Decreased Pain May Mediate Effects of Soft Knee Brace on Activity Limitations in Knee OA

Study data published in Arthritis Care Research support the efficacy of a soft knee brace in minimizing dynamic knee instability in patients with knee osteoarthritis (OA).

Researchers assessed improvements in proprioception and pain after the use of a soft knee brace in patients with knee OA and self-reported knee instability (n=44; 65.9% women). Patients were assessed for activity limitations using the 10-m walk test and the Get Up and Go test; knee joint proprioception was measured using an active joint position sense test. Pain levels were captured after perturbed and level walking on a treadmill, using the Numeric Rating Scale. A handheld pressure algometer was used to identify pressure pain threshold. Dynamic knee instability was evaluated with the Perturbation Response, a measure of deviation in mean knee varus-valgus angle after controlled mechanical perturbation compared with level walking.

Patients had a mean age of 65.7±9.3 years and a mean BMI of 29.8±5.5 kg/m². The effect of a soft knee brace on activity limitations was mediated by decrease in pain and decrease in dynamic knee instability (P <.05) after brace use. Specifically, decrease in pain and in dynamic knee instability accounted for 43% and 13%, respectively, of the overall reduction in time to complete the 10-m walk test. Reduction of pain and decline in knee instability also mediated the effect of wearing a brace on time to complete the Get Up and Go test. However, changes in proprioception and pressure pain threshold levels were not mediating factors for either activity limitation test.

These results highlight the pathway through which wearing a soft knee brace may affect activity limitations in individuals with knee OA. The effect of a knee brace on pain levels and dynamic knee instability were of particular salience in determining activity limitations. These findings may be useful for clinicians in assessing the potential efficacy of a knee brace for patients.

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Reference

Cudejko T, van der Esch M, van den Noort JC, et al. Decreased pain and improved dynamic knee instability mediate the beneficial effect of wearing a soft knee brace on activity limitations in persons with knee osteoarthritis [published online August 12, 2018]. Arthritis Care Res. doi: 10.1002/acr.23722