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Objective: To determine the effects of different angles of lateral wedge
insoles on external knee adduction moment (EKAM) and knee adduction
angular impulse (KAAI) in patients with medial knee osteoarthritis.
Methods: Medline/Pubmed, CINAHL and Scopus, were searched from their
inception through May, 2017. Included studies reported on the immediate
biomechanical effects of different angles of lateral wedge insoles during
walking in people with knee osteoarthritis. The main measures of interest
relating to the biomechanical risks were the first and second peak external
knee adduction moment and knee adduction angular impulse. For the
comparison of the biomechanical effects of different angles of insoles the
studies were divided in three subgroups: insoles with an angle higher than
0° and equal or lower than 5°; angle higher than 5° and equal or lower
than 9°; and insoles with an angle higher than 9°.
Results: Fifteen studies with a total of 415 participants met all eligibility
criteria and were included. The overall effect suggests that lateral wedge
insoles resulted in a statistically significant reduction in the first peak
external knee adduction moment (standardized mean difference SMD –
0.25; 95% confidence interval 95% CI -0.36, -0.13; P<0.01), second
peak external knee adduction moment (SMD -0.26 95% CI -0.48, -0.04;
P=0.02) and knee adduction angular impulse (SMD -0.17 95% CI -0.31, -
0.03; P=0.02). The test of subgroups found no statistically significant
differences.
Conclusion: Meta-analysis suggests that lateral wedge insoles cause small
reductions in the external knee adduction moment and knee adduction
angular impulse. Higher angles don't show higher reductions compare with
lower angles. The optimal angle should be obtained from individual fitting
with the lowest possible angles.