| Summary: | 碩士 === 國立陽明大學 === 醫學工程研究所 === 99 === Knee Osteoarthritis (OA) is a common musculoskeletal disease affect 10% of people over the age of 50 years. The OA patients usually present medial compartment pain and greater knee adduction moment than the normal subjects. The previous studies showed that lateral heel wedge, knee brace can effectively reduce the knee pain and improve the ambulation ability. However, discomforts of wearing othotics are also reported. The knee OA usually acquires normal or high arch foot type and the increase of genu varum deformity resulted in increasing forefoot varus angle. This study hypothesized that a forefoot medial wedge combined with rearfoot lateral wedge could effectively the knee pain and reduced the OA knee varus moment.
Totally, 16 female patients with mild medial compartment knee OA (KL grade I and II) were recruited from the local medical center Shin Kong Wu Ho-Su Memorial Hospital. The kinematic and kinetic measured variables of normal walking, cross obstacle walking were used to assess the efficacy from four conditions, bare foot, shod with sandal, sandal with two types of shoe insoles.
The result showed that either type of insoles could effectively reduce the knee varus moment and reduced knee pain. In level walking, the twist insole had larger ankle dorsiflexion and smaller plantarflexion at times of heel off and toe-off; and greater inversion at loading response and push off; small peak vertical reaction force, smaller knee varus moment at the gait phase of the loading response and push off, but largest at the phase of midstance. Wearing the twist insole increased the toe-out angle and ankle inversion moment. But no significant change in knee adduction moment impulse and lever arm. In cross obstacle gait analysis study, all measured variables showed significant difference between leading and trail limbs for four conditions and no significant difference between wearing sandal, with or without two types of insoles.
In conclusion, the commercial sports insole with dynamic arch support and twist insole could effectively reduce knee varus moment with greater toe-out placement angle.
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