Effect of knee orthosis on walking performance in individuals with knee osteoarthritis

Main Article Content

Amornthep Jankaew
Patraporn Sitilertpisan
Samatchai Chamnongkich

Abstract

Background: Knee orthosis has been recommended as part of conservative treatment for individuals with knee osteoarthritis (OA). However, the effects of common types of knee orthosis on function and pain during movement are still inconclusive.


Objectives: To compare the effect of two types of knee orthosis (knee sleeve and OA knee brace) on walking variables and knee pain in individuals with mild to moderate severity of knee OA and to determine the association between knee pain and type of knee orthosis that the participants felt most satisfied with.


Materials and methods: Twenty-four individuals (20 females and 4 males) diagnosed with knee OA participated in this study. Participants rated the overall knee pain they experienced in the past month, answered the Knee injury and Osteoarthritis Outcome Score (KOOS) and underwent a 40-meter fast paced walk test in three conditions: no-orthosis, knee sleeve, and OA knee brace. Walking time (second) and speed (meter/second) to complete the test were recorded. After each condition, the participants reported the level of pain during walking by a numerical rating scale (NRS). After completing all the tests, the participants indicated the type of knee orthosis that they felt most satisfied with. One-way repeated measure analysis of variance and Friedman test were used to compare the results from the three conditions. Spearman’s rho was used to examine the correlation between level of pain and the type of knee orthosis that participants chose. The level of significant was set at p<0.05.


Results: Significant differences in walking time and speed were found between the three testing conditions (p<0.05). A reduction in walking time and an increased walking speed were revealed when either type of knee orthosis was worn with walking speed in decreasing order as followed: OA knee brace>knee sleeve>no-orthosis condition. Comparing with no-orthosis, OA knee brace and knee sleeve conditions significantly reduced pain (p<0.01). No significant difference in level of pain during walking between the two orthosis conditions was found (p=0.33). The correlation between the overall knee pain in the past month and the type of knee orthosis chosen was not significant (r=-0.354, p=0.09).


Conclusion: Improvement in walking variables was found in knee OA patients with mild to moderate severity when either OA knee brace or knee sleeve was worn as compared to not wearing knee orthosis. In addition, both knee sleeve and OA knee brace aided in the reduction of knee pain during walking.

Article Details

How to Cite
Jankaew, A., Sitilertpisan, P., & Chamnongkich, S. (2017). Effect of knee orthosis on walking performance in individuals with knee osteoarthritis. Journal of Associated Medical Sciences, 50(3), 479. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/93788
Section
Research Articles

References

1. Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, et al. Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol 2007; 34(1): 172-80.

2. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol 2006; 33(11): 2271-9.

3. Roopsawang I, Aree-Ue S. Knee osteoarthritis in adult and older thais living in rural and urban areas: a comparative study. Pacific Rim Int J Nurs Res 2015; 19(3): 187-201 (in Thai).

4. Koedwan C, Bunin J, Teerasombut C, Kuptniratsaikul V. The prevalence of knee OA in community-based elders. Thai J Phys Ther 2016; 38(2): 59-70 (in Thai).

5. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull 2013;105:185-99. doi: 10.1093/bmb/lds038.

6. Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003; 62(12): 1145-55. doi: 10.1136/ard.2003.011742.

7. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000; 43(9): 1905-15. doi: 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-P

8. McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 22(3): 363-88. doi: 10.1016/j.joca.2014.04.001.

9. Beaudreuil J, Bendaya S, Faucher M, Coudeyre E, Ribinik P, Revel M, et al. Clinical practice guidelines for rest orthosis, knee sleeves, and unloading knee braces in knee osteoarthritis. Joint Bone Spine 2009; 76(6): 629-36. doi: 10.1016/j.jbspin.2009.02.002.

10. Chuang SH, Huang MH, Chen TW, Weng MC, Liu CW, Chen CH. Effect of knee sleeve on static and dynamic balance in patients with knee osteoarthritis. Kaohsiung J Med Sci 2007; 23(8): 405-11.

11. Bryk FF, Jesus JF, Fukuda TY, Moreira EG, Marcondes FB, Santos MG. Immediate effect of the elastic knee sleeve use on individuals with osteoarthritis. Rev Bras Reumatol 2011; 51(5): 440-6.

12. Richards JD, Sanchez-Ballester J, Jones RK, Darke N, Livingstone BN. A comparison of knee braces during walking for the treatment of osteoarthritis of the medial compartment of the knee. J Bone Joint Surg Br 2005; 87(7): 937-9.

13. Kirkley A, Webster-Bogaert S, Litchfield R, Amendola A, MacDonald S, McCalden R, et al. The effect of bracing on varus gonarthrosis. J Bone Joint Surg Am 1999; 81(4): 539-48.

14. Dobson F, Hinman RS, Roos EM, Abbott JH, Stratford P, Davis AM, et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013; 21(8): 1042-52. doi: 10.1016/j.joca.2013.05.002.

15. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29(8): 1039-49.

16. Schiphof D, Boers M, Bierma-Zeinstra SM. Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis. Ann Rheum Dis 2008; 67(7): 1034-6. doi: 10.1136/ard.2007.079020.

17. Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 2005; 6:3. doi: 10.1186/1471-2474-6-3.

18. Chaipinyo K. Test-retest reliability and construct validity of the Thai version of Knee Osteoarthritis Outcome Scores (KOOS). Thai J Phy Ther 2009; 31(2): 67-76 (in Thai).

19. Brazier JE, Harper R, Munro J, Walters SJ, Snaith ML. Generic and condition-specific outcome measures for people with osteoarthritis of the knee. Rheumatology (Oxford) 1999; 38(9): 870-7.

20. Elboim-Gabyzon M, Rozen N, Laufer Y. Gender differences in pain perception and functional ability in subjects with knee osteoarthritis. ISRN Orthop 2012; 2012: 413105. doi: 10.5402/2012/413105.

21. Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 2003; 1: 64. doi: 10.1186/1477-7525-1-64.

22. de Groot IB, Favejee MM, Reijman M, Verhaar JA, Terwee CB. The Dutch version of the Knee Injury and Osteoarthritis Outcome Score: a validation study. Health Qual Life Outcomes 2008; 6: 16. doi: 10.1186/1477-7525-6-16.

23. Xie F, Li SC, Roos EM, Fong KY, Lo NN, Yeo SJ, et al. Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Knee injury and Osteoarthritis Outcome Score (KOOS) in Asians with knee osteoarthritis in Singapore. Osteoarthritis Cartilage 2006; 14(11): 1098-103. doi: 10.1016/j.joca.2006.05.005.

24. White DK, Niu J, Zhang Y. Is symptomatic knee osteoarthritis a risk factor for a trajectory of fast decline in gait speed? Results from a longitudinal cohort study. Arthritis Care Res (Hoboken) 2013;65(2):187-94.doi: 10.1002/acr.21816.

25. Duffell LD, Jordan SJ, Cobb JP, McGregor AH. Gait adaptations with aging in healthy participants and people with knee-joint osteoarthritis. Gait Posture 2017; 57: 246-51. doi: 10.1016/j.gaitpost.2017.06.015.

26. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing 1997; 26(1): 15-9.

27. Schmalz T, Knopf E, Drewitz H, Blumentritt S. Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee. J Rehabil Res Dev 2010; 47(5): 419-29.

28. Segal NA. Bracing and orthoses: a review of efficacy and mechanical effects for tibiofemoral osteoarthritis. PM R 2012; 4(5 Suppl): S89-96. doi: 10.1016/j.pmrj.2012.01.018.

29. Bockrath K, Wooden C, Worrell T, Ingersoll CD, Farr J. Effects of patella taping on patella position and perceived pain. Med Sci Sports Exerc 1993; 25(9): 989-92.

30. Edin B. Cutaneous afferents provide information about knee joint movements in humans. J Physiol 2001; 531(Pt 1): 289-97.

31. Briem K, Ramsey DK. The role of bracing. Sports Med Arthrosc 2013; 21(1): 11-7. doi: 10.1097/JSA.0b013e31827562b5.

32. Komistek RD, Dennis DA, Northcut EJ, Wood A, Parker AW, Traina SM. An in vivo analysis of the effectiveness of the osteoarthritic knee brace during heel-strike of gait. J Arthroplasty 1999; 14(6): 738-42.

33. Pollo FE, Otis JC, Backus SI, Warren RF, Wickiewicz TL. Reduction of medial compartment loads with valgus bracing of the osteoarthritic knee. Am J Sports Med 2002; 30(3): 414-21. doi: 10.1177/03635465020300031801.

34. Callaghan MJ, Parkes MJ, Felson DT. The Effect of Knee Braces on Quadriceps Strength and Inhibition in Subjects With Patellofemoral Osteoarthritis. J Orthop Sports Phys Ther 2016; 46(1): 19-25. doi: 10.2519/jospt.2016.5093.

35. Dessery Y, Belzile EL, Turmel S, Corbeil P. Comparison of three knee braces in the treatment of medial knee osteoarthritis. Knee 2014; 21(6): 1107-14. doi: 10.1016/j.knee.2014.07.024.