PEG Soft Knee Braces SPEG0003V1
Transcription
PEG Soft Knee Braces SPEG0003V1
Product Evaluation Soft Knee Braces Document Code Date Product Evaluation Group Adam Horrocks Andrew Nicol Ryan Cassidy Rachel Taylor Richard Thomas Zoe Wright Cameron Hall SPEG0003V1 23rd December 2015 Orthotist Clinical Director Orthotist Orthotist Head of Business Development Orthotist Orthotist PEG Recommendations Mild Knee Support Firmer Feel Redundant Tissue Increased lever arm Black Steeper SK Ossur Thermo Wrap Steeper Long SK Ossur Bio Skin www.steepergroup.com Product Group Soft Knee Braces Products Evaluated SK Style Braces • Standard Knee Brace (Steeper) • Bio Skin Hinged Knee Skin (Ossur) • Stabimed Wraparound Functional Soft Brace (Medi) • ThermoWrap knee Brace (Ossur) • Bea wrap knee brace (Beagle) • Townsend Sports Series Knee Brace (Beagle) Long SK Style Braces • Drytex Playmaker Wraparound (Donjoy) • Long SK (Steeper) Sleeve Style Knee braces • Stabilised knee skin (Steeper) • Bio Skin standard knee skin (Ossur) • Beagle Stability knee brace (Beagle) • Genu Hit GS (Beagle) Aim The aim of this document is to inform & educate the reader about a range of knee braces to assist the reader in comparing them. As a group, we have met and evaluated these braces and hope to give the reader a greater knowledge of their properties. Criteria The criteria for evaluation soft knee braces and these were selected by looking at the ordering history and selecting the most popular braces. Functional ligament braces and OA knee braces were excluded from the evaluation however will be evaluated at a later date. Method Additional Information Direct Evaluation We tried the braces on ourselves and on each other whilst considering the supplied instructions. Expert Opinion We identified the most frequent user of each type of brace and conducted telephone interviews to find out their opinion, likes and dislikes. The 5 most frequent users of these braces were highlighted with the aim of gathering 3 or more opinions on the brace. Survey Monkey A survey was conducted to gain the opinion of all orthotists in the company from the point of view of the patient and of the orthotist. Clinical Evidence A search was performed for any clinical evidence specific to the brace being evaluated. Objective Information Objective information such as cost and delivery times was gathered. Braces have been grouped into four sections to allow for ease of comparison. These are: Swedish type, leaf spring, sock type and other braces. The division is listed above in Products Evaluated. 2 Product Evaluation Contents Product Standard Knee Brace (Steeper) Page 4 Bio Skin Hinged Knee Skin (Ossur) 6 Stabimed Wraparound Functional Soft Brace (Medi) 8 ThermoWrap Knee Brace (Ossur) 10 Bea Wrap Knee Brace (Beagle) 12 Townsend Sports Series Knee Brace (Beagle) 14 Drytex Playmaker Wraparound (Donjoy) 16 Long SK (Steeper) 18 Stabilised Knee Skin (Steeper) 20 Bio Skin Standard Knee Skin (Ossur) 22 Beagle Stability Knee Brace (Beagle) 24 Genu Hit GS (Beagle) 26 Conclusion 28 3 Standard Knee Brace Supplier Model No. Application Expert opinion Steeper RSL-SKB/CX/BE/x P Medio lateral stability and patella control osteoarthritis, Rheumatoid arthritis. “Generally good compliance with this brace, an excellent entry level brace” “Firm material and hem leads to a little firmer fit than the neoprene alternative” Evaluation Features Cost Evidence PEG Observations • Universal application • Wrap around There was no clinical evidence found specifically for this brace. A neat fitting, comfortable short soft knee brace that generally gives low level support. Material is slightly firmer than the neoprene alternative; this material also leads to a better appearance. Advice on use Advantages • Has posterior straps for a better fit • Neat knee joints • Gives compression • Can bend steels to profile • Contours well • Top posterior strap is elastic for comfort • Open behind the knee Disadvantages • Only comes in beige • Unable to limit flexion/extension 4 Steeper SK Brace – Patient Perspective Patient Perspective of SK brace 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace This is a good entry-level SK brace which has good appearance and an above average level of support for this style of brace. This is possibly due to its firmer material and well-finished seams. The fit of the brace also scored above average with excellent scores for ease of don and doffing. Steeper SK Brace – Orthotist Perspective Orthotist Perspective of SK Brace 4 3.5 3 2.5 2 1.5 1 0.5 0 Ease of adjument Quality of instructions Average Ease of fitting Range of size Brace From the Orthotist perspective the brace scores well in comparison to other similar braces to adjust and proves an easy brace to fit in comparison to the average. It has an average range of sizes to cater for the majority of patients however the range lacks an XXL size. 5 BioSkin Hinged Knee Skin Supplier Model No. Ossur RSL-4130x Ultima RSL-5130x Ultima 2S RSL-5133x Ultima 2SOL (x denotes size) Application Mild sprains, inflammation, MCL & LCL sprains, meniscal tears, early osteoarthritis, patella tendonitis. “Thinner material than the thermo-wrap and a good close contour to patient's leg” “Lightweight and popular with younger patients due to colour and neat fit under trousers. The sizing chart seems a little out however and I tend to go up a size when ordering” Expert opinion Evaluation Features Cost Evidence PEG Observations • Universal application • Wrap around or pull on • Provides compression and warmth • Donut buttress for extra patella support on pull on version £32.89 There was no clinical evidence found specifically for this brace. This is a neat fitting, comfortable brace that gives good compression. This brace is ideal for a more active person who desires a cosmetic looking, low profile brace. The brace only comes in black which seems to appeal to the younger patient and fit isn’t ideal if there is a lot of soft tissue to control. When ordering it is advised to go up one size as the measurement chart is slightly out. Advice on use Advantages • Has posterior straps for a better fit • Pull on version difficult to don, but does have finger loops at the top to assist • Gives very good compression • Can bend steels to profile • Steels are curved for extra stiffness • Front opening – straps are elastic for comfort, top and bottom, front and back. Disadvantages • Joints are not removable • Only comes in black • Unable to limit flexion/extension 6 BioSkin Hinged Knee Skin – Patient Perspective Patient Perspective of Ossur Bioskin Hinged Knee Skin 6 4 2 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace This brace scores very well in the appearance area and is well above average. It fits well due to a thin flexible material contouring well to the shape of the leg and knee. The functionality of the brace is average. BioSkin Hinged Knee Skin – Orthotist Perspective Orthotist Perspective of Ossur Bioskin Hinged Knee Skin 3.8 3.6 3.4 3.2 3 2.8 Ease of adjument Quality of instructions Average Ease of fitting Range of size Brace These results are slightly contradictory to the expert opinions where this brace scored very well. The range of sizes scored particularly low and this may be due to the sizing chart being slightly out leading to braces coming up a little short. 7 Stabimed Wraparound Functional Soft Brace (Original) Supplier Model No. Application Medi Expert opinion “Hinges are quite bulky and so not suitable for some bi-lateral users” 826/x Mild to moderate instabilities of the knee joint, Meniscus injuries, traumatic or degenerative deformities of the knee joint for protection in the later stages of rehabilitation. “Looks sporty because of colour and material is breathable, the straps can get confusing for patients however as they are not fixed to side struts” Evaluation Features Cost Evidence PEG Observations • Polycentric hinges • Wrap around • Breathable and moisture wicking material • Flexion and extension stops There was no clinical evidence found specifically for this brace. This brace gave only minimal support despite its bulky appearance. Although the knee joints look supportive the brace does not contour to the leg well. The material, although a little firmer than the neoprene alternative strength wise also does not contour to the leg very well and if wearing a pair, the knee joints will more than likely catch on each other. This brace is one to avoid however it is worth mentioning that a new version of this brace is on the market and many, if not all, of the shortfalls of this brace have been addressed according to the manufactures. This brace will be evaluated in due course. Advice on use Advantages • Numbered straps • Media and lateral anti-migration silicone strips • Extension/flexion stops included • True to size • Good instructions and tools supplied for fitting the stops Disadvantages • Bulky knee joints • Only in black • Gives minimal support 8 Stabimed– Patient Perspective Stabimed Patient Perspective 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Stabimed Surprisingly this brace scored well on appearance however the functionality of the brace is highlighted, as below average as is the fit. It scored well in relation to the ease of fit, which does seem slightly contradictory to the expert opinion, which pointed out the poor strapping configuration. Stabimed – Orthotist Perspective Stabimed Orthotist Perspective 3.8 3.6 3.4 3.2 3 2.8 Ease of adjument Quality of instructions Ease of fitting Orthotist Perspective Average Range of size Orthotist Perspective Stabimed Orthotist’s seem to find this brace an easy brace to fit possibly due to its wrap around nature. The brace is supplied with good instructions and the range of sizes covered in this range is also above average. 9 ThermoWrap Knee Brace Supplier Model No. Application Expert opinion Ossur RSL-029x Mild sprains, inflammation, meniscal tears, early osteoarthritis, patella tendonitis. “Good thermal properties, some patients like the warmth they give” “Easy to fit and adjust, the stitching can come undone for more active users” “Steels can come out for adjustment” Evaluation Features Cost Evidence PEG Observations • Universal application • Wrap around • Provides compression and warmth • Hyper extension version available There was no clinical evidence found specifically for this brace. A comfortable short soft knee brace that generally gives minimal support. Generally suited to the less mobile patient and accommodates soft tissues well due to flexibility of the material. Advice on use Advantages • Has posterior straps for a better fit • Neat knee joints • Gives compression • Can bend steels to profile • Scooped shape top and bottom for better fit • Tabs on the end of the straps to make it easier to fasten/unfasten • Closed behind the knee but with ventilation Disadvantages • Knee quite open at the front • Only comes in beige • Unable to limit flexion/extension 10 ThermoWrap – Patient Perspective Patient Perspective of Ossur Thermowrap 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace This brace proves an easy knee brace to don and doff and patients felt the brace was above average in appearance. The functionality of the brace correlates to the observations made by the PEG group with the instructions slightly above par with the average score for the selected braces. ThermoWrap – Orthotist Perspective Orthotist Perspective of Ossur Thermowrap 3.8 3.6 3.4 3.2 3 2.8 2.6 Ease of adjument Quality of instructions Ease of fitting Average Range of size Brace A very popular brace with orthotist’s that has scored exceptionally well in all areas. This is an excellent go to brace that fits a full range of sizes and is easy to fit and adjust too. An excellent entry level stock item that is popular with patients and orthotist alike. 11 Bea Wrap Knee Brace Supplier Model No. Application Expert opinion Beagle RSL-BWST/0x Rheumatoid Arthritis, Mild to moderate hyperextension, mild to moderate valgus/ varus knee deformity. “Comparable to the Ossur Thermo wrap” “Good posterior opening” “Beagle will make a one off size for large or small patient” Evaluation Features Cost Evidence PEG Observations • Universal application • Wrap around • Provides compression and warmth There was no clinical evidence found specifically for this brace. A neat fitting, comfortable short soft knee brace that generally gives entry low level support. A good option if a large posterior opening is desired by the patient and the flexibility of the material contours well similarly to the Ossur equivalent. Advice on use Advantages • Thicker material • Neat knee joints • Gives compression • Can bend steels to profile • Tabs on the end of the straps to make it easier to fasten/unfasten • Open behind the knee • Scooped shape top and bottom for better fit Disadvantages • Knee quite open at the front • Only comes in beige • Unable to limit flexion/extension • 12 Bea Wrap Knee Brace – Patient Perspective Or Patient Perspective of BeaWrap Knee Brace 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace All in all the brace scores slightly below par aside from the ease of don and doff, this is more than likely to the front opening nature of the brace. A very similar brace to the Ossur equivalent on the whole. Bea Wrap Knee Brace – Orthotist Perspective Orthotist Perspective of BeaWrap Knee Brace 4 3.5 3 2.5 2 1.5 1 0.5 0 Ease of adjument Quality of instructions Average Ease of fitting Range of size Brace The orthotist findings correlate well to the patient perspective with the ease of fitting again scoring well. Again this is probably due to the front opening closure. 13 Townsend Sports Series Brace Supplier Model No. Beagle Application MCL or mild ligament injuries, patient who requires semi rigid support for knee sprains. “Nice looking but disappointed with the hinge” “Looks quite sporty but a little on the heavy side and the hinges are bulky in comparison to other brands equivalent” Expert opinion Evaluation Features Cost Evidence PEG Observations SB12/60x – 12” SB16/60x – 16” • Universal application • Wrap around • Provides compression and warmth • Extension and flexion stops There was no clinical evidence found specifically for this brace. This is a very impressive looking knee brace but functionally works no better than the basic knee braces. It feels on the heavy side in comparison to most others. Advice on use Advantages • 2 straps on the 12” and 4 on the 16” • Wrap around design • XXXL and XXXXL available by special order • Comes in 2 lengths • Replacement sleeves available • Pull on version available with patella buttress • Open behind the knee • Condylar pads sewn in Disadvantages • Standard hinge in 12” version and TM5+ hinge in the 16” version • Bulky joints • Minimal support 14 Townsend Sports Series – Patient Perspective Patient Perspective of Townsend Sports Series Or 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace Appearance of the brace has scored well and this continues the theme from the expert user interviews that patients like black braces and generally associate them with sport. Over all the brace does not score well in fit or function which again supports the expert user comments on weight. Townsend Sports Series – Orthotist Perspective Orthotist Perspective of Townsend Sports Series 3.8 3.6 3.4 3.2 3 2.8 Ease of adjument Quality of instructions Average Ease of fitting Range of size Brace Not a popular brace with orthotists, other than providing some good instructions has scored poorly in all areas. The orthotist findings correlate well to the patient perspective with the ease of fitting again scoring well. Again this is probably due to the front opening closure. 15 Drytex Playmaker Supplier Model No. Donjoy Application Varius/valgus knee support “Nice looking brace, seem to need replacing frequently but this could be because it’s used on a more active patient.’ Expert opinion 11-0759/xx - wrap 11-0558/xx – pull on “Ideal for a straighter leg as there isn’t much contour in the fabric” “Looks good and has a wide size range” Evaluation Features Cost Evidence PEG Observations • Universal application • Pull on or wrap around • Provides compression and warmth • Extension and flexion stops There was no clinical evidence found specifically for this brace. This is an impressive looking knee brace and is functionally very similar to other brands of long SK bracing. Very straight cut to the fabric so if you have a patient with excessive soft tissue, excessive valgas/ varum deformities then consider a different brace. Advice on use Advantages • 4 straps • Extenal hinges with flexion/extension stops • Looks impressive • Long brace • Good instructions Disadvantages • Only comes in black • On the wrap around version the knee is very open at the front • Gives minimal support • No tools supplied for adding the extension/flexion straps 16 Drytex Playmaker – Patient Perspective Patient Perspective of Drytex Playmaker Or 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace Contrary to expert opinion the playmaker hasn’t scored particularly well in appearance however the function of the brace has. The brace seems to fit well according to the survey results which does not seem to support the comments on the brace being quite a straighter fit. The only thing I can put this down to is that the people who use this brace pick their patients wo fit the brace well. Drytext Playmaker – Orthotist Perspective Orthotist Perspective of Drytex Playmaker 4 3 2 1 0 Ease of adjument Quality of instructions Average Ease of fitting Range of size Brace Popular with orthotist for the range of sizes available, the quality of instructions seem to score well too however doesn’t seem an easy brace to adjust. 17 Long Knee Brace Supplier Model No. Application Expert opinion Steeper RSL-LKB/CX/BE/x P Medio lateral stability and patella control osteoarthritis, Rheumatoid arthritis. “A great stock brace with steels that are easy to shape” “Comparable to other stock long SK braces and a reasonable price too” Evaluation Features Cost Evidence PEG Observations • Longer version of the Standard Knee Brace (40cm) • Universal application • Wrap around There was no clinical evidence found specifically for this brace. A neat fitting, comfortable soft knee brace that generally gives entry level support. Steels are easy to contour to the leg and the knee joints are neat too. Advice on use Advantages • Has posterior straps for a better fit • Neat knee joints • Gives compression • Can bend steels to profile • Contours well • Open behind the knee • Gives more control than the standard brace Disadvantages • Only comes in beige • Unable to limit flexion/extension • Only the XL has 4 straps, small sizes may benefit from this too 18 Steeper Long Knee Brace – Patient Perspective Patient Perspective of Long Brace 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions RSL Long Fit and function of the brace are fairly average in comparison to the average. The appearance of the brace is a little below par but this could be due to it only being available in beige. Steeper Long Knee Brace – Orthotist Perspective Orthotist Perspective of Long Knee Brace 4 3 2 1 0 Ease of adjument Quality of instructions Ease of fitting Average Range of size RSL Long The brace is easy to fit and adjust however the size range could be improved along with the instructions. 19 Stabilised Knee Skin Supplier Model No. Application Expert opinion Steeper RSL-SKS/CX/BE/x P Medio lateral stability and patella control knee instability, post op rehabilitation, strains / sprains, bursitis, tendonitis osteoarthritis, rheumatoid arthritis. “Good brace, patients happy with it as it fit’s nice and neat.” “Happy to use these, they are comparable to other similar braces and patients seem happy with them.” Evaluation Features Cost Evidence PEG Observations • Universal application • Pull on • Provides compression and warmth • Doughnut support around the patella There was no clinical evidence found specifically for this brace. A neat fitting, comfortable short soft knee brace that generally gives minimal support. It gives only low level control to the patella so only useful in mild conditions. Seems overall a slightly better fit than the Beagle version. Advice on use Advantages • 2 metal stays at each side • Buttress around the patella, doughnut shaped • Compression and warmth • Airprene material Disadvantages • Only comes in beige • Does not give the patella much support • One piece straps 20 Stabilised Knee Skin – Patient Perspective Patient Perspective of Stabilised Knee Sleve 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace A popular brace with patients scoring well in all areas aside from ease of don/doff. This may be due to the patient group that use them being slightly less dextrous in their upper limbs. Stabilised Knee Skin – Orthotist Perspective Orthotist Perspective of Stabilised Knee Sleve 4 3.5 3 2.5 2 1.5 1 0.5 0 Ease of adjument Quality of instructions Ease of fitting Average Range of size Brace Again the orthotist perspective supports the patients. Results suggest that the brace is a good fitting brace with a good range of sizes. 21 Bio Skin Standard Knee Skin Supplier Model No. Ossur Application Mild sprains, inflammation, meniscal tears. “Thinner material than thermowrap meaning a close fit and contour to patient’s leg” Expert opinion P RSL-4111x – with straps RSL-4110x – without straps RSL-5110x – 25 without straps “Closer intermit fit than the neoprene alternative so great low profile option but sizing does tend to be out a little and I usually go up a size” Evaluation Features Cost Evidence PEG Observations • Universal application • Pull on • Provides compression and warmth • 2 types of material There was no clinical evidence found specifically for this brace. This is a very neat fitting, comfortable short soft knee that gives good compression although can be quite difficult to get on. Is should be fairly tight when worn however continuing the Bioskin theme it is recommended that you go up one size from the sizing chart.. Advice on use Advantages • Strap version has posterior straps for a better fit/compression • All straps are elastic • Gives very good compression • Spiral stays rather than joints so slimmer Disadvantages • Only comes in black 22 BioSkin Standard Knee Skin – Patient Perspective Patient Perspective of Ossur Bioskin SK Skin 5 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace Fit of this brace has been reported poor in the survey findings and I’m sure this is down to the inaccuracy of the sizing chart. The appearance of the brace fits in well with the notion that black braces are sporty looking and appealing to many. Not the easiest brace to don and doff however this a brace that is meant to be worn tightly to aid compression, the downside to this is that it takes a bit of a pull to get on. BioSkin Standard Knee Skin – Orthotist Perspective Orthotist Perspective of Ossur Bioskin SK Skin 4 3.5 3 2.5 2 1.5 1 0.5 0 Ease of adjument Quality of instructions Average Ease of fitting Brace Range of size The orthotist perspective very much reflects the findings of the patient in that it isn’t particularly easy to fit or adjust. The sizing issue for mentioned has been reflected in the survey also. 23 Stability Knee Brace Supplier Model No. Beagle Application Patella disorders Expert opinion “Can take steels out if required to shape but pretty similar to other brands available’. Evaluation Features Cost Evidence PEG Observations RSL-SK/02x doughnut RSL-SK/02x horseshoe P • Universal application • Pull on • Provides compression and warmth • Doughnut or horseshoe option There was no clinical evidence found specifically for this brace. A neat fitting, comfortable short soft knee brace that generally gives entry level support. It again gives low level control to the patella however does come with two options for the knee buttress to gain the desired control and comfort. Advice on use Advantages • 2 metal stays at each side • Buttress around the patella, doughnut shaped or horseshoe • Compression and warmth Disadvantages • Only comes in beige • Does not give the patella much support • One piece straps 24 Stability Knee Brace – Patient Perspective Patient Perspective of Beagle Stability Knee Brace 5 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace Not an easy brace to don possible due to the pull on nature of this type of brace, scored poorly in all areas aside from the aesthetics. Stability Knee Brace – Orthotist Perspective Orthotist Perspective of Beagle Stability Knee Brace 4 3.5 3 2.5 2 1.5 1 0.5 0 Ease of adjument Quality of instructions Ease of fitting Average Range of size Brace Orthotist have not scored this brace well in area with similar findings to the patients in all areas. 25 Genu Hit GS Supplier Model No. Beagle Application Minor ligament insufficiency, knee strains or sprains, gonarthritis, postoperative and post traumatic inflammation of the knee. “Good alternative to neoprene” Expert opinion RSL-07014x P “Minimal support but looks sporty and is low profile” Evaluation Features • • • Cost Evidence PEG Observations Lateral joint stays that can be individually shaped The central element of this innovation is a patented oval insert made of an anatomically contoured flat knitted fabric, which means there are no annoying seams in the popliteal region The fastening tapes go all the way around, which improves function and fit There was no clinical evidence found specifically for this brace. Neat fitting brace that requires good dexterity to pull on. Only available in a pull on sleeve so a good level of flexibility is required by patient to don and doff. Use for more active patients that require minimal support. Weaved fabric is a good alternative to neoprene style braces. Advice on use Advantages • Neat fitting • Low profile • Good compression • A good alternative to neoprene Disadvantages • Good dexterity needed to pull on • Strap round calf gets tangled when not wearing if not stored correctly. • Only available in black. 26 Genu Hit GS – Patient Perspective Patient Perspective of Genu Hit Knee Brace 5 4 3 2 1 0 Appearance of brace Functionality of brace Fit of brace Average Ease of Don/doff Quality of instructions Brace Excellent scoring brace across the board. Popular with orthotist and patients alike, fit and function are well above the average and a good looking brace too. Genu Hit GS – Orthotist Perspective Orthotist Perspective of Genu Hit Knee Brace 6 5 4 3 2 1 0 Ease of adjument Quality of instructions Ease of fitting Average Range of size Brace Again top marks across the board scoring well in all areas. Good range of sizes, easy to fit and good instructions are all plus points for this brace. 27 Conclusion There are many factors to consider when ordering soft knee braces. This evaluation has attempted to highlight the pros and cons of the most commonly ordered braces by Steeper orthotist. The Survey Monkeys completed by orthotist across the country are an integral part of the process of evaluation however are somewhat contradictory on occasion to the expert opinion. This may be due to the expert user being more familiar with the brace in question so has a much better idea of when and when not to prescribe the particular brace. Interesting comments and correlations were made to the colour of braces we have evaluated with the general feeling that black braces are regarded as sporty and appealing to younger patients generally scoring better in appearance while the beige alternatives were not viewed in this way. Material type was a variant that was commented on throughout the evaluation process with the Ossur Thermowrap and Bleage BeaWrap regarded as fixable and easy to fit. The flip side to this is that the Steeper SK is a firmer therefore more supportive brace. The Bioskin braces all seemed to have the common theme that they were poor fitting. I believe this is down to inaccuracies in the sizing chart as opposed to the actual fit of the brace. Of the SK style braces the Bioskin is the best black brace fit and function but only if you order the correct size (remembering to add one size). It is a popular brace that if used with the right patient group has good compliance and fit. It isn’t particularly good at controlling or accommodating large amounts of soft tissues for this the Ossur Thermowrap or beagle equivalent would be much better for this with more flexibility and contouring. The Steeper brace is an excellent brace due to the firmer nature of the material and seems. From a support perspective the Stabimed looks a step up from the SK however has found to be a brace to avoid with bulky hinges and poor fitting fabric. As mentioned in the evaluation however the version 2 has addressed many of the negatives and will be evaluated in due course. The Townsend brace also unfortunately falls into the same category with heavy steels and hinges. Of the two long SK braces evaluated the playmaker was regarded as more aesthetically pleasing however the Steeper brace was easier to adjust and generally contoured better than the playmaker. The clear favourite with the pull on sleeves was the Beagle Genu hit. This could be due to the nature of the woven flexible fabric that is used which seems to be a popular alternative to neaoprean. All of the braces proved difficult to don and doff suggesting that patients with good dexterity need only be considered for this type of brace. 28