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The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys. Ther. 79(4).

Cherian et al. (2015)

Strength and functional improvement using pneumatic brace with extension assist for end-stage knee osteoarthritis: a prospective, randomized trial. J. Arthroplasty. 30(5).

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Prevalence of radiographic osteoarthritis – it all depends on your point of view. Rheum. 45(6)

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The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis. B. J. Sports Med. 51(16).

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Incidence of bicompartmental osteoarthritis in patients undergoing total and unicompartmental knee arthroplasty: is the time ripe for a less radical treatment?. J. Knee Surg. 27(1).

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Military Case Study

Levitation TCO Knee Brace Case Study: 18-year-old male with patellar dislocation, fracture, and osteochondral lesion.

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Research Summary


Bannuru, R.R., Osani, M.C., Vaysbrot, E.E., Arden, N.K., Bennell, K., Bierma-Zeinstra, S.M.A., Kraus, V.B., Lohmander, L.S., Abbott, J.H., Bhandari, M., Blanco, F.J., Espinosa, R., Haugen, I.K., Lin, J., Mandl, L.A., Moilanen, E., Nakamura, N., Snyder-Mackler, L., Trojian, T., Underwood, M., McAlindon, T.E. (2019). Osteo. Cartl. 27(11).

Key Findings

In an effort to update and expand upon Osteoarthritis Research Society International (OARSI) Guidelines for non-surgical management of knee, hip, and polyarticular osteoarthritis (OA), a panel of experts evaluated systematically-compiled evidence for 60 unique interventions. The evaluation informed the development of updated guidelines, which also included recommendations for patients who experience gastrointestinal (GI) comorbidities, cardiovascular (CV) comorbidities, frailty, and widespread pain and/or depression.

For patients with knee OA and no comorbidities, recommended non-pharmacologic treatments included aquatic exercise, gait aids, cognitive behavioral therapy with an exercise component, and self-management programs. These recommendations were also given to patients with GI, CV, and widespread pain/depression comorbidities. Pharmacologic recommendations for patients with no comorbidities include oral NSAIDs. More specific pharmacological recommendations were provided for patients with each of the four comorbidities.

relevance to levitation

Levitation is unique amongst OA knee braces for its ability to offload all three compartments of the knee while simultaneously providing powerful knee extension assistance (KEA). Its unique combination of features allow it to transcend OARSI’s treatment categories by addressing multiple facets of knee OA management. OARSI prioritizes non-pharmacological treatments, recommending weight management and exercise (in addition to education) as a first line of treatment. Levitation’s ability to reduce load on the knee joint has been shown to be equivalent to weight loss of 45 lb 1– Budarick, A.R. et al. (2020). J. Biomech. Eng. 142(1), a clinically-relevant decrease for most patients that functionally addresses OARSI’s weight management recommendation. The benefits of exercise for improving pain and function are also noted by OARSI. By offloading the knee joint and assisting knee extension 2 – Budarick, A.R. et al. (2020). J. Biomech. Eng. 142(1)
– McGibbon, C.A. et al. 2020. Front. Bioeng. Biotech. doi:10.3389/fbioe.2020.604860
, Levitation reduces pain, allowing patients with multicompartmental and patellofemoral knee OA to more fully participate in and benefit from physical exercise 3– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review..

Additionally, the guidelines remarked on the poor quality of supporting research for biomechanical interventions, including bracing, at the time of the study. Spring Loaded has prioritized an evidence-based approach to the development of Levitation. Recent studies have demonstrated Levitation’s efficacy at offloading joint forces, relieving knee pain, increasing function, and improving overall quality of life 4– Bishop, E.L. et al. (2020) Osteo. Cart. Under Peer Review. 28: S243-S244
– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review.

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