Rehabilitation Effect And Biomechanical Analysis Of Orthopedic Insole On Patellofemoral Pain Syndrome

Purpose: To investigate the influence of orthopedic insole on subjective perception of pain,knee function,foot pressure,lower limb muscle function in patients with patellofemoral pain syndrome and to analyze the biomechanical mechanism.Methods: 20 subjects(9men,11women)with patellofemoral pain syndrome were randomly divided into blank control group(n=10)and experimental group(orthopedic insole group,n=10).During the 12-week experimental period,subjects in the blank control group did not do any experimental intervention,and subjects in the experimental group wore customized orthopedic insoles.All subjects in the two groups maintain previous life,diet and exercise habits during the experiment.However,other rehabilitation treatment and training will not be carried out on all subjects during the experiment.Before the start of experiment and after the end of 12-week experiment,the ICB plantar pressure test treadmill was used to measure the plantar pressure of all subjects in the static standing state,and the surface electromyography system was used to collect the lower extremity surface EMG data in the walking state.The infrared light point high-speed motion capture system is used to measure the joint angle of each joint of the lower limbs.The score of Visual Analogue Scale(VAS)and Japanese Orthopaedic Association score(JOA)of knee joint function were tested before and after the intervention.Result: After 12-week experimental intervention,no significant difference was observed for the score of VAS and JOA in the blank control group(p>0.05);There was a significant reduction in subjective pain scores in the experimental group(p<0.01);and there was a significant improvement in the JOA knee function score(p<0.01).Under the static standing state,the date of plantar pressure in the blank control group and the experimental group were not significantly different from those before the experiment(p<0.05).Under the walking state,there was no significant difference in the root mean square amplitude and neuromuscular ration of the vastus medialis oblique and the vastus lateralis,and no different significance was observed in the limb joint motion angle of the blank control group(p>0.05).The root mean square amplitude of the vastus medialis oblique of lower limb of the experimental group was significantly higher than that before the intervention(p<0.05),but there was no significant change in the vastus lateralis of lower limb(p>0.05);The neuromuscular ratio of the vastus medialis oblique and the vastus lateralis in the right lower limb of the experimental group was significantly different from that before the intervention(p <0.05),and there was no significant change in the left limb(p>0.05).The joint motion angles of the lower limb of the experimental group were significantly changed after the intervention(p<0.05).Conclusion:(1)Orthopedic insole has a good rehabilitation intervention effect on pain level and knee function in patients with patellofemoral pain syndrome.(2)Orthopedic insole has no effect on plantar pressure and lower limb static stability in patients with patellofemoral pain syndrome.(3)Orthopedic insole can effectively improve the recruitment ability of the vastus medialis oblique in patients with patellofemoral pain syndrome,and can promote the balance of the patellofemoral joints(4)Long-term wear of orthopedic insole improves symptoms of patellofemoral pain syndrome by reducing the angle of internal femoral rotation and the degree of foot valgus in patients with patellofemoral pain syndrome.