Effectiveness of a valgus knee brace on biomechanical and clinical outcomes during walking and stair climbing in individuals with knee osteoarthritis

Al-Zahrani, YA

Abstract

The knee is the joint which is most affected by osteoarthritis (OA). Knee OA is more
common in older individuals and occurs more in the medial than the lateral compartment.
When we stand, walk or climb stairs, our weight is transmitted through our knee joints
and this is known as load which is higher in individuals with medial knee OA than
healthy counterparts. Additionally, muscle weakness is a factor in medial knee OA and
previous work has demonstrated increased muscle co-contraction in these patients. In this
thesis we assessed the loading on the knee joint and muscle co-contraction after wearing
an assistive device (a valgus knee brace) which is a common treatment in this disease.
Whilst previous literature has demonstrated changes in loading with valgus knee braces
during over-ground walking, no studies (to date) have assessed the effect of valgus knee
braces on knee loading and muscle co-contraction during ascending and descending stairs
immediately, and after a period of use. In addition, it is an un-documented opinion that
knee bracing affects muscle strength and control around the knee and weakens the joint
so this research also aimed to confirm or refute this theory. To accomplish the research,
we performed three separate trials; a) a repeatability trial in seven patients to determine
the reliability of the outcome measures for the future study; b) a clinical trial of fifteen
individuals with medial knee OA would wore a valgus knee brace for a period of three
months with an interim assessment at six weeks for pain and muscle strength/function; c)
finally, a small pilot study of seven patients investigating combined orthotic treatments
on biomechanical outcome measures. In summary the results of this thesis have
demonstrated positive biomechanical and clinical outcomes when wearing a valgus knee
brace for a sustained period. This was further improved biomechanically with the
combination treatment with a lateral wedge insole which reduced knee loading more
during stair ascent and descent, in comparison to the orthotic devices alone in the same
session. Future studies to find out the effect of a combination of an off-the-shelf valgus
knee brace and off-the-shelf lateral wedge insole on knee loading, clinical and
radiological outcomes after a period of longer wear were indicated.

Citation

Al-Zahrani, Y. Effectiveness of a valgus knee brace on biomechanical and clinical outcomes during walking and stair climbing in individuals with knee osteoarthritis. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Nov 10, 2014
• Publicly Available Date: Nov 10, 2014