Abstract
Background
There is evidence that valgus knee orthosis improves clinical and biomechanical outcomes
in individuals with medial knee osteoarthritis (MKOA). It is unclear whether variations
in pressure application by orthosis straps can affect the biomechanical outcomes.
This study aimed to determine the dose–response relationship between different orthosis
straps tensions and changes in knee adduction moment (KAM) parameters in individuals
with MKOA.
Method
Twenty-four individuals with symptomatic MKOA were enrolled in this quasi-experimental
study. Five tension conditions in orthosis straps were tested in 20-mmHg increments,
from 0 (no pressure) to 100 (maximal pressure) mmHg. Patients were asked to adjust
the orthosis strap tension based on their perceived comfort. After each condition,
a 3D gait analysis was performed, and KAM parameters were calculated. The participants
also reported their satisfaction with knee orthosis adjustment for each pressure condition.
Results
With successive increases in strap tension from 40 to 80 mmHg, the first peak, second
peak, and angular impulse of KAM decreased nonlinearly (from 6 % to 25 %). Increasing
the orthosis strap tension to 100 mmHg significantly decreased (P < 0.05) the participants’
satisfaction level. The effective dosages (IC50) of pressure for the first peak, second peak, and angular impulse of KAM as responses
were 58, 65, and 69 mmHg, respectively.
Conclusion
The KAM decline was not linear as the strap pressure increased. Patients were dissatisfied
with orthosis adjustment when strap tension was above 80 mmHg. The optimum dosage
of pressure on the knee joint's lateral side for adjusting an orthosis' strap tension
is approximately 69 mmHg.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 3,
2022
Received in revised form:
September 23,
2022
Received:
March 21,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
