title: Effects of an unloader knee brace on knee-related symptoms and function in people with post-traumatic knee osteoarthritis after anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  This pilot study evaluated the immediate and four-week effects of an unloader knee brace on knee-related symptoms and performance-based function in people with knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR).
  
  
  METHODS
  Individuals with knee OA, five to 20years post-ACLR, were recruited for two within-subject randomized studies: immediate effects (n=18) and four-week effects (n=11). Patient-reported knee-related symptoms (knee pain, perceived task difficulty, confidence, stability) were assessed during hop for distance and step-down tests, while performance-based function was assessed with hopping distance under three conditions: i) no brace; ii) unadjusted brace (sagittal plane support); and iii) adjusted brace (sagittal plane support with varus/valgus readjustment). Participants in the four-week brace effect study were randomized to wear the unadjusted or adjusted brace for four weeks after baseline (no brace) testing, and repeated tests in their allocated brace at four-week follow-up. Friedman tests evaluated differences between the three brace conditions for each variable for the immediate brace effect study (p<0.05), and Wilcoxon signed-rank tests evaluated differences between no brace and allocated brace for the four-week study (p<0.05).
  
  
  RESULTS
  The adjusted and unadjusted unloader braces produced immediate improvements in knee confidence during hop for distance, and knee pain during step-down. Following the four-week brace intervention, the allocated brace improved knee confidence, perceived task difficulty and stability during hop for distance; and knee pain, perceived task difficulty, confidence, and stability during step-down.
  
  
  CONCLUSIONS
  The unloader knee brace, adjusted or unadjusted, has the potential to improve knee-related symptoms associated with knee OA after ACLR.
authors.affiliation: Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia; Department of Mechanical Engineering, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Harvi F
authors.initials: HF
authors.lastname: Hart
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia; School of Allied Health, La Trobe University, Bundoora, Victoria, Australia. Electronic address: k.crossley@latrobe.edu.au.
authors.forename: Kay M
authors.initials: KM
authors.lastname: Crossley
authors.affiliation: Department of Mechanical Engineering, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Ackland
authors.affiliation: Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia.
authors.forename: Sallie M
authors.initials: SM
authors.lastname: Cowan
authors.affiliation: Department of Mechanical Engineering, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D001696:Biomechanical Phenomena; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D020370:Osteoarthritis, Knee / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D013997:Time Factors; D055815:Young Adult
keywords: Function; Knee brace; Osteoarthritis; Rehabilitation; Symptoms