scholarly journals Offloader knee braces for knee osteoarthritis

Medwave ◽  
2021 ◽  
Vol 21 (03) ◽  
pp. e8114-e8114
Author(s):  
Francesca Moller ◽  
Luis Ortíz-Muñoz ◽  
Sebastián Irarrázaval
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Walking Distance ◽  
Pharmacological Management ◽  
High Prevalence ◽  
Special Surgery ◽  
Knee Braces ◽  
Management Alternatives

INTRODUCTION Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.

scholarly journals Offloader knee braces for knee osteoarthritis

Medwave ◽  
2021 ◽  
Vol 21 (03) ◽  
pp. e8114-e8114
Author(s):  
Francesca Moller ◽  
Luis Ortíz-Muñoz ◽  
Sebastián Irarrázaval
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Walking Distance ◽  
Pharmacological Management ◽  
High Prevalence ◽  
Special Surgery ◽  
Knee Braces ◽  
Management Alternatives

INTRODUCTION Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.

The effects of cryotherapy on pain and function in individuals with knee osteoarthritis: a systematic review of randomized controlled trials

2019 ◽  
Vol 33 (8) ◽  
pp. 1310-1319 ◽  
Author(s):  
Lucas Ogura Dantas ◽  
Roberta de Fátima Carreira Moreira ◽  
Flavia Maintinguer Norde ◽  
Paula Regina Mendes Silva Serrao ◽  
Francisco Alburquerque-Sendín ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Clinical Relevance ◽  
Meta Analysis ◽  
The Body ◽  
Keywords Knee ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Evaluation Approach ◽  
The Mean

Objective:To investigate the effectiveness of cryotherapy on pain and physical function in knee osteoarthritis.Data sources:An electronic search was performed up to February 2019 on PubMed/MEDLINE, EMBASE, CINAHL, Lilacs, Cochrane, Web of Science, Ibecs, and Scielo databases with keywords knee osteoarthritis and cryotherapy.Methods:Two authors independently performed the study selection. All languages and publication dates were considered. The PEDro scale was used to assess the methodological quality of the studies, and the body of evidence was analyzed and synthesized using the Grading of Recommendations, Assessment, Development, and Evaluation approach. The clinical relevance of the included studies was evaluated using the criteria proposed in the Cochrane Handbook for Systematic Reviews of Interventions.Results:Of the five studies, 202 subjects were included. All studies included participants with established knee osteoarthritis. The mean PEDro score was 4.20/10, and meta-analysis was not possible due to heterogeneity among the studies. The mean clinical relevance was 3/5. Only two studies were considered for analysis based on the GRADE approach, and low level of evidence was synthesized regarding the effectiveness of cryotherapy for pain management, knee stiffness, knee range of motion, and physical function. Application techniques, frequency, and duration did not affect outcomes.Conclusions:There were insufficient primary studies to draw any conclusions about the effectiveness of cryotherapy on pain and physical function on individuals with knee osteoarthritis.

scholarly journals Acutherapy for Knee Osteoarthritis Relief in the Elderly: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Zidan Gong ◽  
Rong Liu ◽  
Winnie Yu ◽  
Thomas Kwok-Shing Wong ◽  
Yuanqi Guo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Knee Pain ◽  
Meta Analysis ◽  
The Elderly ◽  
Knee Stiffness ◽  
Trial Quality ◽  
Placebo Intervention ◽  
Selection Of

Purpose. This systematic review and meta-analysis was conducted to investigate the effects of various acutherapies on knee osteoarthritis (KOA) relief in the elderly. Methods. Five databases were accessed from inception to July 2017 for searching randomized controlled trials (RCTs) on acutherapy for KOA relief in the elderly. Data were pooled after trial quality assessment for meta-analysis. Outcomes were the scores of knee pain, knee stiffness, and physical function accessed by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Results. 17 RCTs including 4774 subjects were included. The results indicated that acutherapy significantly affected knee pain (standardized mean difference, i.e., SMD = - 0.73, [95% CI, -0.98 to -0.47], P <0.001), knee stiffness (SMD = -0.66, [95%CI, -0.85 to -0.47], P <0.001), and physical function (SMD = -1.56, [95%CI, -2.17 to -0.95], P<0.001) when compared with control condition without intervention of any acutherapy. Moreover, acutherapy was more effective than corresponding sham (placebo) intervention applied on nonacupoints (SMD = -0.16, [95% CI, -0.32 to -0.01], P = 0.04). However, no significant differences were found on treatment effects between acutherapy and sham acutherapy at the same acupoints (SMD= - 0.09, [95%CI, -0.40 to 0.21], P = 0.55). Conclusions. Acutherapy was an effective approach for KOA relief in the elderly. The selection of acupoints position could be a crucial factor that influences the treatment efficacy of acutherapy.

scholarly journals Effect of vitamin D supplementation on pain and physical function in patients with knee osteoarthritis (OA): an OA Trial Bank protocol for a systematic review and individual patient data (IPD) meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035302 ◽  
Author(s):  
Xingzhong Jin ◽  
Benny Antony ◽  
Xia Wang ◽  
Monica SM Persson ◽  
Timothy McAlindon ◽  
...  
Keyword(s):  
Vitamin D ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Clinical Signs ◽  
Vitamin D Supplementation ◽  
Patient Data ◽  
Knee Oa ◽  
Patient Reported

IntroductionObservational data suggest that vitamin D deficiency is associated with the onset and progression of knee osteoarthritis (OA). However, randomised controlled trials (RCTs) to date investigating the efficacy of vitamin D supplementation in knee OA have reported conflicting results. Further research is needed to clarify the effects of vitamin D on patient-reported outcomes and determine whether there are patient subgroups who may benefit from the supplementation. The aim of this individual patient data (IPD) meta-analysis is to identify patient-level predictors of treatment response to vitamin D supplementation on pain and physical function.Methods and analysisA systematic literature search will be conducted for RCTs of vitamin D supplementation on knee OA. Authors of original RCTs will be contacted to obtain the IPD. The primary outcomes will include long-term (≥12 months) pain and physical function. Secondary outcomes will include medium-term (≥6 months and <12 months) and short-term (<6 months) pain and physical function, as well as patient global assessment, quality of life and adverse events. Potential treatment effect modifiers to be examined in the subgroup analyses include age, gender, body mass index, baseline knee pain severity and physical function, baseline vitamin D level, radiographic stage, presence of bone marrow lesions on MRI, presence of clinical signs of local inflammation and concomitant depressive symptoms. Both one-step and two-step modelling methods will be used to determine the possible modifiable effect of each subgroup of interest.Ethics and disseminationResearch ethical or governance approval is exempt for this study as no new data are being collected. This study will be the first IPD meta-analysis to clarify the effect of vitamin D supplementation on clinical symptoms in different subgroups of patients with knee OA. The findings will be disseminated through peer-review publications and conference presentations.PROSPERO registration numberCRD42018107740.

scholarly journals Safety and effectiveness of Enhanced External Counterpulsation (EECP) in Refractory Angina Patients: Systematic Reviews and Meta-Analysis

2021 ◽  
Author(s):  
Seyed Mansoor Rayegani ◽  
Saeed Heidari ◽  
Majid Maleki ◽  
Maryam Seyed-Nezhad ◽  
Maryam Heidari ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Walking Distance ◽  
Cochrane Library ◽  
Refractory Angina ◽  
Exclusion Criteria ◽  
External Counterpulsation ◽  
Significant Difference ◽  
Enhanced External Counterpulsation

Enhanced external counterpulsation (EECP) is believed to be a non-invasive treatment for coronary artery disease and angina. The aim of this study was to determine the safety and effectiveness of EECP in refractory angina patients through a systematic reviews and meta-analysis. We conducted a comprehensive search of the literature published on PubMed, Cochrane library, Scopus, ScienceDirect, Trip Database and Google Scholar databases using appropriate keywords and specific strategy with no time limit. Having selected and screened the studies based on the defined inclusion and exclusion criteria and evaluating their quality based on the Cochrane checklist. For the meta-analysis,the Mantel-Haenszel method or the generic Inverse Variance was used. Analyses were done with Review Manager 5.2 software. A number of 299 studies were initially reviewed and finally, seventeen studies were included in the meta-analysis based on the inclusion and exclusion criteria. Also, thirteen outcomes were analyzed and the results of meta-analysis in twelve outcomes including (Systolic Blood Pressure (7 studies), Diastolic Blood Pressure (7 studies), Pulse Pressure (4 studies), Mean Arterial Pressures (4 studies), Heart Rate (6 studies), Angina episodes (7 studies), Walking distance (2 studies),Canadian Cardiovascular Society classification (6 studies), Flow-Mediated Dilation (3 studies), Daily Nitrate Usage (4 studies), Exercise Treadmill Test-Time (2 studies), ST-segment depression (2 studies)demonstrated a significant clinical advantage in the EECP treatment effectiveness in patients with angina. No significant difference was observed regarding EECP usefulness (P = 0.18) in the outcome of brachial artery diameter (2 studies). Based on the meta-analysis, the results indicate the safety and effectiveness of EECP in patients with angina pectoris and indicate the usefulness of this treatment in these patients. In general, the authors believe that the general conclusion in this regard requires some studies with a large sample size and a control group assignment.

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