title: Effects of knee bracing on postural control after anterior cruciate ligament rupture.
abstract: METHODS
  Randomized clinical trial.
  
  
  OBJECTIVE
  To investigate the effects of functional knee braces on postural control in patients with anterior cruciate ligament (ACL) rupture.
  
  
  BACKGROUND
  ACL rupture leads to both mechanical knee instability and deficits in proprioception. Although elastic knee braces do not increase mechanical stability, patients report improved stability when wearing a brace. Elastic braces were found to reduce the loss of proprioception. It is, however, still unclear whether they also improve postural control, which involves the processing of proprioceptive input at a higher level.
  
  
  METHODS
  We studied 58 patients with isolated unilateral ACL rupture using computerized dynamic posturography and compared overall stability index (OSI) scores for injured and uninjured legs with and without a knee brace. In addition, patients were classified as copers and non-copers depending on knee function.
  
  
  RESULTS
  Within subjects, OSI scores were 3.0 ± 1.1° for uninjured legs when unbraced, 2.8±1.3° for uninjured legs when braced (p=0.17), 3.7 ± 1.5° for unbraced injured legs, and 2.9 ± 1.3° for braced injured legs (p<0.001). For the injured legs of copers and non-copers, OSI scores were 3.4° ± 1.2° for copers and 4.0° ± 1.6° for non-copers in the unbraced condition (p=0.11) and 2.7 ± 1.0° for copers and 3.1 ± 1.4° for non-copers in the braced condition (p=0.26).
  
  
  CONCLUSIONS
  Elastic knee braces increase postural stability by approximately 22% in patients with ACL rupture. There was no difference in postural stability between uninjured and injured legs in the braced condition. One possible explanation is that bracing improves both proprioception and postural control.
authors.affiliation: Trauma Research Group, Department of Orthopedics and Trauma Surgery, German Armed Forces Hospital of Ulm, Ulm, Germany. HG_Palm@yahoo.de
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Palm
authors.forename: Florian
authors.initials: F
authors.lastname: Brattinger
authors.forename: Bernd
authors.initials: B
authors.lastname: Stegmueller
authors.forename: Gerhard
authors.initials: G
authors.lastname: Achatz
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Riesner
authors.forename: Benedikt
authors.initials: B
authors.lastname: Friemert
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D001915:Braces; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007718:Knee Injuries / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D012421:Rupture