The Effect of Extension Constraint Knee Bracing on Dynamic Balance, Gait Mechanics, and Joint Alignment

Butler, Robert J.; Queen, Robin M.; Wilson, Becky; Stephenson, John M.; Barnes, C. Lowry

doi:10.1016/j.pmrj.2013.09.011

PM&R

2013

DOI: 10.1016/j.pmrj.2013.09.011

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The Effect of Extension Constraint Knee Bracing on Dynamic Balance, Gait Mechanics, and Joint Alignment

Robert J. Butler

Robin M. Queen

Becky Wilson³

et al.

Abstract: Extension constraint knee braces alter joint alignment, dynamic balance, knee mechanics during gait, and vertical loading during gait. However, the changes in motion observed were lower than those induced by the constraining mechanism.

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Cited by 4 publications

(1 citation statement)

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“…An increase in knowledge regarding the anatomy and function of the anterior cruciate ligament (ACL) has resulted in more anatomic reconstructions after injury. Additionally, current rehabilitation protocols return patients to range of motion, 13 weightbearing, 17 and strength-building exercises more quickly after reconstruction. 8,46 Thus, the ACL reconstruction graft is exposed to forces similar to anatomic loading of the native ACL in the early postoperative period, when the graft is still healing and undergoing remodeling.…”

mentioning

confidence: 99%

Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study

LaPrade

Venderley

Dahl

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:A need exists for a functional anterior cruciate ligament (ACL) brace that dynamically supports the knee joint to match the angle-dependent forces of a native ACL, especially in the early postoperative period.Purpose/Hypothesis:The purpose of this study was to quantify the posteriorly directed external forces applied to the anterior proximal tibia by both a static and a dynamic force ACL brace. The proximal strap forces applied by the static force brace were hypothesized to remain relatively constant regardless of knee flexion angle compared with those of the dynamic force brace.Study Design:Controlled laboratory study.Methods:Seven healthy adult males (mean age, 27.4 ± 3.4 years; mean height, 1.8 ± 0.1 m; mean body mass, 84.1 ± 11.3 kg) were fitted with both a static and a dynamic force ACL brace. Participants completed 3 functional activities: unloaded extension, sit-to-stand, and stair ascent. Kinematic data were collected using traditional motion-capture techniques while posteriorly directed forces applied to the anterior aspect of both the proximal and distal tibia were simultaneously collected using a customized pressure-mapping technique.Results:The mean posteriorly directed forces applied to the proximal tibia at 30° of flexion by the dynamic force brace during unloaded extension (80.2 N), sit-to-stand (57.5 N), and stair ascent (56.3 N) activities were significantly larger, regardless of force setting, than those applied by the static force brace (10.1 N, 9.5 N, and 11.9 N, respectively; P < .001).Conclusion:The dynamic force ACL brace, compared with the static force brace, applied significantly larger posteriorly directed forces to the anterior proximal tibia in extension, where the ACL is known to experience larger in vivo forces. Further studies are required to determine whether the physiological behavior of the brace will reduce anterior knee laxity and improve long-term patient outcomes.Clinical Relevance:ACL braces that dynamically restrain the proximal tibia in a manner similar to physiological ACL function may improve pre- and postoperative treatment.

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mentioning

confidence: 99%

Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study

LaPrade

Venderley

Dahl

et al. 2017

Orthopaedic Journal of Sports Medicine

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Walking with an induced unilateral knee extension restriction affects lower but not upper body biomechanics in healthy adults

et al. 2018

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Medición del aumento del consumo de energía en las deformidades progresivas de flexión de la rodilla en la marcha

Pardo

Galvis

Naranjo

et al. 2016

Revista Colombiana de Ortopedia y Traumatología

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The Effect of Extension Constraint Knee Bracing on Dynamic Balance, Gait Mechanics, and Joint Alignment

Abstract: Extension constraint knee braces alter joint alignment, dynamic balance, knee mechanics during gait, and vertical loading during gait. However, the changes in motion observed were lower than those induced by the constraining mechanism.

Cited by 4 publications

References 25 publications

Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study

Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study

Walking with an induced unilateral knee extension restriction affects lower but not upper body biomechanics in healthy adults

Medición del aumento del consumo de energía en las deformidades progresivas de flexión de la rodilla en la marcha

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