Long-Term Effects of AposTherapy in Patients with Osteoarthritis of the Knee: A Two-Year Followup

Abstract

Several biomechanics treatments for knee osteoarthritis (OA) have emerged with the goal of reducing pain and improving function. Through this, researchers have hoped to achieve a transition from the pathological gait patterns to coordinated motor responses. The purpose of the study was to determine the long-term effects of a therapy using a biomechanical device in patients with knee OA. Patients with knee OA were enrolled to active and control groups. The biomechanical device used in therapy (AposTherapy) was individually calibrated to each patient in the active group. Patients in the control group received standard treatment. Outcomes were the Western Ontario and McMaster Osteoarthritis Index (WOMAC), Aggregated Locomotor Function (ALF), Short Form 36 (SF-36), and Knee Society Score assessments. The active and control groups were similar at the baseline (group difference in all scores P > 0.05). The active group showed a larger improvement over time between groups in all three WOMAC categories (F = 16.8, 21.7, and 18.1 for pain, stiffness, and function; all P < 0.001), SF-36 Physical Scale (F = 5.8; P = 0.02), Knee Society Knee Score (F = 4.3; P = 0.044 ), and Knee Society Function Score (F = 6.5; P = 0.014 ). At the two-year endpoint, the active group showed significantly better results (all P ≤ 0.001). The groups showed a difference of 4.9, 5.6, and 4.7 for the WOMAC pain, stiffness, and function scores, respectively, 10.8 s in ALF score, 30.5 in SF-36 Physical Scale, 16.9 in SF-36 Mental Scale, 17.8 in Knee Society Knee Score, and 25.2 in Knee Society Function Score. The biomechanical therapy examined was shown to significantly reduce pain and improve function and quality of life of patients with knee OA over the long term.

The effect of a non-invasive biomechanical treatment on subjective and objective measures in patients with knee osteoarthritis- A retrospective analysis on a UK population

“…The results suggest that most improvements occurred by 3 months, but further improvements occur between 3 and 6 months, apart from SLS in gait and MCS subscale of SF-36. This supports previous work which found that the largest improvements occurred within the initial few months of therapy and are then maintained (32). The improvements in WOMAC scores meet the OMERACT-OARSI guidelines for clinical response to treatment, signifying true positive impacts felt by patients (45).…”

“…However, it reflects previous research on the therapy on different populations with similar improvements in gait and PROM's (33)(34)(35)60). Therefore, it could be assumed that the improvements can be maintained with the high compliance rates in the treatment (32). Nevertheless, future research should continue to investigate the long-term clinical effect of the treatment, in prospective, randomised control trial (RCT) design whilst tracking decay rates for joint replacement surgeries.…”

Patients with chronic non-specific low back pain who reported reduction in pain and improvement in function also demonstrated an improvement in gait pattern

“…It must address wider perspectives of generalized neuromuscular control. In recent years, several publications regarding the effect of a novel non-invasive biomechanical device for different musculoskeletal disorders have been published [12][13][14][15]. A unique foot-worn device enables the relocation of the center of pressure [16] while training neuromuscular control [17].…”

A novel self-care biomechanical treatment for obese patients with knee osteoarthritis

“…The biomechanical device and treatment methodology have been previously described in depth . The biomechanical device was individually calibrated for each study participant according to his/her motion characteristics and symptoms .…”