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R Moyer - One of the best experts on this subject based on the ideXlab platform.
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biomechanical effects of Valgus Knee bracing a systematic review and meta analysis
Osteoarthritis and Cartilage, 2015Co-Authors: R Moyer, Trevor B Birmingham, Dianne Bryant, J R Giffin, Kendal A Marriott, Kristyn M LeitchAbstract:To review and synthesize the biomechanical effects of Valgus Knee bracing for patients with medial Knee osteoarthritis (OA). Electronic databases were searched from their inception to May 2014. Two reviewers independently determined study eligibility, rated study quality and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated. Thirty studies were included with 478 subjects tested while using a Valgus Knee brace. Various biomechanical methods suggested Valgus braces can decrease direct measures of medial Knee compressive force, indirect measures representing the mediolateral distribution of load across the Knee, quadriceps/hamstring and quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait. Meta-analysis from 17 studies suggested a statistically significant decrease in the external Knee adduction moment (KAM) during walking, with a moderate-to-high effect size (SMD = 0.61; 95% CI: 0.39, 0.83; P < 0.001). Meta-regression identified a near-significant association for the KAM effect size and duration of brace use only (β, -0.01; 95% CI: -0.03, 0.0001; P = 0.06); with longer durations of brace use associated with smaller treatment effects. Minor complications were commonly reported during brace use and included slipping, discomfort and poor fit, blisters and skin irritation. Systematic review and meta-analysis suggests Valgus Knee braces can alter Knee joint loads through a combination of mechanisms, with moderate-to-high effect sizes in biomechanical outcomes.
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Effects of combined custom Valgus Knee brace and custom lateral wedge foot orthotic use during stair ascent
Osteoarthritis and Cartilage, 2014Co-Authors: R Moyer, Trevor B Birmingham, Kendal A Marriott, Kristyn M Leitch, J R GiffinAbstract:s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S112 173 EFFECTS OF COMBINED CUSTOM Valgus Knee BRACE AND CUSTOM LATERAL WEDGE FOOT ORTHOTIC USE DURING STAIR ASCENT R. Moyer, T. Birmingham, K. Marriott, K. Leitch, J. Giffin. Western Univ.,
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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
Archives of Physical Medicine and Rehabilitation, 2013Co-Authors: R Moyer, Trevor B Birmingham, Kristyn M Leitch, Colin E Dombroski, Robert Walsh, Thomas R Jenkyn, Robert J GiffinAbstract:Abstract 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.
Kristyn M Leitch - One of the best experts on this subject based on the ideXlab platform.
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biomechanical effects of Valgus Knee bracing a systematic review and meta analysis
Osteoarthritis and Cartilage, 2015Co-Authors: R Moyer, Trevor B Birmingham, Dianne Bryant, J R Giffin, Kendal A Marriott, Kristyn M LeitchAbstract:To review and synthesize the biomechanical effects of Valgus Knee bracing for patients with medial Knee osteoarthritis (OA). Electronic databases were searched from their inception to May 2014. Two reviewers independently determined study eligibility, rated study quality and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated. Thirty studies were included with 478 subjects tested while using a Valgus Knee brace. Various biomechanical methods suggested Valgus braces can decrease direct measures of medial Knee compressive force, indirect measures representing the mediolateral distribution of load across the Knee, quadriceps/hamstring and quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait. Meta-analysis from 17 studies suggested a statistically significant decrease in the external Knee adduction moment (KAM) during walking, with a moderate-to-high effect size (SMD = 0.61; 95% CI: 0.39, 0.83; P < 0.001). Meta-regression identified a near-significant association for the KAM effect size and duration of brace use only (β, -0.01; 95% CI: -0.03, 0.0001; P = 0.06); with longer durations of brace use associated with smaller treatment effects. Minor complications were commonly reported during brace use and included slipping, discomfort and poor fit, blisters and skin irritation. Systematic review and meta-analysis suggests Valgus Knee braces can alter Knee joint loads through a combination of mechanisms, with moderate-to-high effect sizes in biomechanical outcomes.
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Effects of combined custom Valgus Knee brace and custom lateral wedge foot orthotic use during stair ascent
Osteoarthritis and Cartilage, 2014Co-Authors: R Moyer, Trevor B Birmingham, Kendal A Marriott, Kristyn M Leitch, J R GiffinAbstract:s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S112 173 EFFECTS OF COMBINED CUSTOM Valgus Knee BRACE AND CUSTOM LATERAL WEDGE FOOT ORTHOTIC USE DURING STAIR ASCENT R. Moyer, T. Birmingham, K. Marriott, K. Leitch, J. Giffin. Western Univ.,
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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
Archives of Physical Medicine and Rehabilitation, 2013Co-Authors: R Moyer, Trevor B Birmingham, Kristyn M Leitch, Colin E Dombroski, Robert Walsh, Thomas R Jenkyn, Robert J GiffinAbstract:Abstract 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.
Trevor B Birmingham - One of the best experts on this subject based on the ideXlab platform.
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biomechanical effects of Valgus Knee bracing a systematic review and meta analysis
Osteoarthritis and Cartilage, 2015Co-Authors: R Moyer, Trevor B Birmingham, Dianne Bryant, J R Giffin, Kendal A Marriott, Kristyn M LeitchAbstract:To review and synthesize the biomechanical effects of Valgus Knee bracing for patients with medial Knee osteoarthritis (OA). Electronic databases were searched from their inception to May 2014. Two reviewers independently determined study eligibility, rated study quality and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated. Thirty studies were included with 478 subjects tested while using a Valgus Knee brace. Various biomechanical methods suggested Valgus braces can decrease direct measures of medial Knee compressive force, indirect measures representing the mediolateral distribution of load across the Knee, quadriceps/hamstring and quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait. Meta-analysis from 17 studies suggested a statistically significant decrease in the external Knee adduction moment (KAM) during walking, with a moderate-to-high effect size (SMD = 0.61; 95% CI: 0.39, 0.83; P < 0.001). Meta-regression identified a near-significant association for the KAM effect size and duration of brace use only (β, -0.01; 95% CI: -0.03, 0.0001; P = 0.06); with longer durations of brace use associated with smaller treatment effects. Minor complications were commonly reported during brace use and included slipping, discomfort and poor fit, blisters and skin irritation. Systematic review and meta-analysis suggests Valgus Knee braces can alter Knee joint loads through a combination of mechanisms, with moderate-to-high effect sizes in biomechanical outcomes.
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Effects of combined custom Valgus Knee brace and custom lateral wedge foot orthotic use during stair ascent
Osteoarthritis and Cartilage, 2014Co-Authors: R Moyer, Trevor B Birmingham, Kendal A Marriott, Kristyn M Leitch, J R GiffinAbstract:s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S112 173 EFFECTS OF COMBINED CUSTOM Valgus Knee BRACE AND CUSTOM LATERAL WEDGE FOOT ORTHOTIC USE DURING STAIR ASCENT R. Moyer, T. Birmingham, K. Marriott, K. Leitch, J. Giffin. Western Univ.,
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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
Archives of Physical Medicine and Rehabilitation, 2013Co-Authors: R Moyer, Trevor B Birmingham, Kristyn M Leitch, Colin E Dombroski, Robert Walsh, Thomas R Jenkyn, Robert J GiffinAbstract:Abstract 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.
J R Giffin - One of the best experts on this subject based on the ideXlab platform.
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biomechanical effects of Valgus Knee bracing a systematic review and meta analysis
Osteoarthritis and Cartilage, 2015Co-Authors: R Moyer, Trevor B Birmingham, Dianne Bryant, J R Giffin, Kendal A Marriott, Kristyn M LeitchAbstract:To review and synthesize the biomechanical effects of Valgus Knee bracing for patients with medial Knee osteoarthritis (OA). Electronic databases were searched from their inception to May 2014. Two reviewers independently determined study eligibility, rated study quality and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated. Thirty studies were included with 478 subjects tested while using a Valgus Knee brace. Various biomechanical methods suggested Valgus braces can decrease direct measures of medial Knee compressive force, indirect measures representing the mediolateral distribution of load across the Knee, quadriceps/hamstring and quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait. Meta-analysis from 17 studies suggested a statistically significant decrease in the external Knee adduction moment (KAM) during walking, with a moderate-to-high effect size (SMD = 0.61; 95% CI: 0.39, 0.83; P < 0.001). Meta-regression identified a near-significant association for the KAM effect size and duration of brace use only (β, -0.01; 95% CI: -0.03, 0.0001; P = 0.06); with longer durations of brace use associated with smaller treatment effects. Minor complications were commonly reported during brace use and included slipping, discomfort and poor fit, blisters and skin irritation. Systematic review and meta-analysis suggests Valgus Knee braces can alter Knee joint loads through a combination of mechanisms, with moderate-to-high effect sizes in biomechanical outcomes.
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Effects of combined custom Valgus Knee brace and custom lateral wedge foot orthotic use during stair ascent
Osteoarthritis and Cartilage, 2014Co-Authors: R Moyer, Trevor B Birmingham, Kendal A Marriott, Kristyn M Leitch, J R GiffinAbstract:s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S112 173 EFFECTS OF COMBINED CUSTOM Valgus Knee BRACE AND CUSTOM LATERAL WEDGE FOOT ORTHOTIC USE DURING STAIR ASCENT R. Moyer, T. Birmingham, K. Marriott, K. Leitch, J. Giffin. Western Univ.,
Enrico Giannì - One of the best experts on this subject based on the ideXlab platform.
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Which osteotomy for a Valgus Knee
International orthopaedics, 2009Co-Authors: Giancarlo Puddu, Massimo Cipolla, Guglielmo Cerullo, Vittorio Franco, Enrico GiannìAbstract:A Valgus Knee is a disabling condition that can affect patients of all ages. AntiValgus osteotomy of the Knee is the treatment of choice to correct the Valgus, to eliminate pain in the young or middle age patient, and to avoid or delay a total Knee replacement. A distal femoral lateral opening wedge procedure appears to be one of the choices for medium or large corrections and is particularly easy and precise if compared to the medial femoral closing wedge osteotomy. However, if the deformity is minimal, a tibial medial closing wedge osteotomy can be done with a faster healing and a short recovery time.
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osteotomies the surgical treatment of the Valgus Knee
Sports Medicine and Arthroscopy Review, 2007Co-Authors: Giancarlo Puddu, Massimo Cipolla, Guglielmo Cerullo, Enrico GiannìAbstract:Lateral compartment arthrosis from congenital Valgus or the result of previous lateral meniscectomy can be a disabling condition. Realignment osteotomy, which may avoid or delay the need for a total Knee replacement, is appropriate for young or middle-aged patients suffering from a painful Valgus kn
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Opening wedge osteotomy of the distal femur in the Valgus Knee
Osteoarthritis of the knee, 1Co-Authors: Giancarlo Puddu, Massimo Cipolla, Guglielmo Cerullo, E Vittorio, Enrico GiannìAbstract:Osteoarthrosis of the Valgus Knee has many causative factors. Degenerative changes of the articular cartilage can occur through tension, compression or shear. They are highly related to the forces exerted on the bearing surfaces. The overload caused by congenital Valgus deformity or secondary to articular or metaphyseal fractures and lateral meniscectomy are aetiologically important. In essence biophysical cause for osteoarthrosis is an overload or a concentration of forces beyond the ability of the cartilage and subchondral bone to cope.
