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Herzliya Pituah, Israel

The management of knee osteoarthritis (OA) focuses on reducing the levels of pain and disability. Recently, a novel biomechanical device and treatment methodology (AposTherapy) was shown to reduce the knee adduction moment while simultaneously challenging the neuromuscular control system through perturbation. The purpose of the study was to investigate the changes in gait patterns and clinical measurements following treatment with a novel biomechanical device on patients with knee OA. A total of 745 patients with bilateral knee OA were analyzed. Patients completed a gait test, Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire and SF-36 Health Survey at baseline and after 12 weeks. The biomechanical device was individually calibrated to each patient. Shifting the center of pressure, through changes in the location of the biomechanical elements causes realignment and reduction in the knee adduction moment. Furthermore the configuration of the biomechanical element allows training under controlled perturbation. A significant decrease was found in WOMAC pain (28.6%) and WOMAC function (25.2%) following three months of therapy (p<0.001). A significant increase was found in the patients' physical quality of life (17.8%) and mental quality of life (11.0%) (p<0.001). Gait velocity, cadence step length, stance phase and single limb support phase improved significantly following three months of therapy (7.6%, 4%, 3.7% and 1.6%, respectively). Our results suggest an overall improvement in the gait patterns, level of pain, function and quality of life of patients with knee OA following three months of AposTherapy. Source

Ben lulu O.,ek Medical Center | Rubin G.,ek Medical Center | Rubin G.,Technion - Israel Institute of Technology | Krasnyansky S.,ek Medical Center | And 4 more authors.
Journal of Arthroplasty

The purpose of this study was to examine the correlation between the implanted cup's outer diameter and the actual femoral head diameter removed during surgery. Seventy-five patients with primary total hip arthroplasty were evaluated. The difference between the implanted cup diameter and the femoral head diameter was calculated for each patient. The mean ± SD actual femoral head diameter that was removed and measured during surgery was 48.5 ± 3.7 mm. The mean ± SD cementless implanted cup outer diameter was 51.8 ± 3.5 mm. A high correlation was found between the implanted cup diameter and the actual femoral head diameter (r=0.923). A cut-off point of 4 mm of the measured femoral head diameter should be considered as an additional monitoring indicator. © 2015 Elsevier Inc. Source

McCarthy I.,Royal National Orthopaedic Hospital | Hodgins D.,European Technology for Business Ltd | Mor A.,AposTherapy Research Group | Elbaz A.,AposTherapy Research Group | Segal G.,AposTherapy Research Group
BMC Musculoskeletal Disorders

Background: The purpose of this study was to examine the differences in gait profile between patients with knee osteoarthritis (OA) and healthy control and to create motion characteristics that will differentiate between them. Methods. Twenty three patients diagnosed with knee OA and 21 healthy matched controls underwent a gait test using a sensor system (gaitWALK). Gait parameters evaluated were: stride duration, knee flexion range of motion (ROM) in swing and stance. T-Test was used to evaluate significant differences between groups (P < 0.05). Results: Patients with knee OA had significant lower knee flexion ROM (10.3° ± 4.0°) during stance than matched controls (18.0° ± 4.0°) (p < 0.001). Patients with knee OA had significant lower knee flexion ROM (54.8° ± 5.5°) during swing than matched controls (61.2° ± 6.1) (p = 0.003). Patients with knee OA also had longer stride duration (1.12 s ± 0.09 s) than matched controls (1.06 s ± 0.11 s), but this was not statistically significant (p = 0.073). Motion characteristics differentiate between a patient with knee OA and a healthy one with a sensitivity of 0.952 and a specificity of 0.783. Conclusions: Significant differences were found in the gait profile of patients with knee OA compared to matched control and motion characteristics were identified. This test might help clinicians identify and evaluate a knee problem in a simple gait test. © 2013 McCarthy et al.; licensee BioMed Central Ltd. Source

Debi R.,Assaf Harofeh Medical Center | Mor A.,AposTherapy Research Group | Segal G.,AposTherapy Research Group | Segal O.,AposTherapy Research Group | And 5 more authors.
Disability and Rehabilitation

Purpose: To investigate the correlation between single limb support (SLS) phase (% of gait cycle) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 Health Survey) in patients with knee osteoarthritis (OA). Method. A prospective observational study was employed with 125 adults with bilateral medial compartment symptomatic knee OA who underwent a physical and radiographic evaluation. Velocity, step length and SLS were assessed by a computerised mat (GAITRite). Patients completed the WOMAC and SF-36 Health Survey questionnaires. Results. Statistical analysis examined the correlations between SLS and both questionnaires, between Kellgren & Lawrence (K&L) scores and both questionnaires and between SLS correlations and K&L correlations. We found significantly stronger correlations between SLS and WOMAC-pain, WOMAC-function, the SF-36 pain sub-category, velocity and step length than between K&L scores and these parameters (Pearson's r=0.50 vs. 0.26, 0.53 vs. 0.34, 0.50 vs. 023, 0.81 vs. 0.33, 0.77 vs. 0.37, respectively; all p<0.05). Significant differences in SLS were found over WOMAC-pain, WOMAC-function and SF-36 overall score quartiles (p<0.05 for all). Conclusion. We recommend integrating SLS as an objective parameter in the comprehensive evaluation of patients with knee OA. © 2011 Informa UK, Ltd. Source

Elbaz A.,AposTherapy Research Group | Mor A.,AposTherapy Research Group | Segal O.,AposTherapy Research Group | Agar G.,Assaf Harofeh Medical Center | And 5 more authors.

There is a lack in objective measurements that can assess the symptoms of knee osteoarthritis (KOA). In a previous study it was shown that pain and function are in higher correlation with the single-limb support gait parameter than with radiographic KOA stage. Single limb support represents a phase in the gait cycle when the body weight is entirely supported by one limb, while the contra-lateral limb swings forward. The purpose of this study was to further examine the relationship between single-limb support and the level of pain and function in patients with KOA. 125 adults with bilateral KOA underwent a physical and radiographic evaluation, and completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the SF-36 health survey. Patients walked barefoot at a self-selected speed on a computerized mat. Statistical analysis was used to divide the patients into quintiles based on single-limb support phase value and determine the differences in WOMAC and SF-36 scores between quintiles. Significant differences were found in WOMAC and SF-36 sub-category scores between the single-limb support quintiles. The means of the WOMAC-pain and WOMAC-function sub-categories decreased gradually over single-limb support quintiles (P<. 0.001), and the means of the SF-36 sub-categories increased gradually over the quintiles (P<. 0.001). Results show that single-limb support quintiles can help determine the level of pain, function and quality of life in patients with KOA. These results suggest that single-limb support quintiles may be added as an additional scale for generally assessing the symptomatic stage of KOA. © 2010 Elsevier B.V.. Source

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