Effect of Soft Braces on Pain and Physical Function in Patients With Knee Osteoarthritis: Systematic Review With Meta-Analyses |
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| Institution: | 1. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands;2. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands;3. Department of Research & Development, Peacocks Medical Group, Newcastle upon Tyne, United Kingdom;4. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Australia;5. Center for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway;6. Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands;1. Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran;2. Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran;3. Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran;4. Biomechanics Laboratory, Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran;1. Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Malaysia;2. Department of Biomedical Engineering, Riphah International University, Islamabad, Pakistan;3. Centre for Applied Biomechanics, University of Malaya, Malaysia;4. Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;5. The Chancellery, University of Malaysia Terengganu, Terengganu, Malaysia;1. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Melbourne, The University of Melbourne, VIC, Australia;2. School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia;3. Gold Coast Orthopaedic Research and Education Alliance (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia;1. Department of System Design Engineering, Keio University, Yokohama, Japan;2. Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan;3. Japan Society for the Promotion of Science, Tokyo, Japan;1. Department of Orthopaedic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA;2. Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA;3. University of Missouri Health Care, Columbia, MO, USA |
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| Abstract: | ObjectivesTo systematically review and synthesize the effects of soft braces on pain and on self-reported and performance-based physical function in patients with knee osteoarthritis.Data SourcesThe following electronic databases were searched from inception to April 20, 2016: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, CINAHL, SPORTDiscus, Web of Science, and PEDro.Study SelectionRandomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCTs), such as controlled clinical trials, crossover studies, and case-control studies, were included. Two reviewers independently screened articles and determined inclusion through predefined criteria.Data ExtractionData related to participant demographics, study design and methods, interventions, and outcomes, including numerical means and SDs, were extracted by 1 reviewer. Methodological quality assessment was independently performed by 2 reviewers.Data SynthesisEleven studies were identified, including 6 RCTs and 5 non-RCTs. The methodological quality of included RCTs was low. There was a moderate improvement in pain (standardized mean difference SMD]=.52; 95% confidence interval CI], .14–.89; P=.007; 284 participants) in favor of wearing a brace compared with not wearing a brace for the immediate, within-group comparison. There was a moderate improvement in pain (SMD=.61; 95% CI, .33–.89; P<.001; 206 participants) and a small to moderate improvement in self-reported physical function (SMD=.39; 95% CI, .11–.67; P=.006; 206 participants) in favor of patients receiving a soft brace versus standard care for the prolonged effect, between-group comparison.ConclusionsCurrently available evidence indicates that soft braces have moderate effects on pain and small to moderate effects on self-reported physical function in knee osteoarthritis. These findings highlight the importance of soft braces as a technique to improve pain and physical function in both the short- and long-term. Additional high-quality studies are warranted to improve confidence in the findings. |
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