Abstract：
This study aimed to identify the clinical and biomechanical factors of subjects with excessive foot pronation who are not responsive (i.e., \"non-responders\") to medially wedged insoles to increase knee adduction external moment. Ankle dorsiflexion range of motion, forefoot-shank alignment, passive hip stiffness, and midfoot passive resistance of 25 adults with excessive bilateral pronation were measured. Also, lower-limb angles and external moments were computed during walking with the participants using control (flat surface) and intervention insoles (arch support and 6° medial heel wedge). A comparison between \"responders\" (n = 34) and \"non-responders\" (n = 11) was conducted using discrete and continuous analyses. Compared with the responders, the non-responders had smaller forefoot varus (p = 0.014), larger midfoot passive internal torque peak (p = 0.005), and stiffness measured by the torsimeter (p = 0.022). During walking, non-responders had lower angle peaks for forefoot eversion (p = 0.001), external forefoot rotation (p = 0.037), rearfoot eversion (p = 0.022), knee adduction (p = 0.045), and external hip rotation (p = 0.022) and higher hip internal rotation angle peak (p = 0.026). Participants with small forefoot varus alignment, large midfoot passive internal torque, stiffness, small knee valgus, hip rotated internally, and foot-toed-in during walking did not modify the external knee adduction moment (\"non-responders\"). Clinicians are advised to interpret these findings with caution when considering the prescription of insoles. Further investigation is warranted to fully comprehend the response to insole interventions among individuals with specific pathologies, such as patellofemoral pain and knee osteoarthritis (OA).
摘要：
本研究旨在确定足部过度内旋无反应的受试者的临床和生物力学因素(即，\“无响应者\”）内侧楔入鞋垫以增加膝盖内收外部力矩。踝关节背屈运动范围,前脚-小腿对齐，被动髋关节僵硬,并测量了25例双侧内旋过度的成年人的中足被动阻力。此外，使用对照(平坦表面)和干预鞋垫(足弓支撑和后跟内侧6°楔形)计算参与者行走期间的下肢角度和外部力矩.使用离散和连续分析进行“响应者”（n=34）和“非响应者”（n=11）之间的比较。与响应者相比，无反应者的前脚内翻较小（p=0.014），较大的中足被动内部扭矩峰值（p=0.005），和由扭转计测量的刚度(p=0.022)。在行走过程中,无应答者前足外翻的角度峰较低(p=0.001)，前脚外部旋转（p=0.037），后足外翻(p=0.022),膝关节内收（p=0.045），和外髋旋转（p=0.022）和较高的髋内旋转角度峰值（p=0.026）。小前足内翻对齐的参与者，大的中足被动内部扭矩，刚度,膝盖小外翻，髋部内部旋转，行走过程中的足趾没有改变外部膝盖内收力矩（“无响应者”）。建议临床医生在考虑鞋垫处方时谨慎解释这些发现。进一步的调查是必要的，以充分了解的反应鞋垫干预的个体与特定的病理，如髌股疼痛和膝骨关节炎（OA）。
