Background

Novel designs of lateral wedge insoles with arch support can alter walking biomechanics as a conservative treatment option for knee osteoarthritis. However, variations in foot posture may influence individual responses to insole intervention and these effects are not yet known.

Research question

How does foot posture influence biomechanical responses to novel designs of lateral wedge insoles with arch support?

Methods

This exploratory biomechanical investigation categorized forty healthy volunteers (age 23–34) into pronated (n = 16), neutral (n = 15), and supinated (n = 9) foot posture groups based on the Foot Posture Index. Three-dimensional gait analysis was conducted during walking with six orthotic insole conditions: flat control, lateral wedge, uniform-stiffness arch support, variable-stiffness arch support, and lateral wedge + each arch support. Frontal plane knee and ankle/subtalar joint kinetic and kinematic outcomes were compared among insole conditions and foot posture groups using a repeated measures analysis of variance.

Results

The lateral wedge alone and lateral wedge + variable-stiffness arch support were the only insole conditions effective at reducing the knee adduction moment. However, the lateral wedge + variable-stiffness arch support had a smaller increase in peak ankle/subtalar eversion moment than the lateral wedge alone. Supinated feet had smaller ankle/subtalar eversion excursion and moment impulse than neutral and pronated feet, across all insole conditions.

Significance

Supinated feet have less mobile ankle/subtalar joints than neutral and pronated feet and, as a result, may be less likely to respond to biomechanical intervention from orthotic insoles. Supported lateral wedge insoles incorporating an arch support design that is variable-stiffness may be better than uniform-stiffness since reductions in the knee adduction moment can be achieved while minimizing increases in the ankle/subtalar eversion moment.

中文翻译：

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脚步姿势对步行过程中对刚度变化的即时生物力学响应的影响支持侧楔形鞋垫设计。

背景

带有足弓支撑的侧部楔形鞋垫的新颖设计可以改变步行生物力学，作为膝盖骨关节炎的保守治疗选择。但是，脚姿的变化可能会影响个体对鞋垫干预的反应，而这些影响尚不清楚。

研究问题

足部姿势如何影响对具有足弓支撑的侧部楔形鞋垫的新颖设计的生物力学响应？

方法

这项探索性生物力学研究根据足部姿势指数将40名健康志愿者（年龄23-34岁）分为俯卧（n = 16），中立（n = 15）和仰卧（n = 9）足姿组。在六个矫正鞋垫条件下行走时进行了三维步态分析：平坦控制，侧向楔形，均匀刚度足弓支撑，可变刚度足弓支撑以及侧向楔形+每个足弓支撑。使用重复测量方差分析比较了鞋垫状况和脚姿势组之间的额平面膝关节和踝/距下关节的动力学和运动学结果。

结果

唯一的外侧楔形和外侧楔形+可变刚度足弓支撑是有效减少膝盖内收力矩的唯一鞋垫条件。然而，与单独的侧楔相比，侧楔+变刚度足弓支撑在踝关节/距下骨顶突力矩的增加量较小。在所有鞋垫情况下，pin脚的脚踝/距下外翻偏移和力矩冲动均比中性脚和带旋前的脚小。

意义

俯卧脚的脚踝/距下关节活动度少于中性和旋前脚，因此，矫形鞋垫对生物力学干预的反应可能较小。结合了可变刚度的足弓支撑设计的外侧支撑楔形鞋垫可能比均匀刚度更好，因为可以实现膝关节内收力矩的减少，同时最大程度地减小脚踝/距骨外翻力矩的增加。