Evaluation of pain-reducing and relieving effect of the "Freestyle TM OA" knee orthosis in patients with medial knee arthrosis

Background:Patients suffering from mild-to-moderate medial compartment knee osteoarthritis may be treated with an unloader knee orthosis. However, compliance has been shown to be an issue with such devices.Objectives:The aim of this study was to identify the effects of a new design of knee unloader orthosis on specific gait parameters in patients with mild-to-moderate medial knee osteoarthritis.Methods:The gait of seven patients was assessed in two conditions: without an orthosis and when wearing a new design of unloader knee orthosis. Gait analysis was performed to determine alterations to the adduction moment, speed of walking, step length, cadence and knee sagittal plane range of motion during ambulation for the two test conditions.Results:The knee adduction moment was significantly reduced ( p = 0.001), and the speed of walking significantly increased ( p < 0.001) when wearing the orthosis. However, a reduction in knee range of motion ( p = 0.002) and an increase in step length ( p < 0.001) were observed with the orthosis donned. Cadence was not significantly altered ( p = 0.504).Conclusion:The use of a new design of unloader knee orthosis as a conservative treatment approach for patients with mild-to-moderate medial compartment osteoarthritis appears warranted.Clinical relevanceVarious conservative modalities have been used to reduce pain and improve function in medial compartment osteoarthritis. A new design of an unloader knee orthosis has been developed and is shown to have immediate benefits in patients with mild medial knee osteoarthritis.

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The Effects of Knee Orthosis with Two Degrees of Freedom Joint Design on Gait and Sit-to-Stand Task in Patients with Medial Knee Osteoarthritis

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.04.008 ◽

2020 ◽

Vol 20 (4) ◽

pp. e324-331

Author(s):

Siamak Aghajani Fesharaki ◽

Farzam Farahmand ◽

Hassan Saeedi ◽

Seyed Ahmad Raeissadat ◽

Ehsan Abdollahy ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Flexion ◽

Degrees Of Freedom ◽

Medial Knee ◽

Two Degrees Of Freedom ◽

Stand Test ◽

Joint Design ◽

Sit To Stand ◽

The One ◽

Knee Orthosis

Objectives: Knee bracing as a conservative treatment option for patients with medial knee osteoarthritis (KOA) is of great interest to health practitioners and patients alike. Optimal orthotic knee joint structure is essential to achieve biomechanical and clinical effectiveness. Therefore, this study aimed to identify the effects of a knee orthosis with a new two-degrees-of-freedom (DOF) joint design on selected gait parameters and in a sit-to-stand task in patients with mild-to-moderate medial KOA. Methods: This study was conducted both at the Physical Medicine and Rehabilitation Clinic in Shahid Modarres Academic Hospital and the Biomechanical Laboratory of Rehabilitation Faculty of Iran University of medical Sciences in Tehran, Iran from September 2015 to October 2017. The gait performance of 16 patients was assessed without an orthosis, using a common one-DOF (DOF) knee orthosis and using the same knee orthosis with a two-DOF orthotic joint design. The interactive shearing force between limb and brace in the shell area during a sit-to-stand test was also identified. Repeated measures analysis of variance was used to analyse the data. Results: Compared with walking with no orthosis, both orthosis conditions reduced the external knee adduction moment significantly (P ≤0.05). A significant increase between the one-DOF and two-DOF conditions in terms of walking speed (P = 0.041 and P = 0.009, respectively) and stride length (P = 0.028 and P = 0.038, respectively) was observed. In a sit-to-stand test, wearing the orthosis significantly decreased knee transverse plane range of motion (P ≤0.05). There was a 41.31 ± 8.34 Newtons reduction in knee flexion constraint force. Conclusion: The two-DOF knee orthosis was more comfortable compared to the one-DOF knee orthosis during deep knee flexion. Otherwise, the one- DOF- and two-DOF-braces performed similarly. Keywords: Knee Osteoarthritis; Orthosis; Braces; Gait Analysis; Rotations; Kinematics; Kinetics; Patient Comfort.

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Effect of Therapy Using Aquatic Treadmill on the Functional Status of Patients with Knee Arthrosis

Acta Balneologica ◽

10.36740/abal202001105 ◽

2020 ◽

Vol 62 (1) ◽

pp. 27-32 ◽

Cited By ~ 1

Author(s):

Agnieszka Maruszewska ◽

Lech Panasiuk ◽

Agnieszka Buczaj ◽

Anna Pecyna

Keyword(s):

Range Of Motion ◽

Perceived Exertion ◽

Treadmill Exercise ◽

Exercise Programme ◽

Locomotor System ◽

Lequesne Index ◽

Knee Arthrosis ◽

Index Of Severity ◽

And Function ◽

Aquatic Treadmill

Introduction: Arthrosis is considered as a disease of the whole locomotor system, which may be prevented and treated at early stages. Gonarthrosis develops gradually within 10-15 years, interfering with daily activities and capability for work. Aquatic exercises are considered as a potentially effective therapeutic intervention in persons with knee arthrosis. Aim: Assessment of the effectiveness of a 4-week aquatic treadmill exercise programme, with respect to the measurement of pain, balance, function, and mobility. Materials and Methods: The study covered 15 patients with gonarthrosis, using a 4-week cycle of exercises. The results of measurements included a visual-analogue scale for assessing pain, Time Up and Go (TUG) for balance, 6-meter walk test for mobility and Lequesne index for function. The exercise protocol covered an aquatic treadmill using water jets to destabilize while standing, and achieve high ratings of perceived exertion during walking. Results: The comparison of results obtained by the patients after 20 interventions, with those obtained before therapy allowing the presumption that on the level of significance α= 0.05 there occurred statistically significant differences in the results of the tests performed (p<0.05). This concerned both pain complaints (VAS scale, Lequesne index of severity for arthrosis of the knee), as well as functional tests TUG, and measurement of the range of motion (p = 0.041-0.001). Conclusions: Based on the results of the study a decrease was observed in pain complaints, improvement of the range of motion in the joints, balance and function, after participation in a 4-week aquatic treadmill exercise programme, which contained the components of balance and endurance training.

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Responses to gait retraining using pressure-based auditory feedback for medial knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.02.111 ◽

2021 ◽

Vol 29 ◽

pp. S81-S82

Author(s):

J. He ◽

C. Ferrigno ◽

N. Shakoor ◽

M.A. Wimmer

Keyword(s):

Knee Osteoarthritis ◽

Auditory Feedback ◽

Gait Retraining ◽

Medial Knee ◽

Medial Knee Osteoarthritis

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A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

Clinical Rehabilitation ◽

10.1177/0269215521993636 ◽

2021 ◽

pp. 026921552199363

Author(s):

Martin Schwarze ◽

Leonie P Bartsch ◽

Julia Block ◽

Merkur Alimusaj ◽

Ayham Jaber ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Controlled Trial ◽

Oxford Knee Score ◽

Knee Adduction Moment ◽

Osteoarthritis Of The Knee ◽

Knee Score ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Patient Reported ◽

Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

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