***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background There is controversial evidence regarding whether foot orthoses or knee braces improve pain and function or correct malalignment in selected patients with osteoarthritis ( OA ) of the medial knee compartment . However , insoles are safe and less costly than knee bracing if they relieve pain or improve function . Questions / purpose sWe therefore asked whether laterally wedged insoles or valgus braces would reduce pain , enhance functional scores , and correct varus malalignment comparable to knee braces . Patients and Methods We prospect ively enrolled 91 patients with symptomatic medial compartmental knee OA and r and omized to treatment with either a  10-mm laterally wedged insole  ( index group , n = 45 ) or a valgus brace ( control group , n = 46 ) . All patients were assessed at 6 months . The primary outcome measure was pain severity as measured on a visual analog scale . Secondary outcome measures were knee function score using WOMAC and correction of varus alignment on AP whole-leg radiographs taken with the patient in the st and ing position . Additionally , we compared the percentage of responders according to the OMERACT-OARSI criteria for both groups . Results We observed no differences in pain or WOMAC scores between the two groups . Neither device achieved correction of knee varus malalignment in the frontal plane . According to the OMERACT-OARSI criteria , 17 % of our patients responded to the allocated intervention . Patients in the insole group complied better with their intervention . Although subgroup analysis results should be translated into practice cautiously , we observed a slightly higher percentage of responders for the insole compared with bracing for patients with mild medial OA . Conclusions Our data suggest a laterally wedged insole may be an alternative to valgus bracing for noninvasively treating symptoms of medial knee OA.Level of Evidence Level I , therapeutic study . See the Guidelines for Authors for a complete description of level of evidence OBJECTIVE To investigate the clinical efficacy of the Generation II ( G II ) knee brace , a newly developed knee orthosis , on patients experiencing severe medial compartment osteoarthritis ( OA ) of the knee . DESIGN Case series . SETTING A national medical and pharmaceutical hospital in Japan . PATIENTS Twenty primary OA subjects ( excluding those with secondary OA ) , all older than 55 years of age and experiencing only knee joint problems , were selected according to their ability to walk more than 500 meters independent of support . These patients had arthritis in both knees and no less than one half of normal joint space remaining as revealed by roentgenogram studies . The more severely affected side was selected for bracing . INTERVENTIONS For 12 months , each patient wore a G II knee brace on the affected knee on a daily basis , removing it only at night . To evaluate the effects of G II OA brace alone , additional use of new oral drugs or any other treatment was prohibited from 1 month before application of the G II OA brace and throughout the trial period . MAIN OUTCOME MEASURES Clinical efficacy was evaluated using the Japan Orthopaedic Association 's knee scoring system . X-ray evaluation was performed with patients st and ing on one leg . A dynamometer was used to evaluate isokinetic quadriceps muscle strength . The center of gravity was measured using an X-Y recording . Clinical evaluation was performed every 2 months thereafter . Final evaluation was at 12 months . RESULTS Nineteen of the 20 patients answered that they experienced significant pain relief . Knee pain scores on walking increased from 18.0 to 21.5 and on ascending and descending stairs increased from 12.8 to 15.8 . The femorotibial angle decreased in 12 of the patients , and the mean angle decreased from 185.1 degrees before application to 183.7 degrees with the brace on at the final observation period . In addition , isokinetic quadriceps muscle strength increased from an average of 36.8 Nm to 42.8 Nm for all patients . In 17 patients , quadriceps muscle strength increased , while it decreased in 2 and remained the same in 1 . Finally , lateral movement of the center of gravity decreased compared with before G II application in all patients . CONCLUSION G II bracing is a beneficial treatment for severe medial OA of the knee OBJECTIVE To assess the radiographic and symptomatic effects of treating patients with medial compartment osteoarthritis ( OA ) of the knee with laterally wedged insoles with subtalar strapping of varying elevations . DESIGN Prospect i ve quasi-experimental evaluation . SETTING Outpatient clinic in Japan . PARTICIPANTS Sixty-two women out patients with knee OA who were r and omized into 3 groups according to their birth date s and wedge elevation . INTERVENTIONS Participants wore laterally wedged insoles with subtalar strapping with elevations of 8 , 12 , or 16 mm for 2 weeks . MAIN OUTCOME MEASURES St and ing radiographs were used to analyze the femorotibial angle for each subject , both with and without their respective unilateral insoles . The remission scores of the Lequesne index of severity for knee OA were compared among the 3 groups at the conclusion . Participants were asked to report adverse effects on use of the insoles . RESULTS The 16-mm group ( n=21 ) showed a significantly greater valgus correction of the femorotibial angle than the 8-mm group ( n=20 ) ( P=.013 ) . The remission score was significantly improved in the 12-mm group ( n=21 ) compared with the 16-mm group ( P=.029 ) . Adverse effects were more common in the 16-mm group ( 9/21 , 42.8 % ) than in the 12-mm ( 3/21 , 14.3 % ) or 8-mm ( 2/20 , 10 % ) groups . CONCLUSIONS The degree of change in femorotibial angle with the insole with subtalar strapping was affected by the tilt of the lateral wedge . For constant routine use , the 8- or 12-mm elevation wedged insoles with subtalar strapping may be more comfortable and effective than the 16-mm elevation wedge PURPOSE The purpose s of this study were to assess a ) the effectiveness of Masai Barefoot Technology ( MBT ) shoe in reducing  knee pain in persons with knee osteoarthritis ( OA ) and ( b ) changes in balance , ankle and knee ROM , and ankle strength compared with a high-end walking shoe for 12 wk . METHODS The research design was a r and omized controlled trial ( 123 subjects , knee OA ) . Subjects were r and omized to a MBT ( N = 57 ) or a control shoe ( N = 66 ) . A Western Ontario and McMaster Universities ( WOMAC ) OA index , BMI , balance , active ROM , and ankle torque were quantified at week 0 , 3 , 6 , 9 , and 12 . Two- sample t-tests were done for between-group comparisons . RESULTS There was no significant difference between groups in total pain score . A significant reduction over the 12-wk period was found for both shoe conditions ( -42/500 or 25.6 % MBT , -46.2 or 27.1 % control ) . There was no significant group difference in pain during walking ( t = -1.09 , P = 0.28 ) . Pain during walking was significantly reduced by 5.2/100 mm in the MBT and 9.7/100 mm in the control group . Total pain showed a significant reduction for the MBT -27.4/500 ( -16.6 % ) and the control group -28.9/500 ( -17.0 % ) between baseline and week 3 . Between week 3 and 6 , there was a significant reduction for the MBT group only ( -27.2/500 or -20.0 % ) . There was a significant increase in the static balance between baseline and 12 wk in the MBT group only , although the difference between groups was not significant . DISCUSSION The results indicate that special shoe interventions can reduce pain in subjects with moderate knee OA We examined if a subject-specific amount of lateral wedge added to a foot orthosis could alter knee mechanics to potentially reduce the progression of knee osteoarthritis in patients with medial knee osteoarthritis . Twenty individuals with medial knee osteoarthritis ( > /=2 Kellgren Lawrence grade ) were prescribed a custom laterally wedged foot orthotic device . The prescribed wedge amount was the minimal wedge amount that provided the maximum amount of pain reduction during a lateral step-down test . Following an accommodation period , all subjects returned to the laboratory for a gait analysis . Knee mechanics were collected as the subjects walked at an intentional walking speed . Walking in the laterally wedged orthotic device significantly reduced the peak adduction moment during early stance ( p < 0.01 ) compared to the nonwedged device . Similarly , the wedged orthotic device significantly reduced the knee adduction excursion from heel strike to peak adduction ( p < 0.01 ) compared to the nonwedged device . No differences in the peak adduction moment during propulsion or peak adduction during stance were observed between the orthotic conditions . A subject-specific laterally wedged orthotic device was able to reduce the peak knee adduction moment during early stance , which is thought to be associated with the progression of knee osteoarthritis . Previous studies on this device have reported issues associated with foot discomfort when using wedge amounts > 7 degrees ; however , no such issues were reported in this study . Therefore , providing a custom laterally wedged orthotic device may potentially increase compliance while still potentially reducing disease progression Objective This study aim ed to determine whether the effect of laterally wedged insoles on the adduction moment in knee osteoarthritis ( OA ) declined after one month of wear , and whether higher reported use of insoles was associated with a reduced effect on the adduction moment at one month . Methods Twenty people with medial compartment OA underwent gait analysis in their own shoes wearing i ) no insoles and ; ii ) insoles wedged laterally 5 ° in r and om order .  Testing occurred at baseline and after one month of use of the insoles . Participants recorded daily use of insoles in a log-book . Outcomes were the first and second peak external knee adduction moment and the adduction angular impulse , compared across conditions and time with repeated measures general linear models . Correlations were obtained between total insole use and change in gait parameters with used insoles at one month , and change scores were compared between high and low users of insoles using general linear models . Results There was a significant main effect for condition , whereby insoles significantly reduced the adduction moment ( all p < 0.001 ) . However there was no significant main effect for time , nor was an interaction effect evident . No significant associations were observed between total insole use and change in gait parameters with used insoles at one month , nor was there a difference in effectiveness of insoles between high and low users of the insoles at this time . Conclusion Effects of laterally wedged insoles on the adduction moment do not appear to decline after one month of continuous use , suggesting that significant wedge degradation does not occur over the short-term OBJECTIVE To assess the effect of an insole with subtalar strapping on patients with medial compartment osteoarthritis ( OA ) of the knee . METHODS Novel lateral wedged insoles with elastic subtalar strapping ( the subtalar strapping support group ) and ankle supporters with a lateral wedged heel insert ( the sock-type ankle support group ) were prepared . Eighty-eight female out patients with knee OA were treated with 1 of the 2 insoles for 8 weeks . Femorotibial angle was assessed by st and ing radiographs with and without unilateral insole use for each subject . Symptoms of knee OA were evaluated according to the severity index of Lequesne et al at baseline and at the final assessment . RESULTS Participants wearing the insole with subtalar strapping ( n = 42 ) demonstrated significantly decreased femorotibial angle ( an average of change : -3.1 degrees + /- 2.5 degrees , P < 0.0001 ) , but a significant difference was not found in the sock-type ankle support group ( n = 46 ; -0.4 degrees + /- 1.1 degrees , P > 0.05 ) . In the subtalar strapping support group , pain during bed rest with full extension of the knee ( P < 0.0001 ) , pain after getting up ( P = 0.04 ) , pain on getting up from a seated position ( P = 0.021 ) , maximum distance walked ( P = 0.009 ) , and aggregate severity score ( P < 0.0001 ) were significantly improved compared with baseline . In contrast , significant symptomatic improvement was detected only in the aggregate score ( P = 0.016 ) in the sock-type ankle support group , but not in any of the 10 specific categories . CONCLUSION The lateral wedged insole with subtalar strapping induces correction of the femorotibial angle and symptomatic relief in patients with varus-deformity knee OA OBJECTIVES The goals of the study were to measure the force applied to the lateral side of the knee by a valgus loading brace design ed for patients with medial compartment osteoarthritis ( OA ) and to compare the varus moment at the knee during level gait with and without the brace . METHODS Five subjects diagnosed with medial compartment OA were fitted with a custom Monarch valgus loading knee brace . A 3-dimensional videobased motion analysis system and force plate information were used to calculate forces and moments at the knee . An instrumented condylar bladder was used to determine the force applied to the knee by the brace . The varus moments for the braced and unbraced 
    Output:
    
Results suggest that knee braces and foot orthoses are effective in decreasing pain , joint stiffness , and drug dosage .
They also improve proprioception , balance , Kellgren/Lawrence grading , and physical function scores in subjects with varus and valgus knee osteoarthritis .
Knee braces and foot orthoses could be cautiously considered as conservative management for relief of pain and stiffness and improving physical function for persons with knee osteoarthritis .