Getting active to obtain more evidence

Osteoarthritis of the knee is one of the most common degenerative joint conditions. Its treatment is becoming more important in light of demographic changes and the increasing prevalence of obesity and injury rates at a young age. A research team at Karlsruhe Institute of Technology (KIT) headed up by Dr. Bernd Stetter, Movement Scientist, is currently examining whether the GenuTrain A3 knee support, a specialist model for treating cartilage wear, can exert verifiable relief, even in the early stages of the condition.

Table of Contents

• Comprehensive study design
• Treatment objective: remaining active
• Differentiating activity methodically
• Specialist support for early treatment
• A look at initial results

“It’s important for the feet to be parallel on the floor and stay that way. Your arms are crossed in front of your chest. After I’ve given the signal, you will get up and sit down again repeatedly until I say stop,” says Til Becker, Scientific Assistant at KIT, explaining the movement task of the sit-to-stand test to the subject. “Are you ready?” Claus S.¹ nods and, after the signal is given, starts to perform the exercise at his own speed. He is familiar with the procedure. He completed this and other exercises at KIT’s facilities in the previous test rounds four and five weeks ago.

Recording today’s data will conclude the examination phase conducted by the research group headed up by Dr. Bernd Stetter. Claus S. has to perform further movement tests, such as the six-minute-walking test, a single-leg jump, and climbing stairs. “These tests have been established in osteoarthritis research and allow us to objectively record functional changes over a certain period,” elaborates Claudia Seyler, also a Scientific Assistant at KIT and responsible for data collection. This research project is the subject of her dissertation for her Masters in Sports Science.

Comprehensive study design

Claus S. is one of 34 test subjects suffering from osteoarthritis of the knee who are taking part in this prospective, one-arm longitudinal study. After the baseline recording (T0) where the functional tests were performed without a support, Bauerfeind’s GenuTrain A3 was handed out during the following week (T1). Subsequently, the participants wore the knee support for four weeks during everyday activities before undergoing the test series for the second time (T2). In the week between T0 and T1 as well as one week before T2, a sensor worn around the torso recorded the test subjects’ activity. The goal was to objectively record movement patterns and intensities with and without the support so they could be compared. A heat sensor specially integrated into the support provided information on actual wearing behavior during the four-week wearing phase.

Subjective data was continuously recorded for the entire examination period. For this, the participants filled in the KOOS Questionnaire once a week, which records pain level, symptoms, everyday functionality, ability to exercise, and knee-specific quality of life. During the activity weeks, daily pain levels were queried, differentiated by situations of strain from pain at night to climbing stairs. This subjective data was complemented by information on painkiller consumption. “In order to get a comprehensive picture of changes during everyday activities, the study uses a combination of standardized tests, sensor technology, and patient reports,” Claudia Seyler says, summarizing the study setting.

Treatment objective: remaining active

The KIT researchers purposefully chose the patient group such that test subjects noticeably perceive symptoms but were still active and mobile enough to perform functionally demanding tasks like single-leg jumps. Study Director Bernd Stetter pointed out that it was exactly this mixture that makes this group clinically interesting: “These are people where we can realistically assume that wearing a support will have a positive effect before structural damage has progressed too far.”

“If we’re able to maintain movement and activity, a downward spiral of weight gain and increasing mechanical strain on the joint’s cartilage can often be prevented.”

Dr. Bernd Stetter

The study’s central research questions are therefore: Does wearing a specific osteoarthritis support reduce early-onset pain? And: Does functional performance improve with it? Dr. Stetter highlights that both factors are crucial for the progression of the condition and its treatment: “If we’re able to maintain movement and activity, a downward spiral of weight gain and increasing mechanical strain on the joint’s cartilage can often be prevented.”

Staying as active as possible is also the goal for test subject Claus S. who was diagnosed with osteoarthritis of the knee five years ago. Since then, he has been trying to counteract with cycling, walking, and running. In order to reduce pain after being stationary and during exercise, he and his physician are also working with acupuncture, physiotherapy, and osteopathy. “When I read in the newspaper about the opportunity to take part in a study about osteoarthritis of the knee at KIT, I knew: I wanted to contribute to research so that patients like me can stay mobile for longer.”

Differentiating activity methodically

The current research builds on a series of previous studies that focused primarily on biomechanical laboratory parameters. “It was always noteworthy that joint-relieving aids with rigid constructions exerted verifiable positive effects. In practice, however, their benefits are hampered by a lack of compliance, with mild symptoms at least,” explains Dr. Stetter. After the study also conducted at KIT using the flexible soft brace GenuTrain OA, his research team revisits an essential methodical element in the current examination: objective and differentiated recording of activity during everyday life. The GenuTrain OA study found that overall activity does not necessarily increase but activity in ranges with greater strain does. This is an important link. “It’s not about patients taking many more steps,” Dr. Stetter emphasizes. “The crucial question is whether they can return to activities that are important to them – be it sports or simply a challenging everyday situation.”

Specialist support for early treatment

With the GenuTrain A3, the study examines a specialist support geared towards active patients with restrictions caused by pain during an early stage of osteoarthritis of the knee. “This is where huge opportunities open up for conservative strategies before functional losses manifest,” Dr. Stetter explains.

In order to support treatment compliance with comfort, the GenuTrain A3 features compression knit with soft structure and a supple popliteal region as well as ergonomically shaped donning aids. Integrated functional elements, such as the two-component pad help targeted stimulation of mechanoreceptors which can alleviate symptoms related to osteoarthritis. “Numerous participants have reported that they have noticed improvements when it comes to pain levels and capacity for strain,” Til Becker comments. “This is subjective feedback that corresponds to observations from other studies with supports.” Claus S., too, draws a positive conclusion after his last round of climbing stairs: “The feeling of stability is certainly greater with the support. That’s why I’ll continue wearing it after the study has finished.”

“The feeling of stability is certainly greater with the support. That’s why I’ll continue wearing it after the study has finished.”

Claus S., test subject

A look at initial results

Data collection has now been completed. Looking at the methodology, Dr. Stetter summarizes: “Even now, the combination of sensor-based activity recording and validated questionnaires indicates robust data which should clarify the role of the GenuTrain A3 in the conservative management of early osteoarthritis of the knee.” Initial partial analyses are already available, indicating a reduction in pain during walking, climbing stairs, and at night. The subjective data is also pointing at a reduction in symptoms as a result of wearing the support. But Study Director Dr. Stetter does not want to get ahead of the full evaluation. “It’ll be interesting to see whether these observations are substantiated and what other results the study will have with regards to meaningfully treating osteoarthritis at an early stage.”

¹ The test subject’s last name was anonymized on his request.
² In addition to his scientific activity at KIT, Dr. Bernd Stetter has been the Head of Medical Affairs at Bauerfeind AG since 2024. As a manufacturer of medical aids for the treatment of osteoarthritis of the knee, Bauerfeind is supporting the study presented in this article with its product GenuTrain A3, among others. However, it is not involved in the development of the study design, data collection and analysis, interpretation of the results, or preparation of the manuscript.

Supports and braces for treating osteoarthritis of the knee
Osteoarthritis of the knee requires personalized treatment management based on the progression of the condition and the patient’s needs. Bauerfeind helps joint-preserving treatment with specifically developed supports and braces. The stabilizing GenuTrain A3 knee support promotes movement at an early stage of the condition when symptoms are starting. With moderate symptoms, the flexible GenuTrain OA soft brace provides the affected compartment with targeted relief that patients can adjust themselves. In cases of pronounced axis misalignments and an increased need for stabilization, the SecuTec OA hard-frame brace provides relief by applying force that is gentle on the joints. It counteracts instabilities, thanks to the additionally integrated four-point principle. Find out more.

Pictures: Udo Schönewald, Bauerfeind AG