Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 14, Issue 6, pp 555–563

Study on three-dimensional kinematics and electromyography of ACL deficient knee participants wearing a functional knee brace during running



This investigation examined the muscular activity and 3D knee joint kinematic changes of anterior cruciate ligament-deficient (ACLD) participants in the involved leg under bracing condition during running. Different adaptation strategies have been found between patients who can cope with the injury and patients who cannot. One of the expected changes can be the muscle activation characteristic of the injured knee during strenuous activity with and without a functional knee brace. Three-dimensional kinematic and electromyographical (EMG) data were collected from 11 participants for 10 consecutive gait cycles during running on a treadmill under both braced and unbraced conditions. Participants were administered the “Knee Outcome Survey Activities of Daily Living Scale” to distinguish functional and non-functional candidates. No significant differences on 3D kinematics and EMG data were noted between functional and non-functional participants, thus data analysis focused on comparisons of bracing conditions for one combined group. Bracing significantly reduced total range of motion in the frontal and transverse planes (P<0.05). Muscle activity at heel-strike showed a consistent trend to increase for the hamstrings and decrease for the quadriceps under the braced condition when compared to the unbraced condition. Our findings indicate that bracing the ACLD knee alters the kinematics of the injured leg while running. Tendencies toward reductions in quadriceps and increases in hamstrings activity at heel-strike indicate that bracing might have resulted in added stability of the injured knee. The adaptations to bracing found in this preliminary study further support the potential mechanical and proprioceptive contributions of the functional knee brace to protect the ACLD knee.


Anterior cruciate ligament Knee brace Electromyography Proprioception Running 


  1. 1.
    Beck C, Drez D Jr, Young J, Cannon WD Jr, Stone ML (1986) Instrumented testing of functional knee braces. Am J Sports Med 14:253–256PubMedCrossRefGoogle Scholar
  2. 2.
    Berchuck M, Andriacchi T, Bach B (1990) Gait adaptations by patients who have a deficient anterior cruciate ligament. J Bone Joint Surg 72A:871–877Google Scholar
  3. 3.
    Beynnon B, Pope M, Wertheimer C, Johnson R, Fleming B, Nichols C, Howe J (1992) The effect of functional knee braces on strain on the anterior cruciate ligament in vivo. J Bone Joint Surg 74:1298–1312PubMedGoogle Scholar
  4. 4.
    Beynnon BD, Fleming BC, Churchill DL, Brown D (2003) The effect of anterior cruciate ligament deficiency on translation of the tibia relative to the femur during nonweightbearing and weightbearing. Am J Sports Med 31:99–105PubMedGoogle Scholar
  5. 5.
    Bodor M (2001) Quadriceps protects the anterior cruciate ligament. J Orthop Res 19:629–633CrossRefPubMedGoogle Scholar
  6. 6.
    Boerdoom A, Hof A, Halbertsma J, van Raaij J, Schenk W, Diercks R, van Horn J (2001) Atypical hamstrings activity as a compensatory mechanism in anterior cruciate ligament deficiency. Knee Surg Sports Traumatol Arthrosc 9(4):211–216CrossRefPubMedGoogle Scholar
  7. 7.
    Branch TP (1989) Dynamic EMG analysis of anterior cruciate deficient legs with and without bracing during cutting. Am J Sports Med 17:35–41PubMedCrossRefGoogle Scholar
  8. 8.
    Cawley PW, France EP, Paulos LE (1991) The current state of functional knee bracing research—a review of the literature. Am J Sports Med 19:226–233PubMedCrossRefGoogle Scholar
  9. 9.
    Chmielewski TL, Rudolph KS, Fitzgerald GK, Axe MJ, Snyder-Mackler L (2001) Biomechanical evidence supporting a differential response to acute ACL injury. Clin Biomech 17:586–591CrossRefGoogle Scholar
  10. 10.
    DeVita P, Blankenship Hunter P, Skelly WA (1991) Effects of a functional knee brace on the biomechanics of running. Med Sci Sports Exerc 24:797–806Google Scholar
  11. 11.
    Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med 31(1):75–79PubMedGoogle Scholar
  12. 12.
    Grood EW, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: applications to the knee. J Biomech Eng 105:136–144PubMedCrossRefGoogle Scholar
  13. 13.
    Irrgang JJ, Snyder-Mackler L, Wainner RS, Fu FH, Harner CD (1998) Development of a patient reported measure of function of the knee. J Bone Joint Surg 80:1132–1145PubMedGoogle Scholar
  14. 14.
    Kalund S, Sinkjaer T, Arendt-Nielsen L, Simonsen O (1990) Altered timing of hamstrings muscle action in anterior cruciate ligament deficient patients. The Am J Sports Med 18:245–248CrossRefGoogle Scholar
  15. 15.
    Knoll Z, Kocsis L, Kiss RM (2004) Gait patterns before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 12:7–14CrossRefPubMedGoogle Scholar
  16. 16.
    Limbird TJ, Shiavi R, Frazer M, Borra H (1988) EMG profiles of knee joint musculature during walking: changes induced by anterior cruciate ligament deficiency. J Orthop Res 6:630–638CrossRefPubMedGoogle Scholar
  17. 17.
    Liu W, Maitland M (2000) The effect of hamstring muscle compensation for anterior laxity in the ACL deficient knee during gait. J Biomech 33:871–879CrossRefPubMedGoogle Scholar
  18. 18.
    More RC, Karras B, Neiman R, Fritschy D, Woo SL, Daniel D (1993) Hamstrings—an anterior cruciate ligament protagonist. Am J Sports Med 21:231–237PubMedCrossRefGoogle Scholar
  19. 19.
    Németh G, Lamontagne M, Tho KS, Eriksson E (1997) Electromyographic activity in expert downhill skiers using functional knee braces after anterior cruciate ligament injuries. Am J Sports Med 25:635–641PubMedCrossRefGoogle Scholar
  20. 20.
    Ramsey DK, Lamontagne M, Wretenberg PF, Valentin A, Engstrom B, Németh G (2001) Assessment of functional knee bracing: an in vivo three-dimensional kinetic analysis of the anterior cruciate- deficient knee. Clin Biomech 16:61–70CrossRefGoogle Scholar
  21. 21.
    Ramsey DK, Wretenberg P, Lamontagne M, Németh G (2003) Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Clin Biomech 18:28–34CrossRefGoogle Scholar
  22. 22.
    Reinschmidt C, van den Bogert AJ, Nigg BM, Lundberg A, Murphy N (1997) Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech 30:729–732CrossRefPubMedGoogle Scholar
  23. 23.
    Rudolph K, Axe M, Buchanan T, Scholz J, Snyder-Mackler L (2001) Dynamic stability in the anterior cruciate ligament-deficient knee. Knee Surg Sports Traumatol Arthrosc 9(2):62–71CrossRefPubMedGoogle Scholar
  24. 24.
    Smith J, Malanga GA, Yu B, An KN (2003) Effects of functional knee bracing on muscle-firing patterns about the chronic anterior cruciate ligament-deficient knee. Arch Phys Med Rehabil 84:1680–1686CrossRefPubMedGoogle Scholar
  25. 25.
    Tibone JE, Antich JE (1993) Electromyographic analysis of the anterior cruciate ligament deficient knee. Clin Orthop Relat Res 288:35–39PubMedGoogle Scholar
  26. 26.
    Timoney JM, Inman WS, Quesada PM, Sharkey PF, Barrack RL, Skinner HB, Alexander AH (1993) Return of normal gait patterns after anterior cruciate ligament reconstruction. Am J Sports Med 21:887–889PubMedCrossRefGoogle Scholar
  27. 27.
    Vailas JC, Pink M (1993) Biomechanical effects of functional knee bracing. Sports Med 15:210–218PubMedCrossRefGoogle Scholar
  28. 28.
    Wu GK, Ng GY, Mak AF (2001) Effects of knee bracing on the sensorimotor function of participants with anterior cruciate ligament reconstruction. Am J Sports Med 29(5):641–645PubMedGoogle Scholar
  29. 29.
    Wojtys EM, Huston LJ, Schock HJ, Boylan JP, Ashton-Miller JA (2003) Gender differences in muscular protection of the knee in torsion in size-matched athletes. J Bone Joint Surg 85(5):782–789PubMedGoogle Scholar
  30. 30.
    Wojtys EM, Ashton-Miller JA, Huston LJ (2003) A gender-related difference in the contribution of the knee musculature to sagittal-plane shear stiffness in participants with similar knee laxity. J Bone Joint Surg 84(1):10–16Google Scholar
  31. 31.
    Zeller BL, McCroy JL, Kibler WB, Uhl TL (2003) Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med 31(3):449–456PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.School of Human KineticsUniversity of OttawaOttawaCanada
  2. 2.School of Human Kinetics and Department of Mechanical EngineeringUniversity of OttawaOttawaCanada

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