Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 19, Issue 10, pp 1722–1728 | Cite as

The effect of prophylactic knee bracing on performance: balance, proprioception, coordination, and muscular power

  • Gul BaltaciEmail author
  • Gulcan Aktas
  • Elif Camci
  • Sevim Oksuz
  • Seda Yildiz
  • Tugce Kalaycioglu



Prophylactic knee braces are largely used in the prevention of ligament injuries, but their effectiveness on performance are still controversial. The aim of this study was to determine which brace was the most effective on functional performance.


Twenty-four healthy subjects (14 men and 10 women), between the age of 18 and 22 with no prior history of lower limb injury and brace use, voluntarily participated in this study. Five different prophylactic knee braces were used. The test protocol consisted of dynamic balance, jumping performance, proprioception, coordination, and maximal force. Balance was assessed by the Y balance test; jumping performance was assessed by vertical jump and one-leg hop tests; maximal force, proprioception, and coordination were assessed by using functional squat testing. Proprioceptive test was performed by using the functional squat system machine that the participants were instructed to keep the crosshair on the line, even after the visual aid had disappeared. The subjects without a brace and with the brace by using 5 different braces (DonJoy-USA) were evaluated by five different therapists.


Hinged “H” buttress for the support of the knee brace was found to be more effective than the others in terms of balance. Drytex economy hinged knee brace had the best result in terms of proprioception and maximal force. There were no significant differences in vertical jump and one-leg hop tests (n.s.).


In conclusion, the hinged “H” buttress for support of the knee brace and Drytex economy hinged knee brace produced the best results on the performance parameters. The other three braces demonstrated more variable and less optimal results. Prophylactic knee braces can be used for both healthy subjects and athletes to enhance proprioception, coordination, maximal force, and balance, but it is important to choose the best proper brace to the individuals according to their fitness level.

Level of evidence

(Economic and decision analysis—developing an economic or decision model), Level II.


Prophylactic knee brace Performance Proprioception Coordination 



The authors specially thank Smith & Nephew, DonJoy Inc. Carlsbad, California, for providing all braces according to subjects’ size.

Conflict of interest

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments, other benefits, commitments, or agreements from a commercial entity to provide such benefits. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated. Braces were provided by Smith & Nephew, DonJoy Inc. Carlsbad, California.


  1. 1.
    Ageberg E, Zätterström R, Moritz U (1998) Stabilometry and one-leg hop test have high test-retest reliability. Scand J Med Sci Sports 8:198–202PubMedCrossRefGoogle Scholar
  2. 2.
    Albright JP, Powell JW, Smith W, Martindale A, Crowley E, Monroe J, Miller R, Connolly J, Hill BA, Miller D et al (1994) Medial collateral ligament knee sprains in college football: brace wear preferences and injury risk. Am J Sports Med 22:2–11PubMedCrossRefGoogle Scholar
  3. 3.
    Albright JP, Saterbak A, Stokes J (1995) Use of knee braces in sport. Current recommendations. Sports Med 20:281–301PubMedCrossRefGoogle Scholar
  4. 4.
    BenGal S, Lowe J, Mann G, Finsterbush A, Matan Y (1997) The role of the knee brace in the prevention of anterior knee pain syndrome. Am J Sports Med 25:118–122PubMedCrossRefGoogle Scholar
  5. 5.
    Borsa PA, Lephart SM, Fu FH (1993) Muscular and functional performance characteristics of individuals wearing prophylactic knee braces. J Athl Train 28:336–344PubMedGoogle Scholar
  6. 6.
    Chew KT, Lew HL, Date E, Fredericson M (2007) Current evidence and clinical applications of therapeutic knee braces. Am J Phys Med Rehabil 86:678–686PubMedCrossRefGoogle Scholar
  7. 7.
    Deppen RJ, Landfried MJ (1994) Efficacy of prophylactic knee bracing in high school football players. J Orthop Sports Phys Ther 20:243–246PubMedGoogle Scholar
  8. 8.
    Erickson AR, Yasuda K, Beynnon B, Johnson R, Pope M (1993) An in vitro dynamic evaluation of prophylactic knee braces during lateral impact loading. Am J Sports Med 21:26–35PubMedCrossRefGoogle Scholar
  9. 9.
    Fleming BC, Renstrom PA, Beynnon BD, Engstrom B, Peira G (2000) The influence of functional knee bracing on the anterior cruciate strain biomechanics in weight-bearing knees. Am J Sports Med 28:815–824PubMedGoogle Scholar
  10. 10.
    France EP, Paulos LE (1994) Knee Bracing. J Am Acad Orthop Surg 2:281–287PubMedGoogle Scholar
  11. 11.
    Fujiwara LM, Perrin DH, Buxton BP (1990) The effect of three lateral knee braces on speed and agility in experienced and non-experienced wearers. Athl Train 25:160–161Google Scholar
  12. 12.
    Grace TG, Skipper BJ, Newberry JC, Nelson MA, Sweetser ER, Rothman ML (1988) Prophylactic knee braces and injury to the lower extremity. J Bone Joint Surg Am 70:422–427PubMedGoogle Scholar
  13. 13.
    Greene DL, Hamson KR, Bay RC, Bryce CD (2000) Effects of protective knee bracing on speed and agility. Am J Sports Med 28:453–459PubMedGoogle Scholar
  14. 14.
    Hardin GT, Farr J, Stiene HA (1993) Prophylactic knee braces for football: do they work? Indiana Med 86:308–311PubMedGoogle Scholar
  15. 15.
    Houston ME, Goemans PH (1982) Leg muscle performance of athletes with and without knee support braces. Arch Phys Med Rehabil 63:431–432PubMedGoogle Scholar
  16. 16.
    Kaminski TW, Perrin DH (1996) Effect of prophylactic knee bracing on balance and joint position sense. J Athl Train 31:131–136PubMedGoogle Scholar
  17. 17.
    Kramer JF, Dubowitz T, Fowler P, Schachter C, Birmingham T (1997) Functional knee braces and dynamic performance: a review. Clin J Sport Med 7:32–39PubMedCrossRefGoogle Scholar
  18. 18.
    Kinzey SJ, Armstrong CW (1998) The reliability of the star-excursion test in assessing dynamic balance. J Orthop Sports Phys Ther 27:356–360PubMedGoogle Scholar
  19. 19.
    Liggett CL, Tandy RD, Young JC (1995) The effects of prophylactic knee bracing on running gait. J Athl Train 30:159–161PubMedGoogle Scholar
  20. 20.
    Maffiuletti NA, Bizzini M, Schatt S, Munzinger U (2005) A multi-joint lower-limb tracking-trajectory test for the assessment of motor coordination. Neurosci Lett 384:106–111PubMedCrossRefGoogle Scholar
  21. 21.
    Moir G, Shastri P, Connaboy C (2008) Intersession reliability of vertical jump height in women and men. J Strength Cond Res 22:1779–1784PubMedCrossRefGoogle Scholar
  22. 22.
    Najibi S, Albright JP (2005) The use of knee braces, part 1: Prophylactic knee braces in contact sports. Am J Sports Med 33:602–611PubMedCrossRefGoogle Scholar
  23. 23.
    Osternig LR, Robertson RN (1993) Effects of prophylactic knee bracing on lower extremity joint position and muscle activation during running. Am J Sports Med 21:733–737PubMedCrossRefGoogle Scholar
  24. 24.
    Paluska SA, McKeag DB (2000) Knee braces: current evidence and clinical recommendations for their use. Am Fam Physician 61(411–8):423–424Google Scholar
  25. 25.
    Paluska SA, McKeag DB (1999) Using patellofemoral braces for anterior knee pain. Phys Sportsmed 27:81–82PubMedCrossRefGoogle Scholar
  26. 26.
    Paluska SA, McKeag DB (1999) Prescribing functional braces for knee instability. Phys Sportsmed 27:117–118PubMedCrossRefGoogle Scholar
  27. 27.
    Pietrosimone BG, Grindstaff TL, Linens SW, Uczekaj E, Hertel J (2008) A systematic review of prophylactic braces in the prevention of knee ligament injuries in collegiate football players. J Athl Train 43:409–415PubMedCrossRefGoogle Scholar
  28. 28.
    Podesta L, Sherman MF (1988) Knee bracing. Orthop Clin North Am 19:737–745PubMedGoogle Scholar
  29. 29.
    Risberg MA, Beynnon BD, Peura GD, Uh BS (1999) Proprioception after anterior cruciate ligament reconstruction with and without bracing. Knee Surg Sports Traumatol Arthrosc 7:303–309PubMedCrossRefGoogle Scholar
  30. 30.
    Rishiraj N, Taunton JE, Lloyd-Smith R, Woollard R, Regan W, Clement DB (2009) The potential role of prophylactic/functional knee bracing in preventing knee ligament injury. Sports Med 39:937–960PubMedCrossRefGoogle Scholar
  31. 31.
    Rovere GD, Clarke TJ, Yates CS (1988) Retrospective comparison of taping and ankle stabilisers in preventing ankle injuries. Am J Sports Med 16:228–233PubMedCrossRefGoogle Scholar
  32. 32.
    Rovere GD, Haupt HA, Yates CS (1987) Prophylactic knee bracing in college football. Am J Sports Med 15:111–116PubMedCrossRefGoogle Scholar
  33. 33.
    Sforzo GA, Chen NM, Gold CA, Frye PA (1989) The effect of prophylactic knee bracing on performance. Med Sci Sports Exerc 21:254–257PubMedGoogle Scholar
  34. 34.
    Sitler M, Ryan J, Hopkinson W, Wheeler J, Santomier J, Kolb R, Polley D (1990) The efficacy of a prophylactic knee brace to reduce knee injuries in football. A prospective, randomized study at West Point. Am J Sports Med 18:310–315PubMedCrossRefGoogle Scholar
  35. 35.
    Van Tiggelen D, Witvrouw E, Roget P, Cambier D, Danneels L, Verdonk R (2004) Effect of bracing on the prevention of anterior knee pain–a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 12:434–439PubMedCrossRefGoogle Scholar
  36. 36.
    Veldhuizen JW, Verstappen FT, Koene FM, Greep JM (1994) Effects of cast-bracing of the knee on physical performance in healthy subjects. Int J Sports Med 15:520–524PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Gul Baltaci
    • 1
    Email author
  • Gulcan Aktas
    • 1
  • Elif Camci
    • 1
  • Sevim Oksuz
    • 1
  • Seda Yildiz
    • 1
  • Tugce Kalaycioglu
    • 1
  1. 1.Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe UniversityAnkaraTurkey

Personalised recommendations