Article

A six-month followup of a randomized trial comparing the efficacy of a lateral-wedge insole with subtalar strapping and an in-shoe lateral-wedge insole in patients with varus deformity osteoarthritis of the knee

Toda Orthopedic Rheumatology Clinic, Suita, Osaka, Japan.
Arthritis & Rheumatology (Impact Factor: 7.87). 10/2004; 50(10):3129-36. DOI: 10.1002/art.20569
Source: PubMed

ABSTRACT To assess the effect of a lateral-wedge insole with elastic strapping of the subtalar joint on the femorotibial angle in patients with varus deformity of the knee.
The efficacy of a wedged insole with subtalar straps and that of a traditional wedged insole shoe insert were compared. Sixty-six female outpatients with knee osteoarthritis (OA) were randomized (according to birth date) to be treated with either the strapped or the traditional inserted insole. Standing radiographs with unilateral insole use were used to analyze the femorotibial angles for each patient. In both groups, the baseline and 6-month visual analog scale (VAS) scores for subjective knee pain and the Lequesne index scores for knee OA were compared.
The 61 patients who completed the 6-month study were evaluated. At baseline, there was no significant difference in the femorotibial angle (P = 0.66) and the VAS score (P = 0.75) between the 2 groups. At the 6-month assessment, the 29 subjects wearing the subtalar-strapped insole demonstrated a significantly decreased femorotibial angle (P < 0.0001) and significantly improved VAS scores (P = 0.001) and Lequesne index scores (P = 0.033) compared with their baseline assessments. These significant differences were not observed in the 32 subjects assigned to the traditional shoe-inserted wedged insole.
These results suggest that an insole with a subtalar strap maintained the valgus correction of the femorotibial angle in patients with varus knee OA for 6 months, indicating longer-term clinical improvement with the strapped insert compared with the traditional insert.

0 Followers
 · 
168 Views
  • Source
    • "Key Words: adult; knee osteoarthritis; pain; physical function INTRODUCTION Knee Osteoarthritis (OA) is estimated to be the most common causes of disability in old adults (Toda and Tsukimura, 2004). Patients with knee osteoarthritis suffer from progressive disability when walking, going up and down stairs (Chuang et al., 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT: Knee Osteoarthritis is estimated to be the most common causes of disability in older adults. Knee and hip osteoarthritis pain in older adults is very common and osteoarthritis is one of the most common causes of joint pain and physical, mental and social disability. There is no study in Iran to explore the forms of relationships among pain, demographic characteristics and physical function. Therefore, this study was undertaken to describe the relationship among pain, demographic characteristics and physical function in patients with knee Osteoarthritis Considering Iranian patients’ culture in daily activities. Eighty-one knee Osteoarthritis patients referring to Rheumatology clinic depended on Tabriz University of medical science participated in this study with convenience sampling method. Data was collected through the Western Ontario and McMaster Universities questionnaire, that ordered in three subscales which included pain (5 items), stiffness (2 items) and physical function (17 items). Data analyzed using SPSS software. The results of linear regression analysis indicate the relationship among physical function, pain, stiffness, and duration of disease were significant. From these results it can be concluded pain and joint stiffness are important factors that affect the ability to perform activities of daily living in patients with knee Osteoarthritis. Therefore, we suggest that patients become familiar with nonpharmacologic pain relief methods and muscle strengthening exercises to overcome disability from disease. Key Words: adult; knee osteoarthritis; pain; physical function
    International Journal of Sciences: Basic and Applied Research (IJSBAR) 01/2013; 4(5):1102-1106.
  • Source
    • "wedged insoles that in both healthy and subjects with OA have had mixed results (Baker et al., 2007; Bennell et al., 2011; Fang et al., 2006; Kakihana et al., 2007; Kutzner et al., 2011; Toda and Tsukimura, 2004). The mechanism by which the external adduction moment is reduced in the VS shoe is not clear. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A recently described variable-stiffness shoe has been shown to reduce the adduction moment and pain in patients with medial-compartment knee osteoarthritis. The mechanism associated with how this device modifies overall gait patterns to reduce the adduction moment is not well understood. Yet this information is important for applying load modifying intervention for the treatment of knee osteoarthritis. A principal component analysis (PCA) was used to test the hypothesis that there are differences in the frontal plane kinematics that are correlated with differences in the ground reaction forces (GRFs) and center of pressure (COP) for a variable-stiffness compared to a constant-stiffness control shoe. Eleven healthy adults were tested in a constant-stiffness control shoe and a variable-stiffness shoe while walking at self-selected speeds. The PCA was performed on trial vectors consisting of all kinematic, GRF and COP data. The projection of trial vectors onto the linear combination of four PCs showed there were significant differences between shoes. The interpretation of the PCs indicated an increase in the ankle eversion, knee abduction and adduction, decreases in the hip adduction and pelvic obliquity angles and reduced excursion of both the COP and peak medial-lateral GRFs for the variable-stiffness compared to the control shoe. The variable-stiffness shoe produced a unique dynamic change in the frontal plane motion of the ankle, hip and pelvis that contributed to changes in the GRF and COP and thus reduced the adduction moment at a critical instant during gait suggesting a different mechanism that was seen with fixed interventions (e.g. wedges).
    Journal of Biomechanics 04/2012; 45(9):1619-24. DOI:10.1016/j.jbiomech.2012.04.010 · 2.50 Impact Factor
  • Source
    • "n = 30 6 semaines Gonarthrose (critères non définis) Essai clinique libre Niveau 4 OP CPP Douleur (EVA) S Atteinte fémorotibiale interne Maillefert et al. [13] n = 156 sur 6 mois Gonarthrose (critères ACR) Atteinte fémorotibiale interne RCT de forte puissance Niveau 1 OP CPP vs OP neutre Activité maladie Womac Consommation médicament NS NS Pham et al. [11] Même cohorte que Maillefert et al., revu à 2 ans Gonarthrose (critères ACR) Atteinte fémorotibiale interne RCT de forte puissance OP CPP vs OP neutre Activité maladie WOMAC Consommation médicament Évolution radiologique NS NS S : OP CPP < OP neutre NS Niveau 1 Toda et Tsukirama [18] n = 66 Sexe féminin 6 mois Gonarthrose (critères ACR) Atteinte fémorotibiale interne Genu varum RCT de faible puissance OP BP par strapping vs OP CPP Lequesne Pas de comparaison intergroupe Niveau 2 Toda et al. [20] n = 62 Sexe féminin 2 semaines Gonarthrose (critères ACR) Atteinte fémorotibiale interne RCT de faible puissance OP BP 8 vs 12 vs 16 mm Lequesne Radio (FTA) Tolerance 12 > 16 mm 16 > 12 mm 8 > 12 > 16 mm Niveau 2 Sasaki et al. [17] n = 107 1 à 5 ans Gonarthrose Atteinte fémorotibiale interne Critères radiographiques RCT présentant de nombreux biais OP CPP vs pas d'OP Knee Rating Scale S sur douleur et fonction Niveau 4 Toda et al. [4] n = 90 Sexe féminin 8 semaines Gonarthrose (critères ACR) RCT présentant de nombreux biais OP BP par strapping vs OP CPP Douleur (EVA) Lequesne NS Niveau 4 Toda et Segal [12] n = 88 Sexe féminin 8 semaines Gonarthrose (critères ACR) Atteinte fémorotibiale interne Essai présentant de nombreux biais OP BP par strapping vs OP BP Lequesne Amélioration dans les 2 groupes Niveau 4 Pas de comparaison intergroupe Toda et al. [19] n = 71 Sexe féminin 8 semaines Gonarthrose (critères ACR) Atteinte fémorotibiale interne Essai présentant de nombreux biais OP BP par strapping vs strapping talo-naviculaire Lequesne, âge, poids, taille, masse maigre et grasse, stade Kellgren et lawrence Pas de comparaison du lequesene Niveau 4 Meilleure réponse si âge jeune et masse maigre/masse grasse élevé Tableau 1 (Suite ) Auteur Population Diagnostic Type d'étude Anaes Type d'OP Critères évalués Résultats Toda et al. [21] n = 81 Sexe feminin 15 jours Gonarthrose (critères ACR) Genu varum Atteinte fémorotibiale interne Essai présentant de nombreux biais Niveau 4 3 groupes OP BP strapping (selon durée de port quotidien) vs absence d'OP Lequesne Meilleure réponse entre 5 et 10 heures de port quotidien de l'orthèse Tohyama et al. [16] n = 62 8 à 12 ans Gonarthrose clinique et radiologique Atteinte fémorotibiale interne RCT présentant de nombreux biais Niveau 4 OP CPP vs pas d'OP Knee Rating Scale S sur item douleur NS sur fonctionnel Ohsawa et al. [5] n = 33 23 mois Coxarthrose sur coxa vara ou valga Essai clinique libre Niveau 4 OP type talonnette Douleur (EVA) Merle d'Aubigné S NS "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectifs Élaborer des recommandations concernant la prescription d’orthèses plantaires dans la gonarthrose et la coxarthrose. Méthode La méthodologie utilisée, proposée par la Société française de médecine physique et de réadaptation (Sofmer), associe une revue systématique de la littérature, un recueil quantitatif et qualitatif des pratiques professionnelles et une validation par un panel d’experts pluridisciplinaires. Les critères d’analyses retenus concernent la douleur, l’incapacité fonctionnelle, la consommation d’antalgiques et d’anti-inflammatoires non stéroidiens (AINS) et la progression radiologique de l’arthrose. Les recommandations sont classées, suivant le niveau de preuve scientifique fourni par la littérature, en grade A, B ou C, selon la grille de l’Agence nationale d’accréditation et d’évaluation en santé (Anaes). Résultats Au cours de la gonarthrose fémorotibiale interne, la prescription d’orthèses pronatrices pourrait – en l’absence de contre-indication – avoir un intérêt dans la prise en charge symptomatique de la gonarthrose en réduisant la consommation d’AINS (grade B). Les effets sur l’évolution structurale de l’arthrose ou le retentissement fonctionnel ne sont à ce jour pas démontrés (grade B). En dehors de ce cadre précis, il ne paraît pas indiqué d’avoir recours à des orthèses plantaires dans la prise en charge de la gonarthrose ou de la coxarthrose (grade C). Conclusion Il est nécessaire d’entreprendre des études randomisées contrôlées complémentaires afin de préciser l’indication des orthèses plantaires (sévérité de la gonarthrose, genu varum), voire l’efficacité d’autre type d’orthèse comme les orthèses amortissantes. Les effets secondaires à long terme, notamment sur le compartiment fémoro-tibial externe, pourraient être évalués. Une évaluation médicoéconomique dede la prescription des orthèses plantaires est également souhaitable.
    Revue du Rhumatisme 12/2008; 75(12):1255-1263. DOI:10.1016/j.rhum.2008.02.014
Show more

Preview

Download
2 Downloads