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Abstract Introduction Patient oriented research (POR) invites patients to partner with researchers, clinicians, and other stakeholders, incorporating diverse perspectives to generate scientific evidence meaningful to all parties involved. We adopted a POR approach for this study evaluating the feasibility of conducting a randomized control trial of a novel tri-compartment offloader brace for knee osteoarthritis. We involved patients as partners to enhance study design, implementation and interpretation of key outcomes. Approach Patient involvement consisted of two patient leaders and five patient advisors. Patients participated in 2 virtual focus groups to discuss study outcomes, protocol, results and knowledge translation. Patients were involved in all aspects of the research cycle. Outcomes Patient feedback resulted in changes to study design, documentation, participant recruitment, data collection, results interpretation and knowledge dissemination, improving the participant experience and aligning study outcomes with patient priorities. Study participants showed a high level of protocol adherence and follow-up rates were excellent. We experienced several unexpected benefits including genuine friendships, a deeper understanding of the patient experience, a more pragmatic approach to clinical research, and leadership opportunities for patients. Recommendations We agreed on POR “non-negotiables” to ensure a positive experience for everyone, including creating a safe and comfortable environment, being genuinely receptive to patient feedback, and providing appropriate supports for patients. We strongly recommend that researchers (1) involve patients as early as possible, (2) provide ample and equal opportunities for all patients to be involved, and (3) address system hierarchy by involving patients as equals and fully considering all patient ideas from the beginning of the project. Conclusions While POR is a learning process that is often more challenging than the traditional clinical research approach, the benefits are well worth the additional time and effort required to do it well. Over time, our team experienced a cultural shift and evolution from a top-down research approach to a more inclusive approach considering patient voices as equal to those of researchers. Patient involvement in all aspects of the research process, from question development to results interpretation and dissemination is integral to clinical research advancing equitably.

Background: The use of rehabilitative knee braces after anterior cruciate ligament reconstruction (ACLR) has been controversial. This study aimed to evaluate the early functional outcome associated with post-ACLR brace use. Methods: This prospective observational case–control study was conducted at AKB Center for Arthroscopy, Sports Injury, and Regenerative Medicine, B&B Hospital, Lalitpur, Nepal. A total of 132 patients undergoing arthroscopic ACLR with or without a meniscal procedure were enrolled in this study, with the final analysis consisting of 66 patients in the control group (brace group) and 66 patients in the case group (no brace group). Braces were applied to the affected lower limb in the control group in the operating room immediately after surgery and were continued for 4 weeks post-operatively. The rehabilitation protocol was the same for both groups. The patients were evaluated on the 3rd post-operative day, 2 weeks, 6 weeks, and 12 weeks post-operatively in terms of Lysholm knee scores, clinical tests (Lachman and pivot shift test), range of motion (flexion and extension), VAS scores for pain, thigh girth differences, and the 12-item short-form health survey (SF-12) scores. Results: There were no significant differences between the two groups regarding outcome measures, except the mental component summary of SF-12 which was significantly better in the non-braced group (P = 0.006). Conclusion: There was no significant difference in early functional outcome between the braced and non-braced groups following ACLR with or without a meniscal procedure. Better SF-12 mental component summary scores were seen in the nonbraced group, which indicated possible mental discomfort in patients with brace use. [ABSTRACT FROM AUTHOR]

Introduction: Patient oriented research (POR) invites patients to partner with researchers, clinicians, and other stakeholders, incorporating diverse perspectives to generate scientific evidence meaningful to all parties involved. We adopted a POR approach for this study evaluating the feasibility of conducting a randomized control trial of a novel tri-compartment offloader brace for knee osteoarthritis. We involved patients as partners to enhance study design, implementation and interpretation of key outcomes. Approach: Patient involvement consisted of two patient leaders and five patient advisors. Patients participated in 2 virtual focus groups to discuss study outcomes, protocol, results and knowledge translation. Patients were involved in all aspects of the research cycle. Outcomes: Patient feedback resulted in changes to study design, documentation, participant recruitment, data collection, results interpretation and knowledge dissemination, improving the participant experience and aligning study outcomes with patient priorities. Study participants showed a high level of protocol adherence and follow-up rates were excellent. We experienced several unexpected benefits including genuine friendships, a deeper understanding of the patient experience, a more pragmatic approach to clinical research, and leadership opportunities for patients. Recommendations: We agreed on POR "non-negotiables" to ensure a positive experience for everyone, including creating a safe and comfortable environment, being genuinely receptive to patient feedback, and providing appropriate supports for patients. We strongly recommend that researchers (1) involve patients as early as possible, (2) provide ample and equal opportunities for all patients to be involved, and (3) address system hierarchy by involving patients as equals and fully considering all patient ideas from the beginning of the project. Conclusions: While POR is a learning process that is often more challenging than the traditional clinical research approach, the benefits are well worth the additional time and effort required to do it well. Over time, our team experienced a cultural shift and evolution from a top-down research approach to a more inclusive approach considering patient voices as equal to those of researchers. Patient involvement in all aspects of the research process, from question development to results interpretation and dissemination is integral to clinical research advancing equitably. Plain English Summary: Involving patients as partners in research can be challenging. However, the benefits are well worth the additional time and effort required to do it well. Patients improve the relevance, success and impact of clinical research, and are central to clinical research advancing. We partnered with seven patients from the community to conduct a research study assessing the effectiveness of a new knee brace for people with knee osteoarthritis. Patients participated in 2 virtual Zoom discussions and were involved in all aspects of the research process. The feedback received from patients led to many helpful changes to the study design, documents, recruitment strategies, data collection, and how to understand and share our results. These changes made the study more aligned with patient priorities and improved participants' experience. Study participants followed study instructions and the majority completed the study. Our team also experienced many unexpected benefits of involving patients in research including genuine friendships, a deeper understanding of the patient experience, a more practical approach to clinical research, and more leadership opportunities for patients. We agreed that for everyone on the team to have a good experience, it's important to create a safe and comfortable environment, really listen to and consider patient input, and provide patients the tools and trainings they need to fully participate. We recommend that researchers involve patients in their studies as early as possible, give patients lots of opportunities to be involved, and involve patients as equals, considering their ideas from start to finish. [ABSTRACT FROM AUTHOR]

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Knee braces are commonly used to support the knee joint and improve function. However, brace sliding caused by the misalignment between brace and knee during motion is a common problem, which reduces the therapeutic effect and leads to brace abandonment. To investigate the effect of mechanism combinations on sliding, an experimental brace was designed to isolate the mechanism as the sole variable. Ten healthy participants were recruited, each of whom worn four combinations of lateral/medial mechanisms: lateral and medial single-axis (SA), lateral super gear (SG) and medial non-circular gear (NCG), lateral four-bar linkage (FL) and medial SG, and lateral FL and medial NCG. The knee flexion angle was collected using inertial measurement units, and brace sliding was measured by 3D motion capture system. All combinations had significant changes in peak sliding of thigh and shank compared to the SA combination (p < 0.05), but lateral FL and medial NCG combination had the lowest peak and final sliding during walking and leg-raising, with significant reductions of 40.7 and 85.3% in peak sliding of thigh, and significant reductions of 56.3 and 72.0% in peak sliding of shank, respectively (p < 0.05). Moreover, the mechanism combination did not significantly impact the knee range of motion (p > 0.05). The mechanism combination that fit the instantaneous center of rotation of lateral/medial condyle of knee joint demonstrates a significant reduction in brace sliding. Additionally, the peak sliding during motion is significantly higher than the final sliding. [ABSTRACT FROM AUTHOR]

BACKGROUND: Stroke often induces gait abnormality, such as buckling knee pattern, compromising walking ability. Previous studies indicated that an adequate trailing limb angle (TLA) is critical for recovering walking ability. OBJECTIVE: We hypothesized that correcting gait abnormality by immobilizing the knee joint using a knee orthosis (KO) would improve walking patterns and increase the TLA, and investigated whether walking training using a KO would increase the TLA in post-stroke patients. METHODS: In a randomized controlled trial, thirty-four participants were assigned to KO (walking training using a KO) and non-KO (without using a KO) groups. Twenty-nine completed the three-week gait training protocol. TLA was measured at baseline and after training. A two-way repeated ANOVA was performed to evaluate TLA increases with training type and time as test factors. A t-test compared TLA changes (ΔTLA) between the two groups. RESULTS: ANOVA showed a main effect for time (F = 64.5, p < 0.01) and interaction (F = 15.4, p < 0.01). ΔTLA was significantly higher in the KO group (14.6±5.8) than in the non-KO group (5.0±7.0, p < 0.001). CONCLUSION: Walking training using a KO may be practical and effective for increasing TLA in post-stroke patients. [ABSTRACT FROM AUTHOR]

Purpose: Several anterolateral stabilization procedures have been developed recently to address rotational instability of the knee. Currently, these procedures tend to be systematically used by some practitioners. However, antero-lateral structures of the knee (including the anterolateral ligament, ALL) have a self-healing potential which can reduce the need to perform an antero-lateral procedure. In this study, it was hypothesized that early post-traumatic immobilization of the knee with a knee brace would allow partial healing of antero-lateral structures and also allow control of the pivot shift, thus avoiding antero-lateral extra-articular stabilization. The objective of this study was to compare the severity of pivot shift between two groups of patients who all experienced anterior cruciate ligament (ACL) tear and respectively underwent post-traumatic immobilization of the knee versus no immobilization. Methods: This was a comparative, multicentric (three centers' study) retrospective, consecutive study including 168 patients who underwent ACL reconstruction between May and September 2022. The application or not of post-traumatic immobilization and its duration, the severity of pivot shift observed in the operating room under general anesthesia, the presence of anterolateral lesions as revealed by MRI and the patients' pre-injury sport activity were recorded. Results: A grade 3 pivot shift was found in 44 patients (27%). It was more frequently observed in the group without a brace compared to the group with a knee brace (18 patients out of 36: 50% versus 26 patients out of 132: 19.7%; p = 0.0012). Wearing a brace, whether hinged (OR = 0.221, [0.070–0.652]; p = 0.006) or not (OR = 0.232, [0.076–0.667]; p = 0.0064), was protective from the risk of developing a significant pivot shift. Conclusion: This study demonstrated that the presence of pivot-shift was lower in the patients that had an early post-injury knee brace before their ACL reconstruction. Based on this result, systematic brace placement could be advocated for in patients after knee trauma. Level of evidence: III, prognostic retrospective case–control study. [ABSTRACT FROM AUTHOR]

Abstract This study analyzed the functional design by investigating the distribution of clothing pressure of cycling knee brace using a three-dimensional virtual clothing program. Based on the average body size of Korean men in their 40 s, clothing pressure in wearing and cycling condition were collected on five knee brace products. According to the results, bonding fabric products had a high possibility of increasing inconvenience, as they had a higher clothing pressure at all measurement points and soared in motion application. It could be adjusted differently depending on the location by mixing materials or using details, so the design with thick pile fabric or velcro strap fastening added more pressure to the lower part of the knee. The length and circumference size also affected the clothing pressure. The design with tight upper and lower circumference pressured excessively the legs and rolled up and clumped together, while the one with loose lower circumference lacked the sufficient strength to support the knees. Also, the design with a curved outline due to the difference in the length of the front and back, increased the clothing pressure on the lower thigh or the upper calf. Therefore, the functional design of cycling knee braces requires comprehensive consideration of material thickness and structure, detailed size of length and circumference, fastening details, to reduce the pressure at the center and top of the knee and to support the lower part with proper pressure, as reflecting the pressure on the body location that come into contact during the motion.

This study analyzed the functional design by investigating the distribution of clothing pressure of cycling knee brace using a three-dimensional virtual clothing program. Based on the average body size of Korean men in their 40 s, clothing pressure in wearing and cycling condition were collected on five knee brace products. According to the results, bonding fabric products had a high possibility of increasing inconvenience, as they had a higher clothing pressure at all measurement points and soared in motion application. It could be adjusted differently depending on the location by mixing materials or using details, so the design with thick pile fabric or velcro strap fastening added more pressure to the lower part of the knee. The length and circumference size also affected the clothing pressure. The design with tight upper and lower circumference pressured excessively the legs and rolled up and clumped together, while the one with loose lower circumference lacked the sufficient strength to support the knees. Also, the design with a curved outline due to the difference in the length of the front and back, increased the clothing pressure on the lower thigh or the upper calf. Therefore, the functional design of cycling knee braces requires comprehensive consideration of material thickness and structure, detailed size of length and circumference, fastening details, to reduce the pressure at the center and top of the knee and to support the lower part with proper pressure, as reflecting the pressure on the body location that come into contact during the motion. [ABSTRACT FROM AUTHOR]

The levitation tricompartment offloader (TCO) brace is designed to unload all three knee compartments by reducing compressive forces caused by muscle contraction. This study aimed to determine the effect of the TCO on knee contact forces and quadriceps muscle activity in individuals with knee osteoarthritis. Lower limb kinematics, kinetics, and electromyography data were collected during a chair rise‐and‐lower task. A three‐dimensional inverse dynamics model of the lower leg and foot was used with a sagittal plane knee model to compute knee joint forces. TCO brace use significantly decreased forces in the tibiofemoral [p = 0.001; mean difference, MD (97.5% confidence interval, CI) −0.62 (−0.91, −0.33) body weight (BW)] and patellofemoral [p = 0.001; MD (97.5% CI) −0.88 (−1.36, −0.39) BW] compartments in high‐power mode. Significant reductions in quadriceps tendon force [p = 0.002; MD (97.5% CI) −0.53 (−0.83, −0.23) BW] and electromyography intensity of the vastus medialis [p = 0.018, MD (97.5% CI) −30.7 (−59.1, −2.3)] and vastus lateralis [p = 0.012, MD (97.5% CI) −26.2 (−48.5, −3.9)] were also observed. The TCO significantly reduced tibiofemoral and patellofemoral contact forces throughout chair lower, and when knee flexion was greater than 50° during chair rise in high power. These results demonstrate that the TCO reduces contact forces in the tibiofemoral and patellofemoral joint compartments and confirms that the TCO unloads the joint by reducing compressive forces caused by the quadriceps. Clinical significance: The magnitude of knee joint unloading provided by the TCO is similar to that achieved by clinically recommended levels of bodyweight loss and is therefore expected to result in clinical benefits for knee osteoarthritis patients. [ABSTRACT FROM AUTHOR]

Background and Aims Genu varus is one of the most common lower limb deformities that can affect a person's daily activities and sports performance. This study aims to investigate the effect of the 8-week use of knee braces on the electrical activity frequency of muscles in men with genu varus during walking. Methods This is a quasi-experimental study on 30 male college students with genu varus (aged 20-30 years) who were randomly divided into control and intervention groups. Corrective exercises were performed for 8 weeks using knee braces in the intervention group. The electrical activity of selected muscles was recorded by an electromyography system. For statistical analysis, ANCOVA was used. The significance level was set at 0.05. Results During the loading phase, the results showed a lower frequency of biceps femoris muscle in the intervention group compared to the control group (P=0.041). The frequency of muscles did not show any significant difference between groups in the mid-stance and push-off phases (P>0.05). Conclusion Given the decrease in the frequency of biceps femoris muscle activity in men who used knee braces, it can be concluded that the 8-week use of these brace can be effective in reducing shock absorption in the lower extremity. [ABSTRACT FROM AUTHOR]

Background: Due to the rapid spread of the coronavirus disease-19 (COVID-19), most of the patients expressed a reluctance to undergo postoperative rehabilitation at a rehabilitation clinic. Therefore, in this scenario it was necessary to reshape the crucial role of postoperative rehabilitation of these patients. We conducted a telerehabilitation program based on an artificial intelligence brace (AI brace) which can monitor the progress of rehabilitation through an app and an internet server. Our hypothesis was that home-based telerehabilitation might provide clinical outcomes comparable to face-to-face, hospital-based rehabilitation programs in terms of effectiveness. Methods: A retrospective cohort study enrolled patients who received anterior cruciate ligament reconstruction (ACLR) between January and September 2020. Patients were divided into two groups: the tele-AI group received telerehabilitation with an AI brace while the FTF group had face-to-face, hospital-based rehabilitation. Clinical knee functional scores and Tegner Activity Scale (TAS) were assessed and analyzed until 12 months after the operation. Results: The tele-AI group had higher IKDC scores at 3 months (p = 0.0443) and 6 months (p = 0.0052) after surgery and higher KOOS scores at 1 month (p = 0.0365) and 6 months (p = 0.0375) after surgery. However, no significant difference between the two groups was detected at the end of the follow-up. The tele-AI group had higher TAS than FTF group after 1 year. Conclusions: Telerehabilitation after ACLR seems to provide a superior short-term outcome compared to hospital-based rehabilitation during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In this research, the progressive collapse of braced frames with knee braces in steel structures under fire load was investigated based on the software modeling method. In order to carry out the research 3, 6 and 9-story steel frames with coaxial and off-axis knee bracing systems were considered in the shape of inverted-V and were analyzed and analyzed using the software method and ABAQUS and SAP software. In this regard, at first, the frames were analyzed and designed by modeling the frames in SAP software, and the sections of the frames were determined. In the following, the frame was analyzed in ABAQUS software under the fire load. the frame without and with the removal of the critical elements was analyzed successively under the fire load in the SAP software to check and compare the energy of the frame samples in each case based on the results obtained from the analysis. Based on the study conducted on the frame with off-axis and coaxial knee bracing, it was determined that the bracing type of off-axis had a significant effect on reducing the energy of the frame compared to the coaxial bracing system. The 3, 6 and 9-storyframes with off-axis knee bracing had 35%, 50% and 65% less energy than the frames with coaxial knee braces during the fire and in the entire time period. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Objective: Prophylactic knee braces (PKBs) are widely used by athletes in pivoting and landing sports and have the potential to influence knee movement and alignment, thus modulating anterior cruciate ligament (ACL) injury risk. This systematic review analyses current evidence on the biomechanical effects that PKBs have in the prevention of ACL injuries. Data sources: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Searches were conducted on PubMed, Web of Science, Scopus, Ovid MEDLINE, EMBASE, Cochrane, and CINAHL for studies published from inception until May 31, 2021. Included studies assessed the effects of PKBs on biomechanical variables associated with ACL injuries in landing or pivoting tasks, comparing between braced and unbraced conditions. Main results: A total of 234 articles were identified; from which, 14 controlled, laboratory, biomechanical studies were included in this review. The effects of PKBs on knee biomechanics could be divided into kinematic variables in the coronal, sagittal, and transverse planes; and common kinetic variables, such as ground reaction force (GRF) and ACL load/strain. Also, PKBs were found to have protective effects in coronal and transverse plane kinematics, but results in the sagittal plane were inconclusive. Assessing knee kinetics, PKBs were advantageous in decreasing ACL load/strain but had no significant effect on GRF. Conclusions: Prophylactic knee braces may serve to reduce ACL injury risk by modulating knee coronal and transverse plane movements and ACL load/strain during high-risk maneuvres. Precise recommendations are limited by study heterogeneity. More prospective studies are needed to assess ACL injury risk during high-risk sports using specific PKBs. [ABSTRACT FROM AUTHOR]

One of the urgent tasks in the process of creating biomechanical devices, namely unloading orthoses, is to determine their effectiveness. The paper presents the results of a study of muscle fatigue of the hip synergists during isotonic contractions when performing squats both with and without the use of a knee joint unloading orthosis. In addition to determining indirect indicators that determine peripheral muscle fatigue, namely the number of squats performed and the speed of their implementation, another effective method for studying the progression of muscle fatigue, the method of surface electromyography, was used in the work. The data obtained in field experiments for both indirect indicators and surface electromyography recordings were processed by calculating the root mean square value, which made it possible to evaluate the effectiveness of the knee joint unloading orthosis using a regression statistical model. The coefficient of absolute slope of the linear regression, built on the basis of experimental data, was chosen as the criterion for evaluating the effectiveness. Surface electromyography data were recorded using the iiitech electromyographic reading module and processed using the Spike Recorder software package supplied with the module. Statistical processing of research results and calculations of linear regression coefficients were carried out using the MS Excel package. The analysis of the results obtained indicates the effectiveness of the use of the orthosis involved in the experiments, the use of which makes it possible to delay the decrease in the production strength of active muscle fibers and leads to a slower onset of peripheral muscle fatigue. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis is a degenerative inflammatory disease affecting the entire joint and is characterised by progressive oss of cartilage and associated with pain. The tissue cells absorbs a certain wavelength of Light Amplification by Stimulated Emission of Radiation (LASER) which triggers a number of chemical responses in the cells that promote healing and reduce inflammation. Aim: To find the effect of Class IV LASER on pain and inflammation in knee osteoarthritis of older adults. Materials and Methods: This study utilised an experimental controlled design with pre and post comparison. The study was conducted from March 2023 to January 2024 at Jindal Physio Care, New Delhi, India, with the sample size of 36 subjects (18 each group). Participants were recruited based upon a predefined selection criterion. After signing the informed consent, all the subjects were randomly distributed among two groups (Group A and Group B). Outcome variables were inflammatory biomarkers Interleukins 6 (IL 6), Interleukins 1β (IL 1β), C-Reactive Protein (CRP) and Numeric Pain Rating Scale (NPRS), which were assessed in the beginning and at the end of study period of 10 weeks. Group A was given Placebo LASER along with moist heat, exercises and knee brace while Group B was given Class IV high-intensity LASER along with moist heat, exercises and knee brace. Data were analysed using the Student’s t-test and significance level was kept 95% (p<0.05). Results: There was a significant decrease in NPRS score, IL 6, IL 1β and CRP levels in both the groups at the end of the study. A substantial reduction was found in group B compared to group A (p<0.001). Conclusion: Class IV LASER treatment has been found satisfactory in alleviating pain and inflammation, which may be a promising treatment method for knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background/aims: Knee braces can change loading direction on knees in people with osteoarthritis, thereby reducing symptoms and progression of the disease. The aims of this study were to explore the immediate effect of two types of braces, a pneumatic knee brace with air pressure embedded in a sandal cuff (sandal cuff pressure) and a conventional knee brace on gait, pain and satisfaction during walking in patients with knee medial osteoarthritis. Methods: A total of 28 patients with knee medial osteoarthritis were assigned to two groups, 14 patients used a conventional brace and 14 used a prototype brace with a pneumatic system, which was designed and fabricated by the authors, and followed the mechanism of variable pressures in the stance and swing phases of a gait cycle in a patient's knee. The gait parameters (walking self-selected speed, cadence, step length, knee range of motion, and maximum knee adduction moment, walking speed, cadence and step length) were measured with a Kistler force plate and Vicon motion analysis under two conditions: with and without brace for the conventional brace group, and under three conditions of no brace, brace with sandal cuff pressure, and brace without sandal cuff pressure for the pneumatic brace group. Patients' pain and satisfaction were also measured using a visual analogue scale and Likert scale respectively. Results: Both groups showed a significant reduction in maximum knee adduction moment and pain wearing braces in comparison to no brace during walking (P<0.05). The knee range of motion was significantly decreased in the pneumatic brace group with and without sandal cuff pressure compared with no brace (P<0.001). No significant difference was found for any of the variables when using the pneumatic brace with and without sandal cuff pressure (P>0.05). In the between-group comparison, only patients' satisfaction was significantly reduced when using the pneumatic brace in both walking with (P=0.041) and without (P=0.02) sandal cuff pressure compared to those using the conventional brace. Conclusions: Both conventional and pneumatic braces led to reduced knee adduction moment and pain in patients with knee osteoarthritis. However, using a pneumatic brace reduced the knee range of motion and satisfaction of patients, which could be because the brace was a prototype. [ABSTRACT FROM AUTHOR]

Buildings are always affected by a variety of natural and abnormal forces during their operation. Impact of vehicle collision is an abnormal load which is not usually considered in the design of structures. With the spread of terrorist attacks in many parts of the world, investigation the behavior of structures against unusual loadings, such as blast or vehicle collision has been considered. In this study, steel moment frames with knee braces (2, 5 and 8 story) were designed by SAP 2000 software in two-dimensional according to codes guidelines, and then time history analysis of them was performed by SeismoStruct software subjected to impact of light vehicle collision. The responses such as displacement, drift, acceleration of the stories and the base shear of the frames were compared under the effect of light vehicle collision impact with different velocity (from 10 to 120 km/hr). The results show that the velocity 90, 120 and 100 km/hr causes dynamic instability state in frames with 2, 5 and 8 story respectively. The results also show that the performance level of the mentioned frames based on the maximum stories drift and for the different velocities of impact. For example, in the range of impact velocity of 50 to 80 km/hr, the performance level of 2-story frame was "Life Safety" and regarding to 8-story frame, the performance level was "Immediate Occupancy" for velocities 10 and 20 km/hr.

Purpose: To investigate the functional outcomes for patients who used a novel home-based rehabilitative system during the postoperative period after anterior cruciate ligament (ACL) reconstructions. Methods: Patients undergoing ACL reconstruction surgeries were prospectively enrolled. A home-based rehabilitation system, which is composed of a knee brace with a motion tracker, a mobile app, and a web portal, was applied. Patients could complete the rehabilitation exercise through the audio guidance and the real-time tracking system which displayed the achieved motions on the user interface of the app. Feedbacks from the patients, including the International Knee Documentation Committee (IKDC) scores, were collected and uploaded to the web portal. Each patient would meet a specialized physical therapist face-to-face once a month. At postoperative 6 months, every patient received a GNRB arthrometer examination and a Cybex isokinetic dynamometer examination. Results: A total of 15 patients (10 males and 5 females) were enrolled and followed for at least 6 months. The mean time of return to full knee extension was 1.5 months. The mean difference in laxity measured by GNRB arthrometer at 134 N significantly improved at postoperative 6 months (1.8 ± 1.6 mm) compared to that measured preoperatively (3.4 ± 1.9 mm) (p = 0.024). The peak torques of flexor and extensor muscles measured by Cybex isokinetic dynamometer remained unchanged at postoperative 6 months (p = 0.733 and 0.394, respectively). The patients' IKDC score became smaller at postoperative 1 month (p = 0.011) and significantly improved at postoperative 6 months (p = 0.002). Conclusion: Using a home-based rehabilitative knee brace system after ACL reconstruction is a viable option as patients maintained their knee muscle strengths maintained their muscle strength and achieve similar or better knee range of motion six months postoperatively. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: This study aims to compare the clinical results of patients rehabilitated with or without a rehabilitative knee brace (RKB) after anterior cruciate ligament (ACL) reconstruction. Patients and methods: This retrospective, comparative study was conducted at between January 2013 and December 2017. A total of 119 patients (112 males, 7 females; mean age: 32.0±8.6 years; range, 18 to 45 years) with acute ACL ruptures treated with arthroscopic ACL reconstruction and rehabilitated with (n=56) or without RKB (n=63) participated in the study. The minimum follow-up time was 24 months. The ACL quality of life (QoL) questionnaire, Lysholm Knee Scoring Scale, and Tegner Activity Level Scale were used for the evaluation of the QoL, knee function, and activity level, respectively. The time to return to sports was recorded. The side-to-side difference in the anterior translation of the tibia was measured using a KT-1000 arthrometer. Results: The mean follow-up time was 38.4±9.1 (range, 24 to 56) months. Baseline demographics and clinical characteristics were similar between groups. Regarding QoL, knee function, and activity level, no significant difference was observed between patients who used RKB and those who did not use it at the postoperative 12th month (p=0.95, p=0.56, p=0.98, respectively) and the latest follow-up (p=0.21, p=0.73, p=0.99, respectively). The mean time to return to sports (nearly 11 months for both groups) and side-to-side difference in the anterior tibial translation at the latest follow-up was also similar between groups (p=0.15 and p=0.15, respectively). There was no graft rupture during the follow-up in both groups. The complication rates were 7.9% and 7.1% for no brace and brace groups, respectively, without a statistically significant difference (p=0.87). Conclusion: According to the results of this study, there was no significant difference between the rehabilitative brace and no brace groups in clinical outcomes after ACL reconstruction. [ABSTRACT FROM AUTHOR]

Degenerative knee osteoarthritis (KOA) is the most common form of arthritis with a high prevalence in general population, especially among the elderly. This study aims to design and develop a new acu-magnetic therapeutic knee brace (KB) applying acupuncture point stimulation by magnetic approach to relieve symptomatic KOA, and to evaluate its effectiveness on knee function via a randomized controlled trial (RCT). The embedded magnetic padding in the KB were positioned at the six determined acupuncture points along the four main meridians of the lower limb. A total of 52 subjects with KOA aged 60–80 years old participated in RCT study. They were randomly allocated to an experimental KB group (18 subjects), a sham KB group (17 subjects) and a control group (17 subjects). The results indicated that the intervention of the experimental acu-magnetic KB significantly relieved the subjects' knee stiffness and pain feeling, and improved the physical function, balance ability and knee range of motion after a six-week continuous treatment. No significant changes on the tested parameters were found in the control group, but it is worth noting that the sham group also presented positive results in the first two weeks of wear trial. In general, the designed KB could be used as one of optional nonpharmacological approaches to relieve KOA in the elderly users in daily care. The built-in magnetic padding of KB would not only exert stimulation at acupoints but also could potentially activate their surrounding nerve endings to improve knee joint function. In addition, the designed acu-magnetic KB also demonstrated superior characteristics in magnetic flux permeability, tactile comfort, and washability in use. [ABSTRACT FROM AUTHOR]

Background: Genu valgum is a postural malalignment in the knee joint. This malalignment is accompanied by altered mechanical forces in the tibiofemoral and patellofemoral joints. The purpose of this study was to investigate the effect of using a graded knee brace in two angles of 60 and 30 degrees on the frequency spectrum of ground reaction forces in individuals with genu valgum during landing. Methods: The present study was semi-experimental. Twenty non-athlete male students with genu valgus (age range: 20-30 years) were volunteered to participate in the study. The landing task was done during three conditions including without a knee brace, with a brace at two 30 and 60 degrees of flexion from a height of equal to 30 cm. Bertec force plate was used to record ground reaction forces. Fourier transform was used to calculate ground reaction force-frequency content during both landing conditions with and without a knee brace. Results: The results of this study showed a significant reduction in the frequency content with a power of 99.5% in the mediolateral direction (P=0.02; high effect size) and vertical direction (P=0.075; high effect effect) during landing with a knee brace at 60 degrees of flexion angle compared with without knee brace condition. Also, the median frequency component in the mediolateral direction (P=0.019; low effect size) and in the anterior-posterior direction (P=0.019; high effect effect) showed a significant decrease during wearing a knee brace compared with without it. Conclusion: Regarding the decreasing of median frequency after using the knee brace, it might be effective in the reduction of injury rate in individuals with genu valgum. However, further study warranted to better establish this issue.

Background: Different factors affect walking biomechanics disturb the postural control. Genu valgus is one of the most important lower limb malalignments that affects the postural control and disrupts the posture. The purpose of the present study was to investigate the acute effect of knee brace on the electromyography activity of lower limb muscles in individuals with genu valgus during walking. Methods: In this semi-experimental and a laboratory typ study,. 24 boys with genu valgum (20-30 years old) volunteered to participate in the study. The electrical activity of the selected muscles was recorded by an electromyography system during walking with and without knee brace. Paired t-test was used for statistical analysis at a significance level of 0.05. Results: There was a significant increase in electrical activity of the semitendinosus muscle during walking with knee brace compared to walking without it (p = 0.037, d = 0.89). The electrical activity of other lower limb muscles did not show any significant differences during acute use of knee brace (P >0.05). Conclusion: The semitendinosus muscle in individuals with genu valgus is weak. Therefore, significant increase in the electrical activity of the semitendinosus muscle during wearing of knee brace means delaying the fatigue and indicating improvement in the muscular function.

Objective: Osteoarthritis is one of the most com- mon chronic conditions leading to disability among older people (age 60+ years). Knee osteoarthritis has a significant impact on daily functioning. Pain, stiffness, reduced strength, changes in posture, and reduced knee stability may result in reduced mobility. The aim of this study is to evaluate the short- and long-term effects of conservative therapeutic use of a semi-rigid knee brace for management of patients with knee osteoarthritis, using patient-reported outcomes. Design: Patients with osteoarthritis using a semi-rigid knee brace were asked to complete a questionnaire about the effectiveness of the brace after wearing it for 3 weeks. The primary outcome measure was mobility, assessed using an ordinal scale with and without use of the knee brace. Secondary outcome measures were pain symptoms and overall daily functioning. Results: A total of 381 patients completed the questionnaire. The results show considerably improved mobility while using a knee brace in different mobility groups. In the group of respondents who were limited to their home environment mobility decreased by 74% while using a knee brace. In the group of respondents who were able to walk to a nearby shop mobility increased by 50%, and the group experiencing no mobility restrictions increased from 3% without using a knee brace to 13% while using a knee brace. In addition, 54% of respondents reported a reduction in pain symptoms and 62% of respondents reported an improvement in overall daily functioning while using a knee brace. Conclusion: The results of this large-scale patient-reported outcome measure (PROM) study show that the use of a semi-rigid knee brace appears to provide suitable joint support, offering pain relief and freedom of movement and should be considered a useful non-surgical treatment method for use in patients with knee osteoarthritis Clinical trial: This study does not include a clinical trial. LAY ABSTRACT This study of patient-reported outcome measures regarding the use of stabilizing knee braces for knee osteoarthritis provides insight into the additional care and quality of life provided by the use of these orthopaedic aids. The aims of this study are to measure the effectiveness of knee braces in daily life and to validate the efficacy of using orthopeadic medical aids. In the study, 381 patients with knee Osteoarthritis were provided with knee braces and were asked about the effectiveness of the braces 3 weeks after they first started wearing them. This large-scale study found that the use of knee braces contributed to user-mobility, reduced pain, and increased the possibility to perform daily activities. Knee braces appear to serve as a suitable support for knee joints, providing pain relief and freedom of movement, and should be considered a useful non-surgical treatment method for knee Osteoarthritis.

Acute first-time traumatic patellar dislocation is a prevalent knee injury, particularly in adolescents, often managed conservatively with knee bracing. Recently, medial patellofemoral ligament (MPFL) reconstruction has gained popularity for its potential benefits in reducing redislocation rates and enhancing functional outcomes. This systematic review and meta-analysis compared the outcomes of MPFL reconstruction versus knee bracing for managing acute first-time traumatic patellar dislocation. A comprehensive search of PubMed, Scopus, Google Scholar, and the Cochrane Library identified studies published within the last 10 years that directly compared these treatment approaches, with primary outcomes focusing on redislocation rates and functional recovery measured by Kujala scores. A total of six studies, involving 325 patients, were included in the analysis. Results indicated that MPFL reconstruction significantly reduced redislocation rates (OR: 0.17, 95% CI: 0.09 to 0.32, P < 0.00001) and improved functional outcomes (MD in Kujala scores: 8.10, 95% CI: 6.46 to 9.75) compared to knee bracing. Despite notable heterogeneity across studies (I² = 95%), MPFL reconstruction consistently demonstrated superior long-term knee stability and fewer reoperations. These findings suggest that surgical intervention is the preferred treatment for long-term stability; however, further high-quality randomized controlled trials are recommended to confirm these results., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Elnewishy et al.)

Abstract Purpose To investigate the functional outcomes for patients who used a novel home‐based rehabilitative system during the postoperative period after anterior cruciate ligament (ACL) reconstructions. Methods Patients undergoing ACL reconstruction surgeries were prospectively enrolled. A home‐based rehabilitation system, which is composed of a knee brace with a motion tracker, a mobile app, and a web portal, was applied. Patients could complete the rehabilitation exercise through the audio guidance and the real‐time tracking system which displayed the achieved motions on the user interface of the app. Feedbacks from the patients, including the International Knee Documentation Committee (IKDC) scores, were collected and uploaded to the web portal. Each patient would meet a specialized physical therapist face‐to‐face once a month. At postoperative 6 months, every patient received a GNRB arthrometer examination and a Cybex isokinetic dynamometer examination. Results A total of 15 patients (10 males and 5 females) were enrolled and followed for at least 6 months. The mean time of return to full knee extension was 1.5 months. The mean difference in laxity measured by GNRB arthrometer at 134 N significantly improved at postoperative 6 months (1.8 ± 1.6 mm) compared to that measured preoperatively (3.4 ± 1.9 mm) (p = 0.024). The peak torques of flexor and extensor muscles measured by Cybex isokinetic dynamometer remained unchanged at postoperative 6 months (p = 0.733 and 0.394, respectively). The patients’ IKDC score became smaller at postoperative 1 month (p = 0.011) and significantly improved at postoperative 6 months (p = 0.002). Conclusion Using a home‐based rehabilitative knee brace system after ACL reconstruction is a viable option as patients maintained their knee muscle strengths maintained their muscle strength and achieve similar or better knee range of motion six months postoperatively.

The main aim of this study is to assess the seismic behavior of various knee braced steel frames using nonlinear static and dynamic analyses. For this, structures with four different types of knee braces at heights of 5, 10, 15 and 20 stories are designed through ETABS and then are three-dimensionally modeled via PERFORM 3D. Firstly, various seismic parameters including response modification factor, ductility factor, deflection amplification factor and overstrength factor of the structures are compared via implementing the pushover analysis. Secondly, target models are subjected to five far-fault and five near-fault records. Fragility curves as well as curves obtained from the incremental dynamic analysis (IDA) are then compared, so as to determine the best type of bracing in terms of seismic performance. Benefiting results of non-linear static analyses, top knee, x-knee, chevron knee and double knee braced frames have the best seismic performance, respectively. Likewise, using IDA results in the far-fault area, x-knee, top knee, chevron knee and double-knee braced frames demonstrate the best performance, respectively. In addition, in near-field area at the height of 5 stories, the best performance is correspondingly attributed to x-knee, top-knee, chevron knee and double knee braces, respectively. However, at heights of 10, 15 and 20 stories, chevron knee, double knee, top knee and x-knee braced frames show a better performance, respectively. [ABSTRACT FROM AUTHOR]

Background: Genu valgum is a postural malalignment in the knee joint. This malalignment is accompanied by altered mechanical forces in the tibiofemoral and patellofemoral joints. The purpose of this study was to investigate the effect of using a graded knee brace in two angles of 60 and 30 degrees on the frequency spectrum of ground reaction forces in individuals with genu valgum during landing. Methods: The present study was semi-experimental. Twenty non-athlete male students with genu valgus (age range: 20-30 years) were volunteered to participate in the study. The landing task was done during three conditions including without a knee brace, with a brace at two 30 and 60 degrees of flexion from a height of equal to 30 cm. Bertec force plate was used to record ground reaction forces. Fourier transform was used to calculate ground reaction force-frequency content during both landing conditions with and without a knee brace. Results: The results of this study showed a significant reduction in the frequency content with a power of 99.5% in the mediolateral direction (P=0.02; high effect size) and vertical direction (P=0.075; high effect effect) during landing with a knee brace at 60 degrees of flexion angle compared with without knee brace condition. Also, the median frequency component in the mediolateral direction (P=0.019; low effect size) and in the anterior-posterior direction (P=0.019; high effect effect) showed a significant decrease during wearing a knee brace compared with without it. Conclusion: Regarding the decreasing of median frequency after using the knee brace, it might be effective in the reduction of injury rate in individuals with genu valgum. However, further study warranted to better establish this issue. [ABSTRACT FROM AUTHOR]

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Background: Exercise therapy is recommended by international guidelines as a core treatment for patients with knee osteoarthritis. However, there is a significant gap between recommendations and practice in health care. Digital exercise apps are promising to help solve this undersupply., Objective: This study aims to evaluate the efficacy of a 12-week fully automated app-based exercise intervention with and without a supporting knee brace on health-related outcomes, performance measures, and adherence in patients with knee osteoarthritis., Methods: This closed user group trial included participants with moderate to severe unicondylar painful knee osteoarthritis. Randomization was 1:1:2 into an intervention group (IG) with 2 subgroups (app-based training [IG A] and app-based training and a supportive knee brace [IG AB]) and a control group (CG). The intervention included a 12-week home exercise program with 3 sessions per week. Instructions for the exercises were given via the app and monitored using 2 accelerometers placed below and above the affected knee joint. Participants in the CG did not receive any study intervention but were allowed to make use of usual care. Osteoarthritis-specific pain (Knee Injury and Osteoarthritis Outcome Score) was defined as the primary outcome, and secondary outcomes included all other Knee Injury and Osteoarthritis Outcome Score subscales, general health-related quality of life (Veterans RAND 12-item Health Survey), psychological measures (eg, exercise self-efficacy), performance measures (strength and postural control), and the monitoring of adherence and safety. Outcomes were assessed at baseline and after 12 weeks. Intervention effects were calculated using baseline-adjusted analysis of covariance for the joint comparison of IG A and IG AB versus the CG using a per-protocol approach. Subgroup analyses were conducted for each IG separately., Results: A total of 61 participants were included (IG: n=30, 49%; CG: n=31, 51%; male: n=31, 51%; female: n=30, 49%; mean age 62.9, SD 8.5 years; mean BMI 27.7, SD 4.5 kg/m 2 ). Analysis revealed statistically significant effects in favor of the IG for pain reduction (P<.001; effect size [ES]=0.76), improvements in physical function (P<.001; ES=0.64), improvements in symptoms (P=.01; ES=0.53), improvements in sport and recreation activities (P=.02; ES=0.47), improvements in knee-related quality of life (P<.001; ES=0.76), and improvements in the physical component of general health-related quality of life (P<.001; ES=0.74). Mean differences ranged from 6.0 to 13.2 points (scale range 0-100). ESs indicated small to medium effects. No effects were found for psychological and performance measures. Participants adhered to 92.5% (899/972) of all scheduled exercise sessions., Conclusions: Individuals with knee osteoarthritis undergoing a 12-week sensor-assisted app-based exercise intervention with or without an additional knee brace experienced clinically meaningful treatment effects regarding pain relief and improvements in physical function as well as other osteoarthritis-specific concerns compared to controls., Trial Registration: German Clinical Trials Register (DRKS) DRKS00023269; https://drks.de/search/de/trial/DRKS00023269., (©Valerie Dieter, Pia Janssen, Inga Krauss. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 09.09.2024.)

Objective: Off-loader knee braces have traditionally focused on redistributing loads away from either the medial or lateral tibiofemoral (TF) compartments. In this article, we study the potential of a novel “tricompartment unloader” (TCU) knee brace intended to simultaneously unload both the patellofemoral (PF) and TF joints during knee flexion. Three different models of the TCU brace are evaluated for their potential to unload the knee joint.Methods: A sagittal plane model of the knee was used to compute PF and TF contact forces, patellar and quadriceps tendon forces, and forces in the anterior and posterior cruciate ligaments during a deep knee bend (DKB) test using motion analysis data from eight participants. Forces were computed for the observed (no brace) and simulated braced conditions. A sensitivity and validity analysis was conducted to determine the valid output range for the model, and Statistical Parameter Mapping was used to quantify the effectual region of the different TCU brace models.Results: PF and TF joint force calculations were valid between ~0 and 100 degrees of flexion. All three simulated brace models significantly (p < 0.001) reduced predicted knee joint loads (by 30–50%) across all structures, at knee flexion angles >~30 degrees during DKB.Conclusions: The TCU brace is predicted to reduce PF and TF knee joint contact loads during weight-bearing activity requiring knee flexion angles between 30 and 100 degrees; this effect may be clinically beneficial for pain reduction or rehabilitation from common knee injuries or joint disorders. Future work is needed to assess the range of possible clinical and prophylactic benefits of the TCU brace.

Posterior cruciate ligament (PCL) injuries are not as common as other knee ligament injuries, but may present a challenging scenario for even skilled knee surgeons. Complete PCL tears are typically encountered in the setting of multiligament knee injuries and require surgical treatment. Isolated complete PCL injuries are uncommon and the best treatment is debated, and likely depends on the degree of symptoms and objective instability. However, many PCL injuries will be partial tears (grade I or II). The purpose of this chapter is to describe our treatment of choice for partial PCL injuries through a conservative approach. Level of evidence Level IV.

• Injuries on hip, knee and ankle were caused in parachuting landing with backpack. • Without backpack, knee brace could protect hip, knee and ankle. • With backpack, knee brace could only protect knee. Injuries on lower-extremity joints were caused by high impact force in parachuting landing. Knee brace was used to protect knee by restraining motion of knee. Backpack was necessary in parachuting landing and would increase lower-extremity joints injuries. This study aimed to analyze kinematics and kinetics of hip, knee and ankle for investigating multi-joint protection of knee brace for those joints in parachuting landing with backpack. Seven participants landed from 120 cm height. Kinematics and kinetics of hip, knee and ankle were analyzed. It was found that without backpack knee brace decreased angular displacements of hip (12.0%), knee (10.3%) and ankle (18.6%) on sagittal plane and angular velocities of hip (11.9%), knee (6.6%) and ankle (20.9%) on sagittal plane. With backpack, knee brace decreased angular displacement (5.5%) and angular velocity of knee (6.2%) on sagittal plane, but did not significantly influence those of hip and ankle on sagittal plane. Ground reaction force, joint moments and joint energy absorptions were not significantly influenced with knee brace. In conclusion, in parachuting landing without backpack, knee brace could provide multi-joint protection for hip, knee and ankle. In parachuting landing with backpack, knee brace could still protect knee, but could not protect hip and ankle. [ABSTRACT FROM AUTHOR]

• Unloader brace did not change co-contraction of agonist and antagonist muscles. • Unloader brace produced changes in gluteal and gastrocnemius timing and amplitude, however, the clinical relevance is unclear. • There were no differences between adjusted and unadjusted brace conditions. To determine the immediate effects of a varus unloader knee brace on lower-limb electromyographic activity in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. Electromyographic data were recorded in 19 individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction during walking under three conditions: (i) no brace, (ii) unadjusted brace (no varus adjustment), and adjusted brace (varus adjustment). Variables of interest were statistically analyzed using repeated measures analysis of variance. There were no significant differences in muscle co-contraction between the three test conditions. The adjusted brace resulted in delayed offset of gluteus maximus (mean difference [95% CI]: 72 ms [24, 119]), and earlier onset of gluteus medius (59 ms [21, 97]) compared to no brace. The adjusted brace delayed onset of lateral gastrocnemius compared to no brace (53 ms [28, 78]) and the unadjusted brace (39 ms [7, 71]) and reduced average activation amplitude of gluteus maximus (−4 mV [−6, −1]) and lateral gastrocnemius (−9 mV [−16, −2]) compared to no brace. The unloader brace did not produce significant changes in muscle co-contraction in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. Significant changes in gluteal and gastrocnemius muscle activation timing and amplitude were observed, however, it is not clear whether these changes are of clinical importance. [ABSTRACT FROM AUTHOR]

The conservative techniques of treating knee osteoarthritis (kOA) include wearing orthoses such as knee braces and laterally wedged insoles and applying gait modification techniques such as toe-in gait and toe-out gait. This study aimed at assessing the immediate effects of these techniques in improving physical function of healthy and kOA participants. Five Osteoarthritis Research Society International (OARSI) recommended performance-based tests were randomly applied to measure physical function: (1) 30-second chair stand test (30CST), (2) 40-m (4 × 10) fast-paced walk test (40FPW), (3) stair climb test (SCT), (4) timed up and go test (TUGT) and (5) 6-minute walk test (6MWT) during a single-visit on 20 healthy and 20 kOA patients (age: 59.5 ± 7.33 and 61.5 ± 8.63 years, BMI: 69.95 ± 9.86 and 70.45 ± 8.80 kg/m2). The interventions included natural gait, toe-out gait, toe-in gait, laterally wedged insoles and knee brace. Analysis was performed through repeated-measures ANOVA and independent sample t-test. 30CST and TUGT showed no significant differences for the five test conditions (p > 0.05). Toe-out showed profound effects via pairwise comparison in impairing the physical function while knee brace improved it during 40FPW, SCT and 6MWT. In general, all the tested conservative techniques except laterally wedged insoles had immediate effects on physical performance measures in both healthy and medial knee osteoarthritis participants. The valgus knee brace improved the parameters the most, while toe-out gait impaired them the most. Future studies can develop strategies for improving gait retraining methods on the basis of issues identified by this study. [ABSTRACT FROM AUTHOR]

To compare the effect of unloading knee brace with physical therapy (PT) in Asian patients with osteoarthritis (OA) of the knee. This is a non-random, two-group comparative study. Patients with medial compartment knee OA (n = 41) were assigned to either the brace group (n = 20) or PT group (n = 21). Patients in the brace group were fitted with an unloading knee brace for three months and the PT group received a 60-min session of physiotherapy over the affected knee, three times a week, for three months. The primary outcome measures were the pain visual analogue scale (VAS) and the Western Ontario McMaster University Osteoarthritis Index (WOMAC); the second outcome measures were the 36-item Short-Form Health Survey (SF-36) and patient's satisfaction. The patients were evaluated at baseline, and at one month and three months. Group comparison showed no significant difference regarding pain VAS, WOMAC, SF-36, and patient's satisfaction, except stiffness in WOMAC (P =.006) and social functioning in SF-36 (P =.007). Time and group interaction revealed significant differences only in general health (P =.007) and mental health (P =.006) of SF-36. Within-group comparison found that pain VAS and WOMAC decreased significantly at one months and three months in both groups. The effect of brace fitting in patients with knee OA was similar to that of physical therapy. A Western-made unloading knee brace is acceptable in some Asian people with knee OA. NCT02712710. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the current investigation was to investigate the effects of a prophylactic knee brace on knee joint kinetics and kinematics during single- and double-limb deceleration tasks. Methods: Twenty female university first team-level netballers performed single- and double-limb deceleration tasks under two conditions (prophylactic knee brace/no-brace). Biomechanical data were captured using an eight-camera 3D motion capture system and a force platform. Participants also subjectively rated the comfort/stability properties of the brace, and their knee joint proprioception was examined with and without the knee brace using a weight-bearing joint position sense test. Results: The results showed that during both single- and double-limb deceleration tasks, neither peak anterior cruciate ligament [brace: single = 1.30/double = 1.30 bodyweight (BW) and no-brace: single = 1.19/double = 1.29 BW] P = 0.51, patellofemoral (brace: single = 4.21/double = 4.93 BW and no-brace: single = 3.99/double = 4.63 BW) P = 0.20, nor patellar tendon (brace: single = 6.17/double = 6.49 BW and no-brace: single = 6.07/double = 6.14 BW) P = 0.49 kinetics were significantly affected as a function of wearing the knee brace. The findings also showed that the knee brace helped to increase participants' perceived knee stability (P < 0.001), but there were no statistical improvements in weight-bearing knee proprioception (brace = 3.59 and no-brace = 2.94°) P = 0.44. Conclusions: The current investigation indicates that the utilization of prophylactic knee-bracing akin to the device used in the current study does not appear to reduce the biomechanical parameters linked to the aetiology of knee injuries during netball-specific deceleration movements. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine changes in knee biomechanics during badminton lunges due to fatigue, lunge strategy and knee bracing. Kinetic and kinematic data were collected from 16 experienced right-handed badminton players. Three factor repeated measures ANOVAs (lunge direction—fatigue—brace) were performed with Least Significant Difference pairwise comparisons. In addition, clinical assessments including; Y-balance test, one leg hop distance and ankle dorsiflexion range of motion were performed pre- and postfatigue. The knee showed significantly greater flexion during the forehand lunge compared to backhand. In contrast, the internal rotation velocity and the knee extension moment were greater during backhand. Knee angular velocity in the sagittal plane, peak knee moment and range of moment in the coronal plane and stance time showed significantly lower values postfatigue. In addition, the peak knee adduction moment showed significantly lower values in the braced condition in both the fatigued and nonfatigues states, and no significant differences were seen for peak vertical force, loading rate, approach velocity, or in any of the clinical assessment scores. There appears to be greater risk factors when performing a backhand lunge to the net compared to a forehand lunge, and proprioceptive bracing appears to reduce the loading at the knee.

Objectives: While there is a consensus against bracing after anterior cruciate ligament (ACL) reconstruction, the question of its potential benefits, especially in cases involving meniscus repair, as well as its routine use by the majority of clinicians, remains a topic of debate. This study aims to assess the effectiveness of bracing in relation to clinical scores after ACL reconstruction, regardless of meniscus surgery., Methods: This randomised controlled study involved patients aged 15-55 years who underwent arthroscopic ACL reconstruction surgery. All eligible patients were assigned into two groups: one group received an adjustable frame with a four-point fixation knee brace for a four-week period, while the other did not.A single experienced surgeon performed standard anatomical single-bundle ACL reconstruction. All patients, irrespective of whether they underwent meniscus repair, followed the same rehabilitation protocol. Knee functional questionnaires, including the International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner Activity Scale, Visual Analogue Scale (VAS), and examinations, were collected preoperatively, at six months, one year, and two years postoperatively. The study employed an intention-to-treat analysis and multilevel mixed-effects generalised linear models to compare continuous outcomes between the groups, adjusting for the times of follow-up., Results: A total of 84 patients (42 patients per group) comprised of 75 males (89 %) and average age of 30 ± 9.4 years old. Patient-reported function, physical examination findings, and surgical characteristics were comparable between the two groups. (P-value >0.05) Both groups demonstrated significant improvement in IKDC and Lysholm scores at the end of the two-year follow-up period. (P-value <0.0001) In multivariate analysis, bracing was significantly associated with lower Tegner activity scale than the non-brace group after adjustment for VAS and time (coefficient -0.49, 95 % confidence interval -0.87, -0.10, P-value = 0.013). None of the graft ruptures were reported, and there was no significant difference of return to sports between the groups at the end of the follow-up., Conclusion: The study suggests that knee bracing after ACL reconstruction, regardless of any additional meniscus procedures, fails to enhance subjective or objective outcomes and could potentially have a negative impact on the Tegner activity scale, although the difference is not clinically significant. The routine use of a postoperative brace should be discontinued., Level of Evidence: Level I, Randomised controlled trial with no negative criteria., Competing Interests: The authors have no conflicts of interest relevant to this article., (© 2024 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)