Original articleEffects of Disease Severity on Response to Lateral Wedged Shoe Insole for Medial Compartment Knee Osteoarthritis
Section snippets
Patients and Healthy Volunteers
The recruited subjects were 23 patients with bilateral medial compartment knee OA (ie, 46 knees), representing all consecutive patients examined at the Gait Analysis Laboratory, Division of Physical Therapy and Rehabilitation, Fukui University Hospital, between December 1998 and February 1999, who fulfilled the following exclusion criteria. The exclusion criteria were knee pain due to pathologic conditions other than OA, such as rheumatoid arthritis and pseudogout, and knee with flexion
Results
Table 2 lists the values of step length, stride width, and walking velocity. These parameters were significantly lower in OA patients than the control. The use of lateral wedged insoles in OA patients did not change the step length and walking velocity, but significantly increased the stride width. Peak adduction moment during the stance phase of the gait cycle was significantly higher in knee OA patients than the control (table 3,fig 2). The use of lateral wedged insoles significantly
Discussion
A positive correlation between the magnitude of the knee moment and walking velocity has been already reported.23 Walking velocity may also influence the magnitude of first acceleration peak. However, in the present study, application of lateral wedged insoles did not result in significant changes in these parameters in knee OA patients. Our results of the intrinsic effect of the lateral wedged insoles in knee OA patients excluded the effect of walking velocity. On the other hand, increase of
Conclusions
We confirmed in the present study the kinetic and kinematic benefits of wearing lateral wedged insoles in grades I and II medial compartment knee OA patients. However, there was no correlation between kinetic and kinematic effects, suggesting different pathogenic mechanisms. However, we support the clinical recommendation of the use of lateral wedged insoles for patients only with early and mild knee OA.
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