Foot orthotics for hip and knee osteoarthritis

NewsBot · Feb 13, 2009

Members do not see these Ads. Sign Up.
Is there an evidence-based efficacy for the use of foot orthotics in knee and hip osteoarthritis? Elaboration of French clinical practice guidelines.
Gélis A, Coudeyre E, Hudry C, Pelissier J, Revel M, Rannou F.
Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire Caremeau, Place du Pr Debré, 30029 Nîmes, France. anthony_gelis@yahoo.fr
Joint Bone Spine. 2008 Dec;75(6):714-20.

OBJECTIVE: To develop clinical practice guidelines for the use of foot orthotics (FO) in the treatment of knee and hip osteoarthritis.

METHOD: The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic review of the literature, input from every day clinical practice and external review by a multidisciplinary expert committee, was used. The selected analysis criteria were pain, disability, medications used and X-ray evolution of osteoarthritis. The recommendations are classified according to the level of proof in Grade A, B or C according to the French National Agency for Health Accreditation and Evaluation (NAHAE).

RESULTS: In medial knee osteoarthritis, foot pronation orthotics--when there are no contraindications--can be proposed for their symptomatic impact, especially in the decrease of NSAIDs consumption (Grade B). To this day, there is no evidence of a structural or functional impact on osteoarthritis (Grade B). Outside of this specific clinical framework, there is no validated indication for prescribing foot orthotics in the treatment of knee or hip OA (Grade C).

CONCLUSION: It is necessary to have further randomized controlled trials to better define the indication of Foot orthotics (severity of knee OA, genu varum), test the efficacy of other orthoses such as cushioning FO. The long-term side effects, mainly on the external femorotibial compartment could also be assessed. A medical and economical assessment of FO prescriptions is also quite necessary.
Click to expand...

Admin2 · Feb 13, 2009

Related threads:
Lateral foot wedging for medial knee OA
Do foot orthoses increase the risk for medial knee OA?
Threads tagged with osteoarthritis

NewsBot · Nov 8, 2016

Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: A cross-over, proof-of-concept study
Natalie J. Collins, Rana S. Hinman, Hylton B. Menz, Kay M. Crossley
The Knee; 4 November 2016

Background
The purpose of the study was to determine whether prefabricated foot orthoses immediately reduce pain during functional tasks in people with patellofemoral osteoarthritis, compared to flat insoles and shoes alone.

Methods
Eighteen people with predominant lateral patellofemoral osteoarthritis (nine women; mean [SD] age 59 [10] years; body mass index 27.9 [3.2] kg/m2) performed functional tasks wearing running sandals, and then wearing foot orthoses and flat insoles (random order). Participants rated knee pain during each task (11-point numerical rating scales), ease of performance and knee stability (five-point Likert scales), and comfort (100 mm visual analogue scales).

Results
Compared to shoes alone, foot orthoses (p = 0.002; median difference 1.5 [IQR 3]) and flat insoles (p < 0.001; 2 [3]) significantly reduced pain during step-downs; foot orthoses reduced pain during walking (p = 0.008; 1 [1.25]); and flat insoles reduced pain during stair ambulation (p = 0.001; 1 [1.75]). No significant differences between foot orthoses and flat insoles were observed for pain severity, ease of performance or knee stability. Foot orthoses were less comfortable than flat insoles and shoes alone (p < 0.05).

Conclusions
In people with patellofemoral osteoarthritis, immediate pain-relieving effects of prefabricated, contoured foot orthoses are equivalent to flat insoles. Further studies should investigate whether similar outcomes occur with longer-term wear or different orthosis designs.
Click to expand...

NewsBot · Jul 17, 2019

The efficacy of foot orthoses in individuals with patellofemoral osteoarthritis: a randomised feasibility trial
Jade M. Tan, Hylton B. Menz, Kay M. Crossley, Shannon E. Munteanu, Harvi F. Hart, Kane J. Middleton, Anne J. Smith and Natalie J. Collins
Pilot and Feasibility Studies20195:90

Background
Foot orthoses have the potential to be an efficacious treatment for patellofemoral osteoarthritis (PFOA) but have not been evaluated in clinical trials in this population. This study aimed to determine the: (i) feasibility of conducting a randomised controlled trial (RCT) investigating the efficacy of foot orthoses in individuals with PFOA; and (ii) effects of foot orthoses versus flat shoe inserts on pain, function, and knee-related quality of life (QOL).

Methods
This 6-week, single-blinded pilot RCT randomly allocated participants with PFOA to receive foot orthoses or flat inserts. The primary outcome of feasibility was determined via the following parameters: one participant recruited per week, 20% (35 h/week) adherence to the intervention, 50% log book completion rate, and < 20% drop-out, with results reported using descriptive statistics. Secondary outcomes included average and maximum pain severity (100 mm visual analogue scale), Anterior Knee Pain Scale, and Knee injury and Osteoarthritis Outcome Score, analysed using analysis of covariance.

Results
Twenty-six participants (16 women; mean (SD) age of 60 (8) years) with PFOA were recruited. All feasibility parameters were exceeded, with three participants recruited per week, > 20% (37.2 [9.8] hours/week) adherence to the intervention, 69.2% (18/26) log-book completion, and 3.8% (1/26) drop-outs. The most common adverse events were arch irritation and shoe fit issues, which were more common in the foot orthoses group (67.9% versus 32.1%). There was a trend for the foot orthoses group to report larger improvements in average and maximum pain than the flat insert group, with the mean difference for maximum knee pain severity (21.9 mm, 95% CI − 2.1 to 46.0) exceeding the minimal clinically important difference (15 mm). The estimated sample size for a full-scale RCT is 160 participants. Suggestions to improve study design include a greater number of face-to-face follow-up appointments, a larger variety of foot orthoses to reduce rates of adverse events, and increasing follow-up time to determine long-term efficacy.

Conclusion
This study supports the feasibility of a full-scale RCT to determine the efficacy of foot orthoses versus flat inserts in individuals with PFOA.
Click to expand...

NewsBot · Oct 27, 2019

Immediate effects of foot orthoses on lower limb biomechanics, pain, and confidence in individuals with patellofemoral osteoarthritis
Jade M.Tan et al
Gait & Posture; 24 October 2019

Highlights
•Foot orthoses cause instant changes to ankle biomechanics in people with PFOA.
•No biomechanical difference between flat inserts (sham) and shoes, indicating a good sham device.
•Foot orthoses do not alter knee pain or confidence immediately in people with PFOA.
Click to expand...

Background
Foot orthoses are a recommended treatment for patellofemoral (PF) pain and a number of lower limb osteoarthritis (OA) conditions. However, their mechanism of effect is poorly understood.

Research question
To compare the immediate effects of foot orthoses and flat inserts on lower limb biomechanics, knee pain and confidence in individuals with PFOA.

Methods
Twenty-one participants (14 females; mean ± SD age 58 ± 8 years) with PFOA underwent three-dimensional motion analysis during level-walking, stair ascent and stair descent under three footwear conditions: (i) their own shoes; (ii) prefabricated foot orthoses; and (iii) flat shoe inserts. Participants reported their average levels of knee pain and confidence after each task. Data were analysed with repeated-measures analysis of variance (ANOVA), effect sizes (partial eta squared), and Bonferroni post-hoc tests.

Results
During level-walking, there was a significant main effect of foot orthoses on peak ankle dorsiflexion angle (F2 = 0.773, p < 0.001, ƞ2 = 0.773) and peak ankle external dorsiflexion moment (F2 = 0.356, p = 0.046, ƞ2 = 0.356). Foot orthoses decreased the peak ankle dorsiflexion angle compared to the flat insert and shoe conditions, and decreased the peak ankle external dorsiflexion moment relative to flat inserts. During stair descent, there was a significant main effect of foot orthoses on peak ankle external dorsiflexion moment (F2 = 0.823, p = 0.006, ƞ2 = 0.738), with a trend towards lower peak dorsiflexion moment for foot orthoses compared to the flat insert and shoe conditions. No significant main effects were observed during stair ascent. No other lower limb biomechanical changes were observed across all three conditions. Knee pain and confidence scores were not significantly different across the three conditions.

Significance
Prefabricated foot orthoses altered sagittal plane biomechanics of the ankle during level-walking and stair descent in individuals with PFOA. Further research is required to determine whether these changes are clinically beneficial.
Click to expand...

NewsBot · Dec 19, 2019

The effectiveness of foot orthoses in the treatment of medial knee osteoarthritis: A systematic review
Abdal QadirZafar et al
Gait & Posture; 19 December 2019

Highlights
•Thirty-four papers included in this review.
•Parameters were investigated on how the LWIs can be more beneficial.
•For footwear, barefoot mimicking soles produced the most favourable biomechanics.
•Insoles work in correcting the position of the knee
•Studies do not show how insoles affects patients’ pain and function.
Click to expand...

Background
Knee osteoarthritis is a disease of the joint causing decreased function and pain. Currently, treatments range from medication to surgery, with the use of different insoles and footwear recommended. These methods are effective by either correcting the position of the knee or providing shock absorption. However, there is little understanding of the effective characteristics of these devices.

Research question
This paper aims to investigate this question and provide future areas of research to help better define treatment guidelines. Foot orthoses are an example of non-pharmacological conservative treatments mentioned in National Institute for Health and Care Excellence (NICE) guidelines to treat knee osteoarthritis (OA). These include lateral wedge insoles (LWI), developed with the intention of load reduction of the knee. Different footwear has also been shown to affect pain, biomechanical and functional outcomes in knee OA patients.

Methods
To address what features of LWIs and footwear make them effective in the treatment of knee OA, scientific databases were used to search for papers on this topic and then selected to be included based on pre-defined criteria. Data were extracted and analysed from these studies to provide a basis for possible areas for future development of these foot orthoses, and research required to improve clinical treatment guidelines. Databases used were PubMed, Scopus and Web of Science.

Results and Significance
Thirty-four out of 226 papers were included after application of inclusion and exclusion criteria. Regarding LWIs, the characteristics showing the most beneficial effect on either biomechanical, functional or pain outcomes were customisation, full-length, 5° elevation, shock absorption and arch support. For footwear, barefoot mimicking soles produced the most favourable biomechanics. Results also showed that insoles work in correcting the position of the knee, but it may or may not affect patients’ pain and function.
Click to expand...

NewsBot · Jan 24, 2023

Prefabricated contoured foot orthoses to reduce pain and increase physical activity in people with hip osteoarthritis: protocol for a randomised feasibility trial
Matthew G King et al
BMJ Open. 2022 Sep 6;12(9):e062954

Introduction: The aim of this randomised feasibility trial is to determine the feasibility of conducting an adequately powered randomised controlled trial (RCT) investigating the efficacy of prefabricated contoured foot orthoses in people with hip osteoarthritis (OA). The secondary aims of the trial are to compare the effect of prefabricated contoured foot orthoses to a flat shoe insert comparator on outcomes of hip-related pain, physical activity and quality of life. We hypothesise that the demand, implementation, acceptability and practicality of foot orthoses as a treatment option for people with hip OA will be deemed feasible, informing the development of an adequately powered RCT to evaluate the efficacy and long term outcomes.

Methods and analysis: We will recruit 28 people with hip OA who will be randomised to receive either prefabricated contoured foot orthoses or flat shoe inserts to use for a 6-week period. Both groups will receive standardised education on hip OA and physical activity. The study's primary outcome is the feasibility domains of demand, implementation, acceptability and practicality. The secondary outcomes include the change in Hip Osteoarthritis Outcome Score-12, Patient Health Questionnaire-9, Brief Fear of Movement Scale for OA, Physical activity accelerometry and the Physical Activity Questionnaire-short form. Descriptive statistics will be used to describe feasibility outcomes with limited efficacy analysis used for the secondary outcomes. Linear mixed models will be used to analyse between-group differences at 6 weeks, with baseline values used as covariates, treatment allocation as a fixed factor and participant as a random factor.
Click to expand...

NewsBot · Jan 6, 2024

The distribution of pressure forces of the foot on the ground during gait in patients with hip osteoarthritis
Katarzyna Maria Pawłowska, Jakub Pawłowski, Agnieszka Grochulska
J Back Musculoskelet Rehabil. 2023 Dec 8.

Background: Hip osteoarthritis is a major civilizational challenge of the ageing population, usually due to the reduced function of gait. In the light of this fact, gait analysis has become an important issue for the doctor, the physiotherapist and the patient, as it serves as a useful tool in diagnosis, recovery, and rehabilitation. Pedobarography is one of the most modern gait analysis methods.

Objective: The aim of this study is to assess the distribution of pressure forces of the foot on the ground during gait in patients with hip osteoarthritis.

Methods: Dynamic foot tests were performed by means of a two-meter RSscan® International platform, equipped with 16.384 sensors with the scanning frequency level exceeding 500 Hz. Patients were divided into two groups: the research group of N= 60 individuals with hip osteoarthritis, aged 52-84; and the control group of N= 32 individuals without hip osteoarthritis, aged 50-74. Data distribution analysis was performed with the Shapiro-Wilk test, followed by a non-parametric Mann-Whitney U test.

Results: The differences between the mean results of maximal peak values of pressure and force in such areas as the big toe, metatarsal I, III, IV, V, lateral and medial heel are significantly lower in the research group than in the control group. Only in the area of metatarsal II, the mean value of pressure is higher in the research group than in the control group. For all metatarsals, the midfoot and medial heel mean results of the contact area are significantly higher in the research group than in the control group. The differences between mean load rate were also tested. The test revealed statistical significance of metatarsal II and III, and the medial heel while metatarsal II displayed a higher mean value in the research group than in the control group.

Conclusion: The distribution of the pressure forces of the foot can indicate imbalances which cause degenerative changes. Therefore, early detection of changes can help in prevention or delay of hip osteoarthritis in conjunction with proper therapy.
Click to expand...

NewsBot · Apr 17, 2024

Preventing hip osteoarthritis in athletes: is it really a mission impossible?

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Foot orthotics for hip problems

Foot orthotics and tibial strain

Deep learning algorithms to design foot orthotics

Foot Orthotics in Older Individuals with Cognitive Impairment

Review process after issue of foot orthotics

Foot Orthotics in Archery

3d printed metal foot orthotics

Share This Page