Biomechanics

Human movement science

Early knee osteoarthritis management should first address mechanical joint overload

Early knee osteoarthritis poses a therapeutic dilemma to the musculoskeletal clinician. Despite the recent interest in arthroscopic and injectable regenerative therapies intended to repair or restore a focal target such as cartilage, … READ MORE

Four-step plan for managing knee osteoarthritis

An international task force of osteoarthritis (OA) experts is proposing a four-step plan to prioritize management strategies for symptomatic knee OA – from supplements to surgery. Paddling with Evoke brace By Rita Baron-Faust, … READ MORE

Part 3 – Managing knee osteoarthritis: Systemic pharmacotherapy and intra-articular treatments

Systemic treatments for patients with osteoarthritis (OA) have been shown to have significant positive effects on biomarkers that may be associated with OA disease progression. What does active aging mean to you? CHHM is working to … READ MORE

Part 2 – Managing knee osteoarthritis: Self-help and non-pharmacological interventions

Early intervention for osteoarthritis (OA) of the knee is important for ameliorating the long-term effects of disease. Current treatment goals are focused on symptom relief, but effort is being directed toward the development of … READ MORE

Part 1 – Managing knee osteoarthritis: Rationale for early treatment

Attention to early diagnosis and intervention in patients with osteoarthritis (OA) has increased, but which treatments may have the greatest benefit in slowing or potentially reversing disease progression is unclear. Many … READ MORE

Ambling modifiers: Finding a patient-friendly gait for knee OA

In the interest of improving compliance, studies of gait modifications to reduce moments and forces at the knee in patients with knee osteoarthritis (OA) are increasingly focusing on gait alterations that will not make patients … READ MORE

Delivering healthcare services to children with cerebral palsy and their families

Children with cerebral palsy have complex healthcare needs and often require complex multidisciplinary care. It is important for clinicians to understand which approaches to healthcare service delivery for this population are … READ MORE

Pre-operative exercise boosts TKA outcomes

An evidence-based exercise regimen, designed to enhance knee strength and the ability to complete functional tasks, may speed recovery following total knee arthroscopy, TKA, in patients with knee osteoarthritis. Evoke unloading knee … READ MORE

OA bracing may bolster prehabilitation protocols

Pre-operative exercise has been shown to improve total knee arthroplasty outcomes, but may not be feasible in patients with severe pain. Bracing and other offloading methods can help decrease that pain, potentially improving the … READ MORE

Physiotherapy for functional motor disorders: a consensus

Background Patients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature … READ MORE

OA knee bracing for lateral, severe cases respond positively

OssKin Evoke™ by Jordana Bieze Foster, Lower Extremity Review April 2010 Two studies presented in March suggest that bracing for knee osteoarthritis may be effective in two patient populations that are not well represented in … READ MORE

Knee braces activate brain

A prototype ‘mini’ MRI scanner, developed by Imperial College London, that could be used for diagnosing knee injuries by Jordana Bieze Foster, Lower Extremity Review January 2010 fMRI confirms proprioceptive effects. Functional … READ MORE

Development of the arch: functional implications

Contrary to the conclusions of early research, recent studies suggest that arch height does indeed affect lower extremity function. The biomechanics associated with different arch heights may provide a basis for treatment and … READ MORE

Footwear and risk of knee OA: The search for meaning in moments

Although footwear may in fact play a role in the development of knee osteoarthritis and its clinical management, those relationships are turning out to be much more complicated than once thought. Want a helping hand? Try wearing … READ MORE

Women with knee osteoarthritis experience greater pain sensitivity

Among patients with osteoarthritis of the knee, women experienced greater sensitivity to various pain modalities – such as lower tolerance to heat, cold, and pressure – and greater widespread pain than men. The findings … READ MORE

Paraplegic man walks with own legs again

American man, 26, completes 3.5-metre course thanks to computer system that reroutes signals from his brain to electrodes on his knees. Fig. 1. Partial picture of the overground walking course, depicting the BCI-Parastep system, the … READ MORE

Knee OA, biomechanics, and progression to TKA

Findings related to muscle activity during gait and progression to TKA may explain why interventions to improve joint stability can impact symptoms but not knee adduction moment (KAM). By Cheryl Hubley-Kozey PhD, and Gillian Hatfield … READ MORE

Double bonus – AFOs improve dual-task gait in two ways

Ankle foot orthoses intervene at the level of the body and at the level of activity. But they might also have effects at the level of participation. – Nikta Pirouz CPO By Jordana Bieze Foster, Lower Extremity Review March 2015 … READ MORE

Robotic gait training doesn’t wow young patients with CP

Kids, parents differ on ‘normal’ gait. Although physical therapists and parents often strive for attaining normal gait in children with neuromotor disorders, a new study from researchers at the University of Alberta in Edmonton, … READ MORE

Determination of OA knee brace effectiveness

Osteoarthritic knee braces have been developed to lessen loads in the degenerative compartment while subsequently reducing knee pain in patients with uni-compartmental arthritis. Evoke™ knee brace highlights. OssKin The present … READ MORE

Orthotic devices boost balance over time in children with CP

Balance improves over time in children with cerebral palsy, CP, who switch from a dorsiflexion-free orthotic device to a more restrictive one, according to research from Northwestern University’s Feinberg School of Medicine in … READ MORE

Knee arthroscopy in arthritis: an evidence-practice mismatch

The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, … READ MORE

Growing pains – adapting orthotic devices to maturing patients

Accommodating growth without compromising fit and function is a challenge for practitioners who prescribe orthotic devices for young patients. Adjustments and add-ons—as well as educating parents about expected changes—can make … READ MORE

Toe walking treatment and management

The management of toe walking is controversial — the natural history is poorly defined, and only limited data are available regarding direct comparisons of different treatment modalities. Therefore, the physician’s first decision … READ MORE

Orthotic options for knee OA focus on compliance issues

New research presented in June at the 2015 ISPO Congress underscored the potential long-term benefits of valgus knee bracing for relief of medial knee osteoarthritis (OA) symptoms when patient compliance is high, while other ISPO … READ MORE

Encouraging evidence that off-loader knee braces are effective

Given the encouraging evidence that off-loader braces are effective in mediating pain relief in conjunction with knee OA and malalignment, bracing should be fully used before joint realignment or replacement surgery is considered. … READ MORE

Brace therapy in uni-compartmental OA

Offloading strategies for knee osteoarthritis. Brace therapy plays an important role in conservative treatment of knee OA. Several types of braces are commercially available from multiple manufacturers; however, “unloading” braces … READ MORE

Orthotics part of arthritis treatment

Rheumatologists care for patients with assistive devices such as knee braces or foot orthotics. Although not involved in fitting patients with the appliances, rheumatologists still need to know how to manage these patients and … READ MORE

HARMONY exoskeleton helps patients recover strength and motor skills

Texas engineers introduce advanced upper body rehabilitation robot. HARMONY was specially designed to offer customized therapy for optimal efficacy. Not only does the exoskeleton adjust to patient size, it can also be programmed to be … READ MORE

Knee OA guidelines take patient-centric approach

Updated guidelines and new appropriate use criteria for nonoperative management of knee osteoarthritis aim to focus more directly on typical knee OA patients, who often have comorbidities that can complicate care and are not well … READ MORE

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