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Barefoot or shock absorbing insole for knee osteoarthritis?

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  #1  
Old 25th April 2012, 01:46 PM
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Default Barefoot or shock absorbing insole for knee osteoarthritis?

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Biomechanical and clinical outcomes with shock-absorbing insoles in patients with knee osteoarthritis: immediate effects and changes after 1 month of wear.
Turpin KM, De Vincenzo A, Apps AM, Cooney T, MacKenzie MD, Chang R, Hunt MA.
Arch Phys Med Rehabil. 2012 Mar;93(3):503
Quote:
OBJECTIVES:
To examine the effectiveness of shock-absorbing insoles in the immediate reduction of knee joint load, as well as reductions in knee joint load, pain, and dysfunction after 1 month of wear, in individuals with knee osteoarthritis (OA).

DESIGN:
Pre-post design with participants exposed to 2 conditions (normal footwear, shock-absorbing insoles) with a 1-month follow-up.

SETTING:
University laboratory for testing and general community for intervention.

PARTICIPANTS:
Community-dwelling individuals (N=16; 6 men, 10 women) with medial compartment knee OA.

INTERVENTION:
Participants were provided with sulcus length shock-absorbing insoles to be inserted into their everyday shoes.

MAIN OUTCOME MEASURES:
Primary outcome measures included the peak, early stance peak, and late stance peak external knee adduction moment (KAM); the KAM impulse (positive area under the KAM curve); and peak tibial vertical acceleration. Secondary outcomes included walking pain, the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale and total score, and a timed stair climb task.

RESULTS:
There was a significant reduction in the late stance peak KAM with shock-absorbing insoles (P=.03) during follow-up compared with the baseline test session. No other immediate or longitudinal significant changes (P>.05) in the other KAM parameters or peak tibial acceleration after use of a shock-absorbing insole were observed. However, significant improvements in all measures of pain and function (P<.05) were observed.

CONCLUSIONS:
Shock-absorbing insoles produced significant reductions in self-reported knee joint pain and physical dysfunction with 1 month of wear in patients with knee OA despite no consistent changes in knee joint load. Further research using randomized controlled trials, with larger sample sizes and explorations into long-term use of shock-absorbing insoles and their effect on disease progression, is warranted.
Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis.
Arthritis Rheum. 2006 Aug 31;54(9):2923-2927
Shakoor N, Block JA.
Quote:
OBJECTIVE: To evaluate the effects that modern shoes have on gait and lower extremity joint loads in osteoarthritis (OA).

METHODS: Gait analyses were performed on 75 subjects with knee OA while they were wearing their everyday walking shoes and while they were walking barefoot. The trials involved optoelectronic detection of external markers during ambulation over a multicomponent force plate, and were matched for speed. Comparisons were made of gait parameters and joint loading during trials in which the subjects walked while wearing shoes and while barefoot.

RESULTS: Peak joint loads at the hips and knees significantly decreased during barefoot walking, with an 11.9% reduction noted in the knee adduction moment. Stride, cadence, and range of motion at the lower extremity joints also changed significantly, but these changes could not explain the reduction in the peak joint loads.

CONCLUSION: Shoes may detrimentally increase loads on the lower extremity joints. Once factors responsible for the differences in loads between with-shoe and barefoot walking are better delineated, modern shoes and walking practices may need to be reevaluated with regard to their effects on the prevalence and progression of OA in our society.
(the second one was discussed here)
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Old 28th April 2012, 02:26 PM
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Default Re: Barefoot or shock absorbing insole for knee osteoarthritis?

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Originally Posted by Craig Payne View Post
Spot the difference:

Biomechanical and clinical outcomes with shock-absorbing insoles in patients with knee osteoarthritis: immediate effects and changes after 1 month of wear.
Turpin KM, De Vincenzo A, Apps AM, Cooney T, MacKenzie MD, Chang R, Hunt MA.
Arch Phys Med Rehabil. 2012 Mar;93(3):503


Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis.
Arthritis Rheum. 2006 Aug 31;54(9):2923-2927
Shakoor N, Block JA.

(the second one was discussed here)
No one took the bait

One of the studies is being touted on some barefoot sites as reducing knee osteoarthritis.....

One of the studies is only a theoretical risk reduction and one of the studies is an actual clinical outcome study. Who you gonna believe?
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Old 29th April 2012, 01:13 AM
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Default Re: Barefoot or shock absorbing insole for knee osteoarthritis?

Yeah, I personally don't get the point of the latter. Strap a seal to the sole of each foot or move to the moon and I suspect the peak loads would reduce even further. Its not practical in everyday life!
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Old 2nd May 2012, 02:47 AM
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Default Re: Barefoot or shock absorbing insole for knee osteoarthritis?

Interesting conclusions!
Having severe O/a knees myself , i personally find soft insoles or walking on soft surfaces like the soft sand make my knees 10x worse than a firm orthotic or the hard sand. this from a pain perpersative. But good orthotics and shoes definetly improve pain , barefoot a killer.
might read the full articles before further comment.
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