Clinically-accessible and laboratory-derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis

Journal of Foot and Ankle Research

Research

Eric C. Sayre¹  Alexander Scott²  Michael A. Hunt³  Michael B. Ryan⁴  Calvin T. F. Tse⁵ 

[1] British Columbia Centre On Substance Use, Vancouver, BC, Canada;Department of Physical Therapy, University of British Columbia, 212 – 2177 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada;Department of Physical Therapy, University of British Columbia, 212 – 2177 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada;Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada;Kintec Footlabs Inc., Surrey, BC, Canada;School of Mechatronic Systems Engineering, Simon Fraser University, Burnaby, BC, Canada;Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada;Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada;Kintec Footlabs Inc., Surrey, BC, Canada;

关键词: Lateral wedge insoles;    Knee;    Osteoarthritis;    Walking;    Responder;    Prediction;    Logistic regression;   

DOI  :  10.1186/s13047-023-00671-7

 received in 2023-08-02, accepted in 2023-10-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLateral wedge insoles (both standalone and those incorporating individualized arch support) have been frequently studied for the effects on knee joint loading and pain in people with knee osteoarthritis. It has been shown that many people who use these insoles do not obtain the intended biomechanical effect, and thus may not experience a clinical benefit. The ability to identify biomechanical responders to lateral wedge insoles before research or clinical intervention is an important objective for efficient resource use and optimizing patient outcomes. The purpose of our exploratory, hypothesis-generating study was to provide an initial assessment of variables that are associated with the biomechanical response to lateral wedge insoles in people with knee osteoarthritis.MethodsWe collected a number of demographic (age, sex, body mass index, foot posture), clinical (knee pain, foot pain, radiographic disease severity), and walking-related (speed, knee alignment, frontal plane subtalar movement, and foot rotation) outcomes from 53 individuals with painful, radiographically-confirmed knee osteoarthritis. The walking-related outcomes were obtained using equipment both from the research laboratory and the clinical setting. We used logistic regression to generate predictive models to determine candidate variables associated with a reduction in the knee adduction moment during walking – a surrogate for tibiofemoral load distribution, and a known biomechanical risk factor for osteoarthritis progression – with the use of standalone and arch-supported lateral wedge insoles. Three different response thresholds (2%, 6%, and 10% reductions in the knee adduction moment) were used.ResultsIn general, biomechanical responders were those who walked faster, were female, had less varus alignment, and had less severe radiographic severity. Findings were similar between the standalone and arch-supported lateral wedge insoles, as well as between models using the laboratory-derived or clinically-available measures of walking performance.ConclusionsOur hypothesis-generating study provides valuable information that will inform future research into the efficient and effective use of lateral wedge insoles in the conservative management of knee osteoarthritis.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

12888_2023_5299_Article_IEq4.gif

Fig. 1

12888_2023_5299_Article_IEq1.gif

12936_2017_2051_Article_IEq71.gif

Fig. 1