title: The use of a lateral wedge insole to reduce knee loading when ascending and descending stairs in medial knee osteoarthritis patients.
abstract: BACKGROUND
  Stair climbing is a challenging task to the elderly being the task with the first complaint in patients with mild to moderate knee osteoarthritis. Stair climbing results in around six times more compressive load transmitted through the knee joint than walking on level ground. The purpose of this study was to assess whether lateral wedge insoles would reduce medial compartment knee loading when ascending and descending stairs in patients with medial knee osteoarthritis.
  
  
  METHODS
  Eight patients with medial knee osteoarthritis were tested in random order with and without a pair of 5° off-the-shelf lateral wedge insoles for two separate activities (stair ascent and stair descent). Kinematic and kinetic data were collected for the lower extremity using a sixteen camera motion capture system and two force plates. Primary outcome measures were the external knee adduction moment and the knee adduction angular impulse.
  
  
  RESULTS
  During stair ascent and descent, lateral wedge insoles significantly (P<0.05) reduced the 1st peak external knee adduction moment in early stance (ascent 6.8%, descent 8.4%), the trough in mid stance (ascent 13%, descent 10.7%), 2nd peak in the late stance (ascent 15%, descent 8.3%) and the knee adduction angular impulse compared to the control (standard shoe) with large effect sizes (0.75-0.95).
  
  
  CONCLUSIONS
  In this first study on stairs, lateral wedge insoles consistently reduced the overall magnitude of medial compartment loading during stair ascent and descent. Further research is needed to determine the relationship of this with clinical results when ascending and descending stairs with lateral wedge insoles.
authors.affiliation: Faculty of Rehabilitation Sciences, University of Jordan, Jordan.
authors.forename: Amneh Z
authors.initials: AZ
authors.lastname: Alshawabka
authors.affiliation: School of Health Sciences, University of Salford, UK.
authors.forename: Anmin
authors.initials: A
authors.lastname: Liu
authors.affiliation: Stroke & Vascular Research Centre, University of Manchester, UK.
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Tyson
authors.affiliation: School of Health Sciences, University of Salford, UK. Electronic address: r.k.jones@salford.ac.uk.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D018592:Cross-Over Studies; D005260:Female; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D012775:Shoes / Q000592:standards; D016474:Weight-Bearing / Q000502:physiology
keywords: Adduction moment; Knee osteoarthritis; Lateral wedge insole; Stair climbing