The effectiveness of braces and orthoses for patients with knee osteoarthritis: A systematic review of Japanese-language randomised controlled trials.
BACKGROUND
Knee osteoarthritis is common. The evidence regarding the effectiveness of braces and orthoses for patients with knee osteoarthritis is inconclusive according to English-language literature. English-language reviews to date have not included Japanese-language studies.


OBJECTIVE
This study aimed to collect and synthesise Japanese-language randomised controlled trials investigating the effectiveness of braces and orthoses for patients with knee osteoarthritis.


METHODS
Systematic review.


METHODS
Eight databases were systematically searched from inception to 29 July 2015. Only Japanese-language randomised controlled trials were included. Risk of bias was assessed using Physiotherapy Evidence Database scale. A meta-analysis was not appropriate due to the heterogeneity in the included studies.


RESULTS
Seven randomised controlled trials with low to high risks of bias were included. Six of seven included studies were conducted by the same author group. Limited evidence supported the positive effects of short-lever elastic knee braces to improve pain and functional disability in specific outcomes. No evidence was found to support the use of foot orthoses, such as laterally wedged insoles, medial arch support and metatarsal arch pad.


CONCLUSIONS
Our systematic review found no conclusive evidence about the effectiveness of any braces and orthoses for patients with medial knee osteoarthritis. Future Japanese-language studies should address methodological flaws exposed in this review and strengthen the international evidence base. Clinical relevance This is the first systematic review of Japanese-language randomised controlled trials investigating orthoses for patients with knee osteoarthritis. Clinicians can consider the use of short-lever elastic knee braces to improve specifically pain on squat or walking. Evidence found in this review does not support the use of foot orthoses.
1 International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia.
Koya
K
Mine
2 School of Health Sciences, Tokyo University of Technology, Tokyo, Japan.
Takashi
T
Nakayama
1 International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia.
Steve
S
Milanese
2 School of Health Sciences, Tokyo University of Technology, Tokyo, Japan.
Karen
K
Grimmer
D001915:Braces / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009989:Orthotic Devices / Q000706:statistics & numerical data; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000534:rehabilitation*; D010147:Pain Measurement; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
Knee osteoarthritis; braces and orthoses; randomised controlled trials; systematic review