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

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 RELEVANCE: Various 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.

The Araz medial linkage orthosis: a new orthosis for walking in patients with spinal cord injury: a single patient study.

BACKGROUND: This article describes the development and evaluation of a new medial linkage orthosis to potentially assist paraplegic patients to ambulate. CASE DESCRIPTION AND METHODS: The orthosis was initially designed using the solid works program and was subsequently evaluated when used by a spinal cord injury subject to test the structure during standing and walking. Gait analysis was used to compare the medial linkage orthosis to a standard hip-knee-ankle-foot orthosis. FINDINGS AND OUTCOMES: The results demonstrated improvements in gait velocity, step length, and decreased compensatory motions in the new orthosis compared to the hip-knee-ankle-foot orthosis. CONCLUSIONS: The results propose that this new Araz medial linkage orthosis could be used to assist paraplegic subjects who have adequate ranges of motion and also with weakness or reduced tone to stand and walk. Clinical relevance The Araz medial linkage orthosis can potentially provide standing and walking assistance for spinal cord injury patients.

The effect of patellofemoral bracing on walking in individuals with patellofemoral pain syndrome.

BACKGROUND: Although knee braces are used by individuals with patellofemoral pain syndrome, the effect of patellofemoral bracing on knee flexion during walking has not been elucidated. AIM: The purpose of this study was to evaluate the effect of patellofemoral bracing on sagittal plane knee joint kinematics and temporal spatial parameters during walking in individuals with patellofemoral pain syndrome. STUDY DESIGN: Quasi-experimental. METHODS: Ten subjects with a diagnosis of patellofemoral pain syndrome were fitted with a knee brace incorporating an infrapatellar strap. Testing was performed at baseline and after 6 weeks of use. Gait analysis and a visual analog scale were used to assess outcomes in this study. RESULTS: A 59.6% decrease in pain was reported by using bracing. Bracing significantly improved speed of walking (p ≤ 0.001) and step length (p ≤ 0.001). The mean cadence was also increased following 6 weeks of patellofemoral brace use, but this was not significant (p = 0.077). Knee flexion angles improved during initial contact, loading response, and mid-swing (p ≤ 0.001) after 6 weeks of patellofemoral brace use. CONCLUSION: Knee orthoses resulted in decreased pain, improved temporal spatial parameters (speed of walking and step length), and increased knee flexion angles during ambulation in patients with patellofemoral pain syndrome.

The effect of custom-made splints in patients with the first carpometacarpal joint osteoarthritis.

BACKGROUND: Pain, reduced grip strength, loss of range of motion, and joint stiffness, leading to impaired hand function, and difficulty with daily activities are documented symptoms of first carpometacarpal joint osteoarthritis. Splinting is a common type of conservative treatment for this injury. OBJECTIVES: The aim of this study was to evaluate the effect of custom-made thumb splints on pain, function, grip strength, and key pinch in patients with first carpometacarpal joint osteoarthritis. STUDY DESIGN: Quasi experimental. METHODS: Patients with first carpometacarpal grade I and II osteoarthritis (n = 18) participated in a repeated measure study. The patients all wore custom-made thumb splints. All parameters were measured at baseline, and also after 30, 60, and 90 days from initial supply. A visual analogue scale, along with a disability of the arm, shoulder, and hand questionnaire, a dynamometer and pinch gauge were used to assess pain, function, grip strength, and pinch, respectively. RESULTS: After 60 days of splint usage, grip strength was improved. However, a reduction in pain was demonstrated after only 30 days and this continued to improve with time. Function and pinch strength also increased significantly and continued to do so during the study period when compared to baseline. CONCLUSIONS: The use of a custom-made splint for patients with osteoarthritis of the first carpometacarpal joint produced decreased pain and increased grip strength, pinch strength, and hand function. Clinical relevance Custom-made splints may be recommended for the treatment of first carpometacarpal joint osteoarthritis.