Decreased Pain and Improved Dynamic Knee Instability Mediate the Beneficial Effect of Wearing a Soft Knee Brace on Activity Limitations in Patients With Knee Osteoarthritis

Cudejko, Tomasz; Esch, M. van der; Noort, Josien C. van den; Rijnhart, Judith J. M.; Leeden, M. van der; Roorda, Leo D.; Lems, Willem F.; Waddington, Gordon; Harlaar, Jaap; Dekker, Joost

doi:10.1002/acr.23722

Cited by 20 publications

(21 citation statements)

References 34 publications

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“…Clinical trials support established daily care and interventions, such as lifestyle modifications (weight reduction and footwear), aerobic or strengthening exercises, physical modalities (transcutaneous electrical nerve stimulation devices) and knee bracing to reduce pain and disability in patients with knee OA. The current study proposed the possibility of using FLIPUS as an adjunct to the current standard of daily care and interventions in the treatment of OA knee pain and dysfunction 16 , 34 – 36 . Because of the safety, efficacy and convenience of FLIPUS, it has great potential as a home-based physiotherapy for patients with knee OA, particularly given the need for self-treatment options outside of clinical care that the pandemic has brought upon elderly populations.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of focused low-intensity pulsed ultrasound versus pulsed shortwave diathermy on knee osteoarthritis: a randomized comparative trial

Jia

Chen

et al. 2022

Sci Rep

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The aim of this study was to compare the efficacy and safety of focused low-intensity pulsed ultrasound (FLIPUS) with pulsed shortwave diathermy (PSWD) in subjects with painful knee osteoarthritis (OA). In a prospective randomized trial, 114 knee OA patients were randomly allocated to receive FLIPUS or PSWD therapy. The primary outcome was the change from baseline in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores. Secondary outcomes included the numerical rating scale (NRS) for pain assessment, time up and go (TUG) test, active joint range of motion (ROM) test, and Global Rating of Change (GRC) scale. Data were collected at baseline, 12 days, 12 weeks and 24 weeks. Patients receiving FLIPUS therapy experienced significantly greater improvements in the WOMAC total scores than patients receiving PSWD therapy at 12 days (mean difference, − 10.50; 95% CI − 13.54 to − 7.45; P = 0.000). The results of the NRS, TUG test, ROM test and GRC scale showed that participants treated with FLIPUS reported less pain and better physical function and health status than those treated with PSWD at 12 days (P = 0.011, P = 0.005, P = 0.025, P = 0.011, respectively). Furthermore, patients in the FLIPUS group showed significant improvements in the WOMAC total scores and NRS scores at 12 weeks (mean difference, − 7.57; 95% CI − 10.87 to − 4.26; P = 0.000 and − 1.79; 95% CI − 2.11 to − 1.47, respectively) and 24 weeks (mean difference, − 6.96; 95% CI − 10.22 to − 3.71; P = 0.000 and − 1.37; 95% CI − 1.64 to − 0.96; P = 0.000, respectively) of follow-up. There were no adverse events during or after the interventions in either group. This study concluded that both FLIPUS and pulsed SWD are safe modalities, and FLIPUS was more effective than PSWD in alleviating pain and in improving dysfunction and health status among subjects with knee OA in the short term.Trial registration: Chinese Clinical Trial Registry, ChiCTR2000032735. Registered 08/05/2020, http://www.chictr.org.cn/showproj.aspx?proj=53413.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of focused low-intensity pulsed ultrasound versus pulsed shortwave diathermy on knee osteoarthritis: a randomized comparative trial

Jia

Chen

et al. 2022

Sci Rep

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“…In conclusion, underwater exercise is effective in reducing pain and improving function and quality of life in patients with osteoarthritis. Therefore, aquatic therapy can be used not only with medication, but also with other non-pharma and non-surgical interventions such as land-based exercise [ 45 ], manual therapy [ 46 ], knee bracing [ 47 ] and physical modalities [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Aquatic Exercises for Patients with Osteoarthritis: Systematic Review with Meta-Analysis

Song

2022

Healthcare

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This systematic review examined papers published in Korean, English and newer publications that were not included in previous studies to assess the effect size of aquatic exercise-based interventions on pain, quality of life and joint dysfunction among patients with osteoarthritis. Six national and international databases were used to review literature (published up to 7 March 2019) on randomized controlled trials of aquatic exercise-based interventions in patients with osteoarthritis. For the 20 studies included, a meta-analysis showed that aquatic exercise produces 0.61-point reduction (n = 756; mean difference (MD) = −0.61; 95% confidence interval (CI): −0.90–−0.32) in pain compared with a control group, and aquatic exercise was effective in reducing pain (n = 315; MD = −0.28; 95% CI: −0.50–−0.05) compared with a land-based exercise group. Another meta-analysis showed that aquatic exercise produces 0.77-point improvement in quality of life (n = 279; MD = −0.77; 95% CI: −1.38–−0.15) compared with a control group. Finally, a meta-analysis showed that aquatic exercise produces 0.34-point reduction in joint dysfunction (n = 279; MD = −0.77; 95% CI: −1.38–−0.15) compared with a control group. For patients with osteoarthritis, aquatic-exercise-based interventions are effective for reducing pain and joint dysfunction and improving quality of life.

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“…Because of this, we would like to encourage both general practitioners and specialists to recommend the following techniques to their patients taking their current condition into account. Manual therapy [ 35 ], transcutaneous electrical nerve stimulation, [ 36 ] and knee braces [ 37 ] are proven to reduce pain, the latter having the additional benefit of reducing knee instability, and they can also be effective when there is a valgus or varus deformity. To compensate for decreased muscular strength, resistance [ 38 ] and neuromuscular exercise [ 39 ] have been shown to be effective.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Pain Management of Patients with Osteoarthritis: A Cross-Sectional Study

Mezey

Máté

Paulik

2022

JCM

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Background: Osteoarthritis (OA) is a complex disease associated with chronic pain. Many patients treat their joint pain at a symptomatic level with over-the-counter (OTC) pain medications, often without the knowledge of their physicians. The aim of this study was to provide physicians with data about osteoarthritic patients’ habits of pain management and to examine the explanatory factors of various ways of self-treatment. Methods: A cross-sectional study involving 189 patients with hip or knee OA and scheduled for joint replacement surgery was carried out. Participants filled out a self-administered questionnaire consisting of the Western Ontario and McMaster Universities Osteoarthritis Index and questions about their methods of alleviating pain. Results: 2.6% of patients did not use anything to alleviate their pain, while 63% practiced a non-pharmacological method. Diclofenac was the most frequently used drug, followed by ibuprofen. Profession had the greatest impact on medication habits; patients doing manual work were significantly more likely to take OTC non-steroidal anti-inflammatory drugs and use topical analgesics. Conclusions: Patients utilized a wide variety of pain management techniques. They seemed to use well-known painkillers, even if their side effects were less desirable. Such patients require comprehensive pain management, including educational and behavioural interventions, complemented by topical and oral medication.

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Decreased Pain and Improved Dynamic Knee Instability Mediate the Beneficial Effect of Wearing a Soft Knee Brace on Activity Limitations in Patients With Knee Osteoarthritis

Abstract: This study shows that decreased pain and reduced dynamic knee instability are pathways via which wearing a soft knee brace decreased activity limitations in persons with knee OA. This article is protected by copyright. All rights reserved.

Cited by 20 publications

References 34 publications

Efficacy and safety of focused low-intensity pulsed ultrasound versus pulsed shortwave diathermy on knee osteoarthritis: a randomized comparative trial

Efficacy and safety of focused low-intensity pulsed ultrasound versus pulsed shortwave diathermy on knee osteoarthritis: a randomized comparative trial

Effects of Aquatic Exercises for Patients with Osteoarthritis: Systematic Review with Meta-Analysis

Factors Influencing Pain Management of Patients with Osteoarthritis: A Cross-Sectional Study

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