The Effect of Lateral Wedge Insoles on Lower Limb Biomechanics, Muscle Activity and Knee Adduction Moment During Walking and Running
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: 3D Movement Analysis, Force Plate, Electromyography (EMG).
- Who it may be relevant to
- Registry conditions: Biomechanical Changes, Gait Biomechanics, Gait Analysis in Healthy Subjects, Running Kinematics. Basic parameters: 18 years — 40 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The aim of this prospective, randomized, single-group interventional study is to use quantitative methods to investigate the acute effects of using lateral-wedge insoles on lower extremity biomechanics, muscle activation patterns, and knee adduction moment during walking and running activities in healthy individuals aged 18-40. The primary research questions it seeks to answer are as follows: * Do lateral wedge insoles cause a significant change in knee adduction moment? * Do lateral wedge insoles change lower extremity biomechanics during walking and running? * Do lateral wedge insoles change the activation patterns of lower extremity muscles during walking and running? To compare the effectiveness of lateral wedge insoles, participants will randomly use insoles with 0 (neutral), 5, and 10-degree angles. Participants will do the following: * Put on the shoes and insoles provided to you in the motion analysis laboratory and complete the walking and running protocols, each taking 1 minute, on the treadmill. * While walking at your normal walking speed, step so that your dominant leg is positioned over the force plate. * Repeat all of this for the insoles at the other two angles.
Detailed description
Lower extremity biomechanics plays a significant role in the balance of joint loads and muscle activation patterns during walking. Lateral wedge insoles are an orthotic intervention designed to both correct foot-ankle alignment and alter load distribution in the frontal plane at the knee joint. However, findings regarding the effects of these insoles on lower extremity kinematics, kinetics, and muscle activation patterns in healthy individuals are limited.
The aim of this study is to investigate the acute effects of using lateral wedge insoles on knee adduction moment, lower extremity biomechanics, and muscle activation levels in healthy individuals. The study will utilize a three-dimensional motion analysis system, a force platform, and surface electromyography (EMG). Participants will undergo walking and running tests under three different conditions in a randomized order: a 0° neutral insole, a 5° inclined lateral wedge insole, and a 10° inclined lateral wedge insole.
The data obtained aim to elucidate changes in mechanical loading and muscle activation associated with lateral wedge insoles, thereby strengthening the biomechanical foundations of design principles in insole prescription. Additionally, the reference data obtained from healthy individuals may provide a scientific basis for personalized insole design and rehabilitation protocols applicable to conditions such as knee osteoarthritis in future stages.
Interventions
- Device 3D Movement Analysis
Qualysis optoelectronic motion capture system (Gothenburg, Sweden) with 8 high-speed cameras will be used to record kinematic data at 2000 Hz. 32 reflective markers will be placed on anatomical landmarks. For the walking test, the participant will be asked to walk on a treadmill at a speed of 4 km/h on a 0° incline for 1 minute. For the running test, the participant will be asked to run at a speed of 8 km/h on a 0° incline for 1 minute. During walk and run, the following parameters will be mea - Device Force Plate
An integrated force plate device (BERTEC FP4060, ABD) will be used to measure ground reaction forces (GRF) at 1200Hz to calculate joint moments through inverse dynamics. The knee adduction moment will be calculated in Newton-meters (Nm) as the product of the GRF's horizontal force and the length of the moment arm. The highest value of the knee adduction moment during walking will be recorded as the 'peak knee adduction moment' (pKAM). - Device Electromyography (EMG)
The study will evaluate how EMG values change during walking and running protocols when the participant uses insoles. The Noraxon Ultium EMG (Noraxon, USA) device will be used for this purpose. The selection, localization, and application method of the electrodes to be used in surface EMG will be carried out in accordance with the recommendations of the Surface EMG for Non-invasive Muscle Assessment (SENIAM) guidelines. For EMG, wireless surface electrodes will be placed on the semimembranosus,
Primary outcome measures
- Peak External Knee Adduction Moment (Peak KAM) [Time frame: İmmediately after the intervention (In every insole intervention)]
Secondary outcome measures (2)
- Lower Extremity Joint Kinematics [Time frame: İmmediately after the intervention (In every insole intervention)]
- Muscle Activation [Time frame: İmmediately after the intervention (In every insole intervention)]
Eligibility criteria
Inclusion criteria
- Being able to walk and run 10 meters without assistance
- Not having sustained any injury to the lower extremities, pelvis, or trunk within the past 12 months
- Not having received any treatment for the lower extremities, pelvis, or trunk within the past 6 months
- Shoe size must be between EU 36 (22 cm) and EU 45 (28 cm) according to European Union (EU) standards
- Must have scored between 0 and +5 on the Foot Posture Index scale for both feet
- Have scored between 0 and 20 on the Revised Foot Function Index questionnaire
- Have a body mass index (BMI) between 18 and 25 kg/m²
Exclusion criteria
- Having cognitive impairment, vision or hearing problems, or a systemic disease that could affect overall health
- Having deformities, contractures, or any other abnormalities in the trunk or lower extremities that could affect participation
- Having a diagnosed foot or ankle deformity (e.g., pes planus, pes cavus, hallux valgus, etc.)
- Having any neurological or muscular disorder
- Being an active professional athlete
- Failure to sign the informed consent form
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Crossover
- Masking
- Double blind
- Primary purpose
- Basic science
Study locations
Turkey (Türkiye) · 2 centers
- Laboratories of the Center for Applied Sports Sciences and Research — Erzurum
- Laboratories of the Center for Applied Sports Sciences and Research — Erzurum
Publications
- Yagci G, Erel S, Okunakol V. Validation of the Turkish version of the Revised Foot Function Index for patients with foot and ankle disorders. Foot Ankle Surg. 2020 Aug;26(6):624-629. doi: 10.1016/j.fas.2019.08.002. Epub 2019 Aug 12. PMID 31431327
- Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol). 2006 Jan;21(1):89-98. doi: 10.1016/j.clinbiomech.2005.08.002. Epub 2005 Sep 21. PMID 16182419
- Brandon SCE, Brown MJ, Clouthier AL, Campbell A, Richards JD, Deluzio KJ. Contributions of muscles and external forces to medial knee load reduction due to osteoarthritis braces. Knee. 2019 Jun;26(3):564-577. doi: 10.1016/j.knee.2019.04.006. Epub 2019 May 14. PMID 31097362
- Souza TR, Pinto RZ, Trede RG, Kirkwood RN, Pertence AE, Fonseca ST. Late rearfoot eversion and lower-limb internal rotation caused by changes in the interaction between forefoot and support surface. J Am Podiatr Med Assoc. 2009 Nov-Dec;99(6):503-11. doi: 10.7547/0990503. PMID 19917736
- Edo M, Nishizawa G, Matsumura Y, Nemoto N, Yotsumoto N, Kojima S. The Relationship Between the Effects of Lateral Wedge Insoles and Kinematic Chain Dynamics Between the Hindfoot and Lower Leg in Patients With Osteoarthritis of the Knee. Cureus. 2023 Apr 15;15(4):e37624. doi: 10.7759/cureus.37624. eCollection 2023 Apr. PMID 37200635
- Ulrich B, Hoffmann L, Jolles BM, Favre J. Changes in ambulatory knee adduction moment with lateral wedge insoles differ with respect to the natural foot progression angle. J Biomech. 2020 Apr 16;103:109655. doi: 10.1016/j.jbiomech.2020.109655. Epub 2020 Jan 24. PMID 32057444
- Cain LE, Nicholson LL, Adams RD, Burns J. Foot morphology and foot/ankle injury in indoor football. J Sci Med Sport. 2007 Oct;10(5):311-9. doi: 10.1016/j.jsams.2006.07.012. Epub 2006 Sep 1. PMID 16949867
- Budiman-Mak E, Conrad KJ, Mazza J, Stuck RM. A review of the foot function index and the foot function index - revised. J Foot Ankle Res. 2013 Feb 1;6(1):5. doi: 10.1186/1757-1146-6-5. PMID 23369667
Identifiers
NCT: NCT07639411 · AnkaraYBU2026-1/10 · TDK-2026-2976