Knee Brace Research Articles

Effect of Soft Knee Brace on Shank Movement in Running

Background: Soft knee braces are used for the protection and treatment of knee injuries in light-intensity activities of daily life. Soft knee braces have several functions, such as stabilizing and supporting the lower limb posture. However, previous studies did not investigate the effects of a soft knee brace on the lower limbs during vigorous-intensity activities. Aims: The objective of this study was to investigate the effect of a soft knee brace on the physical load and stability of the lower limb during running as a vigorous-intensity activity. Methods: Participants were asked to run with or without a soft knee brace, and lower-limb movements during running were measured using an inertial sensor on the shank. Results: The result showed that soft knee brace significantly reduced the magnitude and mediolateral standard deviation of shank acceleration. Conclusion: The results of this study indicate the possibility that wearing a soft knee brace can improve the physical load and stability of the lower limbs during running.

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.

Simple Aseismic Reinforcement of Steel Structures Using Knee Braces with High-Hardness Vises

A novel technique for upgrading the seismic resistance of steel buildings by adding knee braces to existing structures using vises was proposed by researchers in 2022. A feature of this retrofitting method is the easy setup owing to its use of vises made from high-hardness metal. Tests were conducted to investigate two main failure modes: slipping failure at the connection and yielding and buckling failure of the knee brace. The retrofitting design is discussed based on a comparison between the slipping strengths obtained through tests and calculations. Furthermore, an analytical study, using the finite element method (FEM), was conducted to evaluate the test results of retrofitted frames that failed in terms of the yielding and buckling of the knee braces. The findings of the analyses are consistent with the test results. This study included a stress relaxation test to assess the long-term performance of the vises.

Exploring predictors of medial collateral ligament tears in lateral approach total knee replacement: A retrospective study

BackgroundMedial collateral ligament (MCL) tears are uncommon in total knee replacement (TKR), but they pose significant surgical challenges, affecting recovery and outcomes. This study analyzed 18 (1.3 %) MCL tear cases from 1429 TKR procedures using a lateral subvastus approach. Logistic regression with Lasso regularization was used to assess factors like gender, BMI, and knee alignment. Midsubstance disruptions were the most common. MCL tears were more frequent in females, those with higher BMI, and valgus alignment. The Lasso model achieved an AUC of 0.83 and an F1 score of 0.76. MethodsA retrospective analysis on 1429 TKR cases performed by three experienced surgeons using the Optimotion Implant system and specialized MCL retractors was conducted. The lateral subvastus approach without parapatellar arthrotomy. A hinged knee brace was applied postoperatively and a posterior stabilized insert was used for MCL tears. Demographic data were collected, and a Lasso regression model with data balancing, was employed to identify MCL tear predictors. ResultsAmong the 1429 TKR cases, 18 cases (1.3 %) involved MCL tears. The average age of these patients was 67.3 years (not statistically significant). The average BMI for patients with MCL tears was 36.7, significantly higher than the overall group average of 31.5, suggesting a link between higher BMI and MCL tears. Females were notably more affected, making up 88.9 % of the MCL tear cases compared to 11.1 % of males. Regarding knee alignment, 38.9 % had valgus alignment (p < 0.05), No significant differences were observed in knee flexion or Knee Society Scores (KSS) following MCL tears. ConclusionsGender, BMI, and knee alignment are significant factors influencing the incidence of MCL tears in TKR procedures. The Lasso model effectively identified individuals at higher risk. Preventive measures, including surgeon training and the use of specialized MCL retractors, were implemented. Functional outcomes such as knee flexion and KSS scores did not show significant differences post-MCL tear.

Efficacy of the mHealth-Based Exercise Intervention re.flex for Patients With Knee Osteoarthritis: Pilot Randomized Controlled Trial.

Exercise therapy is recommended by international guidelines as a core treatment for patients with knee osteoarthritis. However, there is a significant gap between recommendations and practice in health care. Digital exercise apps are promising to help solve this undersupply. This study aims to evaluate the efficacy of a 12-week fully automated app-based exercise intervention with and without a supporting knee brace on health-related outcomes, performance measures, and adherence in patients with knee osteoarthritis. This closed user group trial included participants with moderate to severe unicondylar painful knee osteoarthritis. Randomization was 1:1:2 into an intervention group (IG) with 2 subgroups (app-based training [IG A] and app-based training and a supportive knee brace [IG AB]) and a control group (CG). The intervention included a 12-week home exercise program with 3 sessions per week. Instructions for the exercises were given via the app and monitored using 2 accelerometers placed below and above the affected knee joint. Participants in the CG did not receive any study intervention but were allowed to make use of usual care. Osteoarthritis-specific pain (Knee Injury and Osteoarthritis Outcome Score) was defined as the primary outcome, and secondary outcomes included all other Knee Injury and Osteoarthritis Outcome Score subscales, general health-related quality of life (Veterans RAND 12-item Health Survey), psychological measures (eg, exercise self-efficacy), performance measures (strength and postural control), and the monitoring of adherence and safety. Outcomes were assessed at baseline and after 12 weeks. Intervention effects were calculated using baseline-adjusted analysis of covariance for the joint comparison of IG A and IG AB versus the CG using a per-protocol approach. Subgroup analyses were conducted for each IG separately. A total of 61 participants were included (IG: n=30, 49%; CG: n=31, 51%; male: n=31, 51%; female: n=30, 49%; mean age 62.9, SD 8.5 years; mean BMI 27.7, SD 4.5 kg/m2). Analysis revealed statistically significant effects in favor of the IG for pain reduction (P<.001; effect size [ES]=0.76), improvements in physical function (P<.001; ES=0.64), improvements in symptoms (P=.01; ES=0.53), improvements in sport and recreation activities (P=.02; ES=0.47), improvements in knee-related quality of life (P<.001; ES=0.76), and improvements in the physical component of general health-related quality of life (P<.001; ES=0.74). Mean differences ranged from 6.0 to 13.2 points (scale range 0-100). ESs indicated small to medium effects. No effects were found for psychological and performance measures. Participants adhered to 92.5% (899/972) of all scheduled exercise sessions. Individuals with knee osteoarthritis undergoing a 12-week sensor-assisted app-based exercise intervention with or without an additional knee brace experienced clinically meaningful treatment effects regarding pain relief and improvements in physical function as well as other osteoarthritis-specific concerns compared to controls. German Clinical Trials Register (DRKS) DRKS00023269; https://drks.de/search/de/trial/DRKS00023269.

Effectiveness of a Single Intra-articular Injection of High-Molecular-Weight Hyaluronic Acid Versus NSAIDs on the Visual Analog Pain Scale and Western Ontario and McMaster Universities Osteoarthritis Index Scores in Patients With Knee Osteoarthritis.

This study aimed to determine the effectiveness of a single intra-articular injection of high-molecular-weight (HMW) hyaluronic acid (HA) at a dose of 4 mL/60 mg to reduce pain in people with knee osteoarthritis (OA) over 12 months. This retrospective study was conducted after obtaining ethical approval from Dhaka Medical College and Hospital, Bangladesh. From July 2020 to June 2021, a medical professional conducted the investigation. The investigation encompassed patients aged 40 to 70 hospitalized at our facility and diagnosed with Grade 2 or Grade 3 knee OAaccording to the Kellgren-Lawrence grading method. We divided the patients into two categories based on the treatments they received. Patients in Group A received a single injection of HMW HA (60 mg/4 mL) into the joint, along with instructions on activities of daily living, exercise, and painkillers. Group B patients received conservative therapy, which involved the use of nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, therapeutic exercises, and a knee brace during physical activity. This study compared the efficacy of a single injection of HMW HA in the joint versus NSAIDs for managing OA-related symptoms over 12 weeks. The HA group initially scored similarly to the comparison group. By week three, however, the group receiving HA had considerably higher Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (p=0.019). This pattern continued through weeks 6 (p=0.044), 9 (p=0.016), and 12 (p<0.001). Similarly, by week 3 (p=0.029), the visual analog scale (VAS) scores, which were initially identical (p=0.120), demonstrated a significant preference for HA, and this preference persisted through weeks 6, 9, and 12 (all p<0.001). The results show that by the third week, HA is more effective than NSAIDs at relieving pain and improving symptoms. The study's results indicated that over 12 weeks, the use of HMW HA led to statistically significant reductions in pain intensity, as measured by the VAS. Furthermore, HMW HA demonstrated a more significant improvement in WOMAC ratings, which assess physical function, stiffness, and pain, compared to NSAIDs. The findings suggest that administering HMW HA injections can significantly reduce symptoms and improve functionality in individuals with knee OA.

Bracing for relief: the impact of knee brace design on gait in patellofemoral pain

Bracing for relief: the impact of knee brace design on gait in patellofemoral pain

Machine Learning Based Abnormal Gait Classification with IMU Considering Joint Impairment.

Gait analysis systems are critical for assessing motor function in rehabilitation and elderly care. This study aimed to develop and optimize an abnormal gait classification algorithm considering joint impairments using inertial measurement units (IMUs) and walkway systems. Ten healthy male participants simulated normal walking, walking with knee impairment, and walking with ankle impairment under three conditions: without joint braces, with a knee brace, and with an ankle brace. Based on these simulated gaits, we developed classification models: distinguishing abnormal gait due to joint impairments, identifying specific joint disorders, and a combined model for both tasks. Recursive Feature Elimination with Cross-Validation (RFECV) was used for feature extraction, and models were fine-tuned using support vector machine (SVM), random forest (RF), and extreme gradient boosting (XGB). The IMU-based system achieved over 91% accuracy in classifying the three types of gait. In contrast, the walkway system achieved less than 77% accuracy in classifying the three types of gait, primarily due to high misclassification rates between knee and ankle joint impairments. The IMU-based system shows promise for accurate gait assessment in patients with joint impairments, suggesting future research for clinical application improvements in rehabilitation and patient management.

Reconstruction of the medial collateral ligament complex with aflat semitendinosus auto- or allograft

Replacement of superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) with an allograft. Chronic 3° isolated medial instability and combined anteromedial or posteromedial instability. Infection, open growth plates, restricted range of motion (less than E/F 0-0-90°). Longitudinal incision from medial epicondyle to superficial pes anserinus and exposure of the medial collateral ligament complex. Thawing of the allogeneic semitendinosus tendon graft at room temperature, reinforcement of the tendon ends with sutures and preparation of atwo-stranded graft. Placement of guidewires in the sMCL and POL insertions and control with image intensifier. Tunnel drilling. Pulling the graft loop into the femoral bone tunnel and fixation with aflip button. Pulling the two graft ends into the tibial tunnels. Tibial fixation by knotting the suture ends in a20° flexion on the lateral cortex. Suture the tendon bundles to the remaining remnants of the medial collateral ligament complex to adopt the flat structure of the natural medial collateral ligament complex. Six weeks partial weight-bearing, immediately postoperatively splint in the extended position, after 2weeks movable knee brace for another 4-6weeks. Mobility: 4weeks 0-0-60, 5th and 6th weeks 0-0-90. From 2015-2021, this surgical procedure was performed in 19patients (5women, 14men, age34years). Mean Lysholm score at follow-up after at least 2years was 89 (76-99) points. In 6patients, there was restricted range of motion 3months postoperatively, which resulted in further therapy (3 ×systemic cortisone therapy, 3 ×arthroscopically supported manipulations under anesthesia).

Highly Adhesive and Stretchable Epidermal Electrode for Bimodal Recording Patch.

For numerous biological and human-machine applications, it is critical to have a stable electrophysiological interface to obtain reliable signals. To achieve this, epidermal electrodes should possess conductivity, stretchability, and adhesiveness. However, limited types of materials can simultaneously satisfy these requirements to provide satisfying recording performance. Here, we present a dry electromyography (EMG) electrode based on conductive polymers and tea polyphenol (CPT), which offers adhesiveness (0.51 N/cm), stretchability (157%), and low impedance (14 kΩ cm2 at 100 Hz). The adhesiveness of the electrode is attributed to the interaction between catechol groups and hydroxyls in the polymer blend. This adhesive electrode ensures stable EMG recording even in the presence of vibrations and provides signals with a high signal-to-noise ratio (>25 dB) for over 72 h. By integrating the CPT electrode with a liquid metal strain sensor, we have developed a bimodal rehabilitation monitoring patch (BRMP) for sports injuries. The patch utilizes Kinesio Tape as a substrate, which serves to accelerate rehabilitation. It also tackles the challenge of recording with knee braces by fitting snugly between the brace and the skin, due to its thin and stretchable design. CPT electrodes not only enable BRMP to assist clinicians in formulating effective rehabilitation plans and offer patients a more comfortable rehabilitation experience, but also hold promise for future applications in biological and human-machine interface domains.

Influence of Lead Knee Extension on Ball Velocity and Elbow Varus Torque in Professional and High School Baseball Pitchers.

When the lead leg of a pitcher contacts the ground, the knee braces and then rapidly extends, initiating energy transfer to begin pelvis and trunk rotation. To investigate the relationship of lead knee extension during the pitching delivery with peak lead knee extension velocity, ball velocity, and elbow varus torque in high school and professional pitchers. Descriptive laboratory study. Data from 50 professional (PRO) and 50 high school (HS) pitcher groups were retrospectively analyzed. Pitchers threw 8 to 12 fastballs under 3-dimensional motion analysis (480 Hz). The groups were divided according to high or low lead knee extension: PRO-high (n = 18), PRO-low (n = 16), HS-high (n = 16), and HS-low (n = 17). Lead knee flexion, lead knee extension velocity, ball velocity, and elbow varus torque were analyzed between groups. Regression analyses were performed to quantify associations between lead knee extension and ball velocity and elbow varus torque for all pitchers. At foot contact, all pitchers landed with similar knee flexion. PRO-high and HS-high pitchers had significantly greater lead knee extension through remaining pitching time points compared with the PRO-low and HS-low pitchers. PRO-high pitchers had faster ball velocity than PRO-low pitchers (39.8 ± 1.1 vs 39.3 ± 1.3 m/s, respectively), and HS-high pitchers had faster ball velocity than HS-low pitchers (34.1 ± 2.6 vs 31.2 ± 1.8 m/s, respectively) (P < .05). PRO-high pitchers had decreased elbow varus torque compared with PRO-low pitchers (85.3 ± 10.7 vs 95.4 ± 13.3 N·m, respectively); conversely, HS-high pitchers had greater elbow varus torque than HS-low pitchers (64.2 ± 14.7 vs 56.3 ± 12.2 N·m, respectively). For every 1° increase in lead knee extension, ball velocity increased by 0.47 m/s (P < .001) and elbow varus torque increased by 0.27 N·m (P = .025). Proper lead knee extension allowed efficient energy transfer through the kinetic chain to produce optimal ball velocity and minimize elbow varus torque in professional pitchers. Conversely, while proper lead knee extension improved ball velocity among high school pitchers, this did not minimize elbow varus torque. Professional pitchers can extend their lead knee with minimal impact at the elbow. In high school pitchers, cognizance of proper full-body pitching mechanics remains a priority over increased velocity.

Impact of Psychological Factors on Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Anterior cruciate ligament (ACL) tears are a common orthopaedic injury, and the incidence of ACL reconstruction (ACLR) continues to increase. Current clinical practice guidelines (CPGs) recognize the role of psychological factors in rehabilitation, but patient-reported outcome measures (PROs) and psychological readiness are rarely incorporated into rehabilitation. The purpose of this review was to highlight the importance of psychological health after ACL injury, understand the current metrics used to monitor psychological recovery, and outline how psychological recovery can be better incorporated in current CPGs. A systematic review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA); 63 studies were identified with a PubMed search using the term "ACL Injuries/psychology". Exclusion criteria included lack of consideration of psychological effects or studies validating PROs after ACLR. Studies were reviewed by multiple reviewers, and a total of 38 studies were included after applying exclusion criteria. Systematic review. Level 3b. Two independent reviewers analyzed the included articles to extract sample size, psychological readiness scale or other measures used, and key results. Psychological outcomes, especially kinesiophobia and fear of reinjury, are seen commonly after ACLR. Psychological factors were shown to impede return to sport (RTS), alter measurable knee biomechanics, and potentially increase the risk for re-rupture. Targeted interventions such as kinesiotaping, knee bracing, and imagery training can help improve psychological and functional testing after ACLR. ACLR is often complicated by psychological factors. Psychological readiness is a crucial yet often unincorporated part of rehabilitation. Patients with higher levels of kinesiophobia and lower psychological readiness to RTS specifically should be identified to allow for administration of interventions, such as imagery training, knee bracing, or kinesiotaping, that can mitigate the negative effects of psychological outcomes and improve recovery.

The effects of knee brace use on landing error, balance, and crossover hop test in healthy athletes

Objective: In this study, it was aimed to examine the effects of knee brace use on landing error after jumping, balance and crossover hop test (CHT) in healthy athletes. Methods: After recording the descriptive information of the healthy volunteer athletes and measuring the lower extremity joint range of motion, and the Q angle at the knee, participants were randomized. During the study, randomization was carried out as follows: those who did not use knee braces (GroupNon), those who used simple knee braces (GroupBasic) and those who used ligament-supported knee braces (GroupLig). Y-balance test of lower extremity (YBTL), CHT, and landing error scoring after jumping were applied to the participants. Results: A total of 56 professional athletes (GroupNon, n=19; GroupBasic, n=19; GroupLig, n=18) participated in the study. Characteristics of the participants did not reveal any difference (p&gt;0.05). Compared with the other two groups, lower hip extension range of motion was observed in GroupNon (p˂0.05), and no difference was observed in other lower extremity descriptive data (p&gt;0.05). Furthermore, comparing to the other two groups, a significant (p=0.014) increase was observed only in the velocity of CHT applied to the non-dominant extremity of GroupBasic. No significant difference was observed in the other evaluated parameters (p&gt;0.05). As a result of intra-group correlation analyses, different levels of relationship were determined between the landing results after the jumping and various biomechanical properties according to the choice of knee brace (p˂0.05). Conclusion: It would be appropriate to choose the knee brace to be used in healthy athletes by taking into account the biomechanical defining characteristics of the athlete.

Diagnosis and Management of Knee Arthrofibrosis and Associated Pain-Related Fear Using Multidimensional Clinical Reasoning and Exposure In Vivo Concept: A Case Report

BACKGROUND: A plethora of treatment approaches are used to manage persistent pain, disability, and fear associated with restricted knee range of motion following knee surgery. We used the pain and disability driver model and exposure in vivo concepts to manage pain-related fear and disability. CASE PRESENTATION: A 68-year-old male who underwent arthroscopic partial meniscectomy presented to physical therapy with a medical diagnosis of Complex Regional Pain Syndrome Type I and knee range-of-motion restriction. Despite extensive medical care and physical therapy for 3 years (202 visits), he continued to experience debilitating knee pain and demonstrated a high level of fear. To ambulate, he wore a knee brace and used a trekking pole. OUTCOME AND FOLLOW UP: Interventions to address the knee stiffness included combined tibiofemoral joint mobilization and high-velocity low-amplitude thrust manipulation targeting tibial internal rotation and low-load long-duration sustained capsular stretching using total end range time principle for extension. His fear was managed using techniques inspired by in vivo exposure concepts. Total knee range of motion improved 110 degrees and the patient was able to ambulate for 30 minutes (0.5 mile) without an assistive device with &lt;2/10 pain intensity. DISCUSSION: Outside-the-box clinical reasoning suggested that poor outcomes with previous interventions were likely due to hypervigilance and pain-related fear. This case delineates the value of nonreductionist clinical reasoning in diagnosis and management of musculoskeletal conditions. It also outlines how the exposure in vivo approach helped the patient overcome his long-established avoidance behaviors. JOSPT Cases 2024;4(3):121-132. Epub 2 July 2024. doi:10.2519/josptcases.2024.0034

Knee braces and foot orthoses multimodal 3-month treatment of medial knee osteoarthritis in a randomised crossover trial.

Immediate biomechanical and functional benefits of knee braces and lateral wedge foot orthoses (FO) are often reported on patients with medial knee osteoarthritis. However, the effectiveness of their combined use in a longer-term orthotic treatment remains unclear. The aim was to evaluate pain, function, comfort and knee adduction moment (KAM) during the stance phase of gait with three modalities of orthotic treatment. Twenty-two patients with knee osteoarthritis were analysed in a randomised crossover trial including a knee brace with valgus and external rotation functions (VER), FO and their combined use (VER + FO). Western Ontario and McMaster Universities scale (WOMAC) and Knee injury and Osteoarthritis Outcome Scores and KAM during gait were obtained before and after each orthotic treatment of 3 months. Repeated measures analyses of variance contrasted the factors orthosis (VER, FO, VER + FO), treatment (pre and post) and wear (without and with) on pain, function, comfort and KAM. An interaction between orthosis and treatment on the WOMAC pain (effect size [ES] = 0.17) and a main effect on the pain visual analogue score (ES = 0.24) indicated that VER and VER + FO were more alleviating than FO. The three modalities of orthotic treatment significantly improved functional scores (ES > 0.2) and reduced discomfort (ES = 0.25). A significant multivariate interaction between orthosis and wear (ES = 0.73) showed that the KAM reduction while wearing the orthoses was more pronounced with the VER and VER + FO than the FO. The VER-brace obtained more effectiveness than FO on pain and KAM after 3 months for medial knee osteoarthritis and the combined treatment did not substantially improve biomechanical and functional outcomes. Therapeutic study level I randomised crossover trial.

Are adjunct treatments effective in improving pain and function when added to exercise therapy in people with patellofemoral pain? A systematic review with meta-analysis and appraisal of the quality of interventions

ObjectiveTo compare the effectiveness of adjunct treatments combined with exercise to exercise alone in people with patellofemoral pain (PFP) and explore the quality of intervention descriptions in randomised controlled trials...

Seismic Performance Evaluation of Steel Braces in Enhancing the Lateral Load Resistance of RCC Flat Slab Structures

This research paper conducts a comprehensive investigation into the seismic performance of reinforced concrete flat slab structures, employing different configurations of steel bracing systems. The seismic behavior of flat slab buildings with 5, 7, and 9 stories is scrutinized through Equivalent Lateral Force (ELF) analysis and Response Spectrum Analysis (RSA). The study delves into the efficacy of various bracing configurations, encompassing X-bracing, eccentric bracing, and knee bracing, in augmenting the lateral load resistance of these structures. Additionally, the research evaluates the influence of bracing systems on crucial structural response parameters such as displacement, drift ratio, base shear, and fundamental natural period. Keywords: steel bracing, seismic performance, flat slab structures, comparative study

Analysis of knee-bending motion through three-dimensional scanning for advanced brace design

Knee braces have been increasing in popularity as a means to support joint stability and promote the healing process. In order to enhance the fit, comfort, and design of knee braces, this study investigates knee shape deformations across four knee-bending angles from 0° to 90°. Using three-dimensional (3D) scanning technology, the knee contours of 50 Asian males aged between 22 and 33 were examined. The reliability of the 3D measurements was validated through comparisons with tape measurements on the actual body. The analysis revealed a stretch of the skin covering the patella bone with a notable vertical strain of 19% and horizontal stretching of 7%. The circumference along the muscle belly at the thigh (15 cm above the center of the patella) and at the calf (7.5 cm below the center of the patella) showed no significant changes with different bending angles, and can be used as an indicator for sizing of knee braces. However, at the patella bone level, the bending of the knee from 0° to 90° increased the knee circumference by 6.4%. The results from sectional analysis showed the asymmetry and the lateral shifting of the knee joint during bending. The findings offer guidelines for the design and optimization of knee braces to address knee deformations and individual body shape variations.

THE EFFECTIVENESS OF KNEE BRACES IN CEREBRAL PALSY PATIENTS: A CASE STUDY

This case study examines the effectiveness of knee braces in aiding people with cerebral palsy (CP) in standing. The study focuses on a young boy with CP who struggled with standing due to muscle weakness and stiffness. Custom knee braces were prescribed and fitted as part of the operation to provide external support and stability to the knee joints. The child's standing abilities were assessed before and after the braces were put on. Results showed that the child's standing ability and functional independence significantly improved after using knee braces. This improved knee joint stability and alignment allowed the child to engage more actively in everyday activities and social interactions, resulting in a more regulated and prolonged standing posture. The study underscores the importance of customized therapies and individualized evaluation for optimal functional results in CP patients. Keywords: Knee braces, cerebral palsy, spasticity, knee contracture, rehabilitation, neurodevelopment disorder, standing abilities.

Obturator to Femoral Nerve Transfer: 2-Dimensional Operative Video.

Injury to the femoral nerve can cause femoral nerve palsy,1 resulting in severe ambulation difficulties and loss of sensory function in the anteromedial thigh and medial calf.2,3 Treatment options focus on nerve repair by direct coaptation, nerve grafting, or nerve transfer.3 If the proximal nerve stump is inaccessible, the location of nerve injury is at a distance from the site of muscle innervation, and/or there is a large nerve gap, nerve transfer may be a promising alternative treatment option.4-6 Nerve transfer uses only one coaptation site and allows for a faster recovery time due to a shorter nerve regeneration distance.2,3 A 32-year-old woman presented with persistent and severe proximal right lower extremity weakness after a right retroperitoneal femoral nerve schwannoma resection at an outside institution. After surgery, she reported that she could not flex her right hip or extend her right knee. MRI demonstrated a right femoral nerve gap defect (7.5 cm) at the schwannoma resection site. A right obturator to femoral nerve transfer was performed (see Video). 1.5-year follow-up visit showed that she had begun to have evidence of active recruitment of the right quadriceps muscle and started walking without a knee brace. 2.5-year follow-up visit showed improving strength (4-) in her right quadriceps muscle, independent walking for longer distances, and participation in sporting activities. The patient consented to the procedure, and the patients and any identifiable individuals consented to publication of his/her image. Institutional Review Board approval was not required for this single case observational surgical video.