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首页> 外文期刊>Archives of Physical Medicine and Rehabilitation >Combined effects of a valgus knee brace and lateral wedge foot orthotic on the external knee adduction moment in patients with varus gonarthrosis
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Combined effects of a valgus knee brace and lateral wedge foot orthotic on the external knee adduction moment in patients with varus gonarthrosis

机译：外翻膝关节矫形器和外侧楔形足矫形器对内翻性膝关节内翻患者外膝内收力矩的综合影响

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Objective: To test the hypothesis that a custom-fit valgus knee brace and custom-made lateral wedge foot orthotic will have greatest effects on decreasing the external knee adduction moment during gait when used concurrently. Design: Proof-of-concept, single test session, crossover trial. Setting: Biomechanics laboratory within a tertiary care center. Participants: Patients (n=16) with varus alignment and knee osteoarthritis (OA) primarily affecting the medial compartment of the tibiofemoral joint (varus gonarthrosis). Interventions: Custom-fit valgus knee brace and custom-made full-length lateral wedge foot orthotic. Amounts of valgus angulation and wedge height were tailored to each patient to ensure comfort. Main Outcome Measures: The external knee adduction moment (% body weight [BW]*height [Ht]), frontal plane lever arm (cm), and ground reaction force (N/kg), determined from 3-dimensional gait analysis completed under 4 randomized conditions: (1) control (no knee brace, no foot orthotic), (2) knee brace, (3) foot orthotic, and (4) knee brace and foot orthotic. Results: The reduction in knee adduction moment was greatest when concurrently using the knee brace and foot orthotic (effect sizes ranged from 0.3 to 0.4). The mean decrease in first peak knee adduction moment compared with control was.36% BW*Ht (95% confidence interval [CI], -.66 to -.07). This was accompanied by a mean decrease in frontal plane lever arm of.59cm (95% CI, -.94 to -.25). Conclusions: These findings suggest that using a custom-fit knee brace and custom-made foot orthotic concurrently can produce a greater overall reduction in the knee adduction moment, through combined effects in decreasing the frontal plane lever arm.
机译：目的：为了检验以下假设：定制的外翻膝关节矫形器和定制的外侧楔形足矫形器在同时使用步态时对减少外在膝盖内收力矩的影响最大。设计：概念验证，单个测试会话，交叉测试。地点：三级护理中心内的生物力学实验室。参与者：内翻对准和膝骨关节炎（OA）的患者（n = 16）主要影响胫股关节内侧隔室（内翻性膝关节病）。干预措施：定制外翻膝关节矫形器和定制的全长侧楔形足矫形器。为每位患者量身定制外翻角度和楔形高度。主要观察指标：根据在以下条件下完成的3步步态分析确定的外部膝关节内收力矩（％体重[BW] *身高[Ht]），额面杠杆臂（cm）和地面反作用力（N / kg）。 4个随机条件：（1）对照（无护膝，无足矫形器），（2）护膝，（3）足矫形器，和（4）护膝和足矫形器。结果：同时使用膝关节矫正器和脚矫形器时，膝关节内收力矩的减少最大（效果范围为0.3到0.4）。与对照组相比，第一峰值膝关节内收力矩的平均下降为36％BW * Ht（95％置信区间[CI]，-。66至-.07）。这伴随着额头前臂平均下降59厘米（95％CI，-。94至-.25）。结论：这些发现表明，同时使用定制的膝关节矫正器和定制的脚矫形器，可以通过减少额平面杠杆臂的综合作用，使膝关节内收力矩的总体降低更大。

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