There are few well designed trials on footwear, bracing, and walking aids. There is limited and weak evidence to support the use of footwear, bracing, and walking aids.

The National Institute for Health and Clinical Excellence (NICE) conducted a systematic review of the efficacy and safety of footwear, bracing, and walking aids [National Collaborating Centre for Chronic Conditions, 2008].

• One Cochrane systematic review/meta-analysis and 13 additional relevant RCTs were found.
• The systematic review/meta-analysis included four RCTs (n = 444) which studied insoles and limb braces in people with osteoarthritis of the knee.
• The RCTs differed in the interventions, comparisons, study size, duration of follow up, and methodological quality (susceptibility to biased results).
• Eleven of the additional RCTs studied osteoarthritis of the knee, and two studied osteoarthritis of the thumb.
• Knee osteoarthritis:
• Knee brace:
• Knee pain on walking/climbing stairs: one RCT (n = 119) found a knee brace was more effective than a neoprene sleeve, and more effective than medical treatment.
• Knee pain severity: one RCT (n = 118) found a knee brace provided no additional benefit over medical treatment.
• Function/disability: one RCT (n = 119) found a knee brace to be more effective than neoprene sleeve, and more effective than medical treatment on the WOMAC score, but not on other measures.
• Quality of life: one RCT (n = 118) found a knee brace provided no additional benefit over medical treatment.
• Serious adverse events: none reported.
• Neoprene sleeve:
• Knee pain on walking/climbing stairs: one RCT (n = 119) found a neoprene sleeve was more effective than medical treatment.
• Function/disability: one RCT (n = 119) found a neoprene sleeve was more effective on WOMAC score than medical treatment.
• Serious adverse events: none reported.
• Insoles:
• Knee pain severity: one RCT (n = 147) found insoles provided no significant benefit.
• Stiffness: two RCTs (n = 147 and n = 156) found insoles provided no significant benefit.
• Function/disability: in three RCTs (n = 147, n = 90, and n = 156), one of six comparisons favoured insoles over no or neutral insoles.
• Global assessment: two RCTs (n = 147 and n = 146) found insoles provided no significant benefit.
• Use of analgesics: two RCTs (n = 147 and n = 146) found insoles provided a significant benefit in one of four comparisons.
• Serious adverse events: none reported.
• Patella taping:
• Knee pain severity: two RCTs (n = 14 and n = 87) found medial/therapeutic taping significantly more effective than lateral/control taping on most measures of pain.
• Function/disability: one RCT (n = 87) found medial/therapeutic taping significantly more effective than lateral/control taping on four out five measures of function/disability.
• Personal preference: one RCT (n = 14) found medial taping was preferred over neutral taping; there was no preference over lateral taping.
• Use of analgesics: one RCT (n = 87) found no significant benefit of taping.
• Quality of life: one RCT (n = 87) found therapeutic taping to be significantly more effective than control taping in seven out of eight measures of quality of life.
• Serious adverse events: none reported.
• Shoes:
• Knee pain severity: one RCT (n = 125) found no significant difference between the 'Masai barefoot technology^'® shoe and a high-end walking shoe.
• Stiffness: one RCT (n = 125) found no significant difference between the 'Masai barefoot technology'^® shoe and a high-end walking shoe.
• Serious adverse events: none reported.
• Walking stick:
• Walking speed, steps/minute: one RCT (n = 14) found walking to be significantly improved with both ipsilateral and contralateral cane.
• Stride length: one RCT (n = 14) found no significant difference.
• Serious adverse events: none reported.