| Objective: To observe the rehabilitation effect of the orthotic insole combined with exercise therapy on the elderly and middle age Knee osteoarthritis(KOA)patients,and to provide clinical and theoretical basis for the treatment of KOA.Methods: 1.40 middle-aged and elderly KOA patients with Kellgren Lawrence(KL)level I,II and III and aged between 50 and 75 years old were selected from the department of rehabilitation medicine of a hospital.They were randomly divided into control group and experimental group by random number table,20 cases in each group.2.The control group was treated with exercise therapy only,and the experimental group was treated with orthopedic insole combined with exercise therapy.The orthopedic insole is made of ethylene vinyl acetate copolymer and supported by arched in the middle of the foot.Exercise therapy included knee joint exercise training,static low angle squat training and standing ankle dorsiflexion and plantar flexion training.3.Before and after one month treatment,the Western Ontario and Mc Master Universities Arthritis index(WOMAC)was used to evaluate the knee joint symptoms,including pain,stiffness,difficulty of living activity.The gaitview AFA-50 plantar pressure balance detector was used to evaluate the balance function,including the range of gravity center movement,the balance score of single leg standing with eyes open and closed.The lower limb biomechanical parameters were measured,including the angle of rest calcaneal stand position(RCSP),neutral calcaneal stand Position(NCSP)and tibial torsion.Result: 1.Improvement of balance function: Before treatment,there was no significant difference in the range of gravity center movement and the standing balance score of single leg under open and closed eyes(P > 0.05).After 4 weeks of treatment,the range of gravity center movement in two groups was reduced,and the standing balance score of single leg in the open and closed eyes conditions was increased(P < 0.05);the balance score of single leg standing in the experimental group was higher than control group(P < 0.05),and the range of gravity center movement was not significantly different between the two groups(P > 0.05).2.WOMAC score: Before treatment,there was no significant difference in pain,stiffness and difficulty of life activity between the two groups(P > 0.05).After 4 weeks of treatment,the scores of the two groups were decreased compared with before treatment,the difference was statistically significant(P < 0.05);the scores of WOMAC in experimental group were lower than control group(P < 0.05).3.Changes in biomechanical parameters of lower extremities: Before treatment,there was no statistical difference in biomechanical parameters of lower extremities in two groups(P > 0.05).After 4 weeks of treatment,the angle of RCSP and tibial torsion in 2 groups were decreased compared with before treatment,and the differences were statistically significant(P < 0.05),while the NCSP angle was no statistical significance compared with before treatment(P > 0.05).The tibial torsion angle of the experimental group was lower than control group,and the difference was statistically significant(P < 0.05).There was no significant difference in RCSP and NCSP angle between the two groups(P > 0.05).Conclusion: 1.The single exercise therapy and the orthopedic insole combined with exercise therapy can effectively improve the balance function of the middle age and elderly KOA patients,and that also can alleviate the pain and rigidity of the joint and improve the ability of life activity.2.Compared with the single exercise therapy,orthopedic insole combined with exercise therapy can improve the symptoms and enhance the ability of standing balance of the single leg under the condition of open eyes and closed eyes of the middle age and elderly KOA patients.3.Both single exercise therapy and orthopedic insole combined with exercise therapy can correct the excessive valgus of calcaneus and excessive torsion of tibia,and improve the biomechanical state of lower extremities,while,the effect of orthopedic insole combined exercise training is more obvious... |
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