Session Information
Date: Sunday, November 8, 2015
Title: Osteoarthritis - Clinical Aspects Poster I: Treatments and Metabolic Risk Factors
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: 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 evaluated in quality studies in the literature. There are no studies that compared the effectiveness between the knee brace with metal hinges (no alignment) and knee brace without metal hinges (neoprene sleeve). The purpose is 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 between 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 (CG). The groups neoprene sleeve (NSG) and brace (BG) 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 FTSS) were done at baseline and after 45, 90 and 180 days by a blinded assessor.
Results: Forty patients were randomly assigned to the each group. At baseline the groups were homogeneous for all measures, except for gender where the CG had more women and the pain domain of SF-36 where pain was higher in the CG. The analysis between the groups using ANOVA for repeated measures for pain (NPS), show statistically significant difference between groups over time (p=0,049), with the BG showing better results. Statistically significant differences were found between groups over time for: function – WOMAC questionnaire (global, p=0,005; pain, p=0,004 and function, p<0,001) and Knee Lequesne (p= 0,009) and quality of life – functional capacity domain the SF-36 (0,046) with better results to BG.
Conclusion: The knee brace was effective in improving pain, function and some aspects of quality of life in elderly with knee OA.
Table 1 – Between-groups comparison
T0 |
T45 |
T90 |
T180 |
p |
|||||||||
GC |
GSH |
GCH |
GC |
GSH |
GCH |
GC |
GSH |
GCH |
GC |
GSH |
GCH |
ANOVA |
|
NPS |
6.0 ± 1.1 |
6.0 ± 1.4 |
6.1 ± 1.1 |
5.9 ± 2.1 |
5.2 ± 2.1 |
5.0 ± 2.3 |
5.4 ± 1.8 |
4.8 ± 1.8 |
4.6 ± 2.0 |
5.9±1.6 |
5.4±1.8 |
4.3±2.3 |
0.049* |
WOMAC |
|||||||||||||
Global |
42.6 ± 17.5 |
42.1 ± 16.7 |
40.5 ± 17.4 |
48.2 ± 16.7 |
36.1 ± 16.2 |
34.0 ± 17.6 |
44.3 ± 17.8 |
36.5 ± 19.1 |
29.1 ± 17.2 |
45.1±18.4 |
34.9±19.3 |
29.9±18.7 |
0.005* |
Pain |
8.0 ± 4.2 |
8.5 ± 4.0 |
7.4 ± 3.6 |
9.4 ± 3.7 |
6.4 ± 3.7 |
5.5 ± 3.7 |
8.0 ± 3.8 |
6.7 ± 4.2 |
4.8 ± 3.9 |
8.1±4.2 |
5.8±3.6 |
5.2±4.0 |
0.004* |
Stiffness |
2.6 ± 2.5 |
2.8 ± 2.0 |
2.4 ± 2.2 |
2.8 ± 2.4 |
2.3 ± 1.9 |
1.8 ± 2.2 |
2.9 ± 2.0 |
2.7 ± 2.4 |
1.8 ± 1.9 |
2.7±2.4 |
2.2±2.1 |
1.8±2.1 |
0.408 |
Function |
32.0 ± 12.4 |
30.8 ± 12.0 |
31.0 ± 13.1 |
35.4 ± 12.2 |
27.4 ± 12.0 |
26.8 ± 12.9 |
33.5 ± 14.4 |
27.3 ± 14.3 |
22.5 ± 12.3 |
33.4±12.7 |
26.7±14.6 |
23.0±13.9 |
<0.001* |
Lequesne |
13.4 ± 3.3 |
13.0 ± 3.2 |
12.4 ± 3.0 |
14.3 ± 3.0 |
12.2 ± 3.4 |
11.8 ± 3.4 |
14.0 ± 3.3 |
12.1 ± 3.3 |
11.5 ± 3.8 |
14.3±3.2 |
12.4±3.4 |
10.7±4.2 |
0.009* |
SF-36 |
|||||||||||||
Physical functioning |
21.6 ± 15.6 |
22.5 ± 14.3 |
27.0 ± 19.5 |
19.4 ± 17.3 |
29.6 ± 21.1 |
29.9 ± 20.8 |
22.3 ± 20.0 |
29.4 ± 19.1 |
37.1 ± 22.1 |
25.3±19.1 |
32.8±20.0 |
37.1±25.2 |
0.049* |
Role physical |
43.1 ± 45.6 |
39.4 ± 42.7 |
43.1 ± 47.0 |
38.1 ± 47.0 |
55.0 ± 47.4 |
41.9 ± 46.1 |
30.6 ± 41.8 |
47.5 ± 44.9 |
49.4 ± 49.2 |
30.8±45.1 |
39.4±46.3 |
53.5±48.3 |
0.104 |
Bodily pain |
34.7± 13.6 |
45.7 ± 22.7 |
49.5 ± 18.6 |
38.3 ± 16.1 |
44.3 ± 17.4 |
51.5 ± 23.6 |
37.7 ± 15.1 |
47.6 ± 19.0 |
55.8 ± 22.1 |
40.1±14.7 |
49.8±22.7 |
53.9±19.7 |
0.760 |
General health |
58.8 ± 19.4 |
59.0 ± 23.3 |
63.4 ± 17.7 |
56.1 ± 21.6 |
59.9 ± 24.6 |
65.0 ± 17.3 |
52.6 ± 21.8 |
62.2 ± 23.9 |
69.3 ± 19.0 |
56.8±20.9 |
61.7±25.0 |
66.4±18.7 |
0.185 |
Vitality |
50.4 ± 19.3 |
57.4 ± 18.3 |
51.4 ± 20.3 |
48.3 ± 21.3 |
58.2 ± 19.4 |
54.8 ± 19.4 |
44.3 ± 21.7 |
54.4 ± 15.9 |
58.1 ± 21.7 |
44.8±20.8 |
58.6±19.0 |
55.6±23.7 |
0.071 |
Social functioning |
68.1 ± 22.8 |
72.8 ± 30.5 |
73.1 ± 26.6 |
65.9 ± 23.0 |
77.8 ± 23.9 |
80.0 ± 23.3 |
64.7 ± 25.3 |
75.9 ± 26.3 |
80.6 ± 20.8 |
65.3±27.2 |
79.0±23.7 |
80.9±25.0 |
0.269 |
Role emotional |
48.3 ± 50.0 |
36.7 ± 47.0 |
59.2 ± 49.2 |
40.8 ± 47.4 |
57.5 ± 48.3 |
59.2 ± 47.4 |
43.3 ± 49.6 |
55.0 ± 48.7 |
55.0 ± 50.4 |
48.8±47.7 |
63.3±47.0 |
62.4±47.3 |
0.094 |
Mental health |
59.5 ± 20.4 |
65.1 ± 22.2 |
68.2 ± 18.3 |
58.3 ± 19.4 |
69.0 ± 17.7 |
67.5 ± 22.4 |
54.6 ± 22.7 |
66.2 ± 21.5 |
69.2 ± 22.6 |
55.1±25.1 |
68.5±18.4 |
67.1±22.4 |
0.137 |
TUGT |
14.3 ± 3.5 |
14.1 ± 4.2 |
13.5 ± 3.2 |
15.0 ± 6.2 |
13.4 ± 4.9 |
12.6 ± 2.8 |
13.9 ± 3.9 |
13.1 ± 4.5 |
12.4 ± 2.9 |
14.1±4.8 |
12.6±4.0 |
12.4±3.6 |
0.515 |
6MWT |
311.2 ± 87.6 |
324.1 ± 97.2 |
343.6 ± 72.8 |
305.4 ± 78.9 |
338.9 ± 77.3 |
356.5 ± 72.9 |
298.1 ± 80.4 |
327.4 ± 68.0 |
362.8 ± 88.0 |
291.8±79.7 |
335.1 ±72.6 |
361.1±8.5 |
0.155 |
FTSS |
22.7 ± 6.9 |
22.7 ± 7.0 |
21.7 ± 8.3 |
25.2 ± 12.4 |
21.3 ± 7.1 |
20.1 ± 8.2 |
24.4 ± 9.5 |
21.8 ± 7.7 |
20.1 ± 7.5 |
24.1±9.0 |
20.7±7.3 |
20.2±6.2 |
0.086 |
ANOVA= analysis of variance for repeated measures; CG= control group; NSG= neoprene sleeve group; BG= brace group; T0= baseline; T45= evaluation after 45 days; T90= evaluation after 90 days; T180= evaluation after
180 days; NPS= numerical pain scale; WOMAC= Western Ontario and McMaster Universities Osteoarthritis Index; Lequesne= Lequesne´s algofuncional questionnaire; SF-36= Short-form-36; TUGT= timed up and go test;
6MWT= 6-minutes walk test; FTSS= five times sit to stand.*Statistically significant p value (<0,05).
To cite this abstract in AMA style:
Brumini C Sr., Natour J, Miura LY, Martinez A. Effectiveness of Bracing in Elderly with Knee Osteoartritis: A Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/effectiveness-of-bracing-in-elderly-with-knee-osteoartritis-a-randomized-controlled-trial/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/effectiveness-of-bracing-in-elderly-with-knee-osteoartritis-a-randomized-controlled-trial/