The knee is the joint which is most affected by osteoarthritis (OA). Knee OA is more common in older individuals and occurs more in the medial than the lateral compartment. When we stand, walk or climb stairs, our weight is transmitted through our knee joints and this is known as load which is higher in individuals with medial knee OA than healthy counterparts. Additionally, muscle weakness is a factor in medial knee OA and previous work has demonstrated increased muscle co-contraction in these patients. In this thesis we assessed the loading on the knee joint and muscle co-contraction after wearing an assistive device (a valgus knee brace) which is a common treatment in this disease. Whilst previous literature has demonstrated changes in loading with valgus knee braces during over-ground walking, no studies (to date) have assessed the effect of valgus knee braces on knee loading and muscle co-contraction during ascending and descending stairs immediately, and after a period of use. In addition, it is an un-documented opinion that knee bracing affects muscle strength and control around the knee and weakens the joint so this research also aimed to confirm or refute this theory. To accomplish the research, we performed three separate trials; a) a repeatability trial in seven patients to determine the reliability of the outcome measures for the future study; b) a clinical trial of fifteen individuals with medial knee OA would wore a valgus knee brace for a period of three months with an interim assessment at six weeks for pain and muscle strength/function; c) finally, a small pilot study of seven patients investigating combined orthotic treatments on biomechanical outcome measures. In summary the results of this thesis have demonstrated positive biomechanical and clinical outcomes when wearing a valgus knee brace for a sustained period. This was further improved biomechanically with the combination treatment with a lateral wedge insole which reduced knee loading more during stair ascent and descent, in comparison to the orthotic devices alone in the same session. Future studies to find out the effect of a combination of an off-the-shelf valgus knee brace and off-the-shelf lateral wedge insole on knee loading, clinical and radiological outcomes after a period of longer wear were indicated.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:632568 |
| Date | January 2014 |
| Creators | Al-Zahrani, Y. A. |
| Publisher | University of Salford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://usir.salford.ac.uk/32833/ |
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