How foot progression angle affects knee adduction moment and angular impulse in people with and without medial knee osteoarthritis: a meta‐analysis

2020 ◽  
Author(s):  
Sizhong Wang ◽  
Shiwei Mo ◽  
Raymond C.K. Chung ◽  
Peter B. Shull ◽  
Daniel C. Ribeiro ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Foot Progression Angle ◽  
Angular Impulse

scholarly journals A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

2021 ◽  
pp. 026921552199363
Author(s):  
Martin Schwarze ◽  
Leonie P Bartsch ◽  
Julia Block ◽  
Merkur Alimusaj ◽  
Ayham Jaber ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Oxford Knee Score ◽  
Knee Adduction Moment ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Patient Reported ◽  
Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

scholarly journals Personalization improves the biomechanical efficacy of foot progression angle modifications in individuals with medial knee osteoarthritis

2020 ◽  
Author(s):  
Scott D Uhlrich ◽  
Julie A Kolesar ◽  
Łukasz Kidziński ◽  
Melissa A Boswell ◽  
Amy Silder ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Center Of Pressure ◽  
Knee Adduction Moment ◽  
Abduction Angle ◽  
Valgus Knee ◽  
Lasso Regression ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Foot Progression Angle ◽  
Peak Knee

Abstract Objectives The goal of this study was to evaluate the importance of personalization when selecting foot progression angle modifications that aim to reduce the peak knee adduction moment in individuals with medial knee osteoarthritis. Design One hundred seven individuals with medial knee osteoarthritis walked on an instrumented treadmill with biofeedback instructing them to toe-in and toe-out by 5° and 10° relative to their self-selected foot progression angle. We selected individuals’ personalized foot progression angle as the modification that maximally reduced their larger knee adduction moment peak. Additionally, we used lasso regression to identify which secondary changes in kinematics made a 10° toe-in gait modification more effective at reducing the first knee adduction moment peak. Results Sixty-six percent of individuals reduced their larger knee adduction moment peak by at least 5% with a personalized foot progression angle modification, which is more than (p<0.001) the 54% and 23% of individuals who reduced it with a uniformly-assigned 10° toe-in or toe-out modification, respectively. When toeing-in, greater reductions in the first knee adduction moment peak were related to an increased frontal-plane tibia angle (knee more medial than ankle), a more valgus knee abduction angle, reduced contralateral pelvic drop, and a more medialized center of pressure in the foot reference frame. Conclusions Personalization increases the proportion of individuals with medial knee osteoarthritis who may benefit from modification of their foot progression angle.

Effects of knee orthosis adjustment on biomechanical performance and clinical outcome in patients with medial knee osteoarthritis

2017 ◽  
Vol 41 (6) ◽  
pp. 587-594 ◽  
Author(s):  
Andreas Brand ◽  
Isabella Klöpfer-Krämer ◽  
Mario Morgenstern ◽  
Inga Kröger ◽  
Björn Michel ◽  
...  
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Clinical Effectiveness ◽  
Knee Adduction Moment ◽  
Force Transmission ◽  
Pain Sensation ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Good Patient Compliance ◽  
Gait Function

Background: Valgus bracing in medial knee osteoarthritis aims to improve gait function by reducing the loading of the medial compartment. Orthosis composition and optimal adjustment is essential to achieve biomechanical and clinical effectiveness. Objectives: To investigate biomechanical functionality during gait, pain relief and compliance in patients with knee osteoarthritis using a lightweight adjustable knee unloader orthosis. Study Design: Prospective observational clinical trial. Methods: Instrumented gait analysis in 22 patients with unilateral medial knee osteoarthritis was performed after a 2-week orthosis acclimatisation period. Kinematics and kinetics during gait as well as force transmission from the orthosis to the knee were analysed. Measurements were performed without, at individualised and at reduced orthosis setting. The assessment was supplemented by patient-related pain sensation and compliance questionnaires. Results: Orthosis wear significantly reduced the knee adduction moment by up to 20% depending on orthosis adjustment, whereas pain sensation was significantly reduced by 16%. A significant positive correlation was found between force transmissions and knee adduction moment as well as for frontal knee angle. Compliance was good with a main daily use of 2–6 h. Conclusion: The orthosis provides significant biomechanical improvements, pain relief and good patient compliance. Patients had a biomechanical benefit for the individualised and reduced orthosis adjustments. Clinical relevance In patients with medial knee osteoarthritis, a lightweight medial unloader orthosis effectively reduced external knee adduction moment and pain sensation during daily activities. Thus, use of lightweight orthoses effectively supports conservative treatment in medial knee osteoarthritis.

scholarly journals Effect of real-time biofeedback on peak knee adduction moment in patients with medial knee osteoarthritis: Is direct feedback effective?

2018 ◽  
Vol 57 ◽  
pp. 150-158 ◽  
Author(s):  
Rosie E. Richards ◽  
Josien C. van den Noort ◽  
Martin van der Esch ◽  
Marjolein J. Booij ◽  
Jaap Harlaar
Keyword(s):  
Knee Osteoarthritis ◽  
Real Time ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Direct Feedback
Sign in / Sign up

Export Citation Format

Share Document