| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 106 === Background: Hiking becomes one of more popular activities in Taiwan. There is lots of hiking trails you can enjoy. Recently studies had reported that ascending and descending the stair in hiking led to some situations of knee degeneration or painful knee we may ignored. According the degenerative knee mostly happened in elder women with knee varus deformities, the worse will become knee osteoarthritis or patellofemoral pain syndrome. It will increase the level of knee degeneration if you take NSAIDs to mask the knee pain. However, conservative treatment could delay the level of knee degeneration and reduce the knee adduction movement (Clausen 2014). The conservative treatments include exercises, gait pattern change, walking aid, or real-time biofeedback. The limitation of previous studies were 1) lack of comparison studies between health group and mild knee OA group, 2) lack of long-term effect studies, 3) less real-time biofeedback investigation studies. Purposes: To investigate effects of orthotic insoles and trekking poles on hiking biomechanics in patients with mild degenerative knee osteoarthritis. Methods: This study divided into two parts: 1) a cross-section design to find difference data from VICON motion analysis and AMT force plates between experimental and control group and 2) one group repeated measurement and quasi-experiment design to find immediately effects by using orthotic insole or trekking pole. We will recruit forty participates to 1) orthotic insole group (intervention group) and 2) health group (control group), range of age from forty to seventy-five years old. They will participate voluntarily by pamphlet in communities or mountaineering club and receive Lequesne Index questionnaire, who get the total score 0 is to be control group, however, if they get total score between 1 and 4 is to be experiment group. This study is a one group pretest-posttest quasi-experimental design. Subjects with Knee osteoarthritis related lower extremity pain of study will receive orthotic insole from the foot to knee. Outcome will be evaluated by visual analog scale (VAS) and for pain and WOMAC, as well as kinematic investigations. Result: There had less range of motion, and found that was varus angle in forefoot and rarefoot in experiment group with knee OA. In the knee adduction moment, climbing up one step with orthotic insoles and trekking poles could decrease 5.12% and 15.25% in the first and second peak. Besides, climbing down on step with trekking poles could decrease 6.38% and 11.48% in the first and second peak. Moreover, climbing down on step with orthotic insoles and trekking poles could decrease 6.9% and 17% in the first and second peak. Conclusion: Using the orthotic and bilateral trekking poles in patients with mild degenerative knee OA can decrease knee adduction moment in up/down step climbing effectively.
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