Combining valgus knee brace and lateral foot wedges reduces external forces and moments in osteoarthritis patients

Jafarnezhadgero, Amir Ali; Oliveira, Anderson Souza; Mousavi, Seyed Hamed; Madadi-Shad, Morteza

doi:10.1016/j.gaitpost.2017.09.040

Cited by 25 publications

(27 citation statements)

References 29 publications

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“…Thirdly, the valgus knee bracing mainly provides valgus moment of force for the knee joint. Studies have shown that valgus knee bracing reduced the external knee adduction, but not being beneficial to the external flexion moment and free moment, which are critical factors in the development of KOA [42]. Fourthly, Creep [43] indicated that knee deformation will increase under constant weight-bearing load.…”

Section: Discussionmentioning

confidence: 99%

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: a meta-analysis of randomized trials

Fan

Zhang

et al. 2020

J Orthop Surg Res

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Background: Knee osteoarthritis (KOA), with a high incidence in old-age population, adversely affects their life quality. The valgus knee bracing is an important physical therapy for KOA, but its clinical effects on pain release and functional improvement remained unclear. This meta-analysis is to systematically evaluate the clinical outcomes of valgus knee bracing in patients with KOA. Methods: A meta-analysis of clinical randomized controlled trials (RCTs) on pain and functional changes in patients with KOA after using valgus knee braces. The search period was ranged from the inception of the database to May 2020. The enrolled research databases included PubMed, Embase, and Web of Science databases. Two investigators independently formulated inclusion criteria and exclusion criteria and screened and determined the final enrolled literature. Then the outcome indicators were extracted and organized from the included literature, and the risk of bias was assessed by Cochrane Handbook 5.0.1. Results: A total of 10 articles were included in this study, including 739 patients. Eight articles were related to the visual analog scale (VAS) pain score, and the results showed that RR = − 0.29, 95% CI − 0.73, 0.15], P = 0.20; four articles were related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score, and the results showed that RR = − 0.15, 95% CI [− 0.41, 0.11], P = 0.26; two articles were related to the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the results showed that RR = 0.58, 95% CI [− 4.25, 5.42], P = 0.81; and three articles were related to the KOOS Activities of Daily Living (KOOS-ADL), and the results showed that RR = 0.04, 95% CI [− 0.62, 0.69], P = 0.91. These results indicated that the valgus knee bracing has no statistical significance in pain and functional activity improvement of patients with KOA. The subgroup analysis showed that the follow-up time was the source of the heterogeneity of the VAS pain score.

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Section: Discussionmentioning

confidence: 99%

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: a meta-analysis of randomized trials

Fan

Zhang

et al. 2020

J Orthop Surg Res

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“…Therefore, the effectiveness of valgus knee bracing may be underestimated in the long-term period [40]. Secondly, study have suggested that, if in valgus knee bracing, it will make patient believe that the knee joint on the brace side is injured and subconsciously use the limb on the other side [41]. The movement of the knee joint on the brace side will be reduced, which will negatively affect the improvement of the stiffness of the knee joint as well as the recovery of the joint function, and further affect the improvement of the pain symptoms.…”

Section: Discussionmentioning

confidence: 99%

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: A meta-analysis of Randomized Trials

Fan

Zhang

et al. 2020

Preprint

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Background: KOA, with a high incidence in old-age population, adversely affects their life quality. The valgus knee bracing is an important physical therapy for KOA, but its clinical effects on pain release and functional improvment are remained unclear. This meta-analysis is to systematically evaluate the clinical outcomes of valgus knee bracing in patients with knee osteoarthritis (KOA). Methods : A meta-analysis of clinical randomized controlled trials (RCTs) on pain and functional changes in patients with KOA after using valgus knee braces. The search period was ranged from the inception of the database to May, 2020. The enrolled research databases included PubMed, Embase, and Web of Science databases. Two investigators independently formulated inclusion criteria and exclusion criteria, screened and determined the final enrolled literatures. Then the outcome indicators were extracted and organized from the included literature, and the risk of bias was assessed by Cochrane Handbook 5.0.1.Results :A total of 10 articles were included in this study, including 739 patients. Eight articles were related to the Visual Analogue Scale (VAS) pain score, the results showed that RR = -0.29, 95% CI [-0.73, 0.15], P = 0.20; Four articles were related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score, the results showed that RR = -0.15, 95% CI [-0.41,0.11], P = 0.26; Two articles were related to the Knee Injury and Osteoarthritis Outcome Score (KOOS), the results showed that RR = 0.58, 95% CI [-4.25, 5.42], P = 0.81; Three articles were related to the KOOS activities of daily living (KOOS-ADL), the results showed that RR = 0.04, 95% CI [-0.62,0.69], P = 0.91.These results indicated that the valgus knee bracing have no statistically significant in pain and functional activity improvement of patients with KOA. The subgroup analysis showed that the follow-up time was the source of the heterogeneity of the VAS pain score. Conclusion : Our current evidence suggests that valgus knee bracing may not improve pain release and function activates in KOA patients in the long-term period, but only being beneficial to the short-term rehabilitation.

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“…Based on previous research reports, an appropriate sample size was determined [ 14 , 16 , 17 , 19 ]. Statistical analyses were performed using the software IBM ® SPSS Statistics (IBM ® SPSS Statistics v. 25, IBM Cooperation).…”

Section: Methodsmentioning

confidence: 99%

“…al suggested a correlation between joint realignment and clinical improvement [37]. However, it was noted that most previous studies concentrated on the clinical effects of valgus bracing in patients with medial knee OA [6,[14][15][16][17]19,38].…”

Section: Plos Onementioning

confidence: 99%

“…Previous studies have pointed out that further dynamic investigation is necessary to prove the effectiveness of knee braces for OA treatment. In most cases, former investigations on this issue have only examined the immediate effect of valgus knee braces on aspects such as knee loading [ 14 ] and adduction moment [ 1 , 15 ], muscle co-contraction [ 1 , 16 ], functional joint space and joint contact locations [ 17 ], pain [ 2 , 18 ], and balance rather than the lasting changes after a treatment period [ 1 , 9 ]. Literature research has shown that an analysis of the effect of varus knee braces was less common than valgus [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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The effect of a knee brace in dynamic motion—An instrumented gait analysis

et al. 2020

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Background Osteoarthritis (OA) is a common problem in the older population. To reduce pain and stress in the affected knee joint compartment, a functional knee brace is often prescribed by physicians to protect it from high loads. Objectives An instrumented gait analysis should evaluate how the 4-point knee orthosis for varus or valgus load relief (M.4s OA) changes the kinematics of the knee, especially in the frontal plane. Methods 17 healthy participants took part and were analyzed with an inertial sensor system (MyoMotion) giving continuous, objective information on the anatomical angles. The measurements were made both without wearing a knee brace and with the brace in different settings. Results The results show a significant reduction in the maximum knee abduction and raised knee adduction. The knee brace, with a strong adjustment in varus or valgus orientation, caused a shift of maximum ab-/adduction in the proposed direction in 69% and 75% of the dynamic tests, respectively. The knee motion in the frontal plane shows individual movement patterns.

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Combining valgus knee brace and lateral foot wedges reduces external forces and moments in osteoarthritis patients

Cited by 25 publications

References 29 publications

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: a meta-analysis of randomized trials

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: a meta-analysis of randomized trials

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: A meta-analysis of Randomized Trials

The effect of a knee brace in dynamic motion—An instrumented gait analysis

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