title: Comparison of the efficacy of laterally wedged insoles and bespoke unloader knee orthoses in treating medial compartment knee osteoarthritis.
abstract: BACKGROUND
  Patients suffering from medial compartment knee osteoarthritis (OA) may be treated with unloader knee orthoses or laterally wedged insoles.
  
  
  OBJECTIVE
  The aim of this study was to identify and compare the effects of them on the gait parameters and pain in these patients.
  
  
  METHODS
  Quasi-experimental.
  
  
  METHODS
  Volunteer subjects with medial compartment knee OA (n = 24, mean age 59.29 ± 2.23 years) were randomly assigned to two separate groups and evaluated when wearing an unloader knee orthosis or insoles incorporating a 6° lateral wedge. Testing was performed at baseline and after six weeks of each orthosis use. A visual analog scale score was used to assess pain and gait analysis was utilized to determine gait parameters.
  
  
  RESULTS
  Both orthoses improved all parameters compared to the baseline condition (p = 0.000). However, no significant differences in pain (p = 0.649), adduction moment (p = 0.205), speed of walking (p = 0. 056) or step length (p = 0.687) were demonstrated between them. The knee range of motion (p = 0.000) were significantly different between the two interventions.
  
  
  CONCLUSIONS
  Both orthoses reduced knee pain. Maximum knee range of motion was increased by both interventions although it was 3 degrees less when wearing the knee orthosis. Clinical relevance Both orthoses reduce pain and improve gait anomalies in medial compartment knee OA. Our results suggest a laterally wedged insole can be an alternative conservative approach to unloader knee orthosis for treating symptoms of medial compartment knee OA.
authors.affiliation: University of Social Welfare and Rehabilitation Science, Tehran, Iran.
authors.forename: Mokhtar
authors.initials: M
authors.lastname: Arazpour
authors.forename: Monireh Ahmadi
authors.initials: MA
authors.lastname: Bani
authors.forename: Maryam
authors.initials: M
authors.lastname: Maleki
authors.forename: Farhad Tabatabai
authors.initials: FT
authors.lastname: Ghomshe
authors.forename: Reza Vahab
authors.initials: RV
authors.lastname: Kashani
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hutchins
mesh_terms: D018771:Arthralgia / Q000503:physiopathology; D001696:Biomechanical Phenomena; D005260:Female; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000628:therapy*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome