Dammerer Dietmar, Giesinger Johannes M, Biedermann Rainer, Haid Christian, Krismer Martin, Liebensteiner Michael
Department of Orthopaedic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Arthroscopy. 2015 Mar;31(3):404-9. doi: 10.1016/j.arthro.2014.09.003. Epub 2014 Nov 8.
To assess driving ability (brake response time [BRT]) with commonly used knee braces.
Sixty-four healthy participants (32 women and 32 men) participated in our study. BRT was assessed using a custom-made driving simulator. We assessed BRT for 5 different commonly used knee braces (right leg) used in 9 different settings: without a knee brace (control group); with a typical postoperative knee brace with adjustable range of motion (ROM) and the settings of 0° to 30°, 0° to 60°, 0° to 90°, and 20° to 90° (extension and flexion); and with an unloading knee brace for moderate to severe unicompartmental osteoarthritis, an orthosis for ligament instabilities, a knee brace for patellofemoral disorders, and an elastic knee bandage.
The 64 participants (mean age, 33.5 years) showed significantly impaired BRT with the typical postoperative brace set at an ROM of 0° to 30° (673 milliseconds, P < .001), ROM of 0° to 60° (629 milliseconds, P < .001), ROM of 0° to 90° (607 milliseconds, P = .001), and ROM of 20° to 90° (602 milliseconds, P = .005) compared with the control group. However, no such impaired BRT was found for any other investigated knee brace.
Right-sided ROM-restricting knee braces involve significant impairment of BRT in healthy participants. No such prolonged BRT was found for a patellofemoral realignment brace, a ligament brace, a valgus/osteoarthritis brace, or an elastic knee bandage. However, our findings should be viewed in light of the limitations of the study, which are (1) the lack of a defined decrease in BRT that could lead to an accident and (2) uncertainty of whether the statistical differences are also clinically important.
Level II, lesser-quality randomized controlled trial.
评估使用常用膝关节支具时的驾驶能力(制动反应时间[BRT])。
64名健康参与者(32名女性和32名男性)参与了我们的研究。使用定制的驾驶模拟器评估BRT。我们评估了9种不同情况下使用的5种不同的常用膝关节支具(右腿)的BRT:不使用膝关节支具(对照组);使用具有可调节活动范围(ROM)的典型术后膝关节支具,其设置为0°至30°、0°至60°、0°至90°以及20°至90°(伸展和屈曲);以及使用用于中度至重度单髁骨关节炎的卸载膝关节支具、用于韧带不稳定的矫形器、用于髌股关节疾病的膝关节支具和弹性膝关节绷带。
64名参与者(平均年龄33.5岁)在典型术后支具设置为0°至30°(673毫秒,P <.001)、0°至60°(629毫秒,P <.001)、0°至90°(607毫秒,P =.001)和20°至90°(602毫秒,P =.005)时,与对照组相比,BRT明显受损。然而,对于任何其他研究的膝关节支具,未发现此类BRT受损情况。
右侧限制ROM的膝关节支具会使健康参与者的BRT显著受损。对于髌股关节复位支具、韧带支具、外翻/骨关节炎支具或弹性膝关节绷带,未发现此类BRT延长情况。然而,应根据研究的局限性来看待我们的发现,这些局限性包括:(1)缺乏可能导致事故的BRT明确下降情况;(2)统计差异在临床上是否也很重要尚不确定。
II级,质量较低的随机对照试验。