Clinical biomechanics (Bristol, Avon) · 2026
Immediate effects of lateral wedge insoles on inter-joint coordination in women with knee osteoarthritis: A comparative study of footwear.
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Sabet Fereshteh, Gonçalves Basílio, Anbarian Mehrdad, Kainz Hans, Exel Juliana
Аннотация
BACKGROUND: Knee osteoarthritis is a degenerative condition characterized by pain and increased gait variability. Lateral wedge insoles are prescribed to reduce medial knee joint loading; however, their effects on lower-limb joint coordination variability, pain, and comfort when combined with different footwear remain unclear. This study examined lateral wedge insoles worn with conventional sandals and researcher-made slipper socks in women with knee osteoarthritis.
METHODS: A within-subject design was conducted with 23 women (aged 45-65) diagnosed with bilateral medial compartment knee osteoarthritis (Kellgren-Lawrence grades II and III). Participants walked barefoot, in sandals with lateral wedge insoles, and in slipper socks with lateral wedge insoles. Lower-limb inter-joint coordination was assessed using three-dimensional motion capture, and pain and comfort were evaluated using the Visual Analog Scale and Likert scale. Mann-Whitney U tests compared coordination variability, and Spearman correlations explored relationships between variability, pain, and comfort.
FINDINGS: Coordination mode distributions varied across gait subphases and footwear conditions, but no significant pairwise differences were observed. Slipper socks with lateral wedge insoles showed significantly lower coordination variability for hip-knee (P < 0.001) and knee-ankle (P = 0.04) coupling compared to sandals. Pain was negatively correlated with coordination variability in the sandal condition, while reduced variability in slipper socks was associated with lower pain and improved comfort.
INTERPRETATION: Lateral wedge insoles in sandals increased coordination variability and pain, while slipper socks reduced variability, improving comfort and pain outcomes. Footwear design plays a crucial role in optimizing gait stability and symptom management in knee osteoarthritis.
METHODS: A within-subject design was conducted with 23 women (aged 45-65) diagnosed with bilateral medial compartment knee osteoarthritis (Kellgren-Lawrence grades II and III). Participants walked barefoot, in sandals with lateral wedge insoles, and in slipper socks with lateral wedge insoles. Lower-limb inter-joint coordination was assessed using three-dimensional motion capture, and pain and comfort were evaluated using the Visual Analog Scale and Likert scale. Mann-Whitney U tests compared coordination variability, and Spearman correlations explored relationships between variability, pain, and comfort.
FINDINGS: Coordination mode distributions varied across gait subphases and footwear conditions, but no significant pairwise differences were observed. Slipper socks with lateral wedge insoles showed significantly lower coordination variability for hip-knee (P < 0.001) and knee-ankle (P = 0.04) coupling compared to sandals. Pain was negatively correlated with coordination variability in the sandal condition, while reduced variability in slipper socks was associated with lower pain and improved comfort.
INTERPRETATION: Lateral wedge insoles in sandals increased coordination variability and pain, while slipper socks reduced variability, improving comfort and pain outcomes. Footwear design plays a crucial role in optimizing gait stability and symptom management in knee osteoarthritis.