Article

OBJECTIVE: To analyze knee joint loading, subjective pain relief, and
improvements in function in patients with osteoarthritis (OA) with the use of 2
orthosis adjustments. DESIGN: Patients were tested under 3 different conditions
(without orthosis, orthosis at 4 degrees valgus, and a neutral very flexible
adjustment) in a crossover trial. SETTING: University gait analysis laboratory
with 3-dimensional motion analysis and force platforms. PARTICIPANTS: Patients
(N=11) with a clinical and radiographic diagnosis of unilateral OA in the medial
knee compartment. INTERVENTIONS: Patients wore a knee orthosis designed to unload
the medial knee compartment for 4 weeks in 2 different adjustments (2 weeks in
each adjustment). MAIN OUTCOME MEASURES: Net knee adduction moment and net knee
adduction angular impulse during the stance phase were analyzed by using inverse
dynamics. Subjective pain relief, stiffness, and function improvement were
evaluated using a questionnaire (Western Ontario and McMaster Universities
Osteoarthritis Index). A 6-minute walk test and stair-climbing test also were
performed. RESULTS: Both orthosis adjustments induced subjective pain relief and
improvement in function compared with the condition without orthosis. Knee
adduction moment was significantly decreased with both adjustments, whereas the
decrease observed with the 4 degrees valgus adjustment was significantly greater
than the flexible adjustment (25% vs 12.5%). Compared with the condition without
orthosis, changes in knee adduction angular impulse of 29% and 15% were found
with 4 degrees valgus and the neutral flexible orthosis, respectively. Time
required for the stair-climbing activity was significantly decreased using the
orthosis in 4 degrees valgus adjustment compared with the condition without
orthosis. No significant differences were observed among conditions during the
6-minute walk test. CONCLUSIONS: Both orthosis adjustments were effective in
decreasing symptoms; however, a decrease in knee loading was more effective using
the 4 degrees valgus adjustment, which could contribute to avoidance of disease
progression.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS