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Gepubliceerd in: Journal of Foot and Ankle Research 1/2012

Open Access 01-12-2012 | Poster presentation

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

Auteurs: Amneh Alshawabka, Richard Jones, Sarah Tyson

Gepubliceerd in: Journal of Foot and Ankle Research | bijlage 1/2012

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Background

Stair climbing demands, as compared to walking level, a greater range of motion in the lower extremity accompanied by about six times more load on knee joint [1]. Consequently, pain while climbing stairs is the first complaint in patients with knee osteoarthritis (OA) [2]. The use of lateral wedge insoles aims to decrease medial knee compartment loading by reducing the peak external knee adduction moment (EKAM) during walking [4]. The purpose of this study is 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; age (45.7±5.6 years)) and eight patients with mild knee OA (5 females, 3 males; age (47.3±3)) participated in the study. Subjects performed five trials of step-over-step stairs ascent and descent. Two conditions were investigated: (a) control (Standard shoe) (b) 5 degrees Salford Insole lateral wedge (LW) insoles. Kinematic and kinetic data were collected for the lower extremity using a motion capture system (QTMTm) and two force plates (AMTI force platform stairway). Repeated measures ANOVA and Friedman’s ANOVA were used for statistical analysis.

Results

During ascending stairs, LW significantly reduced the EKAM in early stance (p<.05) and the knee adduction angular impulse (KAAI) (p<.05). Similarly, the EKAM and KAAI had been significantly reduced (p<.05) while wearing LW during descending stairs. Both groups had significantly greater degree of subtalar eversion with LW than in the control condition (Table 1).
Table 1
1st EKAM peak, KAAI and Subtalar eversion angle results for healthy and OA Subjects during ascending (AS) and descending (DS) stairs.
Parameters
 
Mean ± (SD)
Mean ± (SD)
  
Control (Healthy)
LW (Healthy)
Control (OA)
LW (OA)
1st peak EKAM (Nm/Kg)
AS
.385 (.15 )
.357 (.14)
.394 (.13)
.366 (.12)
 
DS
.408 (.11)
.388 (.10)
.364 (.06)
.334 (.05)
KAAI (Nm/Kg/s)
AS
.228 (.15)
.207 (.14)
.189 (.06)
.174 (.06)
 
DS
.228 (.08)
.212 (.08)
.204 (.04)
.186 (.04)
Subtalar peak eversion (degrees)
AS
-5.71 (2.4)
-6.1 (2.9)
-4.41 (.62)
-4.82 (.70)
 
DS
-6.36 (2.3)
-7.06 (2.5)
-4.42 (1.2)
-5.11 (1.5)

Conclusions

Lateral wedge insoles consistently reduced the overall magnitude of EKAM during ascending and descending stairs which has been strongly correlated to decreasing medial compartment loading at the knee joint. Thus, these results give the first indication that that lateral wedge insoles may be useful in decreasing pain levels for patients with knee OA during stair climbing. Further long-term studies are warranted.
Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://​creativecommons.​org/​licenses/​by/​2.​0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Literatuur
1.
go back to reference Andriacchi TP, et al: A study of lower-limb mechanics during stair-climbing. The Journal of Bone and Joint Surgery. 1980, 62 (5): 749- PubMed Andriacchi TP, et al: A study of lower-limb mechanics during stair-climbing. The Journal of Bone and Joint Surgery. 1980, 62 (5): 749- PubMed
2.
go back to reference Costigan PA, Deluzio KJ, Wyss UP: Knee and hip kinetics during normal stair climbing. Gait & posture. 2002, 16 (1): 31-37. 10.1016/S0966-6362(01)00201-6. CrossRef Costigan PA, Deluzio KJ, Wyss UP: Knee and hip kinetics during normal stair climbing. Gait & posture. 2002, 16 (1): 31-37. 10.1016/S0966-6362(01)00201-6. CrossRef
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go back to reference Arden NK, et al: Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Arthritis & Rheumatism. 1999, 42 (7): 1378-1385. 10.1002/1529-0131(199907)42:7<1378::AID-ANR11>3.0.CO;2-I. CrossRef Arden NK, et al: Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Arthritis & Rheumatism. 1999, 42 (7): 1378-1385. 10.1002/1529-0131(199907)42:7<1378::AID-ANR11>3.0.CO;2-I. CrossRef
4.
go back to reference Jones RK, et al: Does increased loading occur on the contralateral side in medial knee osteoarthritis and what impact do lateral wedges have on this?. Osteoarthritis Cartilage. 2011, S176-Suppl 1 Jones RK, et al: Does increased loading occur on the contralateral side in medial knee osteoarthritis and what impact do lateral wedges have on this?. Osteoarthritis Cartilage. 2011, S176-Suppl 1
Metagegevens
Titel
The effects of using a lateral wedge insole on knee loading during ascending and descending stairs
Auteurs
Amneh Alshawabka
Richard Jones
Sarah Tyson
Publicatiedatum
01-12-2012
Uitgeverij
BioMed Central
Gepubliceerd in
Journal of Foot and Ankle Research / Uitgave bijlage 1/2012
Elektronisch ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-5-S1-P11

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