Biomechanical Footwear for Osteoarthritic Knee Pain —Reply

In Reply Dr Lei and colleagues correctly state that the positioning of the external pods of the biomechanical footwear in our trial was individually adjusted. The treatment protocol for adjusting the pods was described in detail in Supplement 3 in the article. This is considerably more detail than most physical therapy or exercise intervention trials provide. Adjustments were done according to this protocol by experienced and trained technicians based on gait patterns and patient-reported symptoms. The attempt to shift the center of pressure in the shoe and foot laterally in patients with medial knee osteoarthritis has been a central principle of most shoe modifications and wedge insoles tested for medial knee osteoarthritis. Independent groups aiming to replicate our findings should follow the treatment protocol but will additionally need to ensure appropriate training of therapists by the manufacturer of the footwear.
Source: JAMA - Category: General Medicine Source Type: research