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The dose-response relationship between lateral foot wedging and the reduction of knee adduction moment.
MedLine Citation:
PMID:  25246374     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Lateral foot wedges represent a biomechanical intervention aimed at reducing medial knee loads. However, the effects of varying wedge amounts on biomechanical variables and orthotic comfort have not been systematically studied. Further, arch height may influence the comfort of laterally wedged devices. Therefore, the primary purpose of this study was to examine the effect of incrementally increasing lateral wedge amounts on knee adduction moment parameters and subjective comfort. The secondary purpose was to relate arch height measures to the comfort of the devices.
METHODS: Twenty-five healthy subjects underwent three-dimensional instrumented gait analysis testing using seven inclinations of lateral wedging (0°, 2°, 4°, 6°, 8°, 10°, 12°). Subjects reported comfort level for each orthotic condition. Arch heights were measured in standing and sitting, and rigidity index and stiffness were calculated.
FINDINGS: The knee adduction moment decreased with wedge amounts up to 6°, but more aggressive amounts did not yield additional reductions. Comfort ratings did not change from baseline until wedge amounts exceeded 8°. In addition, arch height measures, arch rigidity index and stiffness did not relate to the comfort of the orthotic device regardless of the wedge amount.
INTERPRETATION: Knee adduction moment decreased with mild wedge amounts while maintaining comfort. Wedge amounts greater than 6° yielded little additional mechanical benefit and amounts greater than 8° compromised comfort. It appears that 4°-6° of lateral wedging are optimal in regard to desirable biomechanical change and comfort level in healthy individuals.
Authors:
Rima A Tipnis; Philip A Anloague; Lloyd L Laubach; Joaquin A Barrios
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-15
Journal Detail:
Title:  Clinical biomechanics (Bristol, Avon)     Volume:  -     ISSN:  1879-1271     ISO Abbreviation:  Clin Biomech (Bristol, Avon)     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-23     Completed Date:  -     Revised Date:  2014-9-24    
Medline Journal Info:
Nlm Unique ID:  8611877     Medline TA:  Clin Biomech (Bristol, Avon)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ltd. All rights reserved.
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