title: Biomechanical and clinical outcomes with shock-absorbing insoles in patients with knee osteoarthritis: immediate effects and changes after 1 month of wear.
abstract: OBJECTIVE
  To examine the effectiveness of shock-absorbing insoles in the immediate reduction of knee joint load, as well as reductions in knee joint load, pain, and dysfunction after 1 month of wear, in individuals with knee osteoarthritis (OA).
  
  
  METHODS
  Pre-post design with participants exposed to 2 conditions (normal footwear, shock-absorbing insoles) with a 1-month follow-up.
  
  
  METHODS
  University laboratory for testing and general community for intervention.
  
  
  METHODS
  Community-dwelling individuals (N=16; 6 men, 10 women) with medial compartment knee OA.
  
  
  METHODS
  Participants were provided with sulcus length shock-absorbing insoles to be inserted into their everyday shoes.
  
  
  METHODS
  Primary outcome measures included the peak, early stance peak, and late stance peak external knee adduction moment (KAM); the KAM impulse (positive area under the KAM curve); and peak tibial vertical acceleration. Secondary outcomes included walking pain, the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale and total score, and a timed stair climb task.
  
  
  RESULTS
  There was a significant reduction in the late stance peak KAM with shock-absorbing insoles (P=.03) during follow-up compared with the baseline test session. No other immediate or longitudinal significant changes (P>.05) in the other KAM parameters or peak tibial acceleration after use of a shock-absorbing insole were observed. However, significant improvements in all measures of pain and function (P<.05) were observed.
  
  
  CONCLUSIONS
  Shock-absorbing insoles produced significant reductions in self-reported knee joint pain and physical dysfunction with 1 month of wear in patients with knee OA despite no consistent changes in knee joint load. Further research using randomized controlled trials, with larger sample sizes and explorations into long-term use of shock-absorbing insoles and their effect on disease progression, is warranted.
authors.affiliation: Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Turpin
authors.forename: Adrian
authors.initials: A
authors.lastname: De Vincenzo
authors.forename: Amy M
authors.initials: AM
authors.lastname: Apps
authors.forename: Thea
authors.initials: T
authors.lastname: Cooney
authors.forename: Megan D
authors.initials: MD
authors.lastname: MacKenzie
authors.forename: Ryan
authors.initials: R
authors.lastname: Chang
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hunt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D020370:Osteoarthritis, Knee / Q000150:complications / Q000534:rehabilitation*; D010146:Pain / Q000209:etiology / Q000534:rehabilitation*