The effect of knee orthoses on gait parameters in medial knee compartment osteoarthritis: A literature review

2014 ◽  
Vol 40 (2) ◽  
pp. 193-201 ◽  
Author(s):  
Maryam Maleki ◽  
Mokhtar Arazpour ◽  
Mahmoud Joghtaei ◽  
Stephen W Hutchins ◽  
Atefeh Aboutorabi ◽  
...  
Keyword(s):  
Literature Review ◽  
Knee Osteoarthritis ◽  
Step Length ◽  
Medial Compartment ◽  
Medial Knee ◽  
Pain Disability ◽  
Gait Parameters ◽  
Osteoarthritis Knee ◽  
Measure Methods ◽  
Knee Braces

Background: Knee osteoarthritis is a musculoskeletal condition which is most prevalent in the medial compartment. This injury causes considerable pain, disability, and negative changes in kinetic and kinematic parameters. The efficiency of unloader valgus brace as a conservative treatment for medial knee osteoarthritis is not well documented. Objectives: The aim of this study was to review the previous research regarding the biomechanical effects of knee valgus braces on walking in medial compartment knee osteoarthritis patients. Study design: Literature review Methods: According to the population intervention comparison outcome measure methods and based on selected keywords, 12 studies were chosen according to (met) the inclusion criteria. Results: The results indicated that treatment with knee braces was effective in decreasing pain, improving function, ameliorating improvement in range of motion, and increasing speed of walking and step length in conjunction with a reduction in the adduction moment applied to the knee. Conclusion: Osteoarthritis knee braces may be considered for improvement of walking and treatment of medial compartment knee osteoarthritis. Clinical relevance Knee braces are an orthotic intervention that could potentially be significant in assisting in improving the walking parameters and treatment of medial compartment knee osteoarthritis.

The influence of a bespoke unloader knee brace on gait in medial compartment osteoarthritis: A pilot study

2014 ◽  
Vol 38 (5) ◽  
pp. 379-386 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Stephen W Hutchins ◽  
Monireh A Bani ◽  
Sarah Curran ◽  
Andrey Aksenov
Keyword(s):  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Sagittal Plane ◽  
Step Length ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Medial Compartment Osteoarthritis ◽  
Medial Knee Osteoarthritis ◽  
Knee Orthosis

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.

Comparison of the efficacy of laterally wedged insoles and bespoke unloader knee orthoses in treating medial compartment knee osteoarthritis

2012 ◽  
Vol 37 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Monireh Ahmadi Bani ◽  
Maryam Maleki ◽  
Farhad Tabatabai Ghomshe ◽  
Reza Vahab Kashani ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Visual Analog Scale Score ◽  
Step Length ◽  
Medial Compartment ◽  
Analog Scale ◽  
Knee Oa ◽  
Gait Parameters ◽  
Quasi Experimental ◽  
Knee Orthosis

Background: Patients suffering from medial compartment knee osteoarthritis (OA) may be treated with unloader knee orthoses or laterally wedged insoles. Objectives: The aim of this study was to identify and compare the effects of them on the gait parameters and pain in these patients. Study Design: Quasi-experimental. Methods: Volunteer subjects with medial compartment knee OA ( n = 24, mean age 59.29 ± 2.23 years) were randomly assigned to two separate groups and evaluated when wearing an unloader knee orthosis or insoles incorporating a 6° lateral wedge. Testing was performed at baseline and after six weeks of each orthosis use. A visual analog scale score was used to assess pain and gait analysis was utilized to determine gait parameters. Results: Both orthoses improved all parameters compared to the baseline condition ( p = 0.000). However, no significant differences in pain ( p = 0.649), adduction moment ( p = 0.205), speed of walking ( p = 0. 056) or step length ( p = 0.687) were demonstrated between them. The knee range of motion ( p = 0.000) were significantly different between the two interventions. Conclusion: Both orthoses reduced knee pain. Maximum knee range of motion was increased by both interventions although it was 3 degrees less when wearing the knee orthosis. Clinical relevance Both orthoses reduce pain and improve gait anomalies in medial compartment knee OA. Our results suggest a laterally wedged insole can be an alternative conservative approach to unloader knee orthosis for treating symptoms of medial compartment knee OA.

scholarly journals Three‐month efficacy of three knee braces in the treatment of medial knee osteoarthritis in a randomized crossover trial

2020 ◽  
Vol 38 (10) ◽  
pp. 2262-2271
Author(s):  
Xavier Robert‐Lachaine ◽  
Yoann Dessery ◽  
Étienne L. Belzile ◽  
Sylvie Turmel ◽  
Philippe Corbeil
Keyword(s):  
Knee Osteoarthritis ◽  
Crossover Trial ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Randomized Crossover Trial ◽  
Knee Braces

A Sex Comparison of Ambulatory Mechanics Relevant to Osteoarthritis in Individuals With and Without Asymptomatic Varus Knee Alignment

2014 ◽  
Vol 30 (5) ◽  
pp. 632-636 ◽  
Author(s):  
Joaquin A. Barrios ◽  
Danielle E. Strotman
Keyword(s):  
Knee Osteoarthritis ◽  
Varus Knee ◽  
Knee Alignment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Gait Parameters ◽  
Peak Knee ◽  
Gait Mechanics ◽  
Reaction Forces ◽  
Asymptomatic Individuals

The prevalence of medial knee osteoarthritis is greater in females and is associated with varus knee alignment. During gait, medial knee osteoarthritis has been linked to numerous alterations. Interestingly, there has been no research exploring sex differences during walking in healthy individuals with and without varus alignment. Therefore, the gait mechanics of 30 asymptomatic individuals with varus knees (15 females) and 30 normally-aligned controls (15 females) were recorded. Gait parameters associated with medial knee osteoarthritis were analyzed with two-factor analyses of variance. In result, varus males exhibited the greatest peak knee adduction moments, while normal females showed the greatest peak hip adduction angles and pelvic drop excursions. By sex, females exhibited greater peak hip adduction angles and moments and greater pelvic drop excursion, but lesser peak knee adduction angles. By alignment type, varus subjects exhibited greater peak knee adduction angles and moments, midstance knee flexion angles and excursion, and eversion angles and lateral ground reaction forces, but lesser peak hip adduction angles. In conclusion, females generally presented with proximal mechanics related to greater hip adduction, whereas males presented with more knee adduction. Varus subjects demonstrated a number of alterations associated with medial knee osteoarthritis. The differential sex effects were far less conclusive.

scholarly journals Extra excitation of biceps femoris during neuromuscular electrical stimulation reduces knee medial loading

2019 ◽  
Vol 6 (3) ◽  
pp. 181545 ◽  
Author(s):  
Rui Xu ◽  
Dong Ming ◽  
Ziyun Ding ◽  
Anthony M. J. Bull
Keyword(s):  
Electrical Stimulation ◽  
Knee Joint ◽  
Neuromuscular Electrical Stimulation ◽  
Biceps Femoris ◽  
Step Length ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Medial Knee ◽  
Before And After ◽  
Reaction Forces

Medial knee joint osteoarthritis (OA) is a debilitating and prevalent condition. Surgical treatment consists of redistributing the forces from the medial to the lateral compartment through osteotomy, or replacing the joint surfaces. As the mediolateral load distribution is related to the action of the musculature around the knee, the aim of this study was to devise a technique to redistribute these forces non-surgically through changes in muscle excitation. Eight healthy subjects participated in the experiment, and neuromuscular electrical stimulation was used to change the muscle forces around the knee. A musculoskeletal model was used to quantify the loading on the medial compartment of the knee, and a novel algorithm devised and implemented to simulate neuromuscular electrical stimulation. The forces and moments at the knee, ground reaction forces, walking velocity and step length were quantified before and after stimulation. Stimulation of the biceps femoris resulted in a significant decrease in the second peak of the medial knee joint loading by up to 0.17 body weight ( p = 0.016). Kinematic parameters were not significantly affected. Neuromuscular electrical stimulation can decrease the peak loads on the medial compartment of the knee, and thus offers a promising therapy for medial knee joint OA.

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