“The range of non-surgical hip treatment has been expanded”

Osteoarthritis study proves effectiveness of CoxaTrain brace

From Bauerfeind Life Magazin

In short A randomized controlled trial with the novel CoxaTrain was the first to confirm its therapy-relevant effects: reduced pain, increased functional capacity and an improved gait. Pain at rest – which is often the reason to opt for hip replacement surgery – was also significantly reduced after seven days of wearing the brace. The CoxaTrain not only addresses the hip joint but the entire LPHC region. According to Prof. Dr. med. Stefan Sell, who is also co-author of the study, the CoxaTrain opens up more possibilities for conservative hip treatment.

It reduces pain, improves gait and increases functional capacity. Scientists have now confirmed what users of the CoxaTrain experience in everyday life. The effects on the lumbo-pelvic-hip complex (LPHC) are also evident.

For a long time, it seemed unthinkable to use relieving braces for the hip. There were just too many reservations, both regarding effective relief and patient acceptance. Yet the introduction of the novel CoxaTrain hip brace initiated a paradigm shift. Active patients with osteoarthritis of the hip appreciate the comfortable freedom of movement and confirm the practical benefits of the brace, both in everyday life and during exercise (CoxaTrain for work and play). CoxaTrain’s broad-based mode of action is by no means directed only at the hip joint. It specifically targets the periarticular complex consisting of muscles and tendons as well. Users of the brace report improvements in their hip complaints after only a short wearing period. This practical evidence about CoxaTrain has now been backed up by the publication of the first results of a clinical study1 that provide scientific clarity.

Patients with less pain at rest opt against hip replacement

The randomized, controlled study focused on the impact of CoxaTrain on pain perception, functional capacity and gait biomechanics in subjects with mild to moderate unilateral osteoarthritis of the hip (Kellgren-Lawrence grade II–IV). The study was conducted under the direction of movement scientist Hannah Steingrebe at Karlsruhe Institute of Technology (KIT). Co-author was Prof. Dr. med. Stefan Sell, Professor for Sports Orthopedics and Stress Analysis at KIT. For the physician and scientist, the interpretation of the results is clear: “They demonstrate that the CoxaTrain reduces pain, and not just while walking, but also at rest. Both pain conditions improve after seven days of wearing the brace. For me, the decrease in pain at rest is a key outcome of the study. Ultimately, it is the determining factor in the patient’s decision for or against hip replacement surgery,” the doctor knows. “Joint replacement, however, is recommended only for severely advanced osteoarthritis of the hip. Therefore, the development of effective non-surgical treatment methods is of great importance.”

Prof. Dr. med. Stefan Sell, osteoarthritis expert and co-author of the study.

Increased mobility, improved gait

Another fundamental criterion for the effectiveness of the brace in osteoarthritis therapy relates to the functional capacity of the subjects. It can be considered a benchmark for low-pain mobility in everyday life. In this regard, it was shown that the subjects can cover a greater distance when wearing the CoxaTrain, as compared to not wearing it. The walking distance was significantly greater after the one-week intervention phase with the brace compared to the first examination right after putting on the brace. Unambiguously positive effects of the CoxaTrain were also observed in gait analysis. For example, both walking speed and stride length increased significantly compared to the control group. Normalization of the gait pattern, however, could not be achieved. According to Prof. Sell, this is not possible due to irreversible capsular contractures: “You cannot return to the way things were before the onset of the condition.”

Moving the LPHC region

In the sagittal plane, wearing the CoxaTrain resulted in a reduction in the maximum flexion angle and an increase in extension forces compared with not wearing the brace. Additionally, there was a significant increase in the range of motion of the pelvic tilt and the pelvic rotation when wearing the brace. “I was honestly surprised, yet also pleased by this finding,” Prof. Sell explains. “I’ve always been aware of the inter-correlations between the different components in the hip, sacroiliac joints and lower lumbar spine, which is why we refer to it as the LBHC region. In the clinical picture of osteoarthritis of the hip, it should be seen as a single unit that cannot be separated during treatment,” emphasizes Prof. Sell. “Again, measurable effects were seen at the pelvis after the one-week intervention period. The results observed immediately after applying the brace did not yet reach significance. Biomechanical modes of action usually take some time, and patients need to be made aware of this.”

Mean values of distance covered [m] during the 6 minute walking test for the control group (CG) and the HOA group under different brace conditions. *indicating significant differences at α<0.05.

Osteoarthritis also affects soft tissues

In addition to the proven effects on pelvic biomechanics, osteoarthritis of the hip also affects other periarticular structures of the joint.2 Osteoarthritis also affects soft tissues. That is why braces such as CoxaTrain which also focus on stimulating the surrounding muscles and the joint capsule can achieve a positive effect during treatment even without rigid, mechanically relieving components. The ultimate goal is on improving functional capacity by wearing the brace in a way that can be felt and seen by patients. “Not least because of this, compliance among test subjects was very, very high,” concludes Prof. Sell. He is also certain: “A brace like the CoxaTrain represents a clear expansion of our therapeutic possibilities, similar to what we know from osteoarthritis of the knee – it is low-risk option with virtually no side effects. We gain a lot of active time with the CoxaTrain for exercise therapy. The range of non-surgical hip treatment has been expanded.”

Get the white paper

A summary of selected results of the study is available as a PDF in English or German.

1 Steingrebe H. et al.: Frontiers in Bioengineering and Biotechnology; July 2022, Vol. 10, Article 888775 “Effects of Hip Bracing on Gait Biomechanics, Pain and Function in Subjects With Mild to Moderate Hip Osteoarthritis
2 Block, J. A. and Shakoor, N. (2009). The biomechanics of osteoarthritis: Implications for therapy. Curr Rheumatol Rep 11, 15–22

Images: Bauerfeind, Udo Schönewald

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