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The relationship between reductions in knee loading and immediate pain response whilst wearing lateral wedged insoles in knee Osteoarthritis

Jones, RK, Chapman, GJ, Forythe, L, Parkes, MJ and Felson, DF 2014, 'The relationship between reductions in knee loading and immediate pain response whilst wearing lateral wedged insoles in knee Osteoarthritis' , Journal of Orthopaedic Research . (In Press)

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Abstract

Studies of lateral wedge insoles (LWIs) in medial knee osteoarthritis (OA) have shown reductions in the average external knee adduction moment (EKAM) but no lessening of knee pain. Some treated patients actually experience increases in the EKAM which could explain the overall absence of pain response. We examined whether, in patients with painful medial OA, reductions in the EKAM were associated with lessening of knee pain. Each patient underwent gait analysis whilst walking in a control shoe and two LWI’s. We evaluated the relationship between change in EKAM and change in knee pain using Spearman Rank Correlation coefficients and tested whether dichotomising patients into biomechanical responders (decreased EKAM) and non-responders (increased EKAM) would identify those with reductions in knee pain. In 70 patients studied, the EKAM was reduced in both LWIs vs. control shoe (-5.21% and -6.29% for typical and supported wedges, respectively). The change in EKAM using LWIs was not significantly associated with the direction of knee pain change. Further, 54% were biomechanical responders, but these persons did not have more knee pain reduction than non-responders. Whilst LWIs reduce EKAM, there is no clearcut relationship between change in medial load when wearing LWIs and corresponding change in knee pain.

Item Type: Article
Themes: Health and Wellbeing
Schools: Schools > School of Health Sciences > Centre for Health Sciences Research
Schools > School of Health Sciences
Journal or Publication Title: Journal of Orthopaedic Research
Publisher: Elsevier
Refereed: Yes
ISSN: 0736-0266,
Funders: Arthritis Research UK
Depositing User: Prof Richard Jones
Date Deposited: 06 Jun 2014 17:03
Last Modified: 30 Nov 2015 23:43
URI: http://usir.salford.ac.uk/id/eprint/31926

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