Functional knee brace effects after ACL repair

Journal/Book: Phys Rehab Kur Med 9 (1999) M45 / Rehab in Review Vol. 7 Nr. 1 1999.. 1999;

Abstract: DeVita P et al.: Functional Knee Brace Effects During Walking in Patients with Anterior Cruciate Ligament Reconstruction. Am. J. Sports Med. 1998; 26 (6): 778 - 784 Numerous studies have reported that loads on the anterior cruciate ligament (ACL) are directly related to the knee extensor moment. Other studies have described decreased quadriceps muscle activity with ACL deficiency. However these findings have been determined in fully rehabilitated patients. This study sought to evaluate gait parameters with and without a functional knee brace among patients recovering from recent ACL reconstruction. Seven patients (with a mean age of 20.5 years) who had undergone arthroscopically assisted bone-patellar tendon-bone ACL reconstruction were compared to 11 (mean age 21.0 years) uninjured controls. All patients participated in an accelerated rehabilitation program lasting a total of six months. Kinematic and kinetic gait analyses of each patient were performed with and without a knee brace three weeks after surgery. Three patients were tested with a C. Ti. Edge brace while the other four used the Omni Scientific OS-5 brace. Identical gait analyses were performed on controls walking without a brace. Comparisons were then made between patients with a brace and those without and between patients with a brace and controls. Wearing a functional knee brace after an ACL repair resulted in 19% less knee flexion during the stance phase of gait compared to not wearing a brace (p<0.015). Bracing also resulted in a hip extensor moment increase of 40% (p < 0.015) an ankle plantar flexor moment increase of 21 % (p < 0.015) and a knee extensor moment decrease of 41 % (p < 0.009). Compared to controls the braced knees were 37% (p < 0.011) more flexed and had a reduced extensor moment of 42% (p<0.002) resulting in 78 % less work (p < 0.000) at the knee. Conclusion: This gait analysis of seven patients with recent ACL reconstruction suggests that wearing a functional knee brace reduces the knee extensor moment while walking. This research further suggests that reduced quadriceps muscle force with the brace reduces the strain on the newly repaired ACL. ___MH

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