The influence of sole wedges on frontal plane knee kinetics, in isolation and in combination with representative rigid and semi-rigid ankle–foot-orthoses

Schmalz, Thomas; Blumentritt, Siegmar; Drewitz, Heiko; Freslier, Marie

doi:10.1016/j.clinbiomech.2006.02.004

Cited by 66 publications

(50 citation statements)

References 24 publications

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“…5,[12][13][14][15][16][17] Higher wedge inclinations led to a greater reduction of peak EAMs. 12,[18][19][20] In contrast, no reduction of peak EAMs was found by Schmalz et al 21 when walking with wedged shoes without ankle support. In a study from Kakihana et al, 22 increased EAMs were even reported in about 18% of the patients analyzed.…”

mentioning

confidence: 49%

“…14,20 On the other hand, it was reported that ankle stabilization increases the unloading effect of wedges. Schmalz et al 21 reported an unloading effect of wedges in combination with an ankle stabilizing orthosis. No EAM reduction was seen when using the wedges alone.…”

Section: Discussionmentioning

confidence: 99%

“…14 Whereas Schmalz et al 21 showed a greater unloading effect of wedges in combination with ankle stabilization, others assumed that a greater subtalar joint valgus angle is beneficial for the treatment outcome of wedges. 23,24 Since the EAM is widely accepted as an indicator for medial compartment load, the majority of studies have analyzed the effect of lateral wedges on the EAM.…”

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confidence: 99%

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The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

Kutzner

Damm

Heinlein

et al. 2011

Journal Orthopaedic Research

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A conventional method to unload the medial compartment of patients with gonarthrosis and thus to achieve pain reduction is the use of laterally wedged shoes. Our aim was to measure in vivo their effect on medial compartment loads using instrumented knee implants. Medial tibio-femoral contact forces were measured in six subjects with instrumented knee implants during walking with the following shoes: without wedge, with 5 and 10 mm wedges under the lateral sole, and with a laterally wedged insole (5 mm). Measurements were repeated with the shoes in combination with an ankle-stabilizing orthosis. Without orthosis, peak medial forces were reduced by only 1-4% on average. With orthosis, the average reduction was 2-7%. Highest reductions were generally observed with the 10 mm wedge, followed by the 5 mm wedge, and the 5 mm insole. Individual force reductions reached up to 15%. Medial force reductions while walking with wedged shoes were generally small. Due to high inter-individual differences, it seems that some patients might benefit from lateral wedges, whereas others might not. Further analyses of the individual kinematics will show which factors are most decisive for the reduction of medial compartment load. ß

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confidence: 49%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

Kutzner

Damm

Heinlein

et al. 2011

Journal Orthopaedic Research

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“…Therefore, seven conditions were assessed: CON, 1L, 2L, 1M, 2M, 1P and 2P. We choose these wedges as they are the most used in our center of rehabilitation, and they are commonly (Chiu & Shiang, 2007;Erhart et al, 2008;Kakihana et al, 2005;MacLean et al, 2006;Schmalz et al, 2006).…”

Section: Methodsmentioning

confidence: 99%

“…However, there is no consensus about the influence of different wedge insoles on the typical gait pattern (Van Gheluwe & Dananberg, 2004). Some authors found differences in gait waveforms (Chiu & Shiang, 2007;Erhart, Mündermann, Mündermann, & Andriacchi, 2008;Schmalz, Blumentritt, Drewitz, & Freslier, 2006) while others concluded that these devices did not influence the gait pattern of healthy subjects (Kakihana et al, 2005;MacLean, Davis, & Hamill, 2006).…”

Section: Introductionmentioning

confidence: 97%

Influence of wedges on lower limbs’ kinematics and net joint moments during healthy elderly gait using principal component analysis

Soares¹,

Castro²,

Mendes³

et al. 2014

Human Movement Science

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Effectiveness of medial‐wedge insole treatment for valgus knee osteoarthritis

Rodrigues

Ferreira

Pereira

et al. 2008

Arthritis & Rheumatism

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Objective. To assess the efficacy of medial-wedge insoles in valgus knee osteoarthritis (OA). Methods. Thirty consecutive women with valgus-deformity knee OA >8 degrees were randomized into 2 groups: medial insole (insoles with 8-mm medial elevation at the rearfoot [n ‫؍‬ 16]) and neutral insole (similar insole without elevation [n ‫؍‬ 14]). Both groups also wore ankle supports. A blinded examiner assessed pain on movement, at rest, and at night with a visual analog scale (VAS), the Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Femorotibial, talocalcaneal, and talar tilt angles were evaluated at baseline and after 8 weeks of insole use. Results. Significant reductions in the medial insole group were observed for pain on movement (mean ؎ SD VAS pre-and postintervention 8.1 ؎ 1.5 versus 4.2 ؎ 2.4; P ‫؍‬ 0.001), at rest (5.1 ؎ 2.3 versus 2.7 ؎ 2.4; P ‫؍‬ 0.002), and at night (6.1 ؎ 2.7 versus 3.1 ؎ 2.1; P ‫؍‬ 0.001). In addition, a decrease in Lequesne (14.7 ؎ 3.4 versus 9.6 ؎ 3.8; P ‫؍‬ 0.001) and WOMAC scores (74.1 ؎ 14.2 versus 56.1 ؎ 14.9; P ‫؍‬ 0.001) was observed for the medial insole group. In the neutral insole group, a significant reduction was observed only for night pain (mean ؎ SD VAS pre-and postintervention 5.8 ؎ 2.4 versus 4.6 ؎ 2.4; P ‫؍‬ 0.019). An increase in femorotibial angle (169.0 ؎ 3.4 versus 170.8 ؎ 3.7; P ‫؍‬ 0.001) occurred only in the medial insole group. Moreover, the difference in measured femorotibial angles pre-and postintervention was 1.84 ؎ 1.42 versus ؊0.18 ؎ 0.67 (P < 0.001) for the medial and neutral insole groups. Conclusion. The use of medial-wedge insoles was highly effective in reducing pain at rest and on movement and promoted a functional improvement of valgus knee OA.

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The influence of sole wedges on frontal plane knee kinetics, in isolation and in combination with representative rigid and semi-rigid ankle–foot-orthoses

Cited by 66 publications

References 24 publications

The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

Influence of wedges on lower limbs’ kinematics and net joint moments during healthy elderly gait using principal component analysis

Effectiveness of medial‐wedge insole treatment for valgus knee osteoarthritis

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