Advertisement

Effect of a functional knee brace on knee flexion and extension strength after anterior cruciate ligament reconstruction

      Abstract

      Birmingham TB, Kramer JF, Kirkley A. Effect of a functional knee brace on knee flexion and extension strength after anterior cruciate ligament reconstruction. Arch Phys Med Rehabil 2002;83:1472-5. Objectives: To investigate the effect of a knee brace on knee flexion and extension muscular strength of patients after anterior cruciate ligament (ACL) reconstruction and to evaluate whether the effect of the brace depends on patient symptoms and muscular strength. Design: Repeated measures. Setting: A university-based outpatient orthopedic clinic and musculoskeletal assessment laboratory. Participants: Twenty-seven patients (14 women, 13 men; mean age, 28±11y) having undergone arthroscopically assisted ACL reconstruction by using a semitendinosus and gracilis autograft. Intervention: A custom-fit ACL functional knee brace. Main Outcome Measures: The brace effect was calculated as the change in peak torque observed with the brace, expressed as a percentage of peak torque observed without the brace, during isokinetic concentric knee flexion and extension movements performed at 90°/s. Patient symptoms were quantified by using a disease-specific health-related quality of life questionnaire. Results: Knee flexion strength decreased significantly with the brace (mean brace effect=−7.3%, P<.05). The brace effect during knee flexion varied considerably (−52% to 47%) and was significantly related to peak torque observed without the brace (r=−.50, P<.01). All other comparisons and correlations were not significant. Conclusions: These findings suggest that brace effects depend on patient strength. A brace may inhibit knee flexion strength of stronger patients, yet result in no change or even improvements in strength of weaker patients. Future research is required to further elucidate which patients may derive most benefit or detriment from bracing. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Decoster LC
        • Vailas JC
        • Swartz WG.
        Functional ACL bracing a survey of current opinion and practice.
        Am J Orthop. 1995; 24: 838-843
        • Solomonow M.
        Knee bracing after ACL reconstruction.
        Arch Phys Med Rehabil. 2001; 82: 709-710
        • Wojtys EM
        • Kothari S
        • Huston LJ.
        Anterior cruciate ligament functional brace use in sports.
        Am J Sports Med. 1996; 24: 539-546
        • Wu GK
        • Ng GY
        • Mak AF.
        Effects of knee bracing on the functional performance of patients with anterior cruciate ligament reconstruction.
        Arch Phys Med Rehabil. 2001; 82: 282-285
        • Albright JP
        • Saterbak A
        • Stokes J.
        Use of knee braces in sports.
        Sports Med. 1995; 20: 281-301
        • Kramer J
        • Dubowitz T
        • Fowler P
        • Schachter C
        • Birmingham T.
        Functional knee braces and dynamic performance: a review.
        Clin J Sports Med. 1997; 7: 32-39
        • Styf J.
        The effects of functional knee bracing on muscle function and performance.
        Sports Med. 1999; 28: 77-81
        • Houston ME
        • Goemans PH.
        Leg muscle performance of athletes with and without knee support braces.
        Arch Phys Med Rehabil. 1982; 63: 32-39
        • Sforzo GA
        • Chen NM
        • Gold CA
        • Frye PA.
        The effect of prophylactic knee bracing on performance.
        Med Sci Sports Exerc. 1989; 21: 254-257
        • Hiemstra LA
        • Webber S
        • MacDonald PB
        • Kriellaars DJ.
        Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction.
        Med Sci Sports Exerc. 2000; 32: 1472-1479
        • Kramer J
        • Nusca D
        • Fowler P
        • Webster-Bogaert S.
        Knee flexor and extensor strength during concentric and eccentric muscle actions after anterior cruciate ligaments reconstruction using the semitendinosus tendon and ligament augmentation device.
        Am J Sports Med. 1993; 21: 285-291
        • Marder RA
        • Raskind JR
        • Carroll M.
        Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patellar tendon versus semitendinosus and gracilis tendons.
        Am J Sports Med. 1991; 19: 478-484
        • Walla DJ
        • Albright JP
        • McAuley E
        • Martin RK
        • Eldridge V
        • El-Khoury G.
        Hamstring control and the unstable anterior cruciate ligament-deficient knee.
        Am J Sports Med. 1985; 13: 34-39
        • Arcierno SP
        • D'Ambrosia C
        • Solomonow M
        • Baratta RV
        • D'Ambrosia R.
        Electromyography and biomechanics of a dynamic knee brace for anterior cruciate ligament deficiency.
        Orthopedics. 1995; 18: 1101-1107
        • Shelbourne KD
        • Nitz P.
        Accelerated rehabilitation after anterior cruciate ligament reconstruction.
        Am J Sports Med. 1990; 18: 292-299
        • Wojtys EM.
        The ACL deficient knee.
        in: Am Acad Orthop Surg, Rosemont (IL)1994: 110-116
        • Mohtadi NG.
        Quality of life assessment as an outcome in anterior cruciate ligament reconstructive surgery.
        in: The anterior cruciate ligament: current and future concepts. Raven Pr, New York1993: 439-444
        • Mohtadi NG.
        Validation of the quality of life outcome measure (questionnaire) for chronic anterior cruciate ligament deficiency.
        Am J Sports Med. 1998; 26: 350-359
        • Veldhuizen JW
        • Koene FM
        • Oostvogel HJ
        • von Thiel TP
        • Verstappen FT.
        The effects of a supportive knee brace on leg performance in healthy subjects.
        Int J Sports Med. 1991; 12: 577-580
        • Fleming BC
        • Renstrom PA
        • Beynnon BD
        • Engstrom B
        • Peura G.
        The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees.
        Am J Sports Med. 2000; 28: 815-824
        • Birmingham TB
        • Kramer JF
        • Kirkley A
        • Inglis JT
        • Spaulding SJ
        • Vandervoort AA.
        Knee bracing following ACL reconstruction: effects on postural control and proprioception.
        Med Sci Sports Exerc. 2001; 33: 1253-1258