Manipal University, Manipal, Karnataka, India.
Am J Phys Med Rehabil. 2011 Mar;90(3):247-62. doi: 10.1097/PHM.0b013e318206386b.
A systematic analysis was conducted on the effectiveness of knee braces and foot orthoses in conservative management of knee osteoarthritis. The methodologic quality of the randomized clinical trials, controlled clinical trials, and observational studies were systematically reviewed using the Structured Effectiveness Quality Evaluation Scale. Twenty-five studies met the inclusion criteria. The orthoses used in the studies included Generation II osteoarthritis knee brace, valgus knee braces, functional off-loading knee braces, knee sleeves, lateral-wedged insoles with subtalar strapping, medial-wedged insoles, and specialized footwear. Results suggest that knee braces and foot orthoses are effective in decreasing pain, joint stiffness, and drug dosage. They also improve proprioception, balance, Kellgren/Lawrence grading, and physical function scores in subjects with varus and valgus knee osteoarthritis. Knee braces and foot orthoses could be cautiously considered as conservative management for relief of pain and stiffness and improving physical function for persons with knee osteoarthritis. The conclusions of this review are limited by methodologic considerations like poor quality of trials and heterogeneity of interventions.
对膝关节支具和足矫形器在膝骨关节炎保守治疗中的有效性进行了系统分析。采用结构有效性质量评价量表对随机临床试验、对照临床试验和观察性研究的方法学质量进行了系统评价。符合纳入标准的研究共有 25 项。研究中使用的矫形器包括第二代骨关节炎膝关节支具、外翻膝关节支具、功能性减压膝关节支具、膝关节套、带有跟骨固定带的外侧楔形鞋垫、内侧楔形鞋垫和专用鞋。结果表明，膝关节支具和足矫形器可有效减轻疼痛、关节僵硬和药物剂量。它们还可改善内翻和外翻膝骨关节炎患者的本体感觉、平衡、Kellgren/Lawrence 分级和身体功能评分。膝关节支具和足矫形器可谨慎考虑作为膝骨关节炎患者缓解疼痛和僵硬、改善身体功能的保守治疗方法。本综述的结论受到试验质量差和干预措施异质性等方法学考虑因素的限制。
