The immediate effect of a soft knee brace on dynamic knee instability in persons with knee osteoarthritis
Tomasz Cudejko (Amsterdam UMC)
Martin Van Der Esch (Amsterdam UMC)
Jim Schrijvers (Amsterdam UMC)
Rosie Richards (Amsterdam UMC)
Josien C. Van Den Noort (Amsterdam UMC)
Tim Wrigley (University of Melbourne)
Marike Van Der Leeden (Amsterdam UMC)
Leo D. Roorda (Amsterdam UMC)
Willem Lems (Amsterdam UMC)
Jaap Harlaar (TU Delft - Biomechatronics & Human-Machine Control, Amsterdam UMC)
Joost Dekker (Amsterdam UMC)
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Abstract
Objectives Wearing a soft knee brace has been shown to reduce self-reported knee instability in persons with knee OA. There is a need to assess whether a soft knee brace has a beneficial effect on objectively assessed dynamic knee instability as well. The aims of the study were to evaluate the effect of a soft knee brace on objectively assessed dynamic knee instability and to assess the difference in effect between a non-tight and a tight soft knee brace in persons with knee OA. Methods Thirty-eight persons with knee OA and self-reported knee instability participated in a laboratory study. A within-subject design was used comparing no brace vs brace and comparing a non-tight vs a tight brace. The primary outcome measure was dynamic knee instability, expressed by the perturbation response (PR). The PR reflects deviation in the mean knee varus-valgus angle during level walking after a controlled mechanical perturbation. Linear mixed-effect model analysis was used to evaluate the effect of a brace on dynamic knee instability. Results Wearing a brace significantly reduced the PR compared with not wearing a brace (B = -0.16, P = 0.01). There was no difference between a non-tight and a tight brace (B = -0.03, P = 0.60). Conclusion This study is the first to report that wearing a soft knee brace reduces objectively assessed dynamic knee instability in persons with knee OA. Wearing a soft brace results in an objective improvement of knee instability beyond subjectively reported improvement. Trial registration Nederlands Trial register (trialregister.nl) NTR6363