The effect of extension assist orthosis with pneumatic bladders on pain and function for patients with early knee osteoarthritis.

Bracing clinical outcomes function knee osteoarthritis (OA)

Journal

Annals of translational medicine
ISSN: 2305-5839
Titre abrégé: Ann Transl Med
Pays: China
ID NLM: 101617978

Informations de publication

Date de publication:
Oct 2019
Historique:
entrez: 16 11 2019
pubmed: 16 11 2019
medline: 16 11 2019
Statut: ppublish

Résumé

There are few non-invasive treatment options to slow the progression of osteoarthritis (OA). Recently, a novel knee unloader brace with knee extension assist has become commercially available. Therefore, the purpose of this study was to evaluate the preliminary effectiveness of using a novel unloader brace with extension assist to improve pain and functional outcomes for patients with knee OA. Thirty subjects (17 control group, 13 brace group) completed baseline and 6-week follow up testing with no brace. Patients were randomized into a Brace or No Brace group after baseline testing. Functional tests [timed up and go (TUG), stair climbing test (SCT) and six-minute walk (6MW)], self-reported measures [Knee Outcome Survey (KOS), pain, Patient Specific Functional Scale (PSFS)] and isometric knee extension strength were assessed. Repeated measure ANOVAs were used to identify differences in group and time. Pearson correlation coefficients were calculated for both average number of steps in the brace and exercises compliance compared to change in clinical scores for each group. There was a significant interaction effect for "worst pain" (P=0.002), the brace group improved from a 7.3/10 to 4.7/10 at follow-up (P=0.006) while the control group had no change. There was an effect of time for the SCT (P=0.02), "best knee pain" (P=0.050), and knee extension range of motion (ROM) (P=0.041). There were no significant correlations between exercise compliance and change in outcomes, but when the groups were collapsed there was a significant correlation between compliance and change in knee extension ROM (r=0.526; P=0.025). The extension assist pneumatic unloader brace group demonstrated a significant and important reduction in the "worst knee pain". This may indicate that wearing the brace was able to reduce painful flares. Both groups improved over time for the SCT, "best knee pain", and knee extension ROM, which can be attributed to the stretching protocol. This unloader brace is a promising non-invasive treatment option for patients with knee OA when combined with a stretching program.

Sections du résumé

BACKGROUND BACKGROUND
There are few non-invasive treatment options to slow the progression of osteoarthritis (OA). Recently, a novel knee unloader brace with knee extension assist has become commercially available. Therefore, the purpose of this study was to evaluate the preliminary effectiveness of using a novel unloader brace with extension assist to improve pain and functional outcomes for patients with knee OA.
METHODS METHODS
Thirty subjects (17 control group, 13 brace group) completed baseline and 6-week follow up testing with no brace. Patients were randomized into a Brace or No Brace group after baseline testing. Functional tests [timed up and go (TUG), stair climbing test (SCT) and six-minute walk (6MW)], self-reported measures [Knee Outcome Survey (KOS), pain, Patient Specific Functional Scale (PSFS)] and isometric knee extension strength were assessed. Repeated measure ANOVAs were used to identify differences in group and time. Pearson correlation coefficients were calculated for both average number of steps in the brace and exercises compliance compared to change in clinical scores for each group.
RESULTS RESULTS
There was a significant interaction effect for "worst pain" (P=0.002), the brace group improved from a 7.3/10 to 4.7/10 at follow-up (P=0.006) while the control group had no change. There was an effect of time for the SCT (P=0.02), "best knee pain" (P=0.050), and knee extension range of motion (ROM) (P=0.041). There were no significant correlations between exercise compliance and change in outcomes, but when the groups were collapsed there was a significant correlation between compliance and change in knee extension ROM (r=0.526; P=0.025).
CONCLUSIONS CONCLUSIONS
The extension assist pneumatic unloader brace group demonstrated a significant and important reduction in the "worst knee pain". This may indicate that wearing the brace was able to reduce painful flares. Both groups improved over time for the SCT, "best knee pain", and knee extension ROM, which can be attributed to the stretching protocol. This unloader brace is a promising non-invasive treatment option for patients with knee OA when combined with a stretching program.

Identifiants

pubmed: 31728371
doi: 10.21037/atm.2019.04.85
pii: atm-07-S7-S247
pmc: PMC6829002
doi:

Types de publication

Journal Article

Langues

eng

Pagination

S247

Informations de copyright

2019 Annals of Translational Medicine. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: The authors have no conflicts of interest to declare.

Références

Clin Biomech (Bristol, Avon). 2009 May;24(4):366-71
pubmed: 19250725
Arthritis Res Ther. 2009;11(5):R139
pubmed: 19772556
J Knee Surg. 2016 Apr;29(3):218-23
pubmed: 26963073
J Knee Surg. 2016 Nov;29(8):634-638
pubmed: 27750364
Osteoarthritis Cartilage. 2013 Sep;21(9):1154-9
pubmed: 23973125
JAMA. 2018 Dec 25;320(24):2564-2579
pubmed: 30575881
BMC Musculoskelet Disord. 2010 May 06;11:86
pubmed: 20459622
Arthritis Care Res (Hoboken). 2015 Apr;67(4):493-501
pubmed: 25201520
Rheum Dis Clin North Am. 2018 Aug;44(3):513-524
pubmed: 30001790
J Orthop Res. 2019 Feb;37(2):397-402
pubmed: 30387528
Int J Behav Nutr Phys Act. 2011 Jul 28;8:80
pubmed: 21798044
Arch Orthop Trauma Surg. 2016 May;136(5):649-56
pubmed: 26739139
BMJ. 2006 Mar 18;332(7542):639-42
pubmed: 16543327
Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):42-50
pubmed: 25236680
J Arthroplasty. 2015 May;30(5):747-53
pubmed: 25499679

Auteurs

Kathleen Madara (K)

Department of Physical Therapy, University of Delaware, Newark, DE, USA.

Moiyad Aljehani (M)

Department of Physical Therapy, University of Delaware, Newark, DE, USA.
Department of Physical Therapy, Umm Al-Qura University, Makkah, Saudi Arabia.

Federico Pozzi (F)

Department of Physical Therapy, University of Florida, Gainesville, FL, USA.

Elizabeth Colonna (E)

Doctor of Physical Therapy Program - North, Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA.

Joseph A Zeni (JA)

Doctor of Physical Therapy Program - North, Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA.

Classifications MeSH