الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 203 |  |  |
| | | from | 203 | | |
Abstract
In conclusion, this study aimed to determine the
possible mechanical and clinical effects of the different
lateral wedge insoles to assess its role in management of
the medial compartment knee OA. Both the insoles used
suggested clinical symptomatic improvement, while
STSLWI suggested more alignment biomechanical
improvement that was not proved statistically in the study
but was noted for better compliance by patients than LWI
in this study. So, STSLWI may provide mechanical benefit
for moderate medial compartment knee OA patients.
Early diagnosis of OA and management with
conventional treatments may prevent progression of the
disease, that eventually lead to malfunction and
deformities.
The forty-eight primary medial compartment knee OA
were divided into three groups each of sixteen knees:
group A: received conventional physiotherapy for knee
OA.
group B: received conventional physiotherapy for knee OA
and lateral wedge insole (LWI).
group C: received conventional physiotherapy for knee OA
and subtalar strapped lateral wedge insole (STSLWI).
All the three groups received three sessions per week for
four months.
Summary and Conclusions
(145)
Exclusion criteria as following:
1. Use of a gait aid.
2. Use of insoles or foot orthotics
3. Lateral tibiofemoral compartment narrowing greater than
medial.
4. Foot, ankle, knee, hip, back problems.
5. Hip or knee joint replacement.
6. X-ray [kellgren &Lawrence (K/L) grade 1 or 4].
7. Valgus knee alignment >185° on a standardized standing
knee X-ray.
8. ody mass index ( MI) ≥ 36kg/m².
9. Balance impairment.
10. Other causes of arthritis or musculoskeletal disorder of
the lower limb.
11. Mechanical knee trauma, Hypermobility, muscle power
less than 3.
There is an ongoing need for trials of nonpharmacologic
therapies in OA, the use of orthosis in knee
OA has positive outcomes.
The WOMAC score subscale of pain, stiffness and
function showed improvement for all three groups with
high significant difference (P˂0.001); While the total
WOMAC score showed no statistically significant
difference for the patients receiving only physiotherapy
group A.
Summary and Conclusions
(146)
As regards FTA, there was a highly statistically
significant difference between before and after the study
with (P˂0.001) in both wedged insole group B and group
C. This suggested that both lateral wedged insoles
improved alignment of lower limb.
The peak planter pressure in this study showed highly
statistically significant difference (P˂0.001) of all areas of
both groups with wedge insole before and after the study.
While, the group that received physiotherapy only showed
in one area MF only.
These positive outcomes suggest that the LWI and
STSLWI insert may be a viable alternative in the
conservative management of patients with medial
compartment knee OA. As the insoles improved pain,
stiffness, function and total WOMAC score after wearing
the insole 4 months with physiotherapy and follow up.
The LWI could redistribute the knee internal loading
by significantly relieving the contact force and stress on
medial compartment of the knee, the use of LWI and
STSLWI may prevent the progression of medial knee OA if
used in early grades of medial compartment knee OA as
grade 2 and 3.
Both the insoles improved the lower limb alignment
and measurement of peak planter pressure areas that
generally improving pain and preventing deformities.
Significant differences in pressure distribution mean that
Summary and Conclusions
(147)
the OA groups experienced more impact from the ground
during walking. Wearing STSLWI inserted in a flat
footwear with no heels was more effective and showed
more compliance by patients.
Overall, the results of this study were not only
suggesting clinically meaningful symptomatic
improvement with an inexpensive conservative therapy, but
also demonstrate that a less complicated comfortable
orthosis of benefit to medial compartment knee OA. This
study establishes that plantar pressure measurements as
COP can be used to indirectly assess the response in load
distribution across the knee joint with medial OA