Title

The Dose–Response Relationship Between Lateral Foot Wedging and the Reduction of Knee Adduction Moment

Author(s)

Rima A. Tipnis, University of Dayton
Philip A. Anloague, University of DaytonFollow
Lloyd L. Laubach, University of DaytonFollow
Joaquin Alberto Barrios, University of DaytonFollow

Document Type

Article

Publication Date

11-2014

Publication Source

Clinical Biomechanics

Abstract

Background: Lateral foot wedges represent a biomechanical intervention aimed at reducing medial knee loads. However, the effects of varying wedge amounts on biomechanical variables and orthotic comfort have not been systematically studied. Further, arch height may influence the comfort of laterally wedged devices. Therefore, the primary purpose of this study was to examine the effect of incrementally increasing lateral wedge amounts on knee adduction moment parameters and subjective comfort. The secondary purpose was to relate arch height measures to the comfort of the devices.

Methods: Twenty-five healthy subjects underwent three-dimensional instrumented gait analysis testing using seven inclinations of lateral wedging (0°, 2°, 4°, 6°, 8°, 10°, 12°). Subjects reported comfort level for each orthotic condition. Arch heights were measured in standing and sitting, and rigidity index and stiffness were calculated.

Findings: The knee adduction moment decreased with wedge amounts up to 6°, but more aggressive amounts did not yield additional reductions. Comfort ratings did not change from baseline until wedge amounts exceeded 8°. In addition, arch height measures, arch rigidity index and stiffness did not relate to the comfort of the orthotic device regardless of the wedge amount.

Interpretation: Knee adduction moment decreased with mild wedge amounts while maintaining comfort. Wedge amounts greater than 6° yielded little additional mechanical benefit and amounts greater than 8° compromised comfort. It appears that 4°–6° of lateral wedging are optimal in regard to desirable biomechanical change and comfort level in healthy individuals.

Inclusive pages

984–989

ISBN/ISSN

0268-0033

Comments

Permission documentation on file.

Copyright

Copyright © 2014, Elsevier

Publisher

Elsevier

Volume

29

Issue

9

Peer Reviewed

yes

eCommons Citation

Tipnis, Rima A.; Anloague, Philip A.; Laubach, Lloyd L.; and Barrios, Joaquin Alberto, "The Dose–Response Relationship Between Lateral Foot Wedging and the Reduction of Knee Adduction Moment" (2014). Physical Therapy Faculty Publications. 73.
https://ecommons.udayton.edu/dpt_fac_pub/73