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Orthoses versus gait retraining: Immediate response in improving physical performance measures in healthy and medial knee osteoarthritic adults.
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine ( IF 1.7 ) Pub Date : 2020-05-27 , DOI: 10.1177/0954411920924525
Saad Jawaid Khan 1, 2 , Soobia Saad Khan 1 , Juliana Usman 1, 3 , Abdul Halim Mokhtar 4 , Noor Azuan Abu Osman 1, 3, 5
Affiliation  

The conservative techniques of treating knee osteoarthritis (kOA) include wearing orthoses such as knee braces and laterally wedged insoles and applying gait modification techniques such as toe-in gait and toe-out gait. This study aimed at assessing the immediate effects of these techniques in improving physical function of healthy and kOA participants. Five Osteoarthritis Research Society International (OARSI) recommended performance-based tests were randomly applied to measure physical function: (1) 30-second chair stand test (30CST), (2) 40-m (4 × 10) fast-paced walk test (40FPW), (3) stair climb test (SCT), (4) timed up and go test (TUGT) and (5) 6-minute walk test (6MWT) during a single-visit on 20 healthy and 20 kOA patients (age: 59.5 ± 7.33 and 61.5 ± 8.63 years, BMI: 69.95 ± 9.86 and 70.45 ± 8.80 kg/m2). The interventions included natural gait, toe-out gait, toe-in gait, laterally wedged insoles and knee brace. Analysis was performed through repeated-measures ANOVA and independent sample t-test. 30CST and TUGT showed no significant differences for the five test conditions (p > 0.05). Toe-out showed profound effects via pairwise comparison in impairing the physical function while knee brace improved it during 40FPW, SCT and 6MWT. In general, all the tested conservative techniques except laterally wedged insoles had immediate effects on physical performance measures in both healthy and medial knee osteoarthritis participants. The valgus knee brace improved the parameters the most, while toe-out gait impaired them the most. Future studies can develop strategies for improving gait retraining methods on the basis of issues identified by this study.



中文翻译:

矫形器与步态再训练:在健康和内侧膝盖骨关节炎成人中,在改善身体表现指标方面的即时反应。

治疗膝关节骨关节炎(kOA)的保守技术包括穿着矫形器(例如护膝和侧向楔入式鞋垫)以及应用步态调整技术(例如,脚趾内步态和脚趾外步态)。这项研究旨在评估这些技术对改善健康人和kOA参与者身体功能的即时影响。随机采用了五项国际骨关节炎研究协会(OARSI)推荐的基于性能的测试来测量身体机能:(1)30秒的座椅站立测试(30CST),(2)40米(4×10)快节奏步行测试(40FPW),(3)爬楼梯测试(SCT),(4)定时步行测试(TUGT)和(5)一次就诊的20名健康和20 kOA患者进行的6分钟步行测试(6MWT)(年龄:59.5±7.33和61.5±8.63岁,BMI:69.95±9.86和70.45±8.80 kg / m 2)。干预措施包括自然步态,脚趾向外步态,脚趾向步态,侧向楔入式鞋垫和护膝。通过重复测量方差分析和独立样本t检验进行分析。30CST和TUGT在这五个测试条件下均无显着差异(p> 0.05)。通过成对比较,在40FPW,SCT和6MWT期间,脚趾外露在削弱身体机能方面具有深远影响,而膝关节支撑则改善了身体机能。总的来说,所有测试过的保守技术,除了外侧楔形鞋垫,都对健康和内侧膝骨关节炎患者的身体表现指标产生了直接影响。外翻护膝对参数的改善最大,而脚趾踩踏步伐对他们的影响最大。未来的研究可以根据本研究确定的问题,开发出改善步态再训练方法的策略。

更新日期:2020-05-27
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