The Effect of Functional Knee Braces on Muscular Contributions to Joint Rotational Stiffness in Anterior Cruciate Ligament–Deficient and –Reconstructed Patients

Abstract

Functional knee braces are frequently prescribed by physicians to ameliorate the function of individuals with anterior cruciate ligament (ACL) injuries. These braces have been shown in the literature to potentially enhance knee stability by augmenting muscle activation patterns and the timing of muscle response to perturbations. However, very few techniques are available in the literature to quantify how those modifications in lower-limb muscle activity influence stability of the knee. The aim of the present study was to quantify the effect of an off-the-shelf functional knee brace on muscle contributions to knee joint rotational stiffness in ACL-deficient and ACL-reconstructed patients. Kinematic, electromyography, and kinetic data were incorporated into an electromyography-driven model of the lower extremity to calculate individual and total muscle contributions to knee joint rotational stiffness about the flexion–extension axis, for 4 independent variables: leg condition (contralateral uninjured, unbraced ACL injured, and braced ACL injured); knee flexion (5°–10°, 20°–25°, and 30°–35°); squat stability condition (stable and unstable); and injury status (ACL deficient and ACL reconstructed). Participants had significantly higher (P < .05,η2 = .018) total knee joint rotational stiffness values while wearing the brace compared with the control leg. A 2-way interaction effect between stability and knee flexion (P < .05,η2 = .040) for total joint rotational stiffness was also found.