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Summary of the answers to Functional Knee Bracing after completeACL tearing

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  • Summary of the answers to Functional Knee Bracing after completeACL tearing

    Hello dear all,

    Thank you for your interest in this topic. I`m
    summarizing the answers I got on the topic of
    "Functional Knee Bracing after complete ACL tearing"

    My questions were:

    1)Is there any empirical support to show the effects
    > of Functional Knee Brace on proprioceptive or motor
    > control strategy in people with torn ACL? Any
    > literature available?
    > 2)What are the effects of Functional Knee Brace on
    > balance and posture of these patients?
    > 3) The instrument we want to use is the Biodex
    > system, is there any other instrument suitable for
    > this reason? or any valid questionnaire?


    Anne Benjaminse, PT

    1: Harilainen A, Sandelin J.
    Post-operative use of knee brace in bone-tendon-bone
    patellar tendon anterior cruciate ligament
    reconstruction: 5-year follow-up results of a
    randomized prospective study.Scand J Med Sci Sports.
    2006 Feb;16(1):14-8. PMID: 16430676 [PubMed - in

    2: 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
    Sep;15(5):299-304. PMID: 16162987 [PubMed - indexed
    for MEDLINE]

    3: Smith J, Malanga GA, Yu B, An KN.
    Effects of functional knee bracing on muscle-firing
    patterns about the chronic anterior cruciate
    ligament-deficient knee.Arch Phys Med Rehabil. 2003
    Nov;84(11):1680-6.PMID: 14639570 [PubMed - indexed for

    4: Mallory N, Kelsberg G, Ketchell D, Lord JL.
    Clinical inquiries. Does a knee brace decrease
    recurrent ACL injuries? J Fam Pract. 2003
    Oct;52(10):803-4. Review. No abstract available.
    PMID: 14529607 [PubMed - indexed for MEDLINE]

    5: Melegati G, Tornese D, Bandi M, Volpi P,
    Schonhuber H, Denti M.The role of the rehabilitation
    brace in restoring knee extension after anterior
    cruciate ligament reconstruction: a prospective
    controlled study.Knee Surg Sports Traumatol Arthrosc.
    2003 Sep;11(5):322-6. Epub 2003 Jul 16.
    PMID: 12879225 [PubMed - indexed for MEDLINE]

    6: Decoster LC, Vailas JC.
    Functional anterior cruciate ligament bracing: a
    survey of current brace prescription patterns.
    Orthopedics. 2003 Jul;26(7):701-6; discussion 706.
    PMID: 12875565 [PubMed - indexed for MEDLINE]

    7: Kocher MS, Sterett WI, Briggs KK, Zurakowski D,
    Steadman JR. Effect of functional bracing on
    subsequent knee injury in ACL-deficient professional
    skiers.J Knee Surg. 2003 Apr;16(2):87-92.
    PMID: 12741421 [PubMed - indexed for MEDLINE]

    8: Lam RY, Ng GY, Chien EP. Does wearing a functional
    knee brace affect hamstring reflex time in
    subjects with anterior cruciate ligament deficiency
    during muscle fatigue? Arch Phys Med Rehabil. 2002
    Jul;83(7):1009-12. PMID: 12098163 [PubMed - indexed
    for MEDLINE]

    9: 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 Jan;32(1):11-5.
    PMID: 11787904 [PubMed - indexed for MEDLINE]

    10: Rebel M, Paessler HH.
    The effect of knee brace on coordination and neuronal
    leg muscle control: an early postoperative functional
    study in anterior cruciate ligament
    reconstructed patients.
    Knee Surg Sports Traumatol Arthrosc. 2001
    PMID: 11685358 [PubMed - indexed for MEDLINE]

    11: Birmingham TB, Kramer JF, Kirkley A, Inglis JT,
    Spaulding SJ, Vandervoort AA.
    Knee bracing after ACL reconstruction: effects on
    postural control and proprioception.
    Med Sci Sports Exerc. 2001 Aug;33(8):1253-8.
    PMID: 11474323 [PubMed - indexed for MEDLINE]

    12: Rebel M, Passler HH.
    [Effects of knee braces on sensorimotor capabilities
    of patients with ACL reconstruction]
    Sportverletz Sportschaden. 2001 Mar;15(1):16-21.
    PMID: 11338659 [PubMed - indexed for MEDLINE]

    13: Wu GK, Ng GY, Mak AF.
    Effects of knee bracing on the functional performance
    of patients with anterior cruciate ligament
    Arch Phys Med Rehabil. 2001 Feb;82(2):282-5.
    PMID: 11239327 [PubMed - indexed for MEDLINE]

    14: Risberg MA, Beynnon BD, Peura GD, Uh BS.
    Proprioception after anterior cruciate ligament
    reconstruction with and without bracing.
    Knee Surg Sports Traumatol Arthrosc. 1999;7(5):303-9.
    PMID: 10525700 [PubMed - indexed for MEDLINE]

    15: Martinek V, Friederich NF.
    [To brace or not to brace? How effective are knee
    braces in rehabilitation?]
    Orthopade. 1999 Jun;28(6):565-70. Review. German.
    PMID: 10431312 [PubMed - indexed for MEDLINE]

    16: 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 Jan;18(1):28-34.
    PMID: 12527244 [PubMed - indexed for MEDLINE]

    17: Acierno SP, D'Ambrosia C, Solomonow M, Baratta
    RV, D'Ambrosia RD. Electromyography and biomechanics
    of a dynamic knee brace for anterior cruciate
    ligament deficiency.
    Orthopedics. 1995 Nov;18(11):1101-7. Review.
    PMID: 8559695 [PubMed - indexed for MEDLINE]

    18: Branch TP, Hunter R, Donath M.
    Dynamic EMG analysis of anterior cruciate deficient
    legs with and without bracing during cutting.
    Am J Sports Med. 1989 Jan-Feb;17(1):35-41.
    PMID: 2929835 [PubMed - indexed for MEDLINE]

    19: 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 Jan-Feb;31(1):99-105.
    PMID: 12531765 [PubMed - indexed for MEDLINE]

    20: Wojtys EM, Kothari SU, Huston LJ.
    Anterior cruciate ligament functional brace use in
    Am J Sports Med. 1996 Jul-Aug;24(4):539-46.
    PMID: 8827316 [PubMed - indexed for MEDLINE]

    21: 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 Jan;16(1):61-70.
    PMID: 11114445 [PubMed - indexed for MEDLINE]

    22: Beynnon BD, Ryder SH, Konradsen L, Johnson RJ,
    Johnson K, Renstrom PA.
    The effect of anterior cruciate ligament trauma and
    bracing on knee proprioception.
    Am J Sports Med. 1999 Mar-Apr;27(2):150-5.
    PMID: 10102093 [PubMed - indexed for MEDLINE]

    23: McDevitt ER, Taylor DC, Miller MD, Gerber JP,
    Ziemke G, Hinkin D, Uhorchak JM, Arciero RA, Pierre
    Functional bracing after anterior cruciate ligament
    reconstruction: a prospective, randomized, multicenter
    Am J Sports Med. 2004 Dec;32(8):1887-92.
    PMID: 15572317 [PubMed - indexed for MEDLINE]

    24: Lu TW, Lin HC, Hsu HC.
    Influence of functional bracing on the kinetics of
    anterior cruciate ligament-injured knees during level
    Clin Biomech (Bristol, Avon). 2006 Feb 20; [Epub ahead
    of print]
    PMID: 16494979 [PubMed - as supplied by publisher]

    25: Bagger J, Ravn J, Lavard P, Blyme P, Sorensen C.
    Effect of functional bracing, quadriceps and
    hamstrings on anterior tibial translation in anterior
    cruciate ligament insufficiency: a preliminary
    J Rehabil Res Dev. 1992 Winter;29(1):9-12.
    PMID: 1740779 [PubMed - indexed for MEDLINE]
    Associate Professor and Director of Research
    Orthopedics and Rehabilitation
    College of Medicine, University of Vermont

    Yes, there are several publications that have focused
    on the effect of the functional knee braces on
    proprioception and motor control strategies (I have
    published some of this, and a medline search on my
    name will reveal this work). There has also been
    research on the effect of braces on postural control;
    however, I am not sure how to interpret this outcome.
    In the past, I have used the Biodex Balance system,
    but I have found that this device is has not been
    validated and it is unclear what it actually measures
    (I went back and forth with this company for
    some time and finally returned the system to them)...
    You could measure postural sway with a force
    platform, but as I mentioned I am not sure how useful
    this outcome is.

    Katherine S. Rudolph from Department of Physical
    Therapy, University of Delaware has also conducted
    some reseach studies as follow:

    Schmitt, L.C. , Schmitt, L.A., Rudolph, K.S.
    Management of Patient with a Forearm Fracture and
    Median Nerve Injury. J Orthop Sport Phys Ther. 2004

    Lewek, M., Rudolph, K.S., Snyder-Mackler, L.
    Quadriceps Femoris Muscle Weakness and Activation
    Failure in Patients With Symptomatic Knee
    Osteoarthritis. Journal of Orthopaedic Research.
    2004 Jan;22(1):110-5.

    Chmielewski, T.L., Rudolph K.S., Snyder-Mackler, L.
    Development of Dynamic Knee Stability after Acute ACL
    Injury. J Electromyogr Kinesiol. 2002

    Lewek, M., Rudolph, K.S., Axe, M.J., Snyder-Mackler,
    L. The effect of insufficent quad strength on giat
    after anterior cruciate ligament reconstruction. Clin
    Biomech 2002 Jan, 17(1):56-63.

    Williams, G.N., Chmielewski, T.L., Rudolph, K.S.,
    Buchanan, T.S., Snyder-Mackler, L. Dynamic knee
    stability: Current theory and implications for
    clinicians and scientists. J Orthop Sports Phys Ther,
    2001 Oct;31(10):546-66).

    Chmielewski, T.L., Rudolph, K.S., Fitzgerald, G.K.,
    Axe, M.J., Snyder-Mackler, L. Biomechanical Evidence
    Supporting a Differential Response to Acute ACL
    Injury. Clinical Biomechanics. 2001

    Rudolph K.S., Axe, M.J., Buchanan, T.S., Scholz, J.P.,
    Snyder-Mackler, L. Dynamic Stability in the ACL
    deficient knee. Knee Surg Sports Traumatol Arthrosc.

    Rudolph K.S., Axe, M.J., Snyder-Mackler, L. Dynamic
    Stability in the ACL deficient knee: Who can hop?
    Knee Surg Sports Traumatol Arthrosc. 2000;8(5):262-9

    Rudolph, K.S.; Eastlack, M.E.; Axe, M.J.;
    Snyder-Mackler, L. 1998 Basmajian Student Award Paper:
    Movement patterns after anterior cruciate ligament
    injury: a comparison of patients who compensate well
    for the injury and those who require operative
    stabilization. J Electromyogr Kinesiol, 8(6):
    349-362, 1998.

    Kind Regards,

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