在現今的社會中，由於科技的日新月異促使了醫療技術的提升速度也跟隨突飛猛進。在台灣走進高齡化的社會後，花費在老年人身上的醫療資源也不斷的增加當中，而在老年人常發生的疾病中退化性膝關節炎的病患在醫療資源的使用上更佔了明顯之比例。在臨床上常見的治療方式有服用非類固醇類之消炎藥、注射藥物、使用相關輔具等，另外還可以進行侵入式的外科手術修補或是置換人工膝關節，然而在使用手術與藥物等治療方式外，醫療型鞋墊輔具已經慢慢成為受歡迎的非侵入治療方法之一。此類具有功能性的鞋墊輔具器材，該具備了幾何外型設計與鞋材特性選擇等，來因應其足底壓力與解剖曲度的臨床需求，藉以調整人體步態使得足、踝與膝關節相關組織的受力狀況因此而改善。本研究使用模組化楔型鞋墊和客製化楔型鞋墊兩種楔型鞋墊來作為研究方向。研究方法在模組化楔型鞋墊方面而言，本研究將先了解受測者的足壓分布情況後，來選擇適合其足部的模組化楔型鞋墊，並讓受測者進行立即、一個月、三個月穿鞋墊後，進行相關數據蒐集。數據蒐集內容包含WOMAC與Lequesne’s問卷評估、足型足壓量測及行為活動疼痛困難測試。最後進行統計分析比較，以瞭解模組化鞋墊改善病患之疼痛的有效性與其生物力學的影響。另外在客製化楔型鞋墊方面，我們將先依受測者足底構造訂做出專屬於其足型的楔型鞋墊，並利用三維的紅外線動作擷取系統及問卷評估、足型足壓量測，來瞭解穿了客製化楔型鞋後對於其生物力學的影響。結果顯示，模組化楔型鞋墊在經過長期穿著後，在第一次腳雙支撐站立期，不論有穿或沒穿鞋墊後跟內外側足壓都有顯著下降，且不論在那個時間點，穿模組化楔行鞋墊之平均壓力皆顯著小於赤足之平均壓力。在單腳支撐站立期，不論有穿或沒穿鞋墊後跟內外側足壓都有顯著下降，且不論在那個時間點，穿模組化楔行鞋墊之平均壓力皆顯著小於赤足之平均壓力，然而在中足，雖然不論有穿或沒穿鞋墊內外側足壓都有顯著下降，但是此區域已無看到鞋墊的效應。客製化楔型鞋墊，在足壓的部分五雙鞋墊與赤足差異都不大，但在動作分析量測部分在地面反作用力部分，在發現患側與健側都發現了特徵峰值，可是在穿著鞋墊後特徵峰值都消失了，所以不管患側與健側都因該繼續穿著鞋墊阻止膝關節繼續退化。

In the aging society, it has been increasing expenditure of the health care in the elderly. Osteoarthritis (OA) knee is a commonly seen disorder in the elderly. Clinical treatments for knee OA include nonsteroidal anti-inflammatory drug, medicine injection, orthotic devices, and even invasive surgical repair or total knee arthroplasty, in which the insole orthotic has become one of the most popular non-invasive treatment methods. Since the increase comfort of insole is of clinical needs, considering the geometric characteristics of the exterior design in the selection of insole may help to cope with the anatomical curvature of patients’ feet and thus well distribute plantar pressure, which may further improve the gait pattern in patients with knee OA. Current study investigated the effect of two kind’s orthotic devices, namely modulized lateral wedge insoles and individualized wedge insoles, on the distribution of foot pressure during level walking. Pain assessment questionnaires as well as difficulties in various functional tests were also evaluated. Statistical analysis was further performed to understand the impact of modular insole at baseline, and changes at 1 and 3 months follow-up. The results showed that during the loading response and single limb support phase of level walking, the mean plantar pressure and medial and lateral side of the heel decreased with increasing wearing duration both during barefoot and insole condition. In addition, at all evaluation time points, lower mean pressures at heel area were found in insole condition. However, no wedge effect were found around the mid-foot areas.。For the individualized wedge insole, no significant difference in plantar pressure was found among the wedged condition. Although greater peak ground reaction force and its loading rate were found this patient with knee OA, this harmful peak disappeared during all the insole conditions.

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