Effects of knee orthoses on kinesthetic awareness and balance in healthy individuals

Abstract

Introduction: Conflicting evidence exists regarding the effects of knee orthoses on proprioception. One belief is that pressure applied by orthoses heightens kinesthetic awareness and that this affects balance. This study aimed to investigate the effects of two different orthosis designs on kinesthetic awareness and balance in healthy individuals. Methods: Twenty individuals (13 women) participated in this case series study. Each was tested wearing 1/no orthosis, 2/soft elastic orthosis and 3/non-elastic jointed orthosis. Pressure under orthoses was recorded. Kinesthetic awareness was investigated by testing joint position sense and threshold to detection of passive motion. Balance was tested using a modified sensory organization test. Results: Non-elastic jointed orthoses applied the greatest pressure to the knee. With non-elastic jointed orthoses, threshold to detection of passive motion was significantly poorer for pooled results (p ¼ 0.02) and when the start position of the knee was 70 (mean threshold ¼ 0.6 , 0.6 , 0.7 for no-orthosis, elastic and jointed-orthoses; p ¼ 0.03). No major differences were observed in JPS or balance and correlation between proprioception and balance was poor. Conclusions: There may be a limit to the amount of pressure that should be applied to the knee joint by an orthosis. Exceeding this limit may compromise kinesthetic awareness.