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

The objective of this study was to systematically review and synthesize the effect of soft braces on pain, and self-reported and performance-based physical function in patients with knee osteoarthritis.

The 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. Randomized 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.

11 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.

Currently 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.

Targeted hip and knee strengthening

A short online course by Lee Herrington covering the principles of muscle reloading and strengthening for lower limb following injury.