Knee Bracing in Sports Medicine

Bridge, Michael A.; Stanish, William D.; Russell, David R.; Morash, Joel

doi:10.1097/btk.0b013e31818f8ee7

Techniques in Knee Surgery

2008

DOI: 10.1097/btk.0b013e31818f8ee7

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Knee Bracing in Sports Medicine

Michael A. Bridge¹,

William D. Stanish²,

David R. Russell³

et al.

Abstract: Considerable controversy still surrounds the use of knee bracing in the sports medicine patient. Several recent randomized controlled trials have shed new light on the debate. This article reviews the current clinical and biomechanical evidence supporting the efficacy of 5 brace types: prophylactic, rehabilitative, functional, offloader, and patellofemoral knee braces. A summary of evidence-based implications and techniques for selecting and fitting these braces will also be presented.

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2015

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Cited by 2 publications

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“…Knee flexion/extension is often modeled by a hinge joint, even though it is actually the result of combined rolling and gliding, with the instant center of rotation moving inside a circle of diameter ≈ 20 mm centered on the lateral femoral epicondyle [6]- [8].…”

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confidence: 99%

Knee Joint Misalignment in Exoskeletons for the Lower Extremities: Effects on User's Gait

et al. 2015

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Due to the complexity of the human musculoskeletal system and intra/intersubjects variability, powered exoskeletons are prone to human-robot misalignments. These induce undesired interaction forces that may jeopardize safe operation. Uncompensated inertia of the robotic links also generates spurious interaction forces. Current design approaches to compensate for misalignments rely on the use of auxiliary passive degrees of freedom that unavoidably increase robot inertia, which potentially affects their effectiveness in reducing undesired interaction forces. Assessing the relative impact of misalignment and robot inertia on the wearer can, therefore, provide useful insights on how to improve the effectiveness of such approaches, especially in those situations where the dynamics of the movement are quasi-periodic and, therefore, predictable such as in gait. In this paper, we studied the effects of knee joint misalignments on the wearer's gait, by using a treadmillbased exoskeleton developed by our group, the ALEX II. Knee joint misalignments were purposely introduced by adjusting the mismatch between the length of the robot thigh and that of the human thigh. The amount of robot inertia reflected to the user was adjusted through control. Results evidenced that knee misalignment significantly changes human-robot interaction forces, especially at the thigh interface, and this effect can be attenuated by actively compensating for robot inertia. Misalignments caused by an excessively long robot thigh are less critical than misalignments of equal magnitude deriving from an excessively short robot thigh.Index Terms-Active leg exoskeleton (ALEX II), force control, human-robot misalignment, rehabilitation robotics.

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Knee Joint Misalignment in Exoskeletons for the Lower Extremities: Effects on User's Gait

et al. 2015

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Smart Knee Brace Design With Parallel Coupled Compliant Plate Mechanism and Pennate Elastic Band Spring

Jun

Zhou

Ramsey

et al. 2015

Journal of Mechanisms and Robotics

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Recent research on exoskeletons and braces has examined the ways of improving flexibility, wearability or overall weight-reduction. Part of the challenge arises from the significant loading requirements, while the other part comes from the inflexibilities associated with traditional (rigid link-moving joint) system architectures. Compliant mechanisms offer a class of articulated multibody systems that allow creation of lightweight yet adjustable-stiffness solutions for exoskeletons and braces, which we study further. In particular, we will introduce the parallel coupled compliant plate (PCCP) mechanism and pennate elastic band (PEB) spring architecture as potential candidates for brace development. PCCP/PEB system provides adjustable passive flexibility and selective stiffness to the user with respect to posture of knee joint, without need for mediation by active devices and even active sensors. In addition to the passive mode of operation of the PCCP/PEB system, a semi-active design variant is also explored. In this semi-active design, structural stiffness reconfigurability is exploited to allow for changes of preload of the PEB spring to provide force and torque customization capability. The systematic study of both aspects (passive and semi-active) upon the performance of PCCP/PEB system is verified by a lightweight 3D printed physical brace prototype within a ground-truth (optical motion tracking and six degrees-of-freedom (6DOF) force transducer) measurement framework.

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Knee Bracing in Sports Medicine

Cited by 2 publications

References 45 publications

Knee Joint Misalignment in Exoskeletons for the Lower Extremities: Effects on User's Gait

Knee Joint Misalignment in Exoskeletons for the Lower Extremities: Effects on User's Gait

Smart Knee Brace Design With Parallel Coupled Compliant Plate Mechanism and Pennate Elastic Band Spring

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