each bias category deemed low risk) when the study method was deemed at low risk of bias. Among trials in which the control treatment was a neutral insole (n = 7), lateral wedges showed no association (SMD, -0.03 [95% CI, -0.18 to 0.12] on WOMAC; this represents an effect of -0.12 points), and results showed little heterogeneity (I2 = 7.1%). CONCLUSIONS AND RELEVANCE Although meta-analytic pooling of all studies showed a statistically significant association between use of lateral wedges and lower pain in medial knee osteoarthritis, restriction of studies to those using a neutral insole comparator did not show a significant or clinically important association. These findings do not support the use of lateral wedges for this indication.
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Affiliation(s)
- Matthew J Parkes
- Arthritis Research UK Epidemiology Unit, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, England.
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