title: In-shoe plantar pressure measurements for patients with knee osteoarthritis: Reliability and effects of lateral heel wedges.
abstract: Although plantar pressure measurement systems are being used increasingly during gait analyses to investigate foot orthotics, there is limited information describing test-retest reliability of such measurements. Objectives of this study were to (1) examine the test-retest reliability of lateral heel pressure (LHP) and centre of pressure (COP) during walking with and without lateral heel wedges, and (2) evaluate the effects of 4° and 8° lateral heel wedges on the magnitude of LHP, the pathway of the COP and the peak external knee adduction moment (KAM) in subjects with and without knee osteoarthritis (OA). Twenty-six subjects, 12 patients with knee OA and 14 healthy subjects, were evaluated during three lateral heel wedge conditions (control, 4° and 8°) with standardized footwear. Three-dimensional analyses of gait with optical motion capture, floor-mounted force plate and in-shoe plantar pressure were completed on two occasions. Intraclass correlation coefficients (ICC(2, 1)) for LHP were excellent (0.79-0.83) while ICCs for COP in the medial-lateral and anterior-posterior directions were more variable (0.66-0.86). Reliability was slightly diminished when using heel wedges. Standard errors of measurement suggested considerable day-to-day variability in an individual's measures. Lateral heel wedges significantly (p<0.001) increased LHP, shifted COP anteriorly and laterally, and decreased the KAM. No significant differences were observed between subjects with and without OA. Although the day-to-day variability appears too large to confidently evaluate changes in individual patients, and decreases in reliability with increases in wedge size indicate caution, these results suggest in-shoe measurement of LHP and COP are appropriate for use in studies evaluating biomechanical effects of foot orthoses for knee OA.
authors: Wolf Orthopaedic Biomechanics Laboratory, University of Western Ontario, London, Ontario, Canada.
authors: Kristyn M
authors: KM
authors: Leitch
authors: Trevor B
authors: TB
authors: Birmingham
authors: Ian C
authors: IC
authors: Jones
authors: J Robert
authors: JR
authors: Giffin
authors: Thomas R
authors: TR
authors: Jenkyn
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D011312:Pressure; D015203:Reproducibility of Results; D012775:Shoes; D016138:Walking / Q000502:physiology