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本体感觉膝关节支具的使用对骨关节炎膝关节的治疗有影响吗:一项探索性研究。

Can the use of proprioceptive knee braces have implications in the management of osteoarthritic knees: An exploratory study.

作者信息

Kwaees Tariq A, Richards Jim, Rawlinson Gill, Charalambous Charalambos Panayiotou, Chohan Ambreen

机构信息

1 University of Central Lancashire, Preston, UK.

出版信息

Prosthet Orthot Int. 2019 Apr;43(2):140-147. doi: 10.1177/0309364618796852. Epub 2018 Oct 4.

Abstract

BACKGROUND

: Use of proprioceptive knee braces to control symptomology by altering neuromuscular control mechanisms has been shown in patellofemoral pain. Although their potential in patients with knee osteoarthritis is vast, little research has examined their efficacy.

OBJECTIVES

: This study examines the effect of a proprioceptive knee brace on lower limb kinematics and kinetics in healthy participants and in participants with OA.

METHODS

: Thirteen healthy participants were asked to perform a 10-cm step-down task with and without a proprioceptive brace. Data were collected using a 10-camera Qualisys system. Individuals with osteoarthritis completed the Knee injury and Osteoarthritis Outcome Score before and after 4 weeks of intervention.

RESULTS

: During step-down reductions in knee maximum internal rotation, transverse range of movement, transverse plane angular velocity and maximum internal rotation angular velocity was seen. Ankle plantar flexion and inversion angular velocity decreased while inversion and maximum supination angular velocity increased. Improvements in Knee injury and Osteoarthritis Outcome Score were noted across all parameters with brace use.

CONCLUSION

: Positive changes in kinematic variables in multiple planes can be achieved with proprioceptive bracing alongside improved patient outcome. These changes occur at the knee but analysis of other weight bearing joints should not be overlooked in future studies. This study supports the concept of neuromuscular reinforcement and re-education through proprioceptive bracing and its application in the management in knee osteoarthritis.

CLINICAL RELEVANCE

Proprioception can alter symptoms and biomechanics embraced and adjacent lower limb joints. The results of this study highlights the potential uses of non-mechanical bracing in the treatment of osteoarthritis and other potential to bridge the osteoarthritis treatment gap. Furthermore, large-scale research is needed to match disease subset to brace type.

摘要

背景

在髌股关节疼痛中,已证实使用本体感觉膝关节支具通过改变神经肌肉控制机制来控制症状。尽管其在膝关节骨关节炎患者中的潜力巨大,但很少有研究检验其疗效。

目的

本研究探讨本体感觉膝关节支具对健康参与者和骨关节炎参与者下肢运动学和动力学的影响。

方法

13名健康参与者被要求在佩戴和不佩戴本体感觉支具的情况下完成10厘米的下台阶任务。使用10台摄像机的Qualisys系统收集数据。骨关节炎患者在干预4周前后完成膝关节损伤和骨关节炎疗效评分。

结果

在下台阶过程中,膝关节最大内旋、横向运动范围、横向平面角速度和最大内旋角速度均降低。踝关节跖屈和内翻角速度降低,而内翻和最大旋后角速度增加。使用支具后,所有参数的膝关节损伤和骨关节炎疗效评分均有改善。

结论

使用本体感觉支具可在多个平面实现运动学变量的积极变化,同时改善患者预后。这些变化发生在膝关节,但在未来研究中不应忽视对其他负重关节的分析。本研究支持通过本体感觉支具进行神经肌肉强化和再教育的概念及其在膝关节骨关节炎管理中的应用。

临床意义

本体感觉可改变症状以及受累和相邻下肢关节的生物力学。本研究结果突出了非机械支具在骨关节炎治疗中的潜在用途以及弥合骨关节炎治疗差距的其他潜力。此外,需要大规模研究来使疾病亚组与支具类型相匹配。

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