Ashfaq Ahmad, Arooj Munawar, Muhammad Kamran Hanif, Ishaq Ahmed.
Study of the lateral raise in foot wear for the management of medial compartment degenerative joint disease of knee.
Ann King Edward Med Uni Jan ;20(2):104-12.

Background: A wide spread disease, which may lead the patient to severe outcomes e.g. pain, loss of joint motion, inflexibility and even disability, is Knee osteoarthritis (OA). It is most common among adults of older age and should not be ignored at all. Literature does not show any clear pathogenesis for occurrence of Knee OA, but most of the indications point toward biomechanical stresses which may influence the articular cartilage and sub chondral bone. Objective: The Aim of this study is to become aware of the effects of physical therapy with and without laterally raised footwear in the management of medial knee osteoarthritis. Methodology: We have used experimental comparative study in 35 patients which were randomly selected from Department of Physiotherapy, Fatima Memorial Hospital, Shadman, Lahore. The study consisted of 2 groups, Group I (Experimental Group): In experimental group, patients were treated with laterally raised foot wear and physical therapy both. Group II (Control Group): Whereas in control group patients were treated by physical therapy alone. Kellgren and Lawrence (KL) scale was used to assess radiograph of the knee joints after an anteroposterior weight-bearing standing. The assessment of disease in patients was done by using the Western Ontario and McMaster Universities (WOMAC) Index, Muscle flexibility, Muscle strengthening and Tolerance scales. Results: In group-I the mean age of patients observed was 59.52±13.66 years and 65±12.87 years in Group-II. In Group-I, 9 (52.9%) patients were males and 8 (47.1%) patients were females while in Group-II, 9 patients (50%) were male and 9 (50%) were female. In Group-I 2 (11.8%) patients used flat & open shoes, 6 (35.3%) used flat & close shoe, 3 (17.6%) patients used dress shoes and 2 (11.8%) used flat shoes. In Group-I, the frequency of patients wearing laterally raised foot wear in terms of duration was; 5 (29.4%) patients for 20 days, 4 (23.5%) for 24 days, 4 (23.5%) for 25 days, whilst 2 patients used it for 26 and 30 days respectively. Among 10 (58.8%) patients the use of lateral raised foot wear was intermittent wile in 7 (41.2%) patients the use of lateral raised foot wear was continuous. Overall Group-I presented better results compared to Group-II in this study. CONCLUSION: We have concluded in our study that the physical therapy with laterally raised footwear is a successful treatment in the management of medial knee OA. In laterally raised footwear the physical therapy is an effective method in terms of; relief of pain in patient, improvement in function by stiffness reduction and. this treatment method is recommended for the management of medial knee OA.

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