Effect of Knee braces on quadriceps strength and muscle inhibition in patellofemoral OA

Study Type: Therapy
OE Level of Evidence: 2
Journal Level of Evidence: 1
Synopsis
126 patients with patellofemoral joint (PFJ) osteoarthritis (OA) were randomized to either a knee support brace, or a control group without brace support for 6 weeks. The purpose of this study was to determine the effects of a flexible knee brace on quadriceps maximum voluntary contraction (MVC) and athrogenous muscle inhibition (AMI) in PFJ OA patients. Patients in the Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Non-Industry funded
Sponsor: Arthritis Research UK
Conflicts: None disclosed
CONTENT IS LOCKED
Why was this study needed now?
Patellofemoral joint (PFJ) osteoarthritis (OA) is a common form of knee OA that can often result in a reduced quality of life. In patellofemoral joint OA, brace use has been suggested to enhance proprioceptive input and create a feeling of stability. However, a recent survey of health care practitioners identified a common belief that the use of a brace has an adverse effect on quadriceps muscle strength. While previous studies have indicated benefits of flexible knee supports details regarding the effects of these braces are scarce and no high-quality studies have investigated the effects of braces on muscle strength and muscle inhibition, thus, warranting the present study.
What was the principal research question?
What effect does the use of a flexible knee brace have on quadriceps maximum voluntary contraction and athrogenous muscle inhibition in patients with patellofemoral joint osteoarthritis when assessed at up to 12 weeks?
Population: 126 patients (aged 40 to 70) with patellofemoral joint (PFJ) OA were included in this study. Eligible patients had a Kellgren-Lawrence score of 2 or 3 for the PFJ, daily pain for 3 months prior to intervention with a visual analogue scale (VAS) score greater or equal to 40, and lateral or medial patellar facet tenderness on palpation. Patients were instructed to wear their BioSkin Q Brace (Ossur UK, Manchester, UK) for a minimum of 3 hours daily. Additionally, participants were assessed for PFJ symptoms which included pain reproduced with stair climbing or rising from a chair but no pain when walking on level ground. (108 completed study)
Intervention: Brace group: Patients wore a flexible knee brace for a 12-week duration. (n=53; Mean age: 55 +/- 7; 31F/22M)
Comparison: Control group: Patients did not wear a brace for the first 6 weeks of the trial. Brace wearing was initiated after 6 weeks, lasting 12 weeks in duration. (n=55; Mean age: 57 +/- 7; 28F/27M)
Outcomes: Outcomes of this study were quadriceps muscle strength measured by a maximum voluntary contraction (MVC) and quadriceps inhibition evaluated by arthrogenous muscle inhibition (AMI).
Methods: RCT; open-label
Time: Outcomes of this study were measured between groups after 6 weeks of brace intervention. Outcomes were measured within groups after an additional 6 weeks (ie. at 12 weeks) in an open label trial with both groups wearing flexible knee braces. The control group started to wear a brace after the first 6 weeks of the study, and within-group outcomes were measured after an additional 6 weeks (ie. at 18 weeks after the start of trial).
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.