Aims: The aims of this study were to determine the usefulness of a functional knee brace (FKB) or a spiral method of taping in modifying the impaired biomechanics of the ACL-deficient knees towards a safe and more normal pattern, and to assess any compensatory changes at the ankle and hip joints following knee bracing or taping. The study also aimed to compare the difference in gait patterns during simple· level walking and treadmill activities for ACL-deficient subjects. Methods: A prospective experimental study was carried out on 15 ACL-deficient and 15 carefully matched amateur athletes as controls. A comprehensive gait analysis study was designed using a high frequency CODA-mpx30 gait analysis system, force platform and electromyography (EMG) system. The study was carried out during simple level walking, treadmill walking (3.6 Km/hr) and treadmill running (10 Km/hr) which we describe as low and high level physical activities. Treatments investigated included a functional knee brace (FKB) or a special spiral taping method that was applied to the deficient knees. The temporospatial parameters, total range of motion (ROM), joint position, kinetics and EMG parameters were recorded in the knee, ankle and hip joints in different trials with different supports and the results were compared with the baseline data of both the patients and the data derived from the control subjects. Main Results: The FKB significantly reduced total ROM in the ACL-deficient subjects for all levels of walking trials (P<O.05). The FKB significantly reduced peak knee flexion during swing while walking on level ground, but increased maximum knee flexion in swing during walking on the treadmill (P<O.05). Taping significantly increased mean knee angle in stance in both walking modes (P<O.05). Neither FKBs nor taping showed any angulatory kinematic effects on the knee joint during running on the treadmill. The FKBs could significantly reduce the antero-posterior (A-P) displacement of the tibia relative to the femur during level walking mostly in the swing phase. Wearing a brace did not reduce the knee extensor moments, but significantly reduced the hip flexor moments. Taping, however, had no significant effects on knee moment, but increased the generation and absorption of ankle power and decreased hip generation power. Bracing reduced the "support moment" and "support power" in the lower limb, but taping did not change them. No quadriceps avoidance gait pattern was found in this study and the patients showed an extensor knee moment throughout the stance phase. The gastrocnemius muscle was found to have a principal role in the ACL-deficient subjects and wearing a FKB could significantly activate the gastrocnemius muscles earlier in the ACL-deficient subjects, although no effects on peak activity of the muscle were demonstrated. Conclusion: It can be concluded that the functional knee brace used in this study did not show any harmful effects in ACL-deficient knees. It was helpful particularly for low force activities such as level walking. The brace was as effective for walking on the treadmill as walking on level ground although some kinematic changes exist between these two different activities. Taping, however, is not recommended for ACL-deficient knees. Since the ACL-deficient subjects showed good knee control in most running trials, there would appear to be a need for more strenuous activities and these are strongly recommended.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:367590 |
| Date | January 2001 |
| Creators | Rahimi, Abbas |
| Publisher | University of Nottingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://eprints.nottingham.ac.uk/30815/ |
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