The effects of using a lateral wedge insole on knee loading during ascending and descending stairs

Introduction: Stair climbing demands, compared to walking on level ground, a greaterrange of motion in the lower extremity accompanied by about six times more load on theknee joint. Consequently, pain while stair climbing is the first complaint in patients withknee osteoarthritis (OA). The use of lateral wedge insoles aims to decrease medial kneecompartment loading by reducing the peak external knee adduction moment (EKAM)during walking. The purpose of this study .was to assess the biomechanical effects ofwearing lateral wedge insoles on EKAM during stair climbing in elders with and withoutknee OA.Methods: Thirty healthy subjects (21 females, 9 males) and eight patients with medialknee OA (5 females, 3 males) participated in the study. Subjects performed five trials ofstep-over-step stairs ascent and descent. Three conditions were investigated: (1) Barefoot(2) Standard shoe (3) Standard shoe with a lateral wedge insole. Kinematic and kineticdata were collected for the lower extremity using a motion capture system (QTM ) andtwo force plates (AMTI force platform stairway). Repeated measures ANOVA andFriedman's ANOVA were used for statistical analysis.Results: During stairs ascent and descent, a lateral wedge insole significantly (p<0.05)reduced the EKAM's 1 st peak in early stance, 2 nd peak in the late stance, the trough in midstance, and the knee adduction angular impulse for both knee OA and healthy subjects ascompared to standard shoe and barefoot conditions (e.g., 1 st peak in lateral wedgecondition for OA patients (ascent: (0.37±0.02 Nm/Kg, descent: 0.33±0.05 Nm/Kg),standard shoe condition (ascent: 0.39±0.03 Nm/Kg, descent: 0.37±0.06 Nm/Kg) andbarefoot condition (ascent: (0.40±0.03 Nm/Kg, descent: 0.39 ±0.07 Nm/Kg)).Additionally, there was significantly greater range of ankle/subtalar joint complex eversionwith a lateral wedge insole (p<0.05) than in standard shoe and barefoot conditions.Conclusion: Lateral wedge insoles consistently reduced the overall magnitude of EKAM,which has been strongly correlated to decreased medial knee compartment loading. Theseresults support that lateral wedge insoles might be useful in decreasing pain level inpatients with medial knee OA during ascending and descending stairs.

Level dc:type.qualificationlevel

Master's Level (Level 7)

Year dc:date.issued

2012

Author dc:creator

• Alshawabka, A

Language dc:language

en

Identifier

oai:salford-repository.worktribe.com:1338351

OAI identifier oai:identifier

oai:salford-repository.worktribe.com:1338351