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

Abstract

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.

Investigation of bracing to unload muscle and knee contact forces for knee oteoarthritis patients: Modelling, workflow, prototype design and evaluation

“…Since the prototype brace is planned to be tested as a short temporal intervention to investigate the influence on muscle activation, the VAS score is used to evaluate the brace effect on pain. This pain score is a simple subjective measure and has been widely used in the literature to evaluate knee valgus braces (Fan et al [2020]).…”

“…A meta-analysis by Fan et al [2020] concluded that no clinical evidence supports long-term effects from valgus braces on pain improvement and functional activity. Thus, if long-term studies can demonstrate positive effects from the developed brace concept, including reduced knee pain, joint functionality and quality-of-life, the scientific evidence can have a positive impact on the compliance, since the results are based on feedback from KOA patients.…”