Influence of a valgus knee brace on muscle activation and co-contraction in patients with medial knee osteoarthritis

Pagani, Cynthia H. Fantini; Willwacher, Steffen; Kleis, Barbara; Brüggemann, Gert–Peter

doi:10.1016/j.jelekin.2012.10.007

Cited by 30 publications

(20 citation statements)

References 43 publications

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“…It is possible that dynamic effects may differ and that wearing a brace for a greater duration may induce neuromuscular adaptations that could mediate the effect of the brace. In particular, patterns of activation of agonist muscles and antagonistic coactivation in dynamic situations likely influence compartmental contact stress, and these effects would be moderated by the mechanical stability of the joint (e.g., coronal plane laxity permitting greater changes in bone position).…”

Section: Discussionmentioning

confidence: 99%

Effect of a Realigning Brace on Tibiofemoral Contact Stress

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Stockman

Findlay

et al. 2015

Arthritis Care & Research

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Objective. To determine the degree to which focally elevated tibiofemoral joint contact stress is reduced by using a frontal plane realigning brace. Methods. Fifteen volunteers (9 women) with unicompartmental tibiofemoral osteoarthritis underwent weight-bearing radiographic imaging at 15-208 and 5-108 of knee flexion with and without an UnloaderOne knee brace. Discrete element analysis was used to estimate compartment-specific contact stress distributions. Paired t-tests were used to assess the differences in mean contact stress and contact stress distributions, comparing the braced and unbraced conditions. Results. The mean 6 SD age was 56.1 6 6.4 years and body mass index was 28.4 6 4.5 kg/m 2 . Twelve of 15 participants were fit with braces set to unload the medial compartment. For the 15-208 condition, the mean contact stress in the compartment of interest did not significantly change (0.08 6 0.35 MPa; P 5 0.410). Also at 5-108 flexion, the mean contact stress in the compartment of interest did not significantly change with use of the brace (0.24 6 0.45 MPa; P 5 0.175). Conclusion. This is the first study of the effects of a frontal plane realignment brace on in vivo articular contact stress in native human knees. Using the off-the-shelf brace tested, there were no changes in compartmental tibiofemoral contact stress distributions at either 15-208 or 5-108 of knee flexion, revealing no redistribution of contact stress away from the compartment of interest. These findings indicate that the brace that was studied was ineffective for redistributing tibiofemoral contact stress. Further research is necessary to determine whether double-upright or customized frontal plane braces are effective in redistributing compartmental articular contact stress.

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Section: Discussionmentioning

confidence: 99%

Effect of a Realigning Brace on Tibiofemoral Contact Stress

Segal

Stockman

Findlay

et al. 2015

Arthritis Care & Research

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“…Based on previous research reports, an appropriate sample size was determined [ 14 , 16 , 17 , 19 ]. Statistical analyses were performed using the software IBM ® SPSS Statistics (IBM ® SPSS Statistics v. 25, IBM Cooperation).…”

Section: Methodsmentioning

confidence: 99%

“…al suggested a correlation between joint realignment and clinical improvement [37]. However, it was noted that most previous studies concentrated on the clinical effects of valgus bracing in patients with medial knee OA [6,[14][15][16][17]19,38].…”

Section: Plos Onementioning

confidence: 99%

“…Previous studies have pointed out that further dynamic investigation is necessary to prove the effectiveness of knee braces for OA treatment. In most cases, former investigations on this issue have only examined the immediate effect of valgus knee braces on aspects such as knee loading [ 14 ] and adduction moment [ 1 , 15 ], muscle co-contraction [ 1 , 16 ], functional joint space and joint contact locations [ 17 ], pain [ 2 , 18 ], and balance rather than the lasting changes after a treatment period [ 1 , 9 ]. Literature research has shown that an analysis of the effect of varus knee braces was less common than valgus [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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The effect of a knee brace in dynamic motion—An instrumented gait analysis

et al. 2020

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Background Osteoarthritis (OA) is a common problem in the older population. To reduce pain and stress in the affected knee joint compartment, a functional knee brace is often prescribed by physicians to protect it from high loads. Objectives An instrumented gait analysis should evaluate how the 4-point knee orthosis for varus or valgus load relief (M.4s OA) changes the kinematics of the knee, especially in the frontal plane. Methods 17 healthy participants took part and were analyzed with an inertial sensor system (MyoMotion) giving continuous, objective information on the anatomical angles. The measurements were made both without wearing a knee brace and with the brace in different settings. Results The results show a significant reduction in the maximum knee abduction and raised knee adduction. The knee brace, with a strong adjustment in varus or valgus orientation, caused a shift of maximum ab-/adduction in the proposed direction in 69% and 75% of the dynamic tests, respectively. The knee motion in the frontal plane shows individual movement patterns.

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“…The potent effects of malalignment on disease progression, functional decline and knee symptoms have spurred development of a range of therapeutic options . Therapies have been developed to modify the distribution of forces across the knee and reduce load in the affected compartment . Despite their mechanistic appeal, there is controversy about their clinical value and what is the appropriate target population for realignment therapy …”

Section: Introductionmentioning

confidence: 99%