The immediate effect of a soft knee brace on dynamic knee instability in persons with knee osteoarthritis

• Published in: Rheumatology (Oxford, England) Vol. 57; no. 10; pp. 1735 - 1742
• Main Authors: Cudejko, Tomasz, van der Esch, Martin, Schrijvers, Jim, Richards, Rosie, van den Noort, Josien C, Wrigley, Tim, van der Leeden, Marike, Roorda, Leo D, Lems, Willem, Harlaar, Jaap, Dekker, Joost
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2018; Oxford Publishing Limited (England)
• Subjects: Aged; Biomechanical Phenomena; Braces; Female; Humans; Instability; Joint Instability - etiology; Joint Instability - physiopathology; Joint Instability - therapy; Knee; Knee Joint - physiopathology; Linear Models; Male; Middle Aged; Orthopedic apparatus; Osteoarthritis; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - physiopathology; Treatment Outcome; Walking; Walking - physiology; knee; brace; orthotics; knee instability; osteoarthritis
• ISSN: 1462-0324; 1462-0332; 1462-0332
• DOI: 10.1093/rheumatology/key162

Abstract Objectives Wearing a soft knee brace has been shown to reduce self-reported knee instability in persons with knee OA. There is a need to assess whether a soft knee brace has a beneficial effect on objectively assessed dynamic knee instability as well. The aims of the study were to evaluate the effect of a soft knee brace on objectively assessed dynamic knee instability and to assess the difference in effect between a non-tight and a tight soft knee brace in persons with knee OA. Methods Thirty-eight persons with knee OA and self-reported knee instability participated in a laboratory study. A within-subject design was used comparing no brace vs brace and comparing a non-tight vs a tight brace. The primary outcome measure was dynamic knee instability, expressed by the perturbation response (PR). The PR reflects deviation in the mean knee varus-valgus angle during level walking after a controlled mechanical perturbation. Linear mixed-effect model analysis was used to evaluate the effect of a brace on dynamic knee instability. Results Wearing a brace significantly reduced the PR compared with not wearing a brace (B = −0.16, P = 0.01). There was no difference between a non-tight and a tight brace (B = −0.03, P = 0.60). Conclusion This study is the first to report that wearing a soft knee brace reduces objectively assessed dynamic knee instability in persons with knee OA. Wearing a soft brace results in an objective improvement of knee instability beyond subjectively reported improvement. Trial registration Nederlands Trial register (trialregister.nl) NTR6363