Gait Posture. 2025 Jul 17;122:272-278. doi: 10.1016/j.gaitpost.2025.07.319. Online ahead of print.
ABSTRACT
BACKGROUND: Knee osteoarthritis (KOA) is a debilitating condition affecting knee function and mobility. Lateral wedge insoles (LWIs) are used to manage KOA, but their effects in different footwear types need further investigation. This study aimed to evaluate the effects of LWIs on lower-limb joint kinematics in KOA patients, comparing walking barefoot (Bare), conventional sandals with LWIs (SAN), and combo slipper socks with LWIs (SOC), a novel footwear design.
METHODS: 23 female patients with bilateral medial compartment KOA (K-L grades II-III), aged 45-65 years, walked in three conditions: Bare, SAN, and SOC. Assessments included comfort levels (Likert scale), pain severity (Visual Analog Scale), and lower-limb joint kinematics. Statistical analysis utilized paired t-tests with Statistical Parametric Mapping. Results are presented as means ± standard deviations, with comparisons between conditions done via mean differences (MD) and Cohen’s d (d).
RESULTS: Our analysis revealed SOC provides greatest comfort and lowest pain, followed by SAN, with Bare condition exhibited the lowest comfort and highest pain levels. Hip flexion angles during mid-swing were significantly greater in SOC (M=22.07 ± 12.29°) compared to Bare (M=19.80 ± 11.95°; p < 0.01; MD = 2.27°, d=-0.10). Knee flexion during terminal stance was significantly lower in SOC (24.38 ± 1.30°) than in Bare (27.65 ± 1.27°; p < 0.01, MD=-3.27°, d=2.54). Hip external rotation angles during pre-swing were significantly reduced in SAN (-15.36 ± 0.92°) and SOC (-14.82 ± 0.64°) relative to Bare (-17.85 ± 1.04°; p < 0.01, [Bare vs. SAN] MD=2.49, d=-2.54; [Bare vs. SOC] MD=3.09, d=-3.6). SAN also demonstrated significantly lower ankle plantarflexion angles during both stance (1.97 ± 3.71°) and swing (-19.45 ± 4.76°) compared to Bare stance (6.49 ± 3.42°, MD= -4.52°, d=1.27) and swing (-13.33 ± 4.83°;p < 0.001, MD=-6.12°, d=1.27).
CONCLUSION: A unique LWI-integrated design (SOC), improved comfort, reduced pain, and altered joint kinematics during walking in females with medial KOA. These findings demonstrate the potential of SOC for conservative KOA management. Further studies should explore SOC’s impact on joint loading and long-term clinical outcomes.
PMID:40768789 | DOI:10.1016/j.gaitpost.2025.07.319
