Effect of soft braces on pain and physical function in patients with knee osteoarthritis: systematic review with meta-analyses

Publication date: Available online 4 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Tomasz Cudejko, Martin van der Esch, Marike van der Leeden, Leo D. Roorda, Jari Pallari, Kim L. Bennell, Hans Lund, Joost Dekker
ObjectiveTo systematically review and synthesize the effect of soft braces on pain, and 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 Registry for Controlled Trials (CENTRAL), PubMed, EMBASE, CINAHL, SportDiscuss, Web of Science and PEDro.Study selectionRandomized controlled trials (RCT) and non-randomized 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 one reviewer. Methodological quality assessment was independently performed by two reviewers.Data synthesis11 studies were identified, including six randomized controlled trials (RCTs) and five non-RCTs. The methodological quality of included RCTs was low. There was a moderate improvement in pain (SMD 0.52, 95% CI 0.14 to 0.89; P=0.007; 284 participants) in favor of wearing a brace compared to not wearing a brace for the immediate, within-group comparison. There was a moderate improvement in pain (SMD 0.61, 95% CI 0.33 to 0.89; P<0.001; 206 participants) and small to moderate improvement in self-reported physical function (SMD 0.39, 95% CI 0.11 to 0.67; P=0.006; 206 participants) in favor of patients receiving soft brace versus standard care for the prolonged effect, between-group comparison.ConclusionCurrently 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, short and long-term. Further, high quality studies are warranted to improve confidence in the findings.



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