Effects Of Knee Brace Research Articles

The effect of knee braces on knee joint kinematics at different exercise speeds

ABSTRACT This study aims to investigate the influence of a new semi-rigid knee joint braces on kinematics using the Opti-knee knee joint kinematic analysis system at various exercise speeds. Twenty-four healthy young male adults were recruited for this study. Participants were randomly assessed while wearing and not wearing knee brace at four different speeds on a treadmill: normal walking (3.6 km/h), brisk walking (5.4 km/h), jogging (9 km/h), and moderate intensity running (10.8 km/h). Six degrees of freedom kinematic data from the knee joint were collected. Paired t-tests were conducted to calculate the kinematic differences. At speeds of 3.6 km/h and 5.4 km/h, wearing the knee brace led to reduced knee joint mobility in anterior-posterior translation, superior-inferior translation, internal-external rotation, and flexion-extension angles during the stance phase (P < 0.05). At 9 km/h, wearing the brace reduced knee joint internal-external rotation and flexion-extension mobility during the stance phase (P < 0.05). At 10.8 km/h, wearing the brace reduced knee joint flexion-extension mobility during the stance phase (P < 0.05). Wearing brace has significant influence on knee kinematics at four speeds, and the effect of brace varies with the speed of movement.

Effect of knee bracing on clinical outcomes following anterior cruciate ligament reconstruction: A prospective randomised controlled study

While there is a consensus against bracing after anterior cruciate ligament (ACL) reconstruction, the question of its potential benefits, especially in cases involving meniscus repair, as well as its routine use by the majority of clinicians, remains a topic of debate. This study aims to assess the effectiveness of bracing in relation to clinical scores after ACL reconstruction, regardless of meniscus surgery. This randomised controlled study involved patients aged 15-55 years who underwent arthroscopic ACL reconstruction surgery. All eligible patients were assigned into two groups: one group received an adjustable frame with a four-point fixation knee brace for a four-week period, while the other did not.A single experienced surgeon performed standard anatomical single-bundle ACL reconstruction. All patients, irrespective of whether they underwent meniscus repair, followed the same rehabilitation protocol. Knee functional questionnaires, including the International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner Activity Scale, Visual Analogue Scale (VAS), and examinations, were collected preoperatively, at six months, one year, and two years postoperatively. The study employed an intention-to-treat analysis and multilevel mixed-effects generalised linear models to compare continuous outcomes between the groups, adjusting for the times of follow-up. A total of 84 patients (42 patients per group) comprised of 75 males (89 %) and average age of 30±9.4 years old. Patient-reported function, physical examination findings, and surgical characteristics were comparable between the two groups. (P-value >0.05) Both groups demonstrated significant improvement in IKDC and Lysholm scores at the end of the two-year follow-up period. (P-value <0.0001) In multivariate analysis, bracing was significantly associated with lower Tegner activity scale than the non-brace group after adjustment for VAS and time (coefficient -0.49, 95 % confidence interval -0.87, -0.10, P-value=0.013). None of the graft ruptures were reported, and there was no significant difference of return to sports between the groups at the end of the follow-up. The study suggests that knee bracing after ACL reconstruction, regardless of any additional meniscus procedures, fails to enhance subjective or objective outcomes and could potentially have a negative impact on the Tegner activity scale, although the difference is not clinically significant. The routine use of a postoperative brace should be discontinued. Level I, Randomised controlled trial with no negative criteria.

The Effect of Knee Brace on Knee Joint Proprioception and Static Balance in Sarcopenic Elderly Patients with Knee Osteoarthritis

The Effect of Knee Brace on Knee Joint Proprioception and Static Balance in Sarcopenic Elderly Patients with Knee Osteoarthritis

Can a Knee Brace Prevent ACL Reinjury: A Systematic Review.

This systematic review aimed to investigate whether the use of a knee brace when returning to sport (RTS) could prevent a second injury after anterior cruciate ligament reconstruction (ACLR). This study was registered with the PROSPERO database and followed PRISMA guidelines. A systematic search of PubMed, Ovid Medline, Ovid All EBM Reviews, Ovid Embase, EBSCO Sportdiscus and ISI Web of Science databases for meta-analysis, randomized controlled trials and prospective cohort studies published before July 2020 was undertaken. The inclusion criteria were: (1) Comparing with and without a brace at RTS, (2) follow up of at least 18 months after ACLR, (3) reinjury rates included in the outcomes. Two reviewers independently extracted the data. Quality appraisal analyses were performed for each study using the Cochrane Collaboration tools for randomized and nonrandomized trials. A total of 1196 patients in three studies were included. One study showed a lower rate of reinjury when wearing a knee brace at RTS. One study found the knee brace to have a significant protective effect for younger patients (≤17 years). The effectiveness of knee bracing when RTS remains ambiguous. Current data cannot support that using a knee brace when RTS will decrease the rate of reinjury after ACL reconstruction.

Effectiveness of bilateral single-hinged knee bracing in osteoarthritis: A finite element study.

Effectiveness of knee braces remains to be identified. Therefore, the purpose of this study was to investigate the effectiveness of bilateral single-hinged knee bracing in knee osteoarthritis (OA) using finite element (FE) method. A three-dimensional FE model consisted of main model (knee-brace structure) and submodel (strap-muscle system) was developed. The submodel was used to convert the elastic strap-muscle interaction into an equivalent stiffness value required by the main model. Adding 100 N · mm/rad torsion spring to the brace with 5 kPa strap pressure lowered maximum von Mises stress in the knee OA components at a flexion angle greater than or equal to 90°. Separately, employing 10% brace pre-tension to the brace with 5 kPa strap pressure started to reduce stresses at a flexion angle of 70°. The configuration involving a combination of 10% brace pre-tension and 300 N · mm/rad torsion spring with 30 kPa strap tightness produced stress reduction over the entire range from 0° to 100° flexion angle. The basic bilateral single-hinged knee brace has shown to reduce stresses in the knee OA at high flexion angles only. Compared to the torsion spring, the brace pre-tension has shown to provide more significant benefits (i.e. stress reduction at lower flexion angles). The most sophisticated effects were achieved when the torsion spring was used in combination with the brace pre-tension. These two features can be potentially used for the development of an active knee brace if they can be modulated at different flexion angles or during the gait cycle.

The acute effect of knee brace on the electromyography activity of lower limb muscles in individuals with genu valgus during walking

Background: Different factors affect walking biomechanics disturb the postural control. Genu valgus is one of the most important lower limb malalignments that affects the postural control and disrupts the posture. The purpose of the present study was to investigate the acute effect of knee brace on the electromyography activity of lower limb muscles in individuals with genu valgus during walking. Methods: In this semi-experimental and a laboratory typ study,. 24 boys with genu valgum (20-30 years old) volunteered to participate in the study. The electrical activity of the selected muscles was recorded by an electromyography system during walking with and without knee brace. Paired t-test was used for statistical analysis at a significance level of 0.05. Results: There was a significant increase in electrical activity of the semitendinosus muscle during walking with knee brace compared to walking without it (p = 0.037, d = 0.89). The electrical activity of other lower limb muscles did not show any significant differences during acute use of knee brace (P &gt;0.05). Conclusion: The semitendinosus muscle in individuals with genu valgus is weak. Therefore, significant increase in the electrical activity of the semitendinosus muscle during wearing of knee brace means delaying the fatigue and indicating improvement in the muscular function.

The effect of a knee brace in dynamic motion-An instrumented gait analysis.

BackgroundOsteoarthritis (OA) is a common problem in the older population. To reduce pain and stress in the affected knee joint compartment, a functional knee brace is often prescribed by physicians to protect it from high loads.ObjectivesAn instrumented gait analysis should evaluate how the 4-point knee orthosis for varus or valgus load relief (M.4s OA) changes the kinematics of the knee, especially in the frontal plane.Methods17 healthy participants took part and were analyzed with an inertial sensor system (MyoMotion) giving continuous, objective information on the anatomical angles. The measurements were made both without wearing a knee brace and with the brace in different settings.ResultsThe results show a significant reduction in the maximum knee abduction and raised knee adduction. The knee brace, with a strong adjustment in varus or valgus orientation, caused a shift of maximum ab-/adduction in the proposed direction in 69% and 75% of the dynamic tests, respectively. The knee motion in the frontal plane shows individual movement patterns.ConclusionThe use of the brace leads to significant changes in the knee’s movement. Patient-specific movement patterns may explain different effects of functional knee braces on individual persons. Inertial sensors have been shown to be a low-cost, easy-to-use option for individual movement analysis and further personalized therapy.

A comparative study of the acute effects of knee brace vs. kinesiotape on selected isokinetic strength variables of the knee muscles

BACKGROUND: Different methods of treatment for preventing knee injuries, enhancing knee strength and minimising post-injury risks have been explored. Among these methods, Kinesio tape (KT) and knee braces (KB) are commonly used. OBJECTIVE : To investigate the acute effects of KT and KB on isokinetic knee strength parameters. METHODS: A total of 15 healthy sedentary male subjects voluntarily participated in the study. Concentric isokinetic knee extension (EX) and flexion (FLX) strength were measured at three sessions: 1. Baseline 2. with KT (’KT’) 3. with KB (’KB’). Tests were performed at 60, 180 and 240∘/s. Peak moment (PM), Hamstring/Quadriceps ratio (HQR), and joint angle at peak moment (JAPM) were measured. RESULTS: ‘KT’ and ‘KB’ were associated with increase in PMEX, PMFLX, HQR at 60 and 240∘/s (p&lt; 0.05) and increased JAPMEX. No significant difference was observed at 180∘/s (p&gt; 0.05). CONCLUSION: In healthy individuals, ‘I’ shape KT and KB positively affect EX and FLX strengths and HQR, especially at low angular velocity.

Effect of Knee Bracing on Improving Pain &amp; Disability

Effect of Knee Bracing on Improving Pain &amp; Disability

Contributions of muscles and external forces to medial knee load reduction due to osteoarthritis braces

BackgroundBraces for medial knee osteoarthritis can reduce medial joint loads through a combination of three mechanisms: application of an external brace abduction moment, alteration of gait dynamics, and reduced activation of antagonistic muscles. Although the effect of knee bracing has been reported independently for each of these parameters, no previous study has quantified their relative contributions to reducing medial knee loads. MethodsIn this study, we used a detailed musculoskeletal model to investigate immediate changes in medial and lateral loads caused by two different knee braces: OA Assist and OA Adjuster 3 (DJO Global). Seventeen osteoarthritis subjects and eighteen healthy controls performed overground gait trials in unbraced and braced conditions. ResultsAcross all subjects, bracing reduced medial loads by 0.1 to 0.3 times bodyweight (BW), or roughly 10%, and increased lateral loads by 0.03 to 0.2 BW. Changes in gait kinematics due to bracing were subtle, and had little effect on medial and lateral joint loads. The knee adduction moment was unaltered unless the brace moment was included in its computation. Only one muscle, biceps femoris, showed a significant change in EMG with bracing, but this did not contribute to altered peak medial contact loads. ConclusionsKnee braces reduced medial tibiofemoral loads primarily by applying a direct, and substantial, abduction moment to each subject's knee. To further enhance brace effectiveness, future brace designs should seek to enhance the magnitude of this unloader moment, and possibly exploit additional kinematic or neuromuscular gait modifications.

The effect of functional bracing on the arthrokinematics of anterior cruciate ligament injured knees during lunge exercise

BackgroundFunctional knee braces are extensively used for partially and completely torn anterior cruciate ligament (ACL) patients and those who have undergone ACL graft reconstruction, in order to support the healing ACL, improve the joint’s functional stability, and restore the normal joint kinematics. Research questionDoes wearing braces alter the arthrokinematics of the ACL deficient knees during lung exercise? MethodsFor ten male unilateral ACL deficient subjects, 3D knee models were reconstructed from CT images, acquired in rest position. Sagittal plane fluoroscopy was then performed throughout a complete cycle of lunge in braced and non-braced conditions. The 3D kinematics of the knees were obtained using a 2D-3D registration method in which six anatomical bony landmarks on the fluoroscopic images were matched with those on the 3D models. ResultsNo significant difference was found between the tibial anterior-posterior translations and abduction-adduction motions of the braced and non-braced knees. A significant decrease, however, was observed after bracing in the tibial internal rotation at 45° flexion during eccentric (non-braced: 5.9° (±6.7°) vs. braced: 2.4° (±7.0°); p = 0.045), and at 30° flexion during concentric (non-braced: 2.3° (±6.9°) vs. braced: −1.6° (±8.1°); p = 0.001) phases of the lunge cycle. SignificanceThe immediate effect of knee bracing is limited to controlling the tibial rotation of the ACL deficient individuals during the lunge exercise. Hence, care should be taken in prescribing the lunge exercise for rehabilitation of ACL injured patients with high anterior-posterior knee instability, even when wearing knee braces.

Comprehensive Review of Skiing and Snowboarding Injuries.

Skiing and snowboarding have increased in popularity since the 1960s. Both sports are responsible for a substantial number of musculoskeletal injuries treated annually by orthopaedic surgeons. Specific injury patterns and mechanisms associated with skiing and snowboarding have been identified. No anatomic location is exempt from injury, including the head, spine, pelvis, and upper and lower extremities. In these sports, characteristic injury mechanisms often are related to the position of the limbs during injury, the athlete's expertise level, and equipment design. Controversy exists about the effectiveness of knee bracing and wrist guards in reducing the incidence of these injuries. Understanding these injury patterns, proper training, and the use of injury prevention measures, such as protective equipment, may reduce the overall incidence of these potentially debilitating injuries.

Effects of Knee Bracing on Static and Dynamic Balance

Effects of Knee Bracing on Static and Dynamic Balance

The Effect of Knee Braces on Quadriceps Strength and Inhibition in Subjects With Patellofemoral Osteoarthritis.

Secondary analysis of a randomized controlled trial. The use of external supports has been questioned because they may lead to weakness in the surrounding muscles. To our knowledge, there is no investigation into the effect of knee supports or braces on quadriceps muscle strength and quadriceps inhibition in individuals with patellofemoral joint (PFJ) osteoarthritis (OA). To investigate the effects of a flexible knee support on quadriceps maximum voluntary contraction (MVC) and arthrogenous muscle inhibition (AMI) in patients with PFJ OA. The study included 108 participants who had at least 3 months of patellofemoral pain and a Kellgren-Lawrence score of 2 or 3 for PFJ OA. The participants were randomized to a group that wore a flexible knee support (brace) or a group that did not wear a support (no brace) in a 6-week randomized controlled trial, followed by an open-label trial, in which all participants wore the brace for a total of 12 weeks. Quadriceps MVC, measured isometrically, and quadriceps AMI, measured by twitch interpolation, were assessed at the 6-week and 12-week time points. After 6 weeks, MVC did not differ between the brace and no-brace groups (9.09 Nm; 95% confidence interval [CI]: -4.89, 23.07; P = .20). Arthrogenous muscle inhibition significantly decreased in the brace group (-8.62%; 95% CI: -13.90%, -3.33%; P = .002). After 12 weeks, in all of the participants who wore a flexible knee support, MVC increased by 7.98 Nm (95% CI: 2.52, 13.45; P = .004) and AMI decreased (-8.42%; 95% CI: -11.48%, -5.36%; P<.001). Although statistically significant, these results have doubtful clinical significance. A patellofemoral flexible knee support in participants with PFJ OA does not have an adverse effect on quadriceps MVC or AMI. Using a knee support should not be discouraged because of concerns about deleterious effects on quadriceps strength and inhibition. Therapy, level 1b.

The Effect of Knee Bracing on Valgus Collapse during Landing in Physically Active Collegiate Population

The Effect of Knee Bracing on Valgus Collapse during Landing in Physically Active Collegiate Population

The Effect of Knee Braces on Tibial Rotation in Anterior Cruciate Ligament – Deficient Knees During High Demand Athletic Activities

OBJECTIVE To examine if bracing can restrict tibial rotation in anterior cruciate ligament (ACL)-deficient patients during high loading activities. DESIGN Repeated measures. Kinematic data were collected with an 8-camera Vicon system while each patient performed 2 tasks that are known to cause increased rotational and translational loads on the knee: (1) descending from a stair and subsequent pivoting, and (2) landing from a platform and subsequent pivoting. The tasks were repeated under 3 brace conditions for the ACL-deficient knee: (1) wearing a prophylactic brace (braced condition), (2) wearing a patellofemoral brace (sleeved condition), and (3) without brace (unbraced condition). SETTING Biomechanical laboratory study. PATIENTS Twenty-one male subjects with a confirmed unilateral ACL rupture were assessed in vivo. MAIN OUTCOME MEASURES Tibial internal rotation. Two repeated measures ANOVAs tested for differences in tibial internal rotation among the 3 conditions of the ACL-deficient knee and the unbraced condition of the intact knee. RESULTS In both tasks, tibial rotation was significantly lower in the intact knee compared with all 3 conditions of the ACL-deficient knee (P ≤ 0.031). Bracing the ACL-deficient knee resulted in lower rotation than the unbraced (P ≤ 0.001) and sleeved (P ≤ 0.033) conditions. The sleeved condition resulted in lower tibial rotation in the drop landing and pivoting task compared with the unbraced condition (P = 0.019) but not in the stair descending and pivoting task (P = 0.256). CONCLUSIONS Bracing decreased the excessive tibial rotation in ACL-deficient patients during high-demand activities but failed to fully restore normative values. If knee braces can enhance rotational knee stability in ACL-deficient patients, then they could possibly play an important role in preventing further knee pathology in such patients.

Effects of Knee Bracing on Tibial Rotation During High Loading Activities in Anterior Cruciate Ligament–Reconstructed Knees

To test whether knee bracing restores normal rotational knee kinematics in anterior cruciate ligament (ACL)-reconstructed knees during high-demand, athletic activities. Twenty male patients who had undergone unilateral ACL reconstruction with a bone-patellar tendon-bone autograft were assessed in vivo. The mean time from surgery to data collection was 26 months (range, 25 to 28 months). An 8-camera optoelectronic system was used to collect kinematic data while each patient performed 2 demanding tasks: (1) immediate pivoting after descending from a stair and (2) immediate pivoting after landing from a platform. Each task was performed under 3 conditions for the reconstructed knee: (1) wearing a prophylactic brace (braced condition), (2) wearing a patellofemoral brace (sleeved condition), and (3) without a brace (non-braced condition). As a control group, patients with intact ACLs were tested without any bracing. This study protocol was identical to the protocol of a previous study that investigated the effect of bracing on ACL-deficient athletes. For both tasks, the range of motion of tibial rotation was significantly lower in the intact knee compared with all 3 conditions of the ACL-reconstructed knee (P ≤ .014). Placing a brace or a sleeve on the ACL-reconstructed knee resulted in lower rotation than the non-braced condition (P ≤ .022), whereas no significant differences were found between the sleeved and the braced conditions (P ≥ .110). Bracing limited the excessive tibial rotation in ACL-reconstructed knees during pivoting that occurs under high-demand activities. However, full restoration to normative values was not achieved. Thereby, braces have the potential to decrease rotational knee instability that still remains after ACL reconstruction.

The Effect of Knee Braces on Tibial Rotation in Anterior Cruciate Ligament–Deficient Knees During High-Demand Athletic Activities

To examine if bracing can restrict tibial rotation in anterior cruciate ligament (ACL)-deficient patients during high loading activities. Repeated measures. Kinematic data were collected with an 8-camera Vicon system while each patient performed 2 tasks that are known to cause increased rotational and translational loads on the knee: (1) descending from a stair and subsequent pivoting, and (2) landing from a platform and subsequent pivoting. The tasks were repeated under 3 brace conditions for the ACL-deficient knee: (1) wearing a prophylactic brace (braced condition), (2) wearing a patellofemoral brace (sleeved condition), and (3) without brace (unbraced condition). Biomechanical laboratory study. Twenty-one male subjects with a confirmed unilateral ACL rupture were assessed in vivo. Tibial internal rotation. Two repeated measures ANOVAs tested for differences in tibial internal rotation among the 3 conditions of the ACL-deficient knee and the unbraced condition of the intact knee. In both tasks, tibial rotation was significantly lower in the intact knee compared with all 3 conditions of the ACL-deficient knee (P ≤ 0.031). Bracing the ACL-deficient knee resulted in lower rotation than the unbraced (P ≤ 0.001) and sleeved (P ≤ 0.033) conditions. The sleeved condition resulted in lower tibial rotation in the drop landing and pivoting task compared with the unbraced condition (P = 0.019) but not in the stair descending and pivoting task (P = 0.256). Bracing decreased the excessive tibial rotation in ACL-deficient patients during high-demand activities but failed to fully restore normative values. If knee braces can enhance rotational knee stability in ACL-deficient patients, then they could possibly play an important role in preventing further knee pathology in such patients.

Effects of knee bracing on postural control after anterior cruciate ligament rupture

Study designRandomized clinical trial. ObjectivesTo investigate the effects of functional knee braces on postural control in patients with anterior cruciate ligament (ACL) rupture. BackgroundACL rupture leads to both mechanical knee instability and deficits in proprioception. Although elastic knee braces do not increase mechanical stability, patients report improved stability when wearing a brace. Elastic braces were found to reduce the loss of proprioception. It is, however, still unclear whether they also improve postural control, which involves the processing of proprioceptive input at a higher level. MethodsWe studied 58 patients with isolated unilateral ACL rupture using computerized dynamic posturography and compared overall stability index (OSI) scores for injured and uninjured legs with and without a knee brace. In addition, patients were classified as copers and non-copers depending on knee function. ResultsWithin subjects, OSI scores were 3.0±1.1° for uninjured legs when unbraced, 2.8±1.3° for uninjured legs when braced (p=0.17), 3.7±1.5° for unbraced injured legs, and 2.9±1.3° for braced injured legs (p<0.001). For the injured legs of copers and non-copers, OSI scores were 3.4°±1.2° for copers and 4.0°±1.6° for non-copers in the unbraced condition (p=0.11) and 2.7±1.0° for copers and 3.1±1.4° for non-copers in the braced condition (p=0.26). ConclusionElastic knee braces increase postural stability by approximately 22% in patients with ACL rupture. There was no difference in postural stability between uninjured and injured legs in the braced condition. One possible explanation is that bracing improves both proprioception and postural control. Level of evidenceControlled clinical trial, level 2a.

Efficacy of Knee Braces and Foot Orthoses in Conservative Management of Knee Osteoarthritis

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.