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Changes in landing mechanics in patients following anterior cruciate ligament reconstruction when wearing an extension constraint knee brace.

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Date
2014-05
Authors
Butler, Robert J
Dai, Boyi
Garrett, William E
Queen, Robin M
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Abstract
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is associated with a high incidence of second tears (graft tears and contralateral ACL tears). These secondary tears have been attributed to asymmetrical lower extremity mechanics. Knee bracing is one potential intervention that can be used during rehabilitation that has the potential to normalize lower extremity asymmetry; however, little is known about the effect of bracing on movement asymmetry in patients following ACL reconstruction. HYPOTHESIS: Wearing a knee brace would increase knee joint flexion and joint symmetry. It was also expected that the joint mechanics would become more symmetrical in the braced condition. OBJECTIVE: To examine how knee bracing affects knee joint function and symmetry over the course of rehabilitation in patients 6 months following ACL reconstruction. STUDY DESIGN: Controlled laboratory study. LEVEL OF EVIDENCE: Level 3. METHODS: Twenty-three adolescent patients rehabilitating from ACL reconstruction surgery were recruited for the study. The subjects all underwent a motion analysis assessment during a stop-jump activity with and without a functional knee brace on the surgical side that resisted extension for 6 months following the ACL reconstruction surgery. Statistical analysis utilized a 2 × 2 (limb × brace) analysis of variance with a significant alpha level of 0.05. RESULTS: Subjects had increased knee flexion on the surgical side when they were braced. The brace condition increased knee flexion velocity, decreased the initial knee flexion angle, and increased the ground reaction force and knee extension moment on both limbs. Side-to-side asymmetry was present across conditions for the vertical ground reaction force and knee extension moment. CONCLUSION: Wearing a knee brace appears to increase lower extremity compliance and promotes normalized loading on the surgical side. CLINICAL RELEVANCE: Knee extension constraint bracing in postoperative ACL patients may improve symmetry of lower extremity mechanics, which is potentially beneficial in progressing rehabilitation and reducing the incidence of second ACL tears.
Type
Journal article
Subject
biomechanics
function
jump
knee injury
Permalink
https://hdl.handle.net/10161/8891
Published Version (Please cite this version)
10.1177/1941738114524910
Publication Info
Butler, Robert J; Dai, Boyi; Garrett, William E; & Queen, Robin M (2014). Changes in landing mechanics in patients following anterior cruciate ligament reconstruction when wearing an extension constraint knee brace. Sports Health, 6(3). pp. 203-209. 10.1177/1941738114524910. Retrieved from https://hdl.handle.net/10161/8891.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Butler

Robert John Butler

Adjunct Associate Professor in the Department of Orthopaedic Surgery
Construction of standards for a functional testing continuum for ACL patients to optimize durability and performance.Development of field expedient tests to predict musculoskeletal injury. Predictors of the early presentation of knee osteoarthritis following a joint injury. 
Garrett

William Elwood Garrett Jr.

Professor of Orthopaedic Surgery
Muscle forces not only provide propulsion to the body, they also provide protection for the tremendous loads across muscles and joints. Understanding muscle actions joint interaction is key to improving our ability to prevent injury and scientifically rehabilitate ligaments and joints. The laboratory employees EMG analysis of muscle function, high speed motion analysis, force plate, and goniometric data as well as standard exercise physiologic measurements of strength, aerobic and anaerobic powe
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.

Robin Marie Queen

Assistant Professor of Orthopaedic Surgery
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Alphabetical list of authors with Scholars@Duke profiles.
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