March 2013

OSTEOARTHRITIS: Knee braces and wedged insoles both alter gait in patients with knee OA

By Jordana Bieze Foster

A Taiwanese study offers more evidence that offloading knee braces and wedged foot orthoses are both associated with significant biomechanical improvements in patients with knee osteoarthritis (OA).

Investigators from National Taiwan University performed gait analysis on 15 patients with medial compartment knee OA and 15 matched controls. Knee OA patients were analyzed under two orthotic conditions, with a knee orthosis or with lateral wedged cork foot orthoses. Patients with severe pain were excluded.

Both orthotic conditions were associated with significant increases in gait speed, decreases in gait cycle time, and a lateral shift of the center of pressure compared to shoes only. Both significantly decreased peak knee adduction moment, which is commonly used as a surrogate measure for knee loading, as well as knee valgus angle and knee valgus excursion. Both devices, in particular the knee brace, were associated with a trend toward decreased cocontraction of the quadriceps and hamstrings muscles on the lateral side during gait.

The knee brace was associated with significant decreases in knee flexion angle and knee flexion excursion compared to shoes only. The wedged foot orthoses were associated with a slight increase in ankle abduction moment.

The findings are consistent with those of previous studies (see “OA knee braces face off against wedged insoles,” November 2012, page 37).

“Orthotic interventions can improve gait deviations and kinematic and kinetic performance,” said Chun-Te Lin, a doctoral student in the Rehabilitation Engineering Laboratory at National Taiwan University, who presented his group’s findings at the ISPO World Congress in Hyderabad, India.

Source:

Lin C, Chang L. The effects of foot orthoses and knee orthoses on gait pattern and muscular activation of patients with medial compartment knee osteoarthritis. Presented at International Society of Prosthetics and Orthotics 2013 World Congress, Hyderabad, India, February 2013.

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