Different Types of Orthoses in the Management of Genu-recurvatum, What are the Best Choices?

Abstract

Background: Knee joint hyper extension, also named as genu-recurvatum, has been reported in hemiplegic subjects, cerebral palsy, poliomyelitis and other neurological conditions. Although various types of treatment approaches such as use of orthoses, physical therapy and surgery have been used for these patients, clinicians usually prefer to treat it by use of different types of orthoses. Therefore, the aim of this review was to detect the best orthoses used to manage genu-recurvatum.Methods: An extensive search was performed in ISI Web of Knowledge, PubMed, Embase, EBSCO, Google Scholar and Scopus. Hyperextension of knee joint and genu-recurvatum, were used in combination with brace, orthoses and assistive devices in a period between 1960 and 2018. The quality of identified paper was assessed using Black and Down tool. The maximum score of this scale was 28.Results: Fourteen papers were identified in which six papers focused on using AFO, six papers focused on using KAFO, and two papers focused on using knee orthoses. The quality of papers varied between 14 and 20. The external validity of papers varied between 1 and 3. Moreover, the reporting score was between 4 and 9, and internal validity (confounding) was between 2 and 6. Finally, the internal validity (bias) score varied between 3 and 4. Conclusion:Although there is not enough evidence on the efficiency of different orthotic interventions on genu-recurvatum, it can be concluded that use of orthoses is depending on severity of the disease and presence of concurrent valgus deformity. It seems that both AFO and KAFO are good orthotic interventions which can be used to manage genu-recurvatum, depends on the severity of the disease. More studies should be done on this topic.