The effects of using a lateral wedge insole on knee loading during ascending and descending stairs

Alshawabka, A 2012, The effects of using a lateral wedge insole on knee loading during ascending and descending stairs , MPhil thesis, University of Salford.

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Abstract

Introduction: Stair climbing demands, compared to walking on level ground, a greater range of motion in the lower extremity accompanied by about six times more load on the knee joint. Consequently, pain while stair climbing is the first complaint in patients with knee osteoarthritis (OA). The use of lateral wedge insoles aims to decrease medial knee compartment loading by reducing the peak external knee adduction moment (EKAM) during walking. The purpose of this study .was to assess the biomechanical effects of wearing lateral wedge insoles on EKAM during stair climbing in elders with and without knee OA. Methods: Thirty healthy subjects (21 females, 9 males) and eight patients with medial knee OA (5 females, 3 males) participated in the study. Subjects performed five trials of step-over-step stairs ascent and descent. Three conditions were investigated: (1) Barefoot (2) Standard shoe (3) Standard shoe with a lateral wedge insole. Kinematic and kinetic data were collected for the lower extremity using a motion capture system (QTM ) and two force plates (AMTI force platform stairway). Repeated measures ANOVA and Friedman's ANOVA were used for statistical analysis. Results: During stairs ascent and descent, a lateral wedge insole significantly (p<0.05) reduced the EKAM's 1 st peak in early stance, 2 nd peak in the late stance, the trough in mid stance, and the knee adduction angular impulse for both knee OA and healthy subjects as compared to standard shoe and barefoot conditions (e.g., 1 st peak in lateral wedge condition for OA patients (ascent: (0.37±0.02 Nm/Kg, descent: 0.33±0.05 Nm/Kg), standard shoe condition (ascent: 0.39±0.03 Nm/Kg, descent: 0.37±0.06 Nm/Kg) and barefoot condition (ascent: (0.40±0.03 Nm/Kg, descent: 0.39 ±0.07 Nm/Kg)). Additionally, there was significantly greater range of ankle/subtalar joint complex eversion with a lateral wedge insole (p<0.05) than in standard shoe and barefoot conditions. Conclusion: Lateral wedge insoles consistently reduced the overall magnitude of EKAM, which has been strongly correlated to decreased medial knee compartment loading. These results support that lateral wedge insoles might be useful in decreasing pain level in patients with medial knee OA during ascending and descending stairs.

Item Type:	Thesis (MPhil)
Contributors:	Jones, R (Supervisor) and Tyson, S (Supervisor)
Schools:	Schools > School of Health Sciences
Depositing User:	Institutional Repository
Date Deposited:	27 Jul 2021 12:01
Last Modified:	04 Aug 2022 11:28
URI:	https://usir.salford.ac.uk/id/eprint/61308

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