title: Effects of foot orthoses with medial arch support and lateral wedge on knee adduction moment in patients with medial knee osteoarthritis.
abstract: BACKGROUND
  There is contradictory evidence regarding whether the addition of medial arch supports to laterally wedged insoles reduces knee adduction moment, improves comfort, and reduces knee pain during the late stance phase of gait.
  
  
  OBJECTIVE
  To verify if such effects occur in participants with medial knee osteoarthritis.
  
  
  METHODS
  Randomized single-blinded study.
  
  
  METHODS
  Gait analysis was performed on 18 patients affected by medial knee osteoarthritis. Pain and comfort scores, frontal plane kinematics and kinetics of ankle, knee, and hip were compared in four conditions: without foot orthosis, with foot orthoses, with medial arch support, and with foot orthoses with medial arch support and lateral wedge insoles with 6° and 10° inclination.
  
  
  RESULTS
  Lower-extremity gait kinetics were characterized by a significant decrease, greater than 6%, in second peak knee adduction moment in laterally wedged insole conditions compared to the other conditions ( p < 0.001; effect size = 0.6). No significant difference in knee adduction moment was observed between laterally wedged insole conditions. In contrast, a significant increase of 7% in knee adduction moment during the loading response was observed in the customized foot orthoses without lateral inclination condition ( p < 0.001; effect size = 0.3). No difference was found in comfort or pain ratings between conditions.
  
  
  CONCLUSIONS
  Our study suggests that customized foot orthoses with a medial arch support may only be suitable for the management of medial knee osteoarthritis when a lateral wedge is included. Clinical relevance Our data suggest that customized foot orthoses with medial arch support and a lateral wedge reduce knee loading in patients with medial knee osteoarthritis (KOA). We also found evidence that medial arch support may increase knee loading, which could potentially be detrimental in KOA patients.
authors.affiliation: 1 Université Laval, Quebec, QC, Canada.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Dessery
authors.affiliation: 2 Centre de recherche FRQS du Centre hospitalier universitaire de Québec, Quebec, QC, Canada.
authors.forename: Étienne
authors.initials: É
authors.lastname: Belzile
authors.affiliation: 2 Centre de recherche FRQS du Centre hospitalier universitaire de Québec, Quebec, QC, Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Turmel
authors.affiliation: 1 Université Laval, Quebec, QC, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Corbeil
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000628:therapy*; D016059:Range of Motion, Articular; D016037:Single-Blind Method
keywords: Knee adduction moment; comfort; gait analysis; insoles; lower extremity; pain