Decreased pain and improved dynamic knee instability mediate the beneficial effect of wearing a soft knee brace on activity limitations in patients with knee osteoarthritis

Journal article (2019)

Authors

Tomasz Cudejko Amsterdam UMC
Martin van der Esch Amsterdam Rehabilitation Research Center Reade
Josien C. van den Noort Amsterdam UMC
Judith J.M. Rijnhart Amsterdam UMC
Marike van der Leeden Amsterdam UMC
Leo D. Roorda Amsterdam Rehabilitation Research Center Reade
Willem F. Lems Reade and Amsterdam Rheumatology and Immunology Centre
Gordon Waddington University of Canberra
Jaap Harlaar Biomechatronics & Human-Machine Control - Mechanical, Maritime and Materials Engineering , Amsterdam UMC
J. Harlaar Biomechatronics & Human-Machine Control - Mechanical, Maritime and Materials Engineering , Amsterdam UMC
Joost Dekker Amsterdam UMC
Research Group
Biomechatronics & Human-Machine Control (Mechanical, Maritime and Materials Engineering) (TU Delft)
Copyright: © 2019 Tomasz Cudejko, Martin van der Esch, Josien C. van den Noort, Judith J.M. Rijnhart, Marike van der Leeden, Leo D. Roorda, Willem Lems, Gordon Waddington, J. Harlaar, Joost Dekker
DOI: https://doi.org/10.1002/acr.23722
More Info
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Published Date

2019

Language

English

Faculty

Mechanical, Maritime and Materials Engineering

Department

Biomechanical Engineering

Research Group

Biomechatronics & Human-Machine Control

Abstract

Objective: To evaluate whether improvement of proprioception, pain, or dynamic knee instability mediates the effect of wearing a soft knee brace on activity limitations in patients with knee osteoarthritis (OA). Methods: We conducted an analysis of data for 44 patients with knee OA who were enrolled in a laboratory-based trial evaluating the effect of wearing a commercially available soft knee brace. Activity limitations were assessed with the 10-meter walk test and the Get Up and Go test. Knee joint proprioception was assessed by an active joint position sense test; pain was assessed on a numeric rating scale (NRS) (range 0–10); pressure pain threshold (PPT) was assessed with a hand-held pressure algometer; dynamic knee instability was expressed by the perturbation response, i.e., a measure reflecting a deviation in mean knee varus–valgus angle after a controlled mechanical perturbation on a treadmill, with respect to level walking. Mediation analysis was conducted using the product of coefficients approach. Confidence intervals were calculated with a bootstrap procedure. Results: A decrease in pain (scored on an NRS) and a decrease in dynamic knee instability mediated the effect of wearing a soft knee brace on the reduction of activity limitations (P < 0.05), while changes in proprioception and PPT did not mediate this effect (P > 0.05). Conclusion: This study shows that decreased pain and reduced dynamic knee instability are pathways by which wearing a soft knee brace decreases activity limitations in patients with knee OA.