Document Title: Wu-AJSM-Sep01

Article Title: Effects of Knee Bracing on the Sensorimotor Function of Subjects with Anterior Cruciate Ligament Reconstruction

Authors: Gloria K.H. Wu, MPhil, PT, Gabriel Y.F. Ng, PhD, PT, and Arthur F.T. Mak, PhD

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: January/February 1999
(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 29

Issue: 5

Pages: 641-645

Key Words: Knee, brace, anterior cruciate, ACL ligament, anterior-drawer counteraction.

This thought-provoking study found, for people at five months post-ACL-reconstruction and under isokinetic testing, that knee bracing can improve the static proprioception of the knee joint. However, there is no enhancement of the contractile function of the musculature. Also noteworthy: the fact that a similar proprioceptive effect was noted (by the subjects in the testing) irrespective of whether a placebo (fake) or genuine brace was worn is evidence that the proprioception enhancement (or surrogate proprioception) can be obtained by almost anything worn on the knee -- that is, anything from a high-end custom-made functional brace to a simple neoprene sleeve. (Of course, a simple neoprene sleeve would not provide any protection against sideways forcing nor against injurious hyperextension.)

ABSTRACT

The sensorimotor performance of the knee joint in 31 subjects who had undergone unilateral anterior cruciate ligament reconstruction at least 5 months previously was tested under three bracing conditions, 1) the DonJoy Legend brace, 2) a mechanical placebo brace, and 3) no brace, in random order. The accuracy of the subjects’ ability to reproduce specified knee joint angles was tested as well as the isokinetic performance of their knee muscles at 60 and 180 deg/sec. The results showed that subjects with the brace or placebo brace performed similarly in reproducing the knee joint positions, but both groups performed better than the subjects without a brace. Isokinetic tests revealed no difference among the three groups in extensor and flexor peak torque production at 60 deg/sec or total work done by the extensors and flexors at 60 and 180 deg/sec. These results suggest that knee bracing can improve the static proprioception of the knee joint, but not the muscle contractile function, in subjects with anterior cruciate ligament reconstruction under isokinetic testing conditions. The finding of similar performances for joint angle reproduction in the brace and placebo brace groups suggests that the apparent improvement in proprioception with knee bracing was not due to the mechanical restraining action of the brace.

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