Document Title: DeVita-JB-Sep96.shtml
Article Title: A Functional Knee Brace Alters Joint Torque and Power Patterns During Walking and Running
Authors: Paul DeVita, Michael Torry, Kathryn L. Glover and David L. Speroni
Publication: Journal of Biomechanics, Pergamon Press, Elsevier Science.
Date: September 1996
Volume 29, Number 5, pages 583-588
Keywords: ACL injury, functional knee brace, gait, ambulation, walking pattern, running, joint torque, power patterns, proprioceptive, feedback, servo-control.

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Comments: This fascinating study (followed up by DeVita's 1998 AJSM study, also available here in the Knee Library) shows that functional knee braces do have some neuromuscular effects. DeVita notes that ACL deficiency causes substantial changes in muscle-activation patterns. Healthy (free of knee-injury histories) individuals were observed while walking with and without functional braces; the presence of bracing resulted in greater hip and ankle extensor torques, thus resulting in more work being done at the hip and less at the knee -- the same general pattern which arises as a consequence of ACL tearing. However, during running, the wearing of a brace did not result in decreased knee power.

ABSTRACT

Individuals with anterior cruciate ligament (ACL) injury use greater extensor torques at the hip and ankle and lower extensor torques and joint power at the knee during gait compared to healthy subjects. These adaptations may be mediated by (1) altered neuromuscular strategies due to the injury, (2) training effects produced by rehabilitation protocols, and (3) training effects due to the functional knee brace (FKB) used during rehabilitation. The purpose of the study was to test the hypothesis that a FKB can cause individuals to walk and run with the torque and power patterns observed in rehabilitated ACL-injured individuals. Ten healthy subjects were tested walking and running with and without a FKB. Kinematic and ground reaction data were collected and combined with inverse dynamics to estimate the joint torques and powers. Data were analyzed with a two-way repeated measures ANOVA (gait vs knee condition). In walking, the hip and ankle extensor torques were 14.3% (p <0.038) and 5.1% (p <0.003) greater with FKB. In running, the hip extensor torque was 17.0% greater with FKB (p <0.023). Knee torque was not different between conditions. In walking, the work performed at the hip and knee were 11.6% greater (p <0.013) and 17.7% lower with FKB (p <0.025), respectively. Results supported the hypothesis and it was concluded that a FKB may be one causative factor in the development of the unique joint torque and power patterns seen in ACL-injured gait.

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