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Abstract
Background Osteoarthritis (OA) is highly prevalent in the elderly, with the knee being the most commonly affected joint in this population. Knee braces are often used to prevent common problems in knees during daily activities. The purpose of these devices is to decrease pain and improve functionality. In the literature some studies have tested the effectiveness of unloader brace for valgus or varus. However, the braces most used in our clinical setting and the less costly ones have not been described in quality studies in the literature. There are only few studies on this subject and they are methodologically inadequate. There are no studies that compared the effectiveness between the knee brace with metal hinges (no alignment for valgus or varus) and knee brace without metal hinges (neoprene sleeve).
Objectives To evaluate the effectiveness of knee braces on pain, function and quality of life in the elderly with knee OA.
Methods Elderly with knee OA, both genders, with pain scale 3-7cm on a 10cm pain numeric scale were included. Of the 222 patients screened, 120 met the eligibility criteria and were randomized to the groups: neoprene sleeve (without metal hinges); brace (with metal hinges no alignment) or control group. The groups neoprene sleeve (NS) and brace (B) received knee brace and were instructed to use it in daily activities, every day, during three months. Assessment for pain (NPS), function (WOMAC and Knee Lequesne), quality of life (SF-36) and performance tests (6MWT, TUGT and S/L) were done at baseline and after 45 and 90 days by a blinded assessor.
Results Forty patients were randomly assigned to the each group. In the initial evaluation the groups were homogeneous for all measures, except for gender where the control group had more women and the pain domain of the SF-36 the pain was higher in the control group. The analysis between the groups using ANOVA for repeated measures for pain (NPS), show no statistically significant difference between groups over time (p=0,210), however the intragroup analysis showed pain improvement for all groups (p<0,001). Statistically significant differences were found between groups over time for: WOMAC questionnaire domains (global (p<0,001), pain (p<0,001) and function (p<0,001)); functional capacity (0,046) and general health (0,044) domains of the SF-36 and 6-minute walk test (p=0,010) brace group showing better results.
Conclusions The knee brace (with metal hinges no alignment) was effective in improving function, some aspects of quality of life and walk in elderly with knee OA.
References
Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26-35.
Brouwer RW, Jakma TSC, Verhagen AP, Verhaar JAN, Bierma-Zeinstra SMA. Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database of Systematic Reviews 2005, Issue I. Art. No.: CD004020.
Disclosure of Interest None declared