title: The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: a randomised trial.
abstract: Many conservative treatments exist for medial knee osteoarthritis (OA) which aims to reduce the external knee adduction moment (EKAM). The objective of this study was to determine the difference between different shoes and lateral wedge insoles on EKAM, knee adduction angular impulse (KAAI), external knee flexion moment, pain, and comfort when walking in individuals with medial knee OA. Seventy individuals with medial knee OA underwent three-dimensional walking gait analysis in five conditions (barefoot, control shoe, typical wedge, supported wedge, and mobility shoe) with pain and comfort recorded concurrently. The change in EKAM, KAAI, external knee flexion moment, pain, and comfort were assessed using multiple linear regressions and pairwise comparisons. Compared with the control shoe, lateral wedge insoles and barefoot walking significantly reduced early stance EKAM and KAAI. The mobility shoe showed no effect. A significant reduction in latter stance EKAM was seen in the lateral wedge insoles compared to the other conditions, with only the barefoot condition reducing the external knee flexion moment. However, the mobility shoe showed significant immediate knee pain reduction and improved comfort scores. Different lateral wedge insoles show comparable reductions in medial knee loading and in our study, the mobility shoe did not affect medial loading.
authors.affiliation: School of Health Sciences, University of Salford, Salford, United Kingdom.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Jones
authors.affiliation: School of Health Sciences, University of Salford, Salford, United Kingdom.|Clinical Biomechanics & Physical Medicine Section, Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM) and Leeds NIHR Biomedical Research Unit, University of Leeds, Leeds, United Kingdom.
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Chapman
authors.affiliation: Arthritis Research UK Centre of Excellence in Epidemiology, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Parkes
authors.affiliation: Arthritis Research UK Centre of Excellence in Epidemiology, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: Forsythe
authors.affiliation: Arthritis Research UK Centre of Excellence in Epidemiology, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.|Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000628:therapy; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices / Q000706:statistics & numerical data*; D020370:Osteoarthritis, Knee / Q000628:therapy*; D012775:Shoes / Q000706:statistics & numerical data*; D016474:Weight-Bearing
keywords: adduction moment; footwear; knee osteoarthritis; lateral wedge insoles; walking