title: Effect of unilateral and bilateral use of laterally wedged insoles with arch supports on impact loading in medial knee osteoarthritis.
abstract: BACKGROUND
  Increased impact loading is implicated in knee osteoarthritis development and progression.
  
  
  OBJECTIVE
  This study examined the impact ground reaction force (GRF) peak, its loading rate, its relative timing to stance phase timing, and walking speed during unilateral and bilateral use of laterally wedged insoles with arch supports.
  
  
  METHODS
  Within-subject design.
  
  
  METHODS
  Thirty-three female patients with medial knee osteoarthritis were examined with (unilateral 6° and 11°, and bilateral 0°, 6°, and 11°) and without insole use.
  
  
  RESULTS
  Repeated measures MANOVA revealed that the impact force increased significantly in bilateral 11° versus unilateral 6° and without-insole conditions. The loading rate decreased significantly in unilateral 11° versus bilateral 6° insoles. The relative timing increased significantly in each of bilateral 6°, bilateral 11°, and unilateral 11° versus bilateral 0° insoles and in each of bilateral 11° and unilateral 11° versus without-insole condition. There were significant positive correlations between the walking speed and each of the force and loading rate. The Chi-square test revealed insignificant association between the insole condition and the presence of impact forces.
  
  
  CONCLUSIONS
  Unilateral 11° insoles are capable of reducing impact loading possibly through increasing foot pronation. Walking slowly is another possible strategy to reduce loading.
  
  
  CONCLUSIONS
  Unilaterally applied 11° laterally wedged insoles are capable of reducing and delaying the initial impact ground reaction forces and reducing their loading rates during walking in patients with medial knee osteoarthritis, thus reducing osteoarthritis progression. Walking slowly could also be used as a strategy to reduce impact loading.
authors.affiliation: Faculty of Physical Therapy, Cairo University, Giza, Egypt dramira_biomechanics@hotmail.com.
authors.forename: Amira Abdallah
authors.initials: AA
authors.lastname: Abd El Megeid Abdallah
mesh_terms: D004867:Equipment Design; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000517:prevention & control; D004856:Postural Balance / Q000502:physiology; D012775:Shoes; D000072797:Walking Speed / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology*
keywords: Impact loading; osteoarthritis; wedged insoles