首页> 外文期刊>Journal of Foot and Ankle Research >Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study
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Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study

机译:伴有或不伴自定义足弓支撑的外侧楔形物用于膝内侧骨关节炎和足前侧脚患者:一项探索性随机交叉研究

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BackgroundPronated foot posture is associated with many clinical and biomechanical outcomes unique to medial compartment knee osteoarthritis (OA). Though shoe-worn insole treatment, including lateral wedges, is commonly studied in this patient population, their effects on the specific subgroup of people with medial knee OA and concomitant pronated feet are unknown. The purpose of this study was to evaluate whether lateral wedge insoles with custom arch support are more beneficial than lateral wedge insoles alone for knee and foot symptoms in people with medial tibiofemoral knee osteoarthritis (OA) and pronated feet. MethodsTwenty-six people with pronated feet and symptomatic medial knee OA participated in a randomized crossover study comparing five degree lateral wedge foot insoles with and without custom foot arch support. Each intervention was worn for two months, separated by a two-month washout period of no insoles wear. Main outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function subscales, the revised short-form Foot Function Index (FFI-R) pain and stiffness subscales, and the timed stair climb test. Regression modeling was conducted to examine treatment, period, and interaction effects. ResultsTwenty-two participants completed the study, and no carryover or interaction effects were observed for any outcome. Significant treatment effects were observed for the timed stair climb, with greater improvements seen with the lateral wedges with arch support. Within-condition significant improvements were observed for WOMAC pain and physical function, as well as FFI-R pain and stiffness with lateral wedges with arch support use. More adverse effects were reported with the lateral wedges alone, while more people preferred the lateral wedges with arch support overall. ConclusionsAddition of custom arch support to a standard lateral wedge insole may improve foot and knee symptoms in people with knee OA and concomitant pronated feet. These preliminary findings suggest further research evaluating the role of shoe-worn insoles for treatment of this specific sub-group of people with knee OA is warranted. Trial registrationClinicaltrials.gov identifier: NCT02234895 .
机译:背景有脚的足部姿势与内侧隔室膝骨关节炎(OA)独有的许多临床和生物力学结果有关。尽管在该患者人群中普遍研究了穿鞋的鞋垫治疗方法,包括外侧楔形物,但它们对内侧膝OA和伴有脚后跟脚的特定人群的作用尚不清楚。这项研究的目的是评估在患有内侧胫股骨膝骨关节炎(OA)和脚后跟的患者中,具有定制足弓支撑的外侧楔形鞋垫是否比单独的外侧楔形鞋垫更有益于膝和脚症状。方法26例有足冠和有症状内侧膝OA的人参加了一项随机交叉研究,比较了有和没有定制足弓支撑的五度外侧楔形鞋垫。每次干预都需要穿戴两个月,然后两个月不穿鞋垫,因此需要进行两个月的清洗。主要结果包括西安大略省和麦克马斯特大学的骨关节炎指数(WOMAC)疼痛和身体功能子量表,修订后的简短形式的足部功能指数(FFI-R)疼痛和僵硬度子量表以及定时爬楼梯测试。进行回归建模以检查治疗,时期和相互作用效应。结果22位参与者完成了研究,未观察到任何结转或相互作用的影响。对于定时爬楼梯,观察到了显着的治疗效果,带有拱形支撑的侧向楔形则看到了更大的改善。在条件内,观察到WOMAC疼痛和身体功能以及FFI-R疼痛和僵硬(使用足弓支撑的侧楔)的显着改善。据报道,仅使用外侧楔块会产生更多的不良反应,而更多的人更喜欢整体带有弓形支撑的外侧楔块。结论在标准的侧向楔形鞋垫上增加定制足弓支撑可改善患有膝OA并伴有脚后屈的人的脚和膝盖症状。这些初步发现表明,有必要进行进一步的研究,以评估穿鞋的鞋垫在这种特定的膝OA患者中的作用。试用registrationClinicaltrials.gov标识符:NCT02234895。

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