Effects of laterally wedged insoles on knee and subtalar joint moments.

Kakihana, Wataru; Akai, Masami; Nakazawa, Kimitaka; Takashima, Takamichi; Naito, Kenji; Torii, Suguru · Arch Phys Med Rehabil · 2005

biomechanical · Level V

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Abstract

To assess the biomechanic effects of wearing a lateral wedge on the knee joint varus moment during gait in elders with and without knee osteoarthritis (OA). Crossover design whereby subjects walked under 2 different insole conditions: a 0 degrees control wedge and a 6 degrees lateral wedge. A gait laboratory with 3-dimensional motion analysis and force platform equipment. Thirteen healthy subjects and 13 knee patients with OA. Not applicable. Frontal plane angles and moments at the knee and subtalar joints, ground reaction forces, and center of pressure. Moments were derived by using a 3-dimensional inverse dynamics model of the lower extremity. The 6 degrees lateral wedge significantly reduced knee joint varus moment and increased subtalar joint valgus moment in both groups when compared with no wedge. All patients had a greater knee joint varus moment with a similar subtalar joint valgus moment compared with the people without OA. There were diverse, sometimes reversed effects with the insole among the patients. The 6 degrees lateral wedge did not consistently reduce the knee joint varus moment in patients with knee OA. The biomechanic indications and limitations of laterally wedged insoles should be confirmed by a larger study.

Medical subject headings

Anatomy