Lateral wedges - a crossover study
no insole walking condition [24]. Thus, the
differences in clinical outcomes in the present
study cannot be attributed solely to the
biomechanical effects of the lateral wedges.
Indeed, a direct relationship between changes
in KAM magnitudes and pain levels with
foot-based interventions has not been shown
in the literature [31, 32], suggesting that the
relationship between measured external loads
and knee pain magnitudes is complex. Rather,
it is likely that the addition of the custom arch
support played a role in reducing self reported
knee pain in the present study. The reasons for
this are unclear, but may include indirect effects
of the insoles, such as psychological factors
on overall benefits based on insole preference
or foot symptoms obtained with the combined
insoles which then translated into perceived
changes at the knee. Further research is needed
to better elucidate the relationship between foot
mechanics and knee symptoms in this patient
population.
It was clear that participants preferred the
lateral wedges with arch support. Indeed, 17
of 22 participants (78%) indicated an overall
preference of that insole condition and reported
that the combined insole was slightly more
comfortable under the feet. Any difference in
comfort with the combined insole may partially
explain why we observed clinical improvements
with the combined insole but now with the
lateral wedges alone. However, as there were no
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