Effectiveness of Increasing the Angle of Lateral Wedge Insole on Spatiotemporal Gait Parameters in Patients with Medial Knee Osteoarthritis

Document Type: Original research papers

Authors

1 Department of Sport Biomechanics, Faculty of Humanities, Islamic Azad University, Hamedan Branch, Hamedan, Iran.

2 Department of Motor Behavior, Faculty of Humanities, Islamic Azad University, Hamedan Branch, Hamedan, Iran.

Abstract

In previous studies, the effect of lateral wedge insole on gait variables in people with medial knee osteoarthritis has been studied. However, No study was found to examine the effect of insole slope. This study was sought to assess the effect of increasing the angle of lateral wedge insole on spatiotemporal gait parameters in patients with medial knee osteoarthritis.Ten individuals with medial knee osteoarthritis and 10 healthy subjects with similar age, height and mass were selected. The spatiotemporal gait parameters of subjects were calculated in four walking conditions (walking barefoot, walking while wearing shoes with 0°, 5°, 11° insoles). Repeated measures and t-test was used in case of intragroup comparison and MANOVA in case of intergroup comparison. The main effect of insole had a significant effect on walking speed (p = 0.000). Walking speed in wearing shoes with 0° and 5° insoles were significantly higher than other condition. The intragroup analysis showed that walking speed, Double Support time, percent of foot off, and stride and step length in walking barefoot were significantly less than walking while using insoles in both groups. The speed of walking, stride and step length in barefoot conditions showed a significant difference between the two groups (p < 0.05). These findings imply that the use of insole was a similar effect in affected and non- affected limb. To increase the efficiency of gait, according to the results, recommended using laterally wedged insoles in people with medial knee OA.

Keywords

Main Subjects


1.         Abdallah AA, Radwan AY. Biomechanical changes accompanying unilateral and bilateral use of laterally wedged insoles with medial arch supports in patients with medial knee osteoarthritis. Clinical Biomechanics. 2011;26(7):783-9.

2.         Kaufman KR, Hughes C, Morrey BF, Morrey M, An K-N. Gait characteristics of patients with knee osteoarthritis. Journal of Biomechanics. 2001;34(7):907-15.

3.         Jafarnezhadgero A, Majlesi M, Madadi-Shad M. The effects of low arched feet on lower limb joints moment asymmetry during gait in children: A cross sectional study. Foot (Edinb). 2018;34:63-8.

4.         Johnson F, Leitl S, Waugh W. The distribution of load across the knee. A comparison of static and dynamic measurements. The Journal of bone and joint surgery British volume. 1980;62(3):346-9.

5.         Mannisi M, Dell’Isola A, Andersen M, Woodburn J. Effect of lateral wedged insoles on the knee internal contact forces in medial knee osteoarthritis. Gait & posture. 2019;68:443-8.

6.         Jafarnezhadgero AA, Shad MM, Majlesi M. Effect of foot orthoses on the medial longitudinal arch in children with flexible flatfoot deformity: A three-dimensional moment analysis. Gait & Posture. 2017;55:75-80.

7.         Shimada S, Kobayashi S, Wada M, Uchida K, Sasaki S, Kawahara H, et al. Effects of Disease Severity on Response to Lateral Wedged Shoe Insole for Medial Compartment Knee Osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2006;87(11):1436-41.

8.         Collins NJ, Hinman RS, Menz HB, Crossley KM. Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: a cross-over, proof-of-concept study. The Knee. 2017;24(1):76-81.

9.         Jafarnezhadgero A, Shad MM, Majlesi M, Zago M. Effect of kinesio taping on lower limb joint powers in individuals with genu varum. Journal of Bodywork and Movement Therapies. 2018;22(2):511-8.

10.       Hunt MA, Birmingham TB, Giffin JR, Jenkyn TR. Associations among knee adduction moment, frontal plane ground reaction force, and lever arm during walking in patients with knee osteoarthritis. Journal of Biomechanics. 2006;39(12):2213-20.

11.       Kerrigan DC, Lelas JL, Goggins J, Merriman GJ, Kaplan RJ, Felson DT. Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2002;83(7):889-93.

12.       Fischer AG, Ulrich B, Hoffmann L, Jolles BM, Favre J. Effect of lateral wedge length on ambulatory knee kinetics. Gait & Posture. 2018;63:114-8.

13.       Bavardi Moghadam E, Shojaedin SS. The Effect of a Period Stretching Training on Functional Dynamic Balance Performance and Range of Motion Patients with Knee Osteoarthritis. Journal of Sport Biomechanics. 2017;2(4):5-18.

14.       Jafarnezhadgero AA, Majlesi M, Etemadi H, Robertson DGE. Rehabilitation improves walking kinematics in children with a knee varus: Randomized controlled trial. Annals of Physical and Rehabilitation Medicine. 2018;61(3):125-34.

15.       Farahpour N, Majlesi M, Hoseinpouri MR. The Effect of Shoe Type and Load Carrying on Electromyographic Activity of Lower Extremity Muscles during Stair Ascent and Descent. Journal of Sport Biomechanics. 2019;5(2):92-101.

16.       Hurwitz DE, Hulet CH, Andriacchi TP, Rosenberg AG, Galante JO. Gait compensations in patients with osteoarthritis of the hip and their relationship to pain and passive hip motion. J Orthop Res. 1997;15(4):629-35.

17.       Tan JM, Middleton KJ, Hart HF, Menz HB, Crossley KM, Munteanu SE, et al. Immediate effects of foot orthoses on lower limb biomechanics, pain, and confidence in individuals with patellofemoral osteoarthritis. Gait & posture. 2020;76:51-7.

18.       Jafarnezhadgero AA, Oliveira AS, Mousavi SH, Madadi-Shad M. Combining valgus knee brace and lateral foot wedges reduces external forces and moments in osteoarthritis patients. Gait & posture. 2018;59:104-10.

19.       Naili JE, Esbjornsson AC, Iversen MD, Schwartz MH, Hedstrom M, Hager CK, et al. The impact of symptomatic knee osteoarthritis on overall gait pattern deviations and its association with performance-based measures and patient-reported outcomes. Knee. 2017;24(3):536-46.

20.       Kumar D, Manal KT, Rudolph KS. Knee joint loading during gait in healthy controls and individuals with knee osteoarthritis. Osteoarthritis Cartilage. 2013;21(2):298-305.

21.       Nishino K, Omori G, Koga Y, Kobayashi K, Sakamoto M, Tanabe Y, et al. Three-dimensional dynamic analysis of knee joint during gait in medial knee osteoarthritis using loading axis of knee. Gait Posture. 2015;42(2):127-32.

22.       Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39(2):175-91.

23.       Ferrari A, Benedetti MG, Pavan E, Frigo C, Bettinelli D, Rabuffetti M, et al. Quantitative comparison of five current protocols in gait analysis. Gait Posture. 2008;28(2):207-16.

24.       Azadian E, Majlesi M, Jafarnezhadgero AA. The effect of working memory intervention on the gait patterns of the elderly. Journal of Bodywork and Movement Therapies. 2018;22(4):881-7.

25.       Whittle M, ScienceDirect (Online service). Gait analysis an introduction. Edinburgh ; New York: Butterworth-Heinemann; 2007. Available from: http://www.sciencedirect.com/science/book/9780750688833.

26.       Winter DA. Biomechanics and motor control of human movement: John Wiley & Sons; 2009.

27.       Jafarnezhadgero A, Mousavi SH, Madadi-Shad M, Hijmans JM. Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet. Human Movement Science. 2020;70:102593.

28.       Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. Journal of Electromyography and Kinesiology. 2011;21(5):695-703.

29.       Zeni JA, Higginson JS. Differences in gait parameters between healthy subjects and persons with moderate and severe knee osteoarthritis: A result of altered walking speed? Clinical Biomechanics. 2009;24(4):372-8.

30.       Al-Zahrani KS, Bakheit AM. A study of the gait characteristics of patients with chronic osteoarthritis of the knee. Disabil Rehabil. 2002;24(5):275-80.

31.       Bejek Z, Paroczai R, Szendroi M, Kiss RM. Gait analysis following TKA: comparison of conventional technique, computer-assisted navigation and minimally invasive technique combined with computer-assisted navigation. Knee Surg Sports Traumatol Arthrosc. 2011;19(2):285-91.

32.       Huang SC, Wei IP, Chien HL, Wang TM, Liu YH, Chen HL, et al. Effects of severity of degeneration on gait patterns in patients with medial knee osteoarthritis. Med Eng Phys. 2008;30(8):997-1003.

33.       Landry SC, McKean KA, Hubley-Kozey CL, Stanish WD, Deluzio KJ. Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. Journal of Biomechanics. 2007;40(8):1754-61.

34.       Zeni JA, Jr., Higginson JS. Differences in gait parameters between healthy subjects and persons with moderate and severe knee osteoarthritis: a result of altered walking speed? Clin Biomech (Bristol, Avon). 2009;24(4):372-8.

35.       Mahmoudian A, Bruijn SM, Yakhdani HRF, Meijer OG, Verschueren SMP, van Dieen JH. Phase-dependent changes in local dynamic stability during walking in elderly with and without knee osteoarthritis. Journal of Biomechanics. 2016;49(1):80-6.

36.       Jones RK, Nester CJ, Richards JD, Kim WY, Johnson DS, Jari S, et al. A comparison of the biomechanical effects of valgus knee braces and lateral wedged insoles in patients with knee osteoarthritis. Gait & Posture. 2013;37(3):368-72.

37.       Güner S, İnanıcı F, Alsancak S. Long term effects of laterally wedged insoles on knee frontal plane biomechanics in patients with medial knee osteoarthritis. Fizyoter Rehabil. 2012;23(3):111-8.

38.       Hokmi S, Azadian E, Bijarchian MH. The Effect of Lateral Wedge Insole on Inter-joint Coordination during Walking in People with Medial Knee Osteoarthritis. Journal of Advanced Sport Technology. 2020;3(2):158-65.

39.       Jones RK, Zhang M, Laxton P, Findlow AH, Liu A. The biomechanical effects of a new design of lateral wedge insole on the knee and ankle during walking. Human Movement Science. 2013;32(4):596-604.

40.       Gaasbeek RDA, Groen BE, Hampsink B, van Heerwaarden RJ, Duysens J. Valgus bracing in patients with medial compartment osteoarthritis of the knee: A gait analysis study of a new brace. Gait & Posture. 2007;26(1):3-10.

41.       Iijima H, Inoue M, Suzuki Y, Shimoura K, Aoyama T, Madoba K, et al. Contralateral Limb Effect on Gait Asymmetry and Ipsilateral Pain in a Patient with Knee Osteoarthritis: A Proof-of-Concept Case Report. JBJS Case Connector. 2020;10(1):e0418.