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Bartsch A, Sherman SL, Tramer J, Vel MS, Fredericson M. Preserving Knee Health and Delivering Specialized Care for Active Older Athletes. Sports Health 2025:19417381251326527. [PMID: 40145656 PMCID: PMC11951129 DOI: 10.1177/19417381251326527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2025] Open
Abstract
CONTEXT Athletes differ from recreational exercisers in many characteristics and often require tailored treatments uniquely adapted to their situations and requirements. This practice is highlighted in young and middle-aged high-performance athletes. However, with advancing age and declining physical performance, age often outweighs athleticism, discounting the existing distinctions. This review focuses on physiological age-related processes in active older athletes and common knee conditions and elucidates the differences in preventing and treating knee injuries from the active adult population. EVIDENCE ACQUISITION Nonsystematic review with critical appraisal of existing literature. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Nonsteroidal anti-inflammatory drugs may interfere with the muscle hypertrophy mechanism in older athletes and it may be beneficial to adapt to other pharmacological interventions for knee osteoarthritis (OA). Arthroplasty is not typically compatible with high level sports activities; anterior cruciate ligament reconstruction surgery in the older athlete may be an effective option to improve function and enable return to sport, especially in the absence of OA. Chronic degenerative meniscal injuries can usually be treated conservatively, regardless of subjective mechanical symptoms. Acute traumatic meniscal tears in nonarthritic knees that cause effusions or reproducible mechanical symptoms may yet be considered for repair at any age. Conservative options are more dominant for patella tendinopathy, where platelet-rich plasma may be more effective than the classic extracorporeal shockwave therapy. CONCLUSION With the increase of the active older athletic population, prevention and injury treatment strategies must be balanced and tailored to their individual needs. Older athletes have various goals and demands in their respective sports, necessitating distinct prevention and treatment strategies.Strength of Recommendation Taxonomy (SORT):B.
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Affiliation(s)
- Anna Bartsch
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
- Department of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Redwood City, California
- Department of Orthopedics and Trauma Surgery, University Hospital Basel, Basel, Switzerland
| | - Seth Lawrence Sherman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
| | - Joseph Tramer
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Garfield Heights, Ohio
| | - Monica Sri Vel
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
| | - Michael Fredericson
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
- Department of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Redwood City, California
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Bin Sheeha B, Bin Nasser A, Williams A, Granat M, Johnson DS, Althomali OW, Alkhamees NH, Ibrahim ZM, Jones R. Reliability of the Star Excursion Balance Test with End-Stage Knee Osteoarthritis Patients and Its Responsiveness Following Total Knee Arthroplasty. J Clin Med 2024; 13:6479. [PMID: 39518617 PMCID: PMC11546780 DOI: 10.3390/jcm13216479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 10/25/2024] [Accepted: 10/27/2024] [Indexed: 11/16/2024] Open
Abstract
Background/Objectives: The Star Excursion Balance Test (SEBT) is a simple and feasible tool for assessing dynamic balance in individuals with knee osteoarthritis (KOA). It has an advantage as it replicates dynamic balance better than other static balance tools. This study aims to determine how reliable SEBT is among people with end-stage KOA, as well as how responsive it is and how well it correlates with performance-based outcome measures after TKA. Methods: Patients on the waiting list for TKA performed SEBT in the anterior, posteromedial and posteriorlateral directions twice within 7 days. The measurements were repeated 6 and 12 months after TKA. The participants completed performance-based outcome measurements (PBOMs) and the Oxford Knee Score (OKS) before and after TKA to estimate correlation. Results: In all directions, the intraclass correlation coefficient range (ICC) was 0.998-0.993, and there were no significant differences between the test and re-test mean SEBT scores. The standard error of measurement (SEM) ranged from 0.37% to 0.68%, and the minimum detectable change (MDC) ranged from 1.02% to 1.89%. The post TKA SEBT results show significant improvement, with a large effect size. There were large-to-medium correlations between SEBT and PBOMs before and after TKA, while OKS correlated only before surgery. The magnitude of change in SEBT, PBOMs and OKS did not correlate. Conclusions: SEBT is an extremely reliable tool for assessing dynamic balance in all three directions of severe KOA patients. It is sensitive enough to detect balance changes at 6 and 12 months post TKA. SEBT cannot be used to reflect the change in functional outcome improvement after TKA.
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Affiliation(s)
- Bodor Bin Sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (B.B.S.); (N.H.A.); (Z.M.I.)
| | - Ahmad Bin Nasser
- Department of Orthopaedics, College of Medicine, King Saud University, P.O. Box 145111, Riyadh 11362, Saudi Arabia;
| | - Anita Williams
- School of Health and Society, University of Salford, Salford M6 6PU, UK; (A.W.); (M.G.); (R.J.)
| | - Malcolm Granat
- School of Health and Society, University of Salford, Salford M6 6PU, UK; (A.W.); (M.G.); (R.J.)
| | - David Sands Johnson
- Department of Orthopaedics, Stockport NHS Foundation Trust, Stockport SK2 7JE, UK;
| | - Omar W. Althomali
- Department of Physiotherapy, College of Applied Medical Sciences, University of Ha’il, Ha’il P.O. Box 2240, Saudi Arabia
| | - Nouf H. Alkhamees
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (B.B.S.); (N.H.A.); (Z.M.I.)
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (B.B.S.); (N.H.A.); (Z.M.I.)
| | - Richard Jones
- School of Health and Society, University of Salford, Salford M6 6PU, UK; (A.W.); (M.G.); (R.J.)
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Rajabi M, Pourahmadi E, Adel A, Kemmak AR. Economic burden of knee joint replacement in Iran. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:74. [PMID: 39438951 PMCID: PMC11498953 DOI: 10.1186/s12962-024-00583-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/13/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND The knee is the most commonly afflicted weight-bearing joint. Osteoarthritis of the knee is regarded as one of the most commonly diagnosed causes of disability in the elderly. Knee joint replacement can be regarded as a final solution for Osteoarthritis of the knee in which the joint is worn out, accompanied by clinical symptoms such as pain, deformity, and limited movement. AIM this study sought to estimate the economic burden of knee joint replacement procedures carried out in Iran. METHOD This cross-sectional descriptive study utilized the Incidence-based approach to assess the economic burden of knee joint replacement surgeries conducted in Iran during 2022, estimating the costs of the disease from a societal perspective. The sampling method employed was random sampling, and the sample size consisted of 300 patients. Direct costs were calculated employing the top-down approach, while indirect costs were estimated using the human capital approach. Microsoft Excel was employed for data analysis. RESULT The average direct medical costs of the knee replacement procedure per patient were $10,076.87 and $13,099.93 in the public and private sectors, respectively. The average direct non-medical costs of knee joint replacement surgery are $1123.64, with companion costs constituting most of the direct non-medical costs. Finally, the economic burden of the knee joint replacement surgery was estimated at $67340417.28. CONCLUSION Despite insurance coverage, knee joint replacement surgery in Iran incurs substantial costs. With the anticipated rise in the elderly population, the frequency of these procedures is expected to increase, amplifying the economic burden on the Iranian public.
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Affiliation(s)
- Marziyeh Rajabi
- Vice chancellor for public health, Bushehr University of medical science, Bushehr, Iran
| | - Elahe Pourahmadi
- Social Determinants of Health Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Adel
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Health technology assessment research center, Mashhad University of medical science, Mashhad, Iran
| | - Asma Rashki Kemmak
- Health technology assessment research center, Mashhad University of medical science, Mashhad, Iran.
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
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Dzidotor GK, Moorhead JB, Ude CC, Ogueri KS, Ghosh D, Laurencin CT. Functions and Effectiveness of Unloader, Patellofemoral, and Knee Sleeve Orthoses: A Review. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2024; 10:147-171. [PMID: 38983777 PMCID: PMC11233114 DOI: 10.1007/s40883-023-00313-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/18/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2024]
Abstract
Background Knee orthoses have been extensively used as a nonsurgical approach to improving knee deficiencies. Currently, arthritic knee conditions remain the leading cause of disability, and this number is expected to increase. As the use of knee orthoses varies widely, so has their effectiveness which is still largely debatable. Here, we present the functions and effectiveness of the three most prominent knee orthotic models dedicated to supporting knee osteoarthritis-unloader, patellofemoral, and knee sleeves. Purpose/Research Question Considering the depth and diversity of the many clinical studies and documented laboratory reports published to date, this literature review was created to educate the clinician, patient, and researcher on common knee orthoses used for the management of arthritic knee conditions. In doing so, we discuss their design, biomechanical effects, and clinical efficacy, as well as broader outcomes, limitations, and recommendations for use. Results/Synthesis The knee orthoses discussed within the scope of this paper are dedicated to protecting the knee against strenuous compressive loads that may affect the patellofemoral and tibiofemoral joints of the knee. Since the knee has multiple axes of motion and articulating surfaces that experience different loads during functional activities, it can be implied that, to a large extent, knee brace designs can differ drastically. Unloader knee orthoses are designed to decrease tibiofemoral and patellofemoral joint pressures. Patellofemoral knee orthoses are designed to decrease strain on the patellofemoral and quadriceps tendons while stabilizing the patella. Knee sleeves are designed to stabilize movements, reduce pain in joints, and improve proprioception across the knee joint. Conclusion Although patients often report benefits from wearing braces, these benefits have not been confirmed by clinicians and scientific investigators. Results from these three orthosis types show that clinical efficacy is still elusive due to the different methodologies used by researchers. Layman Summary Knee orthoses also referred to as knee brace are commonly used for support and stability of the knee. Unloader knee braces are designed to relieve and support those suffering from knee osteoarthritis by improving physical impairment and reducing pain. Patellofemoral knee braces aim to help patients manage patellofemoral pain syndrome. Rehabilitative compression sleeves, also known as knee sleeves, are often used to assist patients suffering from knee pain and laxity. Important findings on the three knee braces discussed show discrepancies in results. Their effectiveness and validity are yet to be understood.
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Affiliation(s)
- Godwin K. Dzidotor
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Mansfield Rd, Storrs, CT, USA
| | - Jeffrey B. Moorhead
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA
| | - Chinedu C. Ude
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA
- Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Kenneth S. Ogueri
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA
- Institute of Materials Science, University of Connecticut, Mansfield Rd, Storrs, CT, USA
- Department of Materials Science and Engineering, University of Connecticut, Mansfield Rd, Storrs, CT, USA
| | - Debolina Ghosh
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA
| | - Cato T. Laurencin
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Mansfield Rd, Storrs, CT, USA
- Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA
- Institute of Materials Science, University of Connecticut, Mansfield Rd, Storrs, CT, USA
- Department of Materials Science and Engineering, University of Connecticut, Mansfield Rd, Storrs, CT, USA
- Department of Biomedical Engineering, University of Connecticut, Mansfield Rd, Storrs, CT, USA
- Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
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Prabhakar AJ, R S, Thomas DT, Nayak P, Joshua AM, Prabhu S, Kamat YD. Effectiveness of balance training on pain and functional outcomes in knee osteoarthritis: A systematic review and meta-analysis. F1000Res 2023; 11:598. [PMID: 38444514 PMCID: PMC10912788 DOI: 10.12688/f1000research.111998.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 03/07/2024] Open
Abstract
Background: Knee osteoarthritis (OA) is a musculoskeletal disorder that causes pain and increasing loss of function, resulting in reduced proprioceptive accuracy and balance. Therefore, the goal of this systematic review and meta-analysis is to evaluate the effectiveness of balance training on pain and functional outcomes in knee OA. Methods: "PubMed", "Scopus", "Web of Science", "Cochrane", and "Physiotherapy Evidence Database" were searched for studies conducted between January 2000 and December 2021. Randomized controlled trials (RCTs) that investigated the effectiveness of balance training in knee OA, as well as its effects on pain and functional outcome measures, were included. Conference abstracts, case reports, observational studies, and clinical commentaries were not included. Meta-analysis was conducted for the common outcomes, i.e., Visual Analog Scale (VAS), The Timed Up and Go (TUG), Western Ontario and McMaster Universities Arthritis Index (WOMAC). The PEDro scale was used to determine the quality of the included studies. Results: This review includes 22 RCTs of which 17 articles were included for meta-analysis. The included articles had 1456 participants. The meta-analysis showed improvement in the VAS scores in the experimental group compared to the control group [ I 2= 92%; mean difference= -0.79; 95% CI= -1.59 to 0.01; p<0.05] and for the WOMAC scores the heterogeneity ( I 2) was 81% with a mean difference of -0.02 [95% CI= -0.44 to 0.40; p<0.0001]. The TUG score was analyzed, the I 2 was 95% with a mean difference of -1.71 [95% CI= -3.09 to -0.33; p<0.0001] for the intervention against the control group. Conclusions: Balance training significantly reduced knee pain and improved functional outcomes measured with TUG. However, there was no difference observed in WOMAC. Although due to the heterogeneity of the included articles the treatment impact may be overestimated. Registration: The current systematic review was registered in PROSPERO on 7th October 2021 (registration number CRD42021276674).
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Affiliation(s)
- Ashish John Prabhakar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Shruthi R
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Dias Tina Thomas
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Pradeepa Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Abraham M. Joshua
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Srikanth Prabhu
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Yogeesh Dattakumar Kamat
- Consultant Knee & Hip Surgeon, Department of Orthopedics, Kasturba Medical College, Magalore, Manipal Academy of Higher Education, Manipal, India
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Kudo S, Miyashita T, Yamamoto A, Katayama S, Takasaki R. The effects of the functional garment on the biomechanics during the single leg drop landing. J Bodyw Mov Ther 2023; 36:142-147. [PMID: 37949551 DOI: 10.1016/j.jbmt.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/29/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION A functional biomechanics garment (FBG) may help to prevent injury by improved kinematics during motion such as single leg drop landing (SLDL). The purpose of this study was to investigate the effects of the FBG on the biomechanics of SLDL. METHOD Seventeen female university basketball players participated. Characteristics of the FBG were designed based on biomechanics during weight-loaded performance of human movement. The average values of lower limb kinematics and kinetics in the sagittal and frontal planes from 3 SLDL with and without FBG were measured and compared. RESULTS The maximum varus angle of the knee showed a significant difference between the use of FBG (15.3 ± 15.1°) and without the use of FBG (5.9 ± 15.4°), the flexion angular displacement of the hip (with FBG, 21.5 ± 8.1°; without FBG, 24.0 ± 6.7°) between with and without FBG. The moment of the hip with FGB (1.1 ± 0.6 Nm) was significantly smaller than without FGB (1.4 ± 0.8 Nm). DISCUSSION Regarding function of the FBG, the rigid part of the hip could counter the excessive adduction and flexion of the hip, and the elastic part of the thigh could support the varus moment when the elastic part stretched. Therefore, the subjects with FBG could control the frontal motion of the knee, which has a risk of knee injury, such as the dynamic valgus of the knee during the SLDL. CONCLUSION Use of the FBG decreases dynamic knee valgus, which reduces risk of knee injury.
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Affiliation(s)
- Shintarou Kudo
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Osaka, Japan; Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan; AR-Ex Medical Research Center, Tokyo, Japan.
| | - Toshinori Miyashita
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Osaka, Japan
| | - Ayane Yamamoto
- Department of Rehabilitation, AR-Ex Oyamadai Orthopedics Clinic, Setagaya, Tokyo, Japan
| | - Syo Katayama
- Department of Rehabilitation, Meidaimae Orthopedics Clinic, Setagaya, Tokyo, Japan
| | - Raita Takasaki
- Department of Acupuncture, Morinomiya University of Medical Sciences, Osaka, Japan
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Rezaei M, Saeedi H, Hajiaghaei B, Khademi-Kalantari K, Arazpour M. Comparison of Immediate Effect of New Knee brace and Conventional Three-Points Knee Valgus Brace on Knee Adduction Moment and ROM in Patients with Medial Knee Osteoarthritis. J Biomed Phys Eng 2022; 12:431-436. [PMID: 36059283 PMCID: PMC9395621 DOI: 10.31661/jbpe.v0i0.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 10/14/2019] [Indexed: 06/15/2023]
Abstract
The knee unloader brace can change loading on knee which may be effective in reducing symptoms and progression of disease in people with knee osteoarthritis. The purpose of this study was to evaluate the effect of a new knee brace during walking in a patient with medial compartment knee osteoarthritis. Two brace types were used: new brace and conventional brace. A pneumatic cuff of novel brace was fitted in the bottom of the medical slipper that was connected to the cuff section of the knee through the tube. After the knee brace is deployed, its force can vary in different stages of the gait. During the heel strike, the weight of the cuff is compressed on the floor, causing the air to flow inside it and entering the volume of air into the knee pad. The results of using this pneumatic knee brace compared with conventional knee braces on a patient showed that in both cases, the open and closed palatal pump, the adduction moment and ROM was decreased in the stance phase. But the three-point knee pressure, however, was less effective in reducing the adduction moment but also reduced the knee ROM. Using novel brace can eliminate the patient's need for painful and costly surgery to reduce the symptoms of osteoarthritis.
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Affiliation(s)
- Mehdi Rezaei
- PhD, Department of Orthotics and Prosthetics, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hassan Saeedi
- PhD, Department of Orthotics and Prosthetics, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Behnam Hajiaghaei
- PhD, Department of Orthotics and Prosthetics, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Khosro Khademi-Kalantari
- PhD, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mokhtar Arazpour
- PhD, Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
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Efficacy of unloader knee orthosis and lateral wedge insole on static balance in medial knee osteoarthritis. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2022. [DOI: 10.1177/22104917221095256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Medial knee osteoarthritis can contribute to pain and stiffness, interfere with balance and limit functional activities of daily living. Unloader knee orthosis or lateral wedged insoles are current conservative approaches used to treat these conditions. The aim of this study was to identify and compare the effects of them on the balance parameters. Methods 66 subjects with mild to moderate medial knee osteoarthritis were randomly assigned to wear unloader knee brace or full-length 6° lateral wedge insole. Primary outcome balance parameters were stability %, path length and average velocity of center of pressure and mobility score which were investigated by HUMAC® Balance and Tilt system. Secondary outcome measures were knee function score using Knee Injury and Osteoarthritis Outcome Score scale. Assessment was performed at baseline and six months post orthotic intervention period. Findings Both orthoses improved all parameters compared to the baseline condition (p < 0.05). Unloader knee orthosis showed a significant improvement in all balance parameters compared to lateral wedged insoles (p < 0.001) except mobility scores (p = 0.527). Except activities of daily living (p = 0.752) and sports and recreational activities (p = 0.437), unloader knee orthosis had a greater effect on the pain (p = 0.002) and symptoms (p < 0.001) sub scales than lateral wedged insoles. However, quality of life sub-scale scores for insoles were more effective than the knee orthosis. Interpretation Unloader knee orthosis improved balance and knee function scores more than lateral wedged insole, though both orthoses produced significantly improved results compared to baseline assessment.
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Knee osteoarthritis in midlife women. Menopause 2022; 29:748-755. [DOI: 10.1097/gme.0000000000001966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Milner J, Hartnettt D, DeFroda SF. Alternatives to Knee Braces. J Knee Surg 2022; 35:266-272. [PMID: 34600439 DOI: 10.1055/s-0041-1736198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Knee braces continue to be a widely utilized piece of medical equipment, ranging from simple over the counter sleeves to more complex functional braces, with the ability to provide electrical stimulation to muscle groups. Despite their popularity, alternatives to knee braces exist for patients who find braces to be ineffective, uncomfortable, cumbersome, or overly expensive. While high-quality studies are lacking for modalities such as neoprene sleeves, compression stockings, and kinesiotaping, there is promising evidence that these interventions can confer an element of stability and pain relief for a variety of knee pathologies both with regard to acute and chronic injuries as well as in the postoperative rehabilitation period. While no "holy grail" exists for the ideal brace, or bracing alternative, it is important for providers to be aware of the options available to patients as well as the current evidence for these various modalities, so that the provider can best guide musculoskeletal care.
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Affiliation(s)
- John Milner
- Department of Orthopedic Surgery, Brown University, Providence, Rhode Island
| | - Davis Hartnettt
- Department of Orthopedic Surgery, Brown University, Providence, Rhode Island
| | - Steven F DeFroda
- Department of Orthopedic Surgery, University of Missouri System, Columbia, Missouri
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Effect of Knee Orthosis Pressure Variation on Muscle Activities during Sit-to-Stand Motion in Patients with Knee Osteoarthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031341. [PMID: 35162362 PMCID: PMC8835671 DOI: 10.3390/ijerph19031341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 12/04/2022]
Abstract
It is yet not known whether the variation in knee orthotics pressure would lead to changes in muscle activity during-sit-to-stand postural transition in patients with knee osteoarthritis (OA). Participants in this analytical study were patients with knee OA. The research design was a cross-sectional study. They were enrolled in the study through a sample of convenience method. The primary outcome measure was surface electromyography for measuring muscle activity while changing knee orthotics pressure during sit-to-stand motion. Data were summarized with mean and standard deviation while Friedman’s test was performed for multiple comparison of variables, at a significance level of p = 0.05. Seven elderly patients with knee osteoarthritis (mean age 71.4 ± 11.8 years) participated in the study. Moderate orthotics (7.3 mmHg) led to a significant increase in the percentage maximum voluntary contraction (MVC) of tibialis anterior compared to that obtained without orthotics. Rectus femoris, vastus medialis, vastus lateralis, and biceps femoris tended to increase the % MVC with an increase in wearing pressure. It was therefore concluded that the muscle activity during sit-to-stand motion could be increased in patients with knee osteoarthritis by wearing flexible orthotics with varying pressure.
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Hatfield DL, Stranieri AM, Vincent LM, Earp JE. Effect of a Neoprene Knee Sleeve on Performance and Muscle Activity in Men and Women During High-Intensity, High-Volume Resistance Training. J Strength Cond Res 2021; 35:3300-3307. [PMID: 34593725 DOI: 10.1519/jsc.0000000000004072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Hatfield, DL, Stranieri, AM, Vincent, LM, and Earp, JE. Effect of a neoprene knee sleeve on performance and muscle activity in men and women during high-intensity, high-volume resistance training. J Strength Cond Res 35(12): 3300-3307, 2021-The purpose of this study was to assess the effects of a commercially available neoprene knee sleeve (KS) on exercise performance and muscle activity during an exhaustive leg press exercise. Twenty resistance-trained individuals, 11 men {21.0 ± 2.2 years; 77.7 ± 8.7 kg; 1 repetition maximum (1RM/body mass [BM]): 0.30 ± 0.04} and 9 women (22.0 ± 3.5 years; 66.1 ± 9.1 kg; 1RM/BM: 0.30 ± 0.04), all subjects (21.5 ± 2.8 years; 72.5 ± 10.5 kg; 1RM/BM: 0.30 ± 0.04), participated in 3 testing sessions. The second and third sessions were performed using a counterbalanced and randomized design in which subjects exercised with (WS) or without (NS) KSs and performed 6 sets of leg press exercise at 80% of 1RM until failure with a 3-minute rest between sets. Number of repetitions, blood lactate (BL), heart rate (HR), rating of perceived exertion (RPE), and peak and average power were recorded after each set. Surface electromyography (EMG) of the right and left vastus lateralis muscles was also recorded to compare muscle activity between conditions. Significance was set at p ≤ 0.05, and values are presented as mean ± SD. No significant differences were observed in the total number of repetitions for all sets (p = 0.3; WS 75.3 ± 33.7, NS 79.8 ± 34.3) and the number of repetitions per set between conditions (p ≤ 0.05) or between men and women. Similarly, no significance differences (p ≤ 0.05) were observed for BL, HR, RPE, or EMG per set between conditions or between men and women. These results suggest that wearing compressive neoprene KSs has no effect on improving performance and associated variables during high-load, high-volume lower-body resistance training.
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Affiliation(s)
- Disa L Hatfield
- Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island
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The Efficacy of Backward Walking on Static Stability, Proprioception, Pain, and Physical Function of Patients with Knee Osteoarthritis: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5574966. [PMID: 34221078 PMCID: PMC8213492 DOI: 10.1155/2021/5574966] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
Objective Impaired static stability and proprioception have been observed in individuals with knee osteoarthritis (KOA), which serves as a major factor increasing risk of fall. This study aimed to investigate the effects of backward walking (BW) on static stability, proprioception, pain, and physical function in KOA patients. Methods Thirty-two subjects with knee osteoarthritis were randomly assigned to either an BW group (BG, n = 16) or a control group (CG, n = 16). The participants in the BG received combination treatment of a 4-week BW training and conventional treatments, while those in the CG was treated with conventional treatments alone. All the participants were tested for the assessment of static stability [center of pressure (COP) sway, including sway length (SL, mm) and sway area (SA, mm2)] and proprioception [average trajectory error (ATE, %) and completion time (CT, second)]. Additionally, pain and knee function scores were measured by the numerical rating scale (NRS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, respectively. The assessments were conducted before and after intervention. Results The COP sway (SA and SL), ATE, NRS, and WOMAC showed a significant decline at week 4 in the two groups in contrast to their baseline (P < 0.05). Moreover, after 4-week intervention, the SA [(610.50 ± 464.26) mm2 vs. (538.69 ± 420.52) mm2], NRS [(1.56 ± 0.63) vs. (2.25 ± 0.86)], and WOMAC [(11.69 ± 2.50) vs. (16.19 ± 3.94)] showed a significantly greater decrease in the BG compared to the CG (P < 0.05, respectively). However, the proprioception (ATE and CT) was closely similar between both groups at week 4 (P > 0.05). Conclusion BW is an effective adjunct to conventional treatment in reducing pain, improving physical function and static stability for KOA patients. It should be taken into consideration when developing rehabilitation programs for people with KOA.
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14
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Khosravi M, Babaee T, Daryabor A, Jalali M. Effect of knee braces and insoles on clinical outcomes of individuals with medial knee osteoarthritis: A systematic review and meta-analysis. Assist Technol 2021; 34:501-517. [PMID: 33507124 DOI: 10.1080/10400435.2021.1880495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Knee osteoarthritis is a disabling disease, causing pain and reduced function.Orthoses are used to manage this problem, including knee braces and lateral wedge insoles. However, there is still controversy on which type of intervention is more effective. This systematic review and meta-analysis aimed toevaluate the effect of knee braces and lateral wedge insoles and compare their clinical outcomes onindividuals with medial knee osteoarthritis. We conducted the search strategy based on the population, intervention, comparison, andoutcome (PICO) method. We searched with PubMed, EMBASE, Web of Science, and Scopus databases for the related studies. The articles quality assessment was done based on the modified Downs and Black checklist. Totally, we chose 32 controlled trials, including 1.849 participants, for the final evaluation. Almosttwo-thirds of the studies had a moderate quality. The overall outcome suggested that both interventionshad improved pain and function. The difference between both interventions on pain reduction was not significant (standardized mean difference = 0.12, 95% confidence interval = 0.34 to 0.1) based on meta-analysis. Both knee brace and lateral wedge insole can improve pain and function in people with knee osteoarthritis. Using either separately or both of them together are effective.
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Affiliation(s)
- Mobina Khosravi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Taher Babaee
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aliyeh Daryabor
- Department of Physiotherapy, Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Jalali
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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15
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Khosravi M, Arazpour M, Sharafat Vaziri A. An evaluation of the use of a lateral wedged insole and a valgus knee brace in combination in subjects with medial compartment knee osteoarthritis (OA). Assist Technol 2021; 33:87-94. [PMID: 30945994 DOI: 10.1080/10400435.2019.1595788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Aim: The aim of this study was to evaluate the effect (6 weeks) of the use of a knee brace and a lateral wedge insole, both in isolation and combined, on the knee adduction moment (KAM), pain levels, kinematics (velocity, stride length, cadence), knee ROM, function, and satisfaction in patients with knee osteoarthritis (OA).Methods: Twenty-one patients with medial compartment knee OA were participated in this study. A relatively light three-point valgus knee brace (VB) and full length custom-made lateral wedge insole with arch support were prepared for each subject. Patients divided into three groups at random.Results: The use of a custom fit valgus brace with lateral edge insole concurrently can reduce a greater peak KAM than use in isolation (30%). In addition, the use of both interventions can improve walking velocity, cadence, and reduce levels of pain in patients with medial compartment OA.Conclusion: All parameters except stride length and KAM in comparison with first day of wearing interventions improved significantly in the combined, concurrent usage group. The use of a lateral wedge insole and a valgus knee brace in combination can improve the kinetic and kinematic parameters in patients with medial compartment knee OA.
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Affiliation(s)
- Mobina Khosravi
- Orthotics and Prosthetics department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mokhtar Arazpour
- Orthotics and Prosthetics department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran (the Islamic Republic of)
| | - Arash Sharafat Vaziri
- Orthopedic surgery department, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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16
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Machek SB, Cardaci TD, Wilburn DT, Cholewinski MC, Latt SL, Harris DR, Willoughby DS. Neoprene Knee Sleeves of Varying Tightness Augment Barbell Squat One Repetition Maximum Performance Without Improving Other Indices of Muscular Strength, Power, or Endurance. J Strength Cond Res 2021; 35:S6-S15. [PMID: 33201154 DOI: 10.1519/jsc.0000000000003869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Machek, SB, Cardaci, TD, Wilburn, DT, Cholewinski, MC, Latt, SL, Harris, DR, and Willoughby, DS. Neoprene knee sleeves of varying tightness augment barbell squat one repetition maximum performance without improving other indices of muscular strength, power, or endurance. J Strength Cond Res 35(2S): S6-S15, 2021-Neoprene knee sleeves are commonly used by powerlifters and recreational users but are heavily under-researched. Furthermore, no data exist on whether knee sleeves of varying compressive tightness impact muscular performance similar to commonly used knee wraps, which are both generally effective and more so when increasingly constrictive. Fifteen resistance trained, knee sleeve naive, recreational weight lifting men (22.1 ± 4.1 years; 177.5 ± 5.9 cm; 87.8 ± 7.8 kg) visited the laboratory on 3 separate occasions one week apart, assigned in a randomized, crossover, and counterbalanced fashion to either a minimally supportive control sleeve (CS) condition, a manufacturer-recommended sizing neoprene knee sleeve ("normal" sleeve; NS), or a one size smaller (than NS) neoprene knee sleeve (tighter sleeve [TS]). On each visit, subjects sequentially completed vertical jump (countermovement and squat jumps for both peak and mean power), one repetition maximum (1RM) barbell squat, and GymAware assessments (peak power, peak velocity, and dip) at 90% (reported) and 100% (tested) 1RM as well as one-leg extension (1RM, repetitions to failure, and total volume load at 75% 1RM) tests. All data were analyzed using one-way repeated measures analysis of variance at p < 0.05. Analysis revealed a significant condition effect on barbell squat 1RM (p = 0.003; η2 = 0.339), whereby both NS (p = 0.044; 166 ± 24 kg) and TS (p = 0.019; 166 ± 21 kg) outperformed CS (161 ± 22 kg), with no difference between neoprene sleeves. Conversely, no other tested parameters differed between knee sleeve conditions (p ≥ 0.05). The present results demonstrate that neoprene knee sleeves may function independent of tightness, relative to recommended sizing and ultimately unlike knee wraps. Furthermore, the singular benefits observed on barbell squat maximal strength potentially suggests an exercise-specific benefit yet to be fully elucidated.
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Affiliation(s)
- Steven B Machek
- Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas
| | - Thomas D Cardaci
- Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and
| | - Dylan T Wilburn
- Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas
| | | | - Scarlett Lin Latt
- Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas
| | - Dillon R Harris
- Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas
| | - Darryn S Willoughby
- Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas
- Mayborn College of Health Sciences, School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas
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17
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Birjandinejad A, Zandi R, Karimi E. Anthropometric Measurements of Distal Femur to Design the Femoral Component of Total Knee Arthroplasty for the Iranian Population. THE ARCHIVES OF BONE AND JOINT SURGERY 2020; 8:400-406. [PMID: 32766399 DOI: 10.22038/abjs.2018.32420.1861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Acquiring knowledge about anatomic and geometric quantities of bones is among the most vital parameters in orthopedic surgery that has a significant effect on the treatment of various disorders and subsequent outcomes. The aim of this study was to obtain anthropometric information for distal femur in order to compare with similar dimensions of prosthesis used in total knee arthroplasty (TKA) surgery and to design more suitable and optimal components. Methods Morphological data of distal femur were measured in 132 knees (81 males and 51 females) using magnetic resonance imaging (MRI). The data included anterior-posterior (AP) length, medial-lateral (ML) width, medial AP (MAP), lateral AP (LAP), MAP to LAP distance in the anterior distal femur namely anterior medial lateral (AML) width, medial and lateral condyle width, and intercondylar notch. The aspect ratio (ML/AP) was also calculated and the results were compared with similar dimensions of currently used knee implants. Results Our data showed that men are significantly larger in all dimensions than women. In the distal femur with similar AP lengths in both sexes, women had a smaller ML width than men (P<0.001). Comparison between the distal femur and studied prostheses showed no high correlation and similarity between the femoral component and femoral condyle prostheses in the resected surface of the bone. Conclusion The results of this study can provide the data needed to design prostheses suitable for the Iranian population.
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Affiliation(s)
- Ali Birjandinejad
- Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zandi
- Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Karimi
- Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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18
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Khosravi M, Arazpour M, Saeedi H, Rezaei M. Design Evaluation in Novel Orthoses for Patients with Medial Knee Osteoarthritis. J Biomed Phys Eng 2020; 9:719-732. [PMID: 32039103 PMCID: PMC6943847 DOI: 10.31661/jbpe.v0i0.965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 07/10/2018] [Indexed: 11/22/2022]
Abstract
Osteoarthritis of the knee is a debilitating condition affecting increasing numbers of individuals each year. One option for treatment is orthotic knee braces, but a little independent reviews have taken place to date on their relative outcomes for users. This study therefore evaluates the efficacy of different types of knee orthoses (braces) with regard to key aspects of use, including gait parameters, mobility and levels of comfort and compliance in subjects presenting with osteoarthritis (OA) of the knee. The collated data is presented with relevant supporting literature and appropriate descriptions in relation to each knee orthosis type that was identified, within appropriate subsections with advantages and disadvantages appropriately allocated. An analysis of each brace as presented by the corresponding article is then described further in terms of the design and structure, user outcomes and assessment summaries. According to the study carried out in this paper, it is presented and proved that applying the use of knee braces can reduce the knee adduction moment (KAM), but the amount of reduction afforded varies between designs. All of the studies reported significant pain reduction and functional improvement with the use of a knee brace, although their effect on the knee joint range of motion vary. Knee braces long-term use depends upon high levels of comfort and patient compliance, and further studies need to be conducted on larger numbers of subjects over greater time periods to reflect the long-term outcomes accurately
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Affiliation(s)
- M Khosravi
- MSc, Students Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - M Arazpour
- PhD, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- PhD, Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - H Saeedi
- PhD, Orthotics and Prosthetics Department, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - M Rezaei
- PhD, Orthotics and Prosthetics Department, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
- PhD, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mohd Sharif NA, Usman J, Wan Safwani WKZ, Siew Li G, Abdul Karim S, Mohamed NA, Khan SS, Khan SJ. Effects of simple knee sleeves on pain and knee adduction moment in early unilateral knee osteoarthritis. Proc Inst Mech Eng H 2019; 233:1132-1140. [PMID: 31597554 DOI: 10.1177/0954411919874614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Knee sleeves are often prescribed to alleviate pain in people with early knee osteoarthritis. However, the biomechanics underlying their pain-relieving effect are still not well understood. This pre-post study aims at evaluating and comparing the effects of two different types of knee sleeves on knee adduction moment. Patients with clinically diagnosed knee osteoarthritis were recruited from the University of Malaya Medical Centre and were randomly assigned to two test groups using (1) a simple knee sleeve and (2) a simple sleeve with patella cutout. Knee adduction moment was collected using the Vicon motion capture system with two Kistler force plates. Pain, stiffness and physical functions were recorded using the Western Ontario and McMaster Universities Osteoarthritis Index. All measurements were taken before, immediately after and at the completion of 6 weeks of application (primary time point). In total, 17 participants with early unilateral knee osteoarthritis (47.7 (9.7) years) completed the study. Overall results show significant reduction in pain, early stance and late stance knee adduction moment and increased walking speed after 6 weeks of both knee sleeves application. This study results suggest that knee sleeves can reduce knee adduction moments in early unilateral knee osteoarthritis by 14.0% and 12.1% using the simple sleeve and the sleeve with patella cutout, respectively, and can potentially delay disease progression. In addition, knee sleeve with patella cutout does not provide additional benefits when compared to the simple knee sleeve.
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Affiliation(s)
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Applied Biomechanics, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Goh Siew Li
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Samihah Abdul Karim
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Anisah Mohamed
- Institute of Mathematical Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Soobia Saad Khan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Saad Jawaid Khan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Department of Biomedical Engineering, Faculty of Engineering Science and Technology, Ziauddin University, Karachi, Pakistan
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20
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Zamporri J, Aguinaldo A. The Effects of a Compression Garment on Lower Body Kinematics and Kinetics During a Drop Vertical Jump in Female Collegiate Athletes. Orthop J Sports Med 2018; 6:2325967118789955. [PMID: 30140709 PMCID: PMC6096693 DOI: 10.1177/2325967118789955] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The use of compression garments has spread rapidly among athletes, largely because of marketing and perceived benefits. Upon review, it is unclear whether compression garments have a significant effect on performance and recovery, although they have been found to enhance proprioception. Further, it is reported that compression of the knee joint improves both dynamic and static balance. However, there is currently a paucity of data demonstrating the effects of compression garments on the biomechanical risk factors of knee-related injuries in female athletes. Purpose To evaluate the ability of a directional compression garment to alter hip and knee kinematics and kinetics during a drop vertical jump (DVJ) in healthy college-aged female athletes. Study Design Controlled laboratory study. Methods A sample of 23 healthy female collegiate athletes (mean age, 19.6 ± 1.3 years) participating in jumping sports (volleyball, basketball, and soccer) was included in this analysis. Each athlete performed 2 sets of 3 DVJs with and without a directional compression garment. Three-dimensional hip and knee kinematics and kinetics were collected using a standard Helen-Hayes 29-marker set, which was removed and reapplied after the garment was fitted, as well as 8 visible-red cameras and 2 force platforms. Each participant was tested in a single session. Results Hip abduction range of motion was significantly reduced from 12.6° ± 5.5° to 10.2° ± 4.6° (P = .002) while performing DVJs without and with the compression garment, respectively. No statistically significant differences between conditions were found in peak hip abduction, knee valgus range of motion, peak valgus, peak hip abduction moment, and peak knee valgus moment. Conclusion The results of this study show that wearing compression garments does have minimal effects on lower body mechanics during landing from a DVJ, partially supporting the idea that compression garments could acutely alter movement patterns associated with the knee injury risk. However, further research should focus on muscle activation patterns and adaptations over time. Clinical Relevance The use of specifically designed compression garments could aid in the prevention of knee injuries by inducing changes in jumping mechanics.
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Affiliation(s)
- Jacobo Zamporri
- Department of Kinesiology, Point Loma Nazarene University, San Diego, California, USA
| | - Arnel Aguinaldo
- Department of Kinesiology, Point Loma Nazarene University, San Diego, California, USA
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Cudejko T, van der Esch M, van der Leeden M, Roorda LD, Pallari J, Bennell KL, Lund H, Dekker J. Effect of Soft Braces on Pain and Physical Function in Patients With Knee Osteoarthritis: Systematic Review With Meta-Analyses. Arch Phys Med Rehabil 2018; 99:153-163. [DOI: 10.1016/j.apmr.2017.04.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 04/24/2017] [Indexed: 01/01/2023]
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Cudejko T, van der Esch M, van der Leeden M, van den Noort JC, Roorda LD, Lems W, Twisk J, Steultjens M, Woodburn J, Harlaar J, Dekker J. The immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence in patients with knee osteoarthritis. Arthritis Res Ther 2017; 19:260. [PMID: 29191237 PMCID: PMC5709997 DOI: 10.1186/s13075-017-1456-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/18/2017] [Indexed: 01/12/2023] Open
Abstract
Background We aimed to (i) evaluate the immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence, and (ii) to assess the difference in effect between a non-tight and a tight soft brace in patients with knee osteoarthritis (OA). Methods Forty-four patients with knee OA and self-reported knee instability participated in the single-session, laboratory, experimental study. A within-subject design was used, comparing a soft brace with no brace, and comparing a non-tight with a tight soft brace. The outcome measures were pain, self-reported knee instability and knee confidence during level and perturbed walking on the treadmill and activity limitations (10-m walk test and the get up and go (GUG) test). Linear mixed-effect model analysis for continuous outcomes and logistic generalized estimating equations for categorical outcomes were used to evaluate the effect of wearing a soft brace. Results Wearing a soft brace significantly reduced pain during level walking (B − 0.60, P = 0.001) and perturbed walking (B − 0.80, P < 0.001), reduced the time to complete the 10-m walk (B − 0.23, P < 0.001) and the GUG tests (B − 0.23, P = 0.004), reduced self-reported knee instability during level walking (OR 0.41, P = 0.002) and perturbed walking (OR 0.36, P < 0.001), and reduced lack of confidence in the knees during level walking (OR 0.45, P < 0.001) and perturbed walking (OR 0.56, P < 0.001), compared with not wearing a soft brace. There was no difference in effects between a non-tight and tight brace, except for the 10-m walk test. Wearing a tight brace significantly reduced the time to complete the 10-m walk test in comparison with wearing a non-tight brace (B − 0.11, P = 0.03). Conclusion The results of this study indicate that a soft brace is an efficacious intervention targeting pain, activity limitations, self-reported knee instability, and knee confidence in the immediate term in patients with knee OA. Further studies are needed evaluating the mode of action based on exerted pressure, and on the generalization to functioning in daily life. Trial registration trialregister.nl, NTR6363. Retrospectively registered on 15 May 2017.
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Affiliation(s)
- Tomasz Cudejko
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - Martin van der Esch
- Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands.
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - Josien C van den Noort
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Musculoskeletal Imaging Quantification Center (MIQC), Academic Medical Center, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - Willem Lems
- Amsterdam Rheumatology & Immunology Center, Amsterdam Medical Center, Reade, VU University Medical Center, Amsterdam, The Netherlands.,Jan van Breemen Research Institute, Reade, Amsterdam, The Netherlands
| | - Jos Twisk
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn Steultjens
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - James Woodburn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Delft University of Technology, Delft, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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Liu C, Wan Q, Zhou W, Feng X, Shang S. Factors associated with balance function in patients with knee osteoarthritis: An integrative review. Int J Nurs Sci 2017; 4:402-409. [PMID: 31406784 PMCID: PMC6626142 DOI: 10.1016/j.ijnss.2017.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/30/2017] [Accepted: 09/05/2017] [Indexed: 02/07/2023] Open
Abstract
This integrative review is to identify the factors associated with balance function in patients with knee osteoarthritis and explore the relationship between these factors and balance function. Osteoarthritis commonly occurs in elderly people. Patients with knee osteoarthritis have balance impairment, and maintaining knee stability is important for such patients to prevent accidental injuries caused by falling. Therefore, it is important to clarify the factors related to balance function in patients with knee osteoarthritis. The PubMed, Science Direct, CINAHL, Ovid, ProQuest, CNKI, WanFang databases were searched, and relevant articles published up to December 2015 were included. Twenty articles were included in the analysis. Age, gender, dominant limb, foot length, knee alignment, diurnal variation, and meniscus tears were the non-modifiable factors, whereas body mass index, knee pain, muscle strength, joint range of motion, severity, and cognitive loading were the modifiable factors. Knee sleeve and custom-molded insoles showed protective effects against knee osteoarthritis.
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Affiliation(s)
| | - Qiaoqin Wan
- School of Nursing, Peking University, PR China
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Cunha FG, Assad AR, Pereira TJDCC, Souza Pinheiro PID, Barbosa GDM, Lins CADA, Abreu BJ, Vieira WHDB. EFEITO DO AQUECIMENTO SOBRE A FLEXIBILIDADE E O DESEMPENHO FUNCIONAL: ENSAIO CLÍNICO RANDOMIZADO. REV BRAS MED ESPORTE 2017. [DOI: 10.1590/1517-869220172305153076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Introdução: A atividade física deve ser parte fundamental de programas de promoção da saúde. No entanto, sua realização pode expor o indivíduo a riscos de lesão, o que torna necessária a adoção de medidas preventivas como o aquecimento, com o intuito de minimizar os riscos e/ou contribuir para o melhor desempenho funcional. Objetivo: O propósito deste estudo foi analisar o efeito agudo de diferentes tempos de aquecimento sobre flexibilidade, equilíbrio e desempenho funcional em indivíduos fisicamente ativos. Método: Trinta e dois homens saudáveis que realizavam exercício regularmente pelo menos três vezes por semana foram aleatoriamente incluídos em um de quatro grupos (n = 8): G0 (sem aquecimento), G5 (aquecimento por cinco min.), G10 (aquecimento por dez min.) e G15 (aquecimento por quinze min.). Os indivíduos foram avaliados antes e depois da intervenção nas seguintes variáveis: flexibilidade do reto femoral (RF) e dos isquiotibiais (IT), equilíbrio corporal com olhos abertos e fechados e desempenho funcional por meio dos testes de salto triplo horizontal (STH) e shuttle run (SR). O aquecimento foi realizado numa esteira ergométrica entre 70% e 80% da frequência cardíaca máxima estimada para idade. Resultado: Não houve diferenças significativas na flexibilidade e no equilíbrio nas comparações intra e intergrupos (p > 0,05). Contudo, houve melhora significativa do desempenho funcional somente no G10 na comparação intragrupo para as variáveis STH (de 5,88 ± 0,55 para 6,23 ± 0,66; p = 0,0051) e SR (de 4,72 ± 0,13 para 4,61 ± 0,13; p= 0,0194). Conclusão: O aquecimento durante 10 minutos parece melhorar o desempenho funcional em indivíduos ativos, podendo também ser uma alternativa viável para a prevenção de lesão.
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Added MAN, Added C, Kasawara KT, Rotta VP, de Freitas DG. Effects of a Knee Brace With a Patellar Hole Versus Without a Patellar Hole in Patients With Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial. Eval Health Prof 2017; 41:512-523. [PMID: 28770628 DOI: 10.1177/0163278717714307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The objective of this study was to observe the immediate effect of a knee brace with a patellar hole versus without a patellar hole on pain perception in patients with knee osteoarthritis. To accomplish this, a double-blind, randomized controlled trial enrolled 108 patients divided into two groups (knee brace with a patellar hole or without a patellar hole). Patients were evaluated by the Visual Analogue Scale (VAS) in order to measure their pain sensation, the Timed Up and Go (TUG) test was used to evaluate their ability to walk, and the 8-m walking test (8MWT) was used to estimate their walking speed. Both groups presented significant reduction in pain perception, higher function of the lower extremities, and greater mobility while wearing a knee brace. However, the patients who wore a knee brace without a patellar hole presented more favorable results than those who wore a knee brace with a patellar hole: a 1.6-point reduction was found versus 1.1 points in the VAS, the patients presented 0.7 s less time versus 0.4 s in the TUG, and the speed was reduced by 1.4 s versus 0.8 s in the 8MWT. Therefore, the knee brace without a patellar hole presented more favorable results when compared with the knee brace with a patellar hole.
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Affiliation(s)
- Marco Aurélio Nemitalla Added
- 1 Physical Therapy Department, Santa Casa Misericórdia de São Paulo, Brazil.,2 Guarulhos University, Guarulhos, Brazil
| | - Caroline Added
- 3 Student University Center São Camilo, São Paulo, Brazil
| | - Karina Tamy Kasawara
- 2 Guarulhos University, Guarulhos, Brazil.,4 Department of Obstetrics and Gynecology, University of Campinas, Campinas, Brazil
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Mohd Sharif NA, Goh SL, Usman J, Wan Safwani WKZ. Biomechanical and functional efficacy of knee sleeves: A literature review. Phys Ther Sport 2017; 28:44-52. [PMID: 28673759 DOI: 10.1016/j.ptsp.2017.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 04/26/2017] [Accepted: 05/06/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Knee sleeves are widely used for the symptomatic relief and subjective improvements of knee problems. To date, however, their biomechanical effects have not been well understood. OBJECTIVE To determine whether knee sleeves can significantly improve the biomechanical variables for knee problems. METHOD Systematic literature search was conducted on four online databases - PubMed, Web of Science, ScienceDirect and Springer Link - to find peer-reviewed and relevant scientific papers on knee sleeves published from January 2005 to January 2015. Study quality was assessed using the Structured Effectiveness Quality Evaluation Scale (SEQES). RESULTS Twenty studies on knee sleeves usage identified from the search were included in the review because of their heterogeneous scope of coverage. Twelve studies found significant improvement in gait parameters (3) and functional parameters (9), while eight studies did not find any significant effects of knee sleeves usage. CONCLUSION Most improvements were observed in: proprioception for healthy knees, gait and balance for osteoarthritic knees, and functional improvement of injured knees. This review suggests that knee sleeves can effect functional improvements to knee problems. However, further work is needed to confirm this hypothesis, due to the lack of homogeneity and rigor of existing studies.
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Affiliation(s)
- Nahdatul Aishah Mohd Sharif
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siew-Li Goh
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia; Centre for Applied Biomechanics, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Young SE, Bothwell JD, Walsh RM. Safely Managing Acute Osteoarthritis in the Emergency Department: An Evidence-Based Review. J Emerg Med 2016; 51:648-657. [DOI: 10.1016/j.jemermed.2016.05.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
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Lee H, Ha D, Kang YS, Park HS. Biomechanical Analysis of the Effects of Bilateral Hinged Knee Bracing. Front Bioeng Biotechnol 2016; 4:50. [PMID: 27379233 PMCID: PMC4909737 DOI: 10.3389/fbioe.2016.00050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/30/2016] [Indexed: 11/23/2022] Open
Abstract
This research analyzed the effect of bilateral hinged knee braces on a healthy knee from a biomechanical frame in vivo. This was accomplished by fitting a knee brace with two customized wireless force/torque (F/T) sensors that could readily record force and torque during live motion, while the kinetics at the knee were computed using the inverse dynamics of the motion capture and force plate data. Four tasks to test the brace’s effects were drop vertical jumping, pivoting, stop vertical jumping, and cutting. The results showed that the hinges in the knee brace can absorb up to 18% of the force and 2.7% of the torque at the knee during various athletic motions. Thus, the hinges demonstrated minimal effect in reducing the mechanical load on the knee. There were limitations concerning the consistency of the motions performed by the subjects during the trials and the influence of the other portions of the brace to evaluate the overall effectiveness of the brace as a whole. Future works may incorporate a fatigue protocol and injured subjects to better determine the effects of the brace. There is still a need for more research on the biomechanical influence of knee braces to develop safer and more effective products.
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Affiliation(s)
- Hangil Lee
- Mechanical Engineering Department, Korea Advanced Institute of Science and Technology , Daejeon , Korea
| | - Dokyeong Ha
- Mechanical Engineering Department, Korea Advanced Institute of Science and Technology , Daejeon , Korea
| | - Yeoun-Seung Kang
- Mechanical Engineering Department, Korea Advanced Institute of Science and Technology , Daejeon , Korea
| | - Hyung-Soon Park
- Mechanical Engineering Department, Korea Advanced Institute of Science and Technology , Daejeon , Korea
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Maleki M, Arazpour M, Joghtaei M, Hutchins SW, Aboutorabi A, Pouyan A. The effect of knee orthoses on gait parameters in medial knee compartment osteoarthritis: A literature review. Prosthet Orthot Int 2016; 40:193-201. [PMID: 25160784 DOI: 10.1177/0309364614547411] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 07/21/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Knee osteoarthritis is a musculoskeletal condition which is most prevalent in the medial compartment. This injury causes considerable pain, disability, and negative changes in kinetic and kinematic parameters. The efficiency of unloader valgus brace as a conservative treatment for medial knee osteoarthritis is not well documented. OBJECTIVES The aim of this study was to review the previous research regarding the biomechanical effects of knee valgus braces on walking in medial compartment knee osteoarthritis patients. STUDY DESIGN Literature review METHODS According to the population intervention comparison outcome measure methods and based on selected keywords, 12 studies were chosen according to (met) the inclusion criteria. RESULTS The results indicated that treatment with knee braces was effective in decreasing pain, improving function, ameliorating improvement in range of motion, and increasing speed of walking and step length in conjunction with a reduction in the adduction moment applied to the knee. CONCLUSION Osteoarthritis knee braces may be considered for improvement of walking and treatment of medial compartment knee osteoarthritis. CLINICAL RELEVANCE Knee braces are an orthotic intervention that could potentially be significant in assisting in improving the walking parameters and treatment of medial compartment knee osteoarthritis.
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Affiliation(s)
- Maryam Maleki
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - Mokhtar Arazpour
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - Mahmoud Joghtaei
- Department of Automatic Control and Systems Engineering, University of Sheffield, UK
| | - Stephen W Hutchins
- IHSCR, Faculty of Health & Social Care, University of Salford, Salford, UK
| | - Atefeh Aboutorabi
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - Ali Pouyan
- Department of Neurosurgery, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Silva A, Mello MTD, Gávea Junior SA, Queiroz SSD, Tufik S, Mattiello SM. Therapeutic modalities and postural balance of patients with knee osteoarthritis: systematic review. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.003.ar01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AbstractObjective The objective of this review was to evaluate the evidence of the influence of therapeutic modalities on postural balance in patients with knee osteoarthritis (OA).Methods A search for published papers on therapeutic modalities was conducted using the Pubmed, Medline, Lilacs and SciELO databases. The keywords “knee” and “balance” in combination with “osteoarthritis” were used as the search strategy. Randomized controlled clinical trials published in the last 10 years in either English or Portuguese were selected. The PEDro scale was applied to assess the quality of the selected clinical trials.Results A total of 46 studies of patients with knee OA were found, of which seven were analyzed in full and 39 were excluded because they did not meet the inclusion criteria. Of the seven studies reviewed, six were considered to have a high methodological quality on the PEDro scale. Several therapeutic modalities were found (physical exercise, hydrotherapy, electrotherapy and manual therapy), and postural balance improved in only three studies.Conclusion The studies included in this systematic review had a high methodological quality, so it can be concluded that the therapeutic modalities used in those studies improved postural balance in patients with knee OA.
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Immediate effects of an elastic knee sleeve on frontal plane gait biomechanics in knee osteoarthritis. PLoS One 2015; 10:e0115782. [PMID: 25621488 PMCID: PMC4306516 DOI: 10.1371/journal.pone.0115782] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 12/01/2014] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Osteoarthritis of the knee affects millions of people. Elastic knee sleeves aim at relieving symptoms. While symptomatic improvements have been demonstrated as a consequence of elastic knee sleeves, evidence for biomechanical alterations only exists for the sagittal plane. We therefore asked what effect an elastic knee sleeve would have on frontal plane gait biomechanics. METHODS 18 subjects (8 women, 10 men) with osteoarthritis of the medial tibiofemoral joint walked over ground with and without an elastic knee sleeve. Kinematics and forces were recorded and joint moments were calculated using an inverse dynamics approach. Conditions with sleeve and without sleeve were compared with paired t-Tests. RESULTS With the sleeve, knee adduction angle at ground contact was reduced by 1.9 ± 2.1° (P = 0.006). Peak knee adduction was reduced by 1.5 ± 1.6° (P = 0.004). The first peak knee adduction moment and positive knee adduction impulse were decreased by 10.1% (0.74 ± 0.9 Nm • kg-1; P = 0.002) and 12.9% (0.28 ± 0.3 Nm • s • kg-1; P < 0.004), respectively. CONCLUSION Our study provides evidence that wearing an elastic knee sleeve during walking can reduce knee adduction angles, moments and impulse in subjects with knee osteoarthritis. As a higher knee adduction moment has previously been identified as a risk factor for disease progression in patients with medial knee osteoarthritis, we speculate that wearing a knee sleeve may be beneficial for this specific subgroup.
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A kinetic and kinematic analysis of the effect of stochastic resonance electrical stimulation and knee sleeve during gait in osteoarthritis of the knee. J Appl Biomech 2013; 30:104-12. [PMID: 23878205 DOI: 10.1123/jab.2012-0257] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Extended use of knee sleeves in populations at risk for knee osteoarthritis progression has shown functional and quality of life benefits; however, additional comprehensive kinematic and kinetic analyses are needed to determine possible physical mechanisms of these benefits which may be due to the sleeve's ability to enhance knee proprioception. A novel means of extending these enhancements may be through stochastic resonance stimulation. Our goal was to determine whether the use of a knee sleeve alone or combined with stochastic resonance electrical stimulation improves knee mechanics in knee osteoarthritis. Gait kinetics and kinematics were assessed in subjects with medial knee osteoarthritis when presented with four conditions: control1, no electrical stimulation/sleeve, 75% threshold stimulation/sleeve, and control2. An increase in knee flexion angle throughout stance and a decrease in flexion moment occurring immediately after initial contact were seen in the stimulation/sleeve and sleeve alone conditions; however, these treatment conditions did not affect the knee adduction angle and internal knee abduction moment during weight acceptance. No differences were found between the sleeve alone and the stochastic resonance with sleeve conditions. A knee sleeve can improve sagittal-plane knee kinematics and kinetics, although adding the current configuration of stochastic resonance did not enhance these effects.
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Son H, Kim K. A Kinematic Analysis of Patients with Knee Osteoarthritis during Gait on Level Ground, Ramps and Stairs. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hohee Son
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan
| | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University: 15 Naeri Jillyang, Gyuongsan 712-765, South Korea
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Davis AG, Pietrosimone BG, Ingersoll CD, Pugh K, Hart JM. Quadriceps function after exercise in patients with anterior cruciate ligament-reconstructed knees wearing knee braces. J Athl Train 2012; 46:615-20. [PMID: 22488186 DOI: 10.4085/1062-6050-46.6.615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Knee braces and neoprene sleeves are commonly worn by people with anterior cruciate ligament reconstructions (ACLRs) during athletic activity. How knee braces and sleeves affect muscle activation in people with ACLRs is unclear. PURPOSE To determine the effects of knee braces and neoprene knee sleeves on the quadriceps central activation ratio (CAR) before and after aerobic exercise in people with ACLRs. DESIGN Crossover study. PATIENTS OR OTHER PARTICIPANTS Fourteen people with a history of ACLR (9 women, 5 men: age = 23.61 ± 4.44 years, height = 174.09 ± 9.82 cm, mass = 75.35 ± 17.48 kg, months since ACLR = 40.62 ± 20.41). INTERVENTION(S) During each of 3 sessions, participants performed a standardized aerobic exercise protocol on a treadmill. The independent variables were condition (brace, sleeve, or control) and time (baseline, pre-exercise with brace, postexercise with brace, postexercise without brace). MAIN OUTCOME MEASURE(S) Normalized torque measured during a maximal voluntary isometric contraction (T(MVIC)) and CAR were measured by a blinded assessor using the superimposed burst technique. The CAR was expressed as a percentage of full muscle activation. The quadriceps CAR and T(MVIC) were measured 4 times during each session: baseline, pre-exercise with brace, postexercise with brace, and postexercise without brace. RESULTS Immediately after the application of the knee brace, T(MVIC) decreased (P = .01), but no differences between bracing conditions were observed. We noted reduced T(MVIC) and CAR (P < .001) after exercise, both with and without the brace. No differences were seen between bracing conditions after aerobic exercise. CONCLUSIONS The decrease in T(MVIC) immediately after brace application was not accompanied by differences between bracing conditions. Wearing a knee brace or neoprene sleeve did not seem to affect the deterioration of quadriceps function after aerobic exercise.
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Citaker S, Kaya D, Yuksel I, Yosmaoglu B, Nyland J, Atay OA, Doral MN. Static balance in patients with patellofemoral pain syndrome. Sports Health 2012; 3:524-7. [PMID: 23016053 PMCID: PMC3445232 DOI: 10.1177/1941738111420803] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The relationship between one-leg static standing balance (OLSSB) and patellofemoral pain syndrome (PFPS) is unknown. Hypothesis: OLSSB decreases in patients with PFPS. Design: Prospective case series. Methods: Fifty-two women with unilateral PFPS were enrolled in this study. OLSSB was evaluated with a stabilometer. Q angle was measured with a lengthened-arm universal goniometer. Lower extremity alignment was analyzed with full-length standing anteroposterior teleroentgenograms. Quadriceps and hamstring strength was measured on an isokinetic dynamometer. Results: There were significant differences in OLSSB, Q angle, and strength of quadriceps and hamstring between the symptomatic and asymptomatic sides. There was a correlation between the strength of the quadriceps and hamstring and OLSSB, while there was no correlation between OLSSB and the severity of pain, lower extremity alignment, and Q angle on the symptomatic side. Conclusions: OLSSB and quadriceps and hamstring strength decreased and Q angle increased on the symptomatic side in PFPS patients. A relationship between OLSSB and pain, Q angle, and lower extremity alignment was not detected, while there was a correlation between the strength of the quadriceps and hamstring and OLSSB. Clinical Relevance: A quadriceps and hamstring strengthening may be beneficial to improve OLSSB in patients with PFPS.
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Affiliation(s)
- Seyit Citaker
- Department of Physical Therapy and Rehabilitation, Gazi University, Ankara, Turkey
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Souza ACDS, Santos GM. Sensibilidade da Escala de Equilíbrio de Berg em indivíduos com osteoartrite. MOTRIZ: REVISTA DE EDUCACAO FISICA 2012. [DOI: 10.1590/s1980-65742012000200011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo teve objetivo de analisar a sensibilidade e especificidade da Escala de Equilíbrio de Berg (EEB) em detectar o risco de queda em indivíduos com osteoartrite de joelho (OAJ). Verificar a associação entre a capacidade funcional, grau de OAJ, quadro álgico, índice de medo de cair e histórico de queda com o escore da EEB. Participaram 69 indivíduos com OAJ. Foram analisados os pontos de corte 45, 47, 49, 51 e 53 pontos da EEB, quanto à sensibilidade e especificidade do teste. Utilizou-se a escala analógica visual e os questionários WOMAC e Índice de preocupação em cair (FES-I). Os resultados evidenciaram diferença significativa (p=0,001) no escore da EEB entre os indivíduos com OAJ com e sem história de queda. A EEB apresentou correlação com Womac, FES-I, histórico de queda e grau de OAJ. A EEB não apresentou um ponto de corte ideal para indivíduos com OAJ. Contudo, a escala é sensível às diferenças individuais nesta população.
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The assessment of postural control with stochastic resonance electrical stimulation and a neoprene knee sleeve in the osteoarthritic knee. Arch Phys Med Rehabil 2012; 93:1123-8. [PMID: 22425291 DOI: 10.1016/j.apmr.2011.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 10/31/2011] [Accepted: 12/02/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine whether the combination of stochastic resonance (SR) electrical stimulation and a neoprene knee sleeve could improve center of pressure (COP) measures of postural sway during single-leg stance in those with knee osteoarthritis (OA). DESIGN Counterbalanced, repeated-measures intervention study of osteoarthritic adults during 6 different testing conditions: a control condition-control 1 (1); a counterbalance sequence of 4 treatment conditions-no stimulation with sleeve (2), 75% stimulation with sleeve (3), 100% stimulation with sleeve (4), and 150% stimulation with sleeve (5); and a second control condition-control 2 (6). SETTING University sports medicine research laboratory. PARTICIPANTS Subjects (N=52) with radiographically determined, minimal-to-moderate medial knee OA. INTERVENTIONS Neoprene knee sleeve and SR electrical stimulation. MAIN OUTCOME MEASURES COP displacement in the medial-lateral and anterior-posterior directions was collected to resolve the mean velocity, SD, range, and total path length. RESULTS No significant differences were found in the study measures between the testing conditions. Additionally, no significant differences were found between the 3 stimulation conditions or between the sleeve-alone and stimulation conditions for any of the study measures. CONCLUSIONS There were no significant improvements in balance with the use of a neoprene knee sleeve. Additionally, there was no added benefit of the SR stimulation as applied in the current configuration in this population.
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Stochastic resonance electrical stimulation to improve proprioception in knee osteoarthritis. Knee 2011; 18:317-22. [PMID: 20655753 DOI: 10.1016/j.knee.2010.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 06/28/2010] [Accepted: 07/04/2010] [Indexed: 02/02/2023]
Abstract
Proprioceptive deficits occur with knee osteoarthritis (OA) and improving proprioception may slow joint degeneration by allowing more appropriate joint loading. Stochastic resonance (SR) stimulation improves balance and the sensitivity of specific mechanoreceptors. Our purpose was to evaluate the effects of SR electrical stimulation combined with a knee sleeve on proprioception in subjects with knee OA. Joint position sense (JPS) was measured in 38 subjects with knee OA during four conditions in both a partial weight-bearing (PWB) and non weight-bearing (NWB) task: no electrical stimulation/no sleeve, no electrical stimulation/sleeve, 50 μA-RMS stimulation/sleeve, and 75 μA-RMS stimulation/sleeve. Subjects also reported their knee pain, stiffness, functionality (WOMAC), and instability. Repeated measures ANOVA and Spearman correlations were performed to investigate differences between the conditions and relationships among the outcome measures. JPS during the 75 μA-RMS stimulation/sleeve and sleeve alone conditions was significantly improved compared to the control condition in the PWB task. However, the 75 μA-RMS stimulation/sleeve and the sleeve alone conditions did not differ from each other. A moderate correlation was found between the improvements with the 75 μA-RMS stimulation/sleeve condition compared to the JPS of the control condition in the PWB task. No differences in JPS were found between the four conditions in the NWB task. Significant correlations were found between the control JPS and WOMAC indices (p<0.005). Improved proprioception during the PWB task was achieved with a sleeve alone and in combination with SR stimulation. The observed correlations suggest that subjects with larger proprioceptive deficits may benefit most from these therapies.
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Abstract
Osteoarthritis (OA), the third most common diagnosis in the elderly [1], causes significant pain leading to disability and decreased quality of life in subjects 65 years and older [2]. Traditionally, clinicians have relied heavily on the use of non-steroidal anti-inflammatory drugs (NSAIDs) to treat the pain of OA, as numerous studies have proven these agents to be effective. The cardiovascular, gastrointestinal, renal and hepatic toxicities of NSAIDs have limited their use, particularly in the elderly. Acetaminophen has been recommended as initial therapy due to relative safety. Several other topical, oral and intra-articular agents are available today, with use limited by efficacy and side effect profiles. Many non-pharmacologic approaches are available but underused, and may be attractive choices to avoid poly-pharmacy in older patients. We will attempt to highlight the evidence behind available non-surgical therapies for OA while paying specific attention to issues in geriatric patients.
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Affiliation(s)
- Saulat Mushtaq
- Division of Rheumatology, SSM St. Charles Clinic Medical Group, 1475 Kisker, Suite 200, St. Charles, MO 63304 USA
| | - Rabeea Choudhary
- Department of Medicine, Division of Nephrology, University of New Mexico Hospital, 1 UNM, MSC 10–5550, Albuquerque, NM 87131 USA
| | - Carla R. Scanzello
- Department of Medicine, Section of Rheumatology, Rush University Medical Center, 1611 West Harrison Street, Suite 510, Chicago, IL 60612 USA
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Efficacy of knee braces and foot orthoses in conservative management of knee osteoarthritis: a systematic review. Am J Phys Med Rehabil 2011; 90:247-62. [PMID: 21273902 DOI: 10.1097/phm.0b013e318206386b] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A systematic analysis was conducted on the effectiveness of knee braces and foot orthoses in conservative management of knee osteoarthritis. The methodologic quality of the randomized clinical trials, controlled clinical trials, and observational studies were systematically reviewed using the Structured Effectiveness Quality Evaluation Scale. Twenty-five studies met the inclusion criteria. The orthoses used in the studies included Generation II osteoarthritis knee brace, valgus knee braces, functional off-loading knee braces, knee sleeves, lateral-wedged insoles with subtalar strapping, medial-wedged insoles, and specialized footwear. Results suggest that knee braces and foot orthoses are effective in decreasing pain, joint stiffness, and drug dosage. They also improve proprioception, balance, Kellgren/Lawrence grading, and physical function scores in subjects with varus and valgus knee osteoarthritis. Knee braces and foot orthoses could be cautiously considered as conservative management for relief of pain and stiffness and improving physical function for persons with knee osteoarthritis. The conclusions of this review are limited by methodologic considerations like poor quality of trials and heterogeneity of interventions.
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Rannou F, Poiraudeau S, Beaudreuil J. Role of bracing in the management of knee osteoarthritis. Curr Opin Rheumatol 2010; 22:218-22. [DOI: 10.1097/bor.0b013e32833619c4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Beaudreuil J, Bendaya S, Faucher M, Coudeyre E, Ribinik P, Revel M, Rannou F. Clinical practice guidelines for rest orthosis, knee sleeves, and unloading knee braces in knee osteoarthritis. Joint Bone Spine 2009; 76:629-36. [PMID: 19467901 DOI: 10.1016/j.jbspin.2009.02.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Accepted: 02/24/2009] [Indexed: 11/18/2022]
Affiliation(s)
- Johann Beaudreuil
- Service de rhumatologie, hôpital Lariboisière, université Paris-7, Paris, France
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