The effect of functional bracing on the arthrokinematics of anterior cruciate ligament injured knees during lunge exercise

Jalali, M ; Sharif University of Technology | 2018

1383 Viewed
  1. Type of Document: Article
  2. DOI: 10.1016/j.gaitpost.2018.04.022
  3. Publisher: Elsevier B.V , 2018
  4. Abstract:
  5. Background: Functional knee braces are extensively used for partially and completely torn anterior cruciate ligament (ACL) patients and those who have undergone ACL graft reconstruction, in order to support the healing ACL, improve the joint's functional stability, and restore the normal joint kinematics. Research question: Does wearing braces alter the arthrokinematics of the ACL deficient knees during lung exercise? Methods: For ten male unilateral ACL deficient subjects, 3D knee models were reconstructed from CT images, acquired in rest position. Sagittal plane fluoroscopy was then performed throughout a complete cycle of lunge in braced and non-braced conditions. The 3D kinematics of the knees were obtained using a 2D-3D registration method in which six anatomical bony landmarks on the fluoroscopic images were matched with those on the 3D models. Results: No significant difference was found between the tibial anterior-posterior translations and abduction-adduction motions of the braced and non-braced knees. A significant decrease, however, was observed after bracing in the tibial internal rotation at 45° flexion during eccentric (non-braced: 5.9° (±6.7°) vs. braced: 2.4° (±7.0°); p = 0.045), and at 30° flexion during concentric (non-braced: 2.3° (±6.9°) vs. braced: −1.6° (±8.1°); p = 0.001) phases of the lunge cycle. Significance: The immediate effect of knee bracing is limited to controlling the tibial rotation of the ACL deficient individuals during the lunge exercise. Hence, care should be taken in prescribing the lunge exercise for rehabilitation of ACL injured patients with high anterior-posterior knee instability, even when wearing knee braces. © 2018 Elsevier B.V
  6. Keywords:
  7. ACL injury ; Closed chain exercise ; Functional knee brace ; Kinematic ; Knee joint ; Lunge ; Adduction ; Adult ; Anatomic landmark ; Anterior cruciate ligament injury ; Arthrokinematics ; Article ; Clinical article ; Fluoroscopy ; Human ; Joint function ; Joint mobility ; Kinematics ; Knee instability ; Lunge exercise ; Male ; Priority journal ; Range of motion ; Rest ; Three dimensional imaging ; X-ray computed tomography ; Anterior cruciate ligament reconstruction ; Biomechanics ; Brace ; Computer assisted diagnosis ; Joint characteristics and functions ; Knee ; Middle aged ; Pathophysiology ; Physiology ; Postoperative care ; Young adult ; Anterior cruciate ligament ; Anterior cruciate ligament injuries ; Anterior cruciate ligament reconstruction ; Biomechanical phenomena ; Braces ; Exercise ; Female ; Humans ; Image interpretation, computer-assisted ; Joint instability ; Middle aged ; Postoperative care ; Range of motion, articular ; Tomography, X-ray computed ; Young adult
  8. Source: Gait and Posture ; Volume 63 , 2018 , Pages 52-57 ; 09666362 (ISSN)
  9. URL: https://www.sciencedirect.com/science/article/abs/pii/S0966636218304053?via%3Dihub