Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis
Abstract Background Lateral 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 i...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-023-00671-7 |
| _version_ | 1797321397566963712 |
|---|---|
| author | Michael A. Hunt Calvin T. F. Tse Michael B. Ryan Alexander Scott Eric C. Sayre |
| author_facet | Michael A. Hunt Calvin T. F. Tse Michael B. Ryan Alexander Scott Eric C. Sayre |
| author_sort | Michael A. Hunt |
| collection | DOAJ |
| description | Abstract Background Lateral 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. Methods We 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. Results In 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. Conclusions Our 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. |
| first_indexed | 2024-03-08T04:58:00Z |
| format | Article |
| id | doaj.art-f95000002090441a83881b08b43b8646 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:58:00Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-f95000002090441a83881b08b43b86462024-02-07T15:05:47ZengWileyJournal of Foot and Ankle Research1757-11462023-01-01161n/an/a10.1186/s13047-023-00671-7Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritisMichael A. Hunt0Calvin T. F. Tse1Michael B. Ryan2Alexander Scott3Eric C. Sayre4Department of Physical TherapyUniversity of British Columbia212 – 2177 Wesbrook MallV6T 1Z3VancouverBCCanadaMotion Analysis and Biofeedback LaboratoryUniversity of British ColumbiaVancouverBCCanadaKintec Footlabs Inc.SurreyBCCanadaDepartment of Physical TherapyUniversity of British Columbia212 – 2177 Wesbrook MallV6T 1Z3VancouverBCCanadaBritish Columbia Centre On Substance UseVancouverBCCanadaAbstract Background Lateral 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. Methods We 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. Results In 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. Conclusions Our 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.https://doi.org/10.1186/s13047-023-00671-7Lateral wedge insolesKneeOsteoarthritisWalkingResponderPrediction |
| spellingShingle | Michael A. Hunt Calvin T. F. Tse Michael B. Ryan Alexander Scott Eric C. Sayre 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 Lateral wedge insoles Knee Osteoarthritis Walking Responder Prediction |
| title | Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis |
| title_full | Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis |
| title_fullStr | Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis |
| title_full_unstemmed | Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis |
| title_short | Clinically‐accessible and laboratory‐derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis |
| title_sort | clinically accessible and laboratory derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis |
| topic | Lateral wedge insoles Knee Osteoarthritis Walking Responder Prediction |
| url | https://doi.org/10.1186/s13047-023-00671-7 |
| work_keys_str_mv | AT michaelahunt clinicallyaccessibleandlaboratoryderivedpredictorsofbiomechanicalresponsetostandaloneandsupportedlateralwedgeinsolesinpeoplewithkneeosteoarthritis AT calvintftse clinicallyaccessibleandlaboratoryderivedpredictorsofbiomechanicalresponsetostandaloneandsupportedlateralwedgeinsolesinpeoplewithkneeosteoarthritis AT michaelbryan clinicallyaccessibleandlaboratoryderivedpredictorsofbiomechanicalresponsetostandaloneandsupportedlateralwedgeinsolesinpeoplewithkneeosteoarthritis AT alexanderscott clinicallyaccessibleandlaboratoryderivedpredictorsofbiomechanicalresponsetostandaloneandsupportedlateralwedgeinsolesinpeoplewithkneeosteoarthritis AT ericcsayre clinicallyaccessibleandlaboratoryderivedpredictorsofbiomechanicalresponsetostandaloneandsupportedlateralwedgeinsolesinpeoplewithkneeosteoarthritis |