Table 1.
Biomechanical studies about valgus unloader braces
| References | Number, brace, methods, disease | Primary outcome measure |
|---|---|---|
| Arazpour et al. [1] | 7 patients, conventional valgus brace, gait analysis, patients with medial OA | The knee adduction moment was significantly reduced (p = 0.001) |
| Della Croce et al. [4] | 18, pneumatic unloading knee brace, gait analysis, patients with medial OA | A 7.6 % decrease in net peak knee adduction moment with the brace uninflated and 26.0 % with the brace inflated |
| Dessery et al. [5] | 24, custom valgus knee brace (three point bending brace, valgus and external rotation brace, ACL brace), gait analysis, patients with medial OA | The valgus unloader brace and ACL-brace allowed a significant reduction in peak knee adduction moment (KAM) during terminal stance from 0.313 to 0.280 Nm/Bw × Ht (p < 0.001) and 0.293 to 0.268 (p < 0.05) respectively, while no significant reduction was observed with the V3P-brace (p = 0.52) |
| Draganich et al. [6] | 10, conventional brace, custom brace, gait analysis, patients with medial OA | The custom-brace significantly decreased peak adduction moments during gait and stair stepping, compared with baseline and off-the-shelf bracing |
| Fantini Pagani et al. [9] | 16, conventional valgus unloader brace, gait analysis, healthy volunteers | The first and second peak knee adduction moments also decreased during walking with different orthosis adjustments (changes from 5 to 33 %). During running, a significant reduction was observed only between the conditions without orthosis and 8° valgus adjustments (change of 11 %) |
| Fantini Pagani et al. [10] | 10, conventional valgus brace, gait analysis, patients with medial OA | For the second peak knee adduction moment, decreases of 18, 21, and 7 % were observed between baseline and test conditions for the orthosis in 4° valgus, in 8° valgus, and insole, respectively. |
| Fantini Pagani et al. [11] | 14, ankle–foot orthosis, gait analysis, healthy subjects with knee varus alignment | Significant decreases in knee adduction moment, in the frontal plane were observed with the ankle–foot orthosis in all three different adjustments |
| Fu et al. [13] | 10, conventional valgus knee brace, gait analysis, patients with medial OA | Gait analysis indicated statistically significant reductions in peak and mean knee adduction moments in all orthotic groups when compared with a flat insole |
| Johnson et al. [19] | 10, conventional valgus brace, gait analysis, patients with medial OA | The mean improvement in knee adduction moment was a decrease of 0.2255 Nm/kg (range 0.56–0.564 Nm/kg), showing a mean improvement of 48 % (range 16–76 % of original peak moment) |
| Jones et al. [19] | 28, conventional valgus brace, gait analysis, patients with medial OA | The valgus knee brace, reduced the early stance EKAMexternal knee adduction moment by 7 % |
| Laroche et al. [24] | 20, valgus and external rotation brace, gait analysis, patients with medial OA | Knee adduction moments significantly decreased in the terminal stance and push off |
| Lamberg et al. [23] | 15, conventional valgus knee brace, gait analysis, patients with medial OA | Second peak knee adduction moment were reduced (p < 0.05) at post and final compared to baseline (26 %) |
| Lindenfeld et al. [26] | 11, custom valgus knee brace, gait analysis, patients with medial OA | 9 of 11 patients had a decrease in the adduction moment when wearing the brace, with the moment decreasing by as much as 32 % |
| Moyer et al. [29] | 16, custom valgus knee brace, gait analysis, patients with medial OA | Valgus bracing reduced knee adduction moment. The reduction in knee adduction moment was greatest when using the knee brace and a foot orthotic |
| Orishimo et al. [30] | 12, conventional valgus knee brace, gait analysis, normally aligned patients | Peak knee adduction moment and knee adduction impulse decreased with increasing brace tension (main effect of brace, p < 0.001) |
| Ota et al. [31] | 15, custom made valgus brace, gait analysis, patients with medial OA | The peak KAM with KBF was significantly smaller than those with the KB (p = 0.004, the difference between these conditions of KAM: 0.06 Nm/kg) |
| Pollo et al. [32] | 11, conventional valgus knee brace, gait analysis, patients with medial OA | Valgus bracing reduced the adduction moment about the knee by an average of 13 % (7.1 Nm) |
| Ramsey et al. [34] | 16, custom valgus knee brace, gait analysis, patients with medial OA | Knee adduction excursions were significantly reduced with the use of bracing, with excursions reported to be lowest at 4° of valgus correction |
| Self et al. [35] | 5, custom made valgus knee brace, gait analysis, patients with medial OA | The Monarch brace significantly reduced the varus moment at 20 and 25 % of stance |
| Schmalz et al. [36] | 16, conventional valgus brace, gait analysis, patients with medial OA | The mean maximum value of the orthotic valgus moment was 0.053 Nm/kg, which represents approximately 10 % of the external genu varus moment without the brace |