Journal of International Academy of Physical Therapy Research (국제물리치료학회지)

International Academy of Physical Therapy Research (국제물리치료연구학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Combined Wedge on Angle and Moment of Ankle and Knee Joint During Gait in Patients With Genu Varus

  • Received : 2016.06.17
  • Accepted : 2016.09.11
  • Published : 2016.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.

Keywords

References

  1. Sandra J, Randy J, Bruce D. Variations in Varus/Valgus and Internal/External Rotational Knee Laxity and Stiffness across the Menstrual Cycle. J Orthop Res. 2011; 53: 10-13.
  2. Wada M, Imura S, Baba H. Knee laxity in patients with osteoarthritis and rheumatoid arthritis. J Rheumatol. 1996; 35(6): 560-563. https://doi.org/10.1093/rheumatology/35.6.560
  3. Fitzgerald G, Piva S, Irrgang J. Complaints of Joint Instability in Knee Osteoarthritis. J Arthritis Care and Research. 1994.
  4. Bill Vicenzino. Plantar Foot Pressures After the Augmented Low Dye Taping Technique. J Athl Train. 2007; 42(3): 374-380.
  5. Mueller M, Host J, Norton B. Navicular drop as a composite measure of excessive pronation. J Am Podiatr Med Assoc. 1993; 83(4): 198-202. https://doi.org/10.7547/87507315-83-4-198
  6. Tetsworth K, Paley D. Review Malalignment and degenerative arthropathy. Orthop Clin North Am. 1994; 25(3): 367-377.
  7. Kakihana W, Akai M, Nakazawa K. Effects of laterally wedged insoles on knee and subtalar joint moments. Arch Phys Med Rehabil. 2005; 86: 1465-1471. https://doi.org/10.1016/j.apmr.2004.09.033
  8. Sharma L, Hayes K, Felson D. Does laxity alter the relationship between strength and physical function in knee osteoarthritis. Arthritis Rheum. 1999; 42(1): 25-30. https://doi.org/10.1002/1529-0131(199901)42:1<25::AID-ANR3>3.0.CO;2-G
  9. Maly M, Culham E, Costigan P. Static and dynamic biomechanics of foot orthoses in people with medial compartment knee osteoarthritis. Clin Biomech. 2002; 17(8): 603-610. https://doi.org/10.1016/S0268-0033(02)00073-6
  10. Lange B, Chipchase L, Evans A. The effect of low-Dye taping on plantar pressures, during gait, in subjects with navicular drop exceeding 10 mm. J Orthop Sports Phys Ther. 2004; 34(4): 201-209. https://doi.org/10.2519/jospt.2004.34.4.201
  11. Brody D. Running injuries. J Clin Symp. 1980; 32: 2-36.
  12. Kerrigan DC, Lelas J, Goggins J. Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis. Arch Phys Med Rehabil. 2002; 83: 889- 893. https://doi.org/10.1053/apmr.2002.33225
  13. Cicuttini F, Wluka A, Wang Y. Compartment differences in knee cartilage volume in healthy adults. J Rheumatol. 2002; 29(3): 554-556.
  14. Wang J, Kuo K, Andriacchi T. The influence of walking mechanics and time on the results of proximal tibial osteotomy. J Bone Joint Surg Am. 1990; 72(6): 905-909. https://doi.org/10.2106/00004623-199072060-00017
  15. Richard K, Min Z, Philip L. The biomechanical effects of a new design of lateral wedge insole on the knee and ankle during walking. Human Movement Science. 2013; 32: 596-604. https://doi.org/10.1016/j.humov.2012.12.012
  16. Hinman RS, Payne C, Metcalf B. Lateral wedges in knee osteoarthritis: what are their immediate clinical and biomechanical effects and can these predict a three-month clinical outcome. J Arthritis Rheum. 2008; 59: 408-415. https://doi.org/10.1002/art.23326
  17. Prodromos C, Andriacchi T, Galante J. A relationship between gait and clinical changes following high tibial osteotomy. J Bone Joint Surg Am. 1985; 67(8): 1188-1194. https://doi.org/10.2106/00004623-198567080-00007
  18. Kakihana W, Akai M, Yamasaki N. Change of joint moments in the gait of normal subjects wearing laterally wedged insoles. Arch Phys Med Rehabili. 2004; 83: 273-278. https://doi.org/10.1097/01.PHM.0000118035.71195.DE
  19. Butler R, Marchesi S, Royer T. The effect of a subject-specific amount of lateral wedge on knee mechanics in patients with medial knee osteoarthritis. J Orthop Res. 2009; 25: 1121-1127.
  20. Yasuda K, Sasaki T. The mechanics of treatment of the osteoarthritic knee with a wedged insole. Clinic Orthop. 987; 215: 162-172.
  21. Delgado E, Schoenecker P, Rich M. Treatment of severe torsional malaignment syndrome. J Pediatr Orthoep. 1996; 1: 484-484.
  22. Baliunas A, Hurwitz D, Ryals A, Marchesi S. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteo Cart. 2002; 10(7): 573-579. https://doi.org/10.1053/joca.2002.0797
  23. Vinicombe A, Raspovic A, Menz H. Reliability of navicular displacement measurement as a clinical indicator of foot posture. J Am Podiatr Med Assoc. 2001; 91(5): 262-268. https://doi.org/10.7547/87507315-91-5-262
  24. Bennell K, Bowels K, Payne C, Metcalf B. Effects of lateral wedge insoles on symptoms and treatment of knee osteoarthritis. Prosth and Orth International. 2011; 33: 107-116.
  25. Cameron J, Saha S. Management of medial collateral ligament laxity. Orthop Clin North Am. 1994; 25(3): 527-532.