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Arch Phys Med Rehabil. 2012 Mar;93(3):496-502. doi: 10.1016/j.apmr.2011.09.002. Epub 2012 Jan 12.

Is there a dose response for valgus unloader brace usage on knee pain, function, and muscle strength?

Author information

1
School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada.

Abstract

OBJECTIVE:

To examine whether there was a dose response for valgus unloader brace wear on knee pain, function, and muscle strength in participants with medial compartment knee osteoarthritis.

DESIGN:

In this single-group study, participants with medial compartment knee osteoarthritis were followed for approximately 6 months.

SETTING:

Recruitment was conducted in the general community, and testing was performed at a university laboratory.

PARTICIPANTS:

A convenience sample of patients (N=32) who were prescribed a valgus unloader brace agreed to participate, met the inclusion criteria, and completed the baseline data collection. Twenty-four participants (20 men, 4 women) completed baseline and follow-up collections.

INTERVENTION:

Participants wore their valgus unloader brace as needed.

MAIN OUTCOME MEASURES:

Knee extensor, flexor, and plantar flexor strength was tested at baseline and follow-up. Participants filled out Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Medical Outcomes Study 36-Item Short-Form Health Survey questionnaires to assess pain and function. Self-selected walking velocity and stride length were objective measures of function. Brace usage (dose) and activity (step count) were recorded at least 4 days/week for the study duration.

RESULTS:

Positive relationships existed between brace wear usage and percent change in step count (r=.59, P=.006) and percent change in hamstrings strength (r=.37, P=.072). At follow-up, there was significant improvement in hamstrings strength (P=.013), and trends toward improvements in WOMAC pain (P=.059) and WOMAC function (P=.089).

CONCLUSIONS:

Our results indicate that greater brace use may positively affect physical activity level, but there was minimal effect of brace wear dosage on lower-limb muscle strength. Only knee flexion showed a positive relationship. Our finding of no decreased muscle strength indicates that increased brace use over a 6-month period does not result in muscle impairment.

PMID:
22244248
DOI:
10.1016/j.apmr.2011.09.002
[Indexed for MEDLINE]

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