Download PDF
Int J Sports Med 2012; 33(11): 934-939
DOI: 10.1055/s-0032-1304634
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Effect of Brace Design on Patients with ACL-Ruptures

G. Strutzenberger
1   Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
,
M. Braig
2   Department of Sport and Sportscience, Karlsruhe Institute of Technology (KIT), BioMotion Center, Karlsruhe, Germany
,
S. Sell
3   Klinik für Rheumaorthopädie, Sana Joint Center, Bad Wildbad, Germany
,
K. Boes
2   Department of Sport and Sportscience, Karlsruhe Institute of Technology (KIT), BioMotion Center, Karlsruhe, Germany
,
H. Schwameder
1   Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
› Author Affiliations
Further Information

Publication History



accepted after revision 26 January 2012

Publication Date:
15 June 2012 (online)

Also available at
    Permissions and Reprints

Abstract

Different designs of functional knee braces for ACL-injury rehabilitation exist. In addition to the mechanical stabilization provided by rigid shell braces, sleeve braces also address proprioceptive mechanisms, but little is known if this leads to benefits for ACL-deficient subjects. Therefore the aim of this study was to investigate the effect of 2 different functional brace designs (shell and sleeve brace) on functional achievements in ACL-deficient patients. 28 subjects with ACL-ruptured knees performed tests for knee joint laxity, joint position sense, static and dynamic balance and isometric and dynamic lower limb extension strength in non-braced, sleeve braced and shell braced condition. The results showed a significant decrease in knee joint laxity for sleeve (33%; p<0.001) and rigid shell bracing (14%, p=0.039). The sleeve brace revealed a significant increase in dynamic balance after perturbation (20%; p=0.024) and a significant increase in dynamic lower limb peak rate of force development (17%; p=0.015) compared to the non-braced condition. The effects might be caused by the flexible area of support and the incorporated mechanisms to address proprioceptive aspects. Braces might not be needed in simple daily life tasks, but could provide beneficial support in more dynamic settings when patients return to sporting activities after an ACL-injury.

Key words

ACL-deficiency - functional bracing - proprioception - rehabilitation
 

  • References

  • 1 Andersson D, Samuelsson K, Karlsson J. Treatment of anterior cruciate ligament injuries with special reference to surgical technique and rehabilitation: An assessment of randomized controlled trials. Arthroscopy 2009; 25: 653-685
    CrossrefPubMedGoogle Scholar
  • 2 Baltaci G, Aktas G, Camci E, Oksuz S, Yildiz S, Kalaycioglu T. The effect of prophylactic knee bracing on performance: balance, proprioception, coordination, and muscular power. Knee Surg Sports Traumatol Arthrosc 2011; 19: 1722-1728
    CrossrefPubMedGoogle Scholar
  • 3 Bencke J, Damsgaard R, Saekmose A, Jorgensen P, Jorgensen K, Klausen K. Anaerobic power and muscle strength characteristics of 11 years old elite and non-elite boys and girls from gymnastics, team handball, tennis and swimming. Scand J Med Sci Sports 2002; 12: 171-178
    CrossrefPubMedGoogle Scholar
  • 4 Beynnon BD, Fleming BC, Churchill DL, Brown D. The effect of anterior cruciate ligament deficiency and functional bracing on translation of the tibia relative to the femur during nonweightbearing and weightbearing. Am J Sports Med 2003; 31: 99-105
    PubMedGoogle Scholar
  • 5 Beynnon BD, Good L, Risberg MA. The effect of bracing on proprioception of knees with anterior cruciate ligament injury. J Orthop Sports Phys Ther 2002; 32: 11-15
    PubMedGoogle Scholar
  • 6 Birmingham TB, Bryant DM, Giffin JR, Litchfield RB, Kramer JF, Donner A, Fowler PJ. A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction. Am J Sports Med 2008; 36: 648-655
    CrossrefPubMedGoogle Scholar
  • 7 Bortz J. Statistik fuer Human- und Sozialwissenschaftler. 6 ed. Heidelberg: Springer; 2005
    Google Scholar
  • 8 Callaghan MJ, Selfe J, Bagley PJ, Oldham JA. The effects of patellar taping on knee joint proprioception. J Athl Train 2002; 37: 19-24
    PubMedGoogle Scholar
  • 9 Cohen J. Eta-squared and partial eta-squared in fixed factor anova designs. Educ Psychol Meas 1973; 33: 107-112
    CrossrefPubMedGoogle Scholar
  • 10 Cohen J. A power primer. Psychol Bull 1992; 112: 155-159
    CrossrefPubMedGoogle Scholar
  • 11 Cooper RL, Taylor NF, Feller JA. A randomised controlled trial of proprioceptive and balance training after surgical reconstruction of the anterior cruciate ligament. Res Sports Med 2005; 13: 217-230
    CrossrefPubMedGoogle Scholar
  • 12 Delince P, Ghafil D. Anterior cruciate ligament tears: conservative or surgical treatment? A critical review of the literature. Knee Surg Sports Traumatol Arthrosc 2012; 20: 48-61
    CrossrefPubMedGoogle Scholar
  • 13 DeVita P, Lassiter Jr T, Hortobagyi T, Torry M. Functional knee brace effects during walking in patients with anterior cruciate ligament reconstruction. Am J Sports Med 1998; 26: 778-784
    PubMedGoogle Scholar
  • 14 Eastlack ME, Axe MJ, Snyder-Mackler L. Laxity, instability, and functional outcome after ACL injury: copers versus noncopers. Med Sci Sports Exerc 1999; 31: 210-215
    PubMedGoogle Scholar
  • 15 Edin B. Cutaneous afferents provide information about knee joint movements in humans. J Physiol 2001; 531: 289-297
    CrossrefPubMedGoogle Scholar
  • 16 Friden T, Roberts D, Ageberg E, Walden M, Zatterstrom R. Review of knee proprioception and the relation to extremity function after an anterior cruciate ligament rupture. J Orthop Sports Phys Ther 2001; 31: 567-576
    PubMedGoogle Scholar
  • 17 Gruber M, Bruhn S, Gollhofer A. Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training. Int J Sports Med 2006; 27: 636-641
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Huber FE, Irrgang JJ, Harner C, Lephart S. Intratester and intertester reliability of the KT-1000 arthrometer in the assessment of posterior laxity of the knee. Am J Sports Med 1997; 25: 479-485
    CrossrefPubMedGoogle Scholar
  • 20 Jerosch J, Prymka M. Knee joint proprioception in normal volunteers and patients with anterior cruciate ligament tears, taking special account of the effect of a knee bandage. Arch Orthop Trauma Surg 1996; 115: 162-166
    CrossrefPubMedGoogle Scholar
  • 21 Liu-Ambrose T, Taunton JE, MacIntyre D, McConkey P, Khan KM. The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee: a randomized clinical trial. Scand J Med Sci Sports 2003; 13: 115-123
    CrossrefPubMedGoogle Scholar
  • 22 Luber M, Binder E, Schaff P. Stabilisierungseigenschaften von Hartrahmenorthesen und Bandagen mit Gelenkschienen gegen vordere Schublade - Erste Ergebnisse. Orthopaedie-Technik 1998; 5: 350-354
    PubMedGoogle Scholar
  • 23 Mayr HO, Hochrein A, Hein W, Hube R, Bernstein A. Rehabilitation results following anterior cruciate ligament reconstruction using a hard brace compared to a fluid-filled soft brace. Knee 2010; 17: 119-126
    CrossrefPubMedGoogle Scholar
  • 24 McDevitt ER, Taylor DC, Miller MD, Gerber JP, Ziemke G, Hinkin D, Uhorchak JM, Arciero RA, Pierre PS. Functional bracing after anterior cruciate ligament reconstruction: a prospective, randomized, multicenter study. Am J Sports Med 2004; 32: 1887-1892
    CrossrefPubMedGoogle Scholar
  • 25 Muller O, Gunther M, Krauss I, Horstmann T. Physical characterization of the therapeutic device Posturomed as a measuring device – presentation of a procedure to characterize balancing ability. Biomed Tech (Berl) 2004; 49: 56-60
    CrossrefPubMedGoogle Scholar
  • 26 Nemeth G, Lamontagne M, Tho KS, Eriksson E. Electromyographic activity in expert downhill skiers using functional knee braces after anterior cruciate ligament injuries. Am J Sports Med 1997; 25: 635-641
    CrossrefPubMedGoogle Scholar
  • 27 Paluska SA, McKeag DB. Knee braces: current evidence and clinical recommendations for their use. Am Fam Physician 2000; 61: 411-418 423-414
    PubMedGoogle Scholar
  • 28 Ramsey DK, Lamontagne M, Wretenberg PF, Valentin A, Engstrom B, Nemeth G. Assessment of functional knee bracing: an in vivo three-dimensional kinematic analysis of the anterior cruciate deficient knee. Clin Biomech (Bristol, Avon) 2001; 16: 61-70
    CrossrefPubMedGoogle Scholar
  • 29 Ramsey DK, Wretenberg PF, Lamontagne M, Nemeth G. Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Clin Biomech (Bristol, Avon) 2003; 18: 28-34
    CrossrefPubMedGoogle Scholar
  • 30 Renstrom PA, Konradsen L, Beynnon BD. Influence of knee and ankle support on proprioception and neuromuscular control. In: Lephart SM, Fu FH. (eds.). Proprioception and Neuromuscular Control in Joint Stability. Champaign, IL: Human Kinetics; 2000: 301-310
    Google Scholar
  • 31 Risberg MA, Holm I, Steen H, Eriksson J, Ekeland A. The effect of knee bracing after anterior cruciate ligament reconstruction. A prospective, randomized study with two years’ follow-up. Am J Sports Med 1999; 27: 76-83
    CrossrefPubMedGoogle Scholar
  • 32 Selfe J, Richards J, Thewlis D, Kilmurray S. The biomechanics of step descent under different treatment modalities used in patellofemoral pain. Gait Posture 2008; 27: 258-263
    CrossrefPubMedGoogle Scholar
  • 33 Selfe J, Thewlis D, Hill S, Whitaker J, Sutton C, Richards J. A clinical study of the biomechanics of step descent using different treatment modalities for patellofemoral pain. Gait Posture 2011; 34: 92-96
    CrossrefPubMedGoogle Scholar
  • 34 Senter C, Hame SL. Biomechanical analysis of tibial torque and knee flexion angle: implications for understanding knee injury. Sports Med 2006; 36: 635-641
    CrossrefPubMedGoogle Scholar
  • 35 Singer JC, Lamontagne M. The effect of functional knee brace design and hinge misalignment on lower limb joint mechanics. Clin Biomech (Bristol, Avon) 2008; 23: 52-59
    CrossrefPubMedGoogle Scholar
  • 36 Swirtun LR, Jansson A, Renstrom P. The effects of a functional knee brace during early treatment of patients with a nonoperated acute anterior cruciate ligament tear: a prospective randomized study. Clin J Sport Med 2005; 15: 299-304
    CrossrefPubMedGoogle Scholar
  • 37 Wojtys EM, Kothari SU, Huston LJ. Anterior cruciate ligament functional brace use in sports. Am J Sports Med 1996; 24: 539-546
    CrossrefPubMedGoogle Scholar
  • 38 Zatterstrom R, Friden T, Lindstrand A, Moritz U. The effect of physiotherapy on standing balance in chronic anterior cruciate ligament insufficiency. Am J Sports Med 1994; 22: 531-536
    CrossrefPubMedGoogle Scholar
  • 39 Zatterstrom R, Friden T, Lindstrand A, Moritz U. Rehabilitation following acute anterior cruciate ligament injuries – a 12-month follow-up of a randomized clinical trial. Scand J Med Sci Sports 2000; 10: 156-163
    CrossrefPubMedGoogle Scholar