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Document Title: Swirtun-CJSM-Sep05.shtml
Article Title: The Effects of a Functional Knee Brace During Early Treatment of Patients With a Nonoperated Acute Anterior Cruciate Ligament Tear: A Prospective Randomized Study
Authors: Swirtun, Linda R RPT; Jansson, Anna RPT, PhD; Renström, Per MD, PhD
Publication: Clinical Journal of Sports Medicine, Lippincott Williams & Wilkins Inc.
Date: September 2005
Volume 15(5), pages 299-304
Keywords: Sleeve-type knee bracing, functional knee bracing, nonsurgical ACL rehabilitation, nonoperative rehabilitation, prospective study; randomized controlled trial.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: This Scandinavian study shows that full-ACL-tearing (without reconstruction) patients benefit subjectively (i.e. knee feels more stable, which could imply a proprioceptive benefit) from the wearing of a strutted sleeve-type brace. However, no quantitative, objective benefits were noted. Keep in mind that the Bauerfeind SofTec Genu is an off-the-shelf elasticized-fabric sleeve with side struts, and thus is fundamentally different from a rigid hinged-shell-type functional knee brace. A sleeve-type device should not be counted on to provide the reliable protection against injurious hyperextension and sideways forcing that is expected of any well-designed functional knee brace. This study was funded by the German firm Bauerfeind.
Abstract
Objective: To evaluate the effect of a functional knee brace on nonoperated acute anterior cruciate ligament (ACL)-deficient patients.
Design: Prospective randomized clinical trial.
Setting: University clinic.
Patients: Ninety-five patients (18-50 years old) with an acute ACL tear were included in the present study. The subjects were randomized to either brace group, treated with functional bracing from the first testing session (<5 weeks postinjury) to 12 weeks postinjury or a control group, treated without bracing. The patients were followed for 6 months. Twenty-one subjects were excluded due to the following exclusion criteria: partial rupture or articular cartilage injury shown on MRI or with arthroscopy, or other injuries that negatively affected rehabilitation, or dropped out due to surgery (n = 22), or personal reasons (n = 10). Forty-two patients remained in the study, 22 in the brace group and 20 in the control group.
Outcome Measurements: Visual analogue scale, Knee Osteoarthritis Outcome Score, Cincinnati knee score, a brace evaluation form, and muscle peak torque.
Results: When using the brace the subjects in the brace group experienced less (P = 0.047) sense of instability, evaluated with visual analogue scale, than the control group. However, bracing had no effect on any of the variables in Knee Osteoarthritis Outcome Score or Cincinnati knee score and no effect on quadriceps or hamstring muscle peak torque. Subjectively, the brace group experienced a positive effect of the brace on rehabilitation.
Conclusions: Nonoperated acute ACL-deficient patients experienced a positive effect of the brace regarding sense of instability and rehabilitation. However, these findings were not supported by objective outcomes.
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