- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01342458
Effect of Footwear on the Clinical, Functional, and Biomechanical Aspects in Elderly Women With Knee Osteoarthritis (OA) (OA)
January 11, 2015 updated by: Francis Trombini, University of Sao Paulo General Hospital
Therapeutic Effect of Inexpensive, Flexible and Non-heeled Footwear on the Clinical, Functional and Gait Biomechanics in Elderly Women With Knee Osteoarthritis: a Randomized Clinical Trial
The purpose of this study is to determine whether inexpensive, flexible and non-heeled footwear is effective in improving of clinical, functional and gait biomechanics in elderly women with knee osteoarthritis.
Study Overview
Detailed Description
- The clinical and functional aspects will be evaluated using a visual analogue scale (VAS) for pain, Western Ontario and McMaster Universities (WOMAC) and Lequesne questionnaires of quality of life in patients with knee osteoarthritis and testing of six-minute walk (6MWT).
- Biomechanical analysis of gait will be performed by infrared cameras and a force platform. From the data of kinematics and kinetics, will be calculated moments of the knee joint strength by inverse dynamics.
The process (steps) will be divided as follows:
- step 1, in this step there will be sorting and initial assessment of potential participants; pain will be evaluated through VAS, function and quality of life by means of questionnaires WOMAC and Lequesne and the 6MWT, and by evaluating the biomechanics of gait.
- step 2,(3 month follow-up), both groups will be evaluated again by the VAS and WOMAC and Lequesne questionnaires.
- step 3, after 6 months of starting the monitoring process, both groups will be reevaluated through the VAS, WOMAC, Lequesne, 6MWT and biomechanical analysis of gait. This step is the final evaluation, characterizing the end of intervention.
Study Type
Interventional
Enrollment (Actual)
56
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Sao Paulo, Brazil
- University of Sao Paulo General Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
60 years to 80 years (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Kellgren and Lawrence grade 2 or 3
- Being able to walk independently for at least 6 hours per day without the aid of canes or attendant to perform their activities of daily living
- Knee pain between 3 and 8 on the visual analogue scale
Exclusion Criteria:
- Previous history of surgery on knees, ankles and hips in the last 2 years
- Neurological disease
- BMI > 35 kg/m2
- Difference in lower limb length > 1 cm
- Prostheses and / or lower limb orthoses
- Having received steroid injections and hyaluronic acid intra-articular knee in previous periods of three and six months respectively
- Present at the knee joint instability (positive test results in the medial collateral ligament, lateral, anterior and posterior drawer)
- OA of the hip and / or ankle incapacitating or diagnosed OA in lower limbs and spine
- Inflammatory arthritis (eg. rheumatoid arthritis)
- Asymptomatic OA of one or both knees
- Dementia or inability to provide consistent information
- Introduction of Nonsteroidal Anti-inflammatory Drugs and analgesic medications 8 weeks before inclusion or change of dosage of the same after the inclusion
- Being under physiotherapy or acupuncture treatment
- Patients with an indication of prosthesis or orthosis
- Patients who are already using a flexible and non-heeled shoes for more than 25 hours per week (3 ½ hours per day) over the past 6 months
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: Intervention Group
Daily use of the intervention Flexible footwear (Moleca®) for 6 months, for at least 42 hours/week (approximately 6 hours/day, 7 days/week).
The Moleca® shoe (Calçados Beira Rio S.A., Novo Hamburgo, Rio Grande do Sul, Brazil) is a low-cost women's double canvas, flexible, flat, walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm flat insole of ethylene vinyl acetate that provides only protection but no correction.
The mean weight of the shoe is 0.172±0.019
kg (range 0.091 to 0.182 kg), depending on size.
This minimalist footwear is commonly worn by the elderly of all social classes and its average cost is US$ 6.25.
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The patients of the Intervention Group (IG) will be use over 6 month a flexible and non-heeled footwear (Moleca; Calçados Beira Rio S.A., Novo Hamburgo, Rio Grande do Sul, Brazil) is a women's flexible flat walking shoe, without heels, with an anti-slip rubber sole, 5-mm thin, with a 3 mm internal wedge of ethylene vinyl acetate, made out of dubbed canvas.
It had a mean weight of 172 ± 19.6 g, ranging from 142 to 193 g depending upon the size.
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NO_INTERVENTION: Control Group
During the intervention period, patients from the Control Group (CG) were instructed not to wear Flexible footwear (Moleca®) or other similar minimalist footwear.
During everyday activities, the CG group was only permitted to wear a standard, neutral tennis shoe.
At the end of the intervention period, all CG participants also received one pair of Moleca® shoes at no cost.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Western Ontario and McMaster Universities (WOMAC) Pain Subscale
Time Frame: 6 month
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The WOMAC (Western Ontario and McMaster Universities) pain subscale consists of five questions (Likert Scale) relating to the patient's pain in everyday situations.
The Likert Scale version used for all WOMAC items are: none, mild, moderate, severe, and extreme.
The sum of all items of pain subscale ranges from 0 to 20.
Higher scores indicate worse pain.
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6 month
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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WOMAC Stiffness Subscale
Time Frame: 6 month
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The stiffness subscale included in the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) index consists of two questions (Likert Scale) relating articular function of the patient.
The Likert Scale version used for all WOMAC items are: none, mild, moderate, severe, and extreme.
The sum of all items of the stiffness subscale ranges from 0 to 8. Higher scores on the stiffness WOMAC subscale indicate worse articular function.
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6 month
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WOMAC Physical Function Subscale
Time Frame: 6 month
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The physical function subscale included in the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) index consists of seventeen questions (Likert Scale) relating to the patient's physical activities, or skills to move out and take care of themselves.
The Likert Scale version used for all WOMAC items are: none, mild, moderate, severe, and extreme.
The sum of all items of physical function subscale ranges from 0 to 68.
Higher scores on the physical function WOMAC subscale indicate worse functional limitations.
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6 month
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WOMAC Total Score
Time Frame: 6 month
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The WOMAC total score is the sum of all subscale (pain, function and stiffness) (Likert Scale) relating to the patient's physical activities, or skills to move out and take care of themselves.
The Likert Scale version used for all WOMAC items are: none, mild, moderate, severe, and extreme.
The sum of all items ranges from 0 to 96.
Higher scores on the WOMAC total score indicate worse condition.
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6 month
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Global Score of the Lequesne´s Questionaire Algo-functional.
Time Frame: 6 month
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This questionaire consists of three sections (eleven questions): about pain or discomfort, the maximum distance that the patient can walk, and activities of daily living.
Scores range from zero to twenty-four, meaning cases without involvement and with extremely severe impairment, respectively.
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6 month
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Six-minute Walk Test
Time Frame: 6 month
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The six-minute walk test assesses distance in meters walked over 6 minutes.
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6 month
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First Peak of the Knee Adduction Moment (KAM) During Gait.
Time Frame: 6 month
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The first peak of the external knee moment was calculated by mean inverse dynamics approach.
To this procedure, we used the kinematics data of the lower limbs assessed with six infrared cameras and the ground reaction force evaluated by mean a force platform.
This is a continuous measure.
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6 month
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Paracetamol Intake
Time Frame: 6 month
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Paracetamol intake (500 mg), number of tablets per month.
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6 month
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Isabel CN Sacco, PhD, Department of Physical therapy, Speech, and Occupational Therapy, School of Medicine, University of Sao Paulo
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Trombini-Souza F, Fuller R, Goldenstein-Schainberg C, Sacco ICN. Long-term use of minimal footwear in older adult women with knee osteoarthritis: Mechanisms of action in the knee adduction moment. J Biomech. 2020 Jul 17;108:109885. doi: 10.1016/j.jbiomech.2020.109885. Epub 2020 Jun 13.
- Trombini-Souza F, Matias AB, Yokota M, Butugan MK, Goldenstein-Schainberg C, Fuller R, Sacco IC. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial. Clin Biomech (Bristol, Avon). 2015 Dec;30(10):1194-201. doi: 10.1016/j.clinbiomech.2015.08.004. Epub 2015 Aug 14.
- Trombini-Souza F, Fuller R, Matias A, Yokota M, Butugan M, Goldenstein-Schainberg C, Sacco IC. Effectiveness of a long-term use of a minimalist footwear versus habitual shoe on pain, function and mechanical loads in knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord. 2012 Jul 12;13:121. doi: 10.1186/1471-2474-13-121.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
March 1, 2011
Primary Completion (ACTUAL)
June 1, 2013
Study Completion (ACTUAL)
June 1, 2013
Study Registration Dates
First Submitted
April 20, 2011
First Submitted That Met QC Criteria
April 25, 2011
First Posted (ESTIMATE)
April 27, 2011
Study Record Updates
Last Update Posted (ESTIMATE)
January 26, 2015
Last Update Submitted That Met QC Criteria
January 11, 2015
Last Verified
January 1, 2015
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- LABIMPH_OA2
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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