RESUMO
The effects of lateral wedge insole with and without sub-talar strap on pain, arthritic symptoms, functional performance, sports and recreational activities, and knee related quality of life in patients with medial compartment knee osteoarthritis were compared. Community-dwelling men and women aged over 40 years with medial compartment knee osteoarthritis, grades I or II based on Kellgrene and Lawrence grading system were participated in this study. They were randomly allocated in two different groups; lateral wedge insole with and without sub-talar strap. Both groups were required to wear the insoles at home for the duration of four weeks, approximately 5 to 10 hours per day. Participants were asked to complete the Farsi version of Knee injury and Osteoarthritis Outcome Score [KOOS] questionnaire at baseline and at follow-up. The reliability of KOOS for measuring short term and long term symptoms and function in Iranian patients with knee injuries and osteoarthritis has been reported previously. The changes in KOOS subscales were significantly different in both groups over time. Contrary to our hypothesis, the interaction effect was significant between the two groups following our intervention in terms of symptoms, daily living functions, sports and recreational activities, and knee related quality of life, unless pain score. The result of this study suggests that both of the insoles improved pain, symptoms, function in daily living, sports and recreation activities and knee related quality of life in patients with mild medial compartment knee osteoarthritis. However, use of sub-talar strap with lateral wedge insole would be the better prescription for insoles in these patients.
RESUMO
The common mechanism for lateral ankle sprain is inversion, plantar flexion, or the combination of both, if untreated successfully can lead to chronic ankle instability. It seems that the foot position, while touching the ground, has an effective role to cause ankle sprain. Thus it is possible to prevent ankle sprain through limiting foot position. Therefore the aim of this research is to study the effect of plantar flexion and eversion on mediolateral ground reaction force while landing in individuals who suffering from functional ankle instability. In this case-control research study 32 subjects [17 subjects with unilateral functional ankle instability [FAI] and 15 control subjects], aged from 18 to 35 years, were tested. All subjects in instability group were selected by the orthopedic physician, then the anterior drawer and talar tilt tests were performed for diagnosis of functional ankle instability and other physical examinations. Control group were matched with instability group by age, weight, height, gender and body mass index. The subjects standing with single leg on a 40 cm high platform in 25 cm front of a force-plate while the test leg relaxed and non-weight bearing. The subject landed on the test leg on the center of the force-plate. The subjects landed according to four types of position: A: neutral position of ankle and lateral foot wedge, B: neutral position of ankle, C: positive heel and lateral foot wedge and D: positive heel. Among control group, medial ground reaction force increased in the "C" position relative to "B" position [p=0.007] and "C" position relative to "D" position [p=0.018]. In FAI group, lateral ground reaction force increased in "C" position relative to "B" position [p=0.001] and "C" position relative to "A" position [p=0.002]. Also in FAI group medial ground reaction force decreased in "D" position relative to "A" position [p=0.014]. According to the findings, applying lateral foot wedge, while the ankle is in plantar flexion, increases the mediolateral ground reaction forces. Based on the results, position of plantar flexion is more possibly effective than inversion in ankle sprain. According to the study, the lateral foot wedge in ankle plantar flexion position may be more effective than in neutral one to change mediolateral ground reaction forces.