Influence of Functional Bracing on the Kinetics of Anterior Cruciate Ligament-Injured Knees during Level Walking

BACKGROUND: Use of functional knee braces has been suggested to provide protection and to improve kinetic performance of the knee in anterior cruciate ligament-injured patients. However, the efficacy of knee bracing in achieving these goals is still controversial. The purpose of this study was to examine the immediate effects of functional bracing on the three- dimensional kinetics of the knee in individuals with anterior cruciate ligament injuries during level walking. METHODS: Fifteen anterior cruciate ligament- deficient and 15 anterior cruciate ligament-reconstructed subjects were each fitted with a DonJoy Goldpoint brace and walked at a self-selected pace, first without and then with the brace. Kinematic and kinetic data were measured and three-dimensional joint moments and angular impulses at the knee were calculated and compared between bracing conditions and between limbs. FINDINGS: Functional knee bracing did not significantly affect the kinetics of the unaffected knees for either group . Bracing significantly increased the peak abductor moments in anterior cruciate ligament- deficient knees and reduced the bilateral kinetic asymmetry in the coronal plane. For the anterior cruciate ligament- reconstructed group, bracing increased peak moments and impulses of the abductors and extensors. It also reduced bilateral kinetic asymmetry in the sagittal and coronal planes. INTERPRETATION: Effects of the knee brace were apparent in the coronal plane for both anterior cruciate ligament- deficient and anterior cruciate ligament- reconstructed patients, and in the sagittal plane for anterior cruciate ligament-reconstructed patients. Functional bracing can be recommended for anterior cruciate ligament- reconstructed patients to assist in achieving better bilateral kinetic symmetry during gait. For anterior cruciate ligament-deficient patients, apart from bracing, additional emphasis on the rehabilitative training for better kinetic knee performance in the sagittal plane is needed