Effect of three prophylactic knee braces on knee flexion angle and external knee adduction moment in three types of single -leg landing tasks

Document Type : Research Paper

Authors

1 Doctor of Sport Biomechanics, Department of Physical Education, Islamic Azad University, Chalous Branch, Chalus, Iran

2 Associate Professor of Sport Biomechanics, Faculty of Sport Sciences, Mazandaran University, Babolsar, Iran.

3 Associate Professor of Physiotherapy, Movement Disorders Research Center, Babol University of Medical Sciences, Babol, Iran

Abstract

Background and aim: Effect of the knee brace stiffness on lower limb mechanics, which may protect anterior cruciate ligament, under different landing tasks remains still unknown. The purpose of this study was to determine the effect of three prophylactic knee braces on the knee flexion angle and external adduction moment under three types of single-leg landing conditions.
Materials and Methods: Fifteen men performed single-leg landing under three different landing foot orientation tasks (30° toe-out, 30° toe-in and neutral conditions) for three different types of brace stiffness (rigid, semi rigid and simple one). A non- braced condition was included as a baseline measure. kinematic data were captured using a six video-camera motion capture system synchronized with a force platform.
Results: No significant interaction effects of brace stiffness and the landing tasks on flexion angle (P = 0.059) and external knee adduction moment (P = 0.103) were observed. Stiffer braces (rigid and simi rigid) could increase knee flexion angle by 20% as compared to non-braced condition. Furthermore, external knee moment was significantly increased during landing with foot 30° toe-out orientation as compared to the neutral condition (P <0.001).
Conclusion: finding showed that effect of the braces on the variables is independent of landing foot orientations. Stiffer braces could increase knee flexion during landing while toe-out landing may increase external knee moment leading to higher risk of ACL injury.

Keywords

References

Barrios, J. A., Crossley, K. M., & Davis, I. S. (2010). "Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment". Journal of Biomechanics, 43(11): 2208–2213.
Beynnon, B., Pope MH, Wertheimer, CM.(1992). "The effect of functional knee-braces on strain on the anterior cruciate ligament in vivo". J Bone Joint Surg Am; 74(9): 1298–1312.
Boden, BP., Joseph, S., Sarah, B. (2009). "Video analysis of anterior cruciate ligament injury abnormalities in hip and ankle kinematics". Am J Sports Med 37(2): 252–259.
Bradley, JP., Klimkiewicz, JJ., Rytel, MJ., Powell, JW.(2002). "Anterior cruciate ligament injuries in the National Football League. Arthroscopy": The Journal of Arthroscopic & Related Surgery; 18(5): 502-9.
Chang, A., Hochberg, M., Song, J., Dunlop, D., Chmiel, J. S., Nevitt, M., Sharma, L. (2010). "Frequency of varus and valgus thrust and factors associated with thrust presence in persons with or at higher risk of developing knee osteoarthritis". Arthritis & Rheumatism, 62(5): 1403–1411.
Dimitrios, G., Franceska, Z., Evangelos, P., Grigoris, M., Pericles, P., and Anastasios, D. (2013). "Effects of Knee Bracing on Tibial Rotation During High Loading Activities in Anterior Cruciate Ligament Reconstructed Knees", at: http://dx.doi.org/10.1016/j.arthro.2013.07.258.
Ewing, A., Rezaul, K ., Mary, P.,  Peter, V. (2016). "Effects of Prophylactic Knee Bracing on Lower Limb Kinematics, Kinetics, and Energetics During Double-Leg Drop Landing at 2 Heights", The American Journal of Sports Medicine,. 44(7): 1753-61.
Gandomkar, A., Eslami, M., Hosseini nejad, S E., Khezri, D., Jahedi, V. (2014). [Can unstable shoe be used as a safety training, shoe for rehabilitation exercises?]. Rehabilitation; 15(1): 1029-1037. (In Persian)
Goodwin-Gerberich SG, Luhmann S, Finke C, Priest JD, Beard BJ. (1982). "Analysis of severe injuries associated with volleyball activities". Physician Sportsmed, 15(8): 75–79.
Gray,J.,Taunton, J.E., McKenzie, D.C., Clement, D.B., McKonkey, J.P.,  Davidson,R.G. (1985). "A survey of  injuries to  the  anterior cruciate ligament of   knee in female basketball players". Int J Sports Med. 6: 314-316.
Griffin, LY., Albohm, MJ., Arendt, EA., Bahr, R., Beynnon, BD., DeMaio, M, et al. (2006). "Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries". A Review of the Hunt Valley II Meeting, January. The American Journal of Sports Medicine, 34(9): 1512-32.
Hanzlíková, J. Richards, M. Tomsa, A. Chohan, K. May, D. Smékal, J. Selfe. (2016). "The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries", Gait & Posture, 48, 165–170.
Hewett, TE.,  Torg, J.,  Boden, B. (2009). " Video analysis of trunk and knee motion during noncontact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism". Br J Sports Med 43(6):417–422.
Hosseinzadeh, S., Eslami, M., Taghipour, M.(2019). [Comparisons of bracing and patellar taping on knee threedimensional kinematics of women with patellofemoral painsyndrome in stance phase of running]. Journal of Semnan University of Medical Sciences. Volume 21, Issue 2: 205- 393. (In Persian)
Hunt, M. A., Birmingham, T. B., Bryant, D., Jones, I., Giffin, J. R., Jenkyn, T. R., & Vandervoort, A. A. (2008), Lateral trunk lean explains variation in dynamic knee joint load in patients with medial compartment knee osteoarthritis". Osteoarthritis and Cartilage, 16(5): 591–599.
Hunt, M. A., Birmingham, T. B., Giffin, J. R., & Jenkyn, T. R. (2006). "Associations among knee adduction moment, frontal plane ground reaction force, and lever arm during walking in patients with knee osteoarthritis". Journal of Biomechanics, 39(12): 2213–2220.
Jafarnezhadgero AA, Shad MM, Majlesi M. (2017). "Effect of foot orthoses on the medial longitudinal arch in children with flexible flatfoot deformity: A three dimensional moment analysis". gait & posture, 55: 75-80.
Jeheon, M., Hyeyoung, K., Jusung, L., Siddhartha, B. (2018). "Effect of wearing a knee brace or sleeve on the knee joint and anterior cruciate ligament force during drop jumps: A clinical intervention study", Knee, 25(6):1009-1015.
Jim D Richards, Biomechanics in Clinic and Research, January 2008, Edition: 1Publisher: Churchill Livingstone, London Editor: Richards J: ISBN: 0443 10170 1.
Ji-Yong Joo, Young-Kwan Kim,( 2018). "Effects of Landing Foot Orientations on Biomechanics of Knee Joint in Single-legged Landing", Korean Journal of Sport Biomechanics; 28(2): 143-149.
Jonathan, Sinclair., Paul John, T., Hannah Foxcroft. (2019). "Effects of prophylactic knee bracing on knee joint kinetics and kinematics during single- and double-limb post-catch deceleration strategies in university netballers", Sport Sciences for Health. Springer-Verlag Italia S.r.l., part of Springer Nature, 15: 215–222.
Long, M. J., Papi, E., Duffell, L. D., & McGregor, A. H. (2017). "Predicting knee osteoarthritis risk in injured populations". Clinical Biomechanics (Bristol, Avon), 47: 87–95.
Olsen, O-E., Myklebust, G., Engebretsen, L., Bahr, R. (2004). "Injury mechanisms for anterior cruciate ligament injuries in team handball a systematic video analysis". The American Journal of Sports Medicine. 32(4): 1002-12.
Richards, R., van den Noort, J. C., Dekker, J., & Harlaar, J. (2017). "Gait retraining with real-time biofeedback to reduce knee adduction moment: systematic review of effects and methods used". Archives of Physical Medicine and Rehabilitation, 98(1): 137–150.
Rishiraj, N., Jack, E., Robert, Smith., William, R., Brian, N., Robert, W. (2012). "Functional knee brace use effect on peak vertical ground reaction forces during drop jump landing". Knee Surg Sports Traumatol Arthrosc 20:2405–2412.
Rishiraj, N., Taunton, E., Lloyd-Smith, R., Woollard, R., & Regan, W. (2009). "The potential role of prophylactic/functional knee bracing in preventing knee ligament injuries". Sports Medicine, (39) 11: 937-960.
Simic, M., Hunt, M., Bennell, K., Hinman, R., Wrigley, T. (2012). "Trunk lean gait modification and knee joint load in people with medial knee osteoarthritis: The effect of varying trunk lean angles". Arthritis Care & Research, 64(10): 1545-1553.
Sizhong, Wang., Kitty, H., Chan, Rachel H.M. Lam, Daisy N.S. Yuen,Carmen K.M. Fan, Thomas T.C. Chu, Heiner Baur, Roy T.H. Cheung. (2019). "Effects of foot progression angle adjustment on external knee adduction moment and knee adduction angular impulse during stair ascent and descent".Humant Movement Science 64213-220.
Susumu, O., Akira, Kanai., Yoshiya, Torii., Hiroyuki, T. (2015). "Effects of a custom made hinged knee brace with flexion support for patient with knee osteoarthritis: a preliminary study"; Nagoya J. Med. Sci; 77: 95-101,
Teng, P.,  Leonga, P., Huanga, J. (2013). The effect of a knee-ankle restraint on ACL injury risk reduction during jump-landing, Procedia Engineering 60, 300 – 306.
Teng, P., Kong, P., Leong, K. (2017). "Effects of foot rotation positions on knee valgus during single-leg drop landing: Implications for ACL injury risk reduction", Article in The Knee, 24(3): 547-554.
Winter DA. 2009., Biomechanics and motor control of human movement: Fourth Edition, .John Wiley & sons, Hoboken, New Jersey. ISBN: 978-0-470-39818-0.
Wu, d., Zheng c., Wu J, Wang L, Wei X, Wang L. (2018). "Protective knee braces and the biomechanics of the half-squat parachute landing". Aerosp Med Hum perform. 89(1): 26–31.
Yang, C., Lim, B. (2014). "Effects of Knee Brace on the Anterior Cruciate Ligament Injury Risk Factors during Spike Take Off in Female Volleyball Players". Korean Journal of Sport Biomechanics; 24(1): 27-33.
Yu B, Garrett WE. (2007). "Mechanisms of non-contact ACL injuries". British journal of sports medicine, 41(suppl 1): 147-i51.

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