Megan Y Shaw, Phillip A Gribble, Jamie L Frye

The aim of this study was to determine if the use of ankle braces helps improve dynamic stability during fatigue. 10 healthy volleyball palyers participated in the study and performed three jump-landing tasks with the following conditions: No brace; lace-up ankle brace and active ankle brace. Each condition was tested three times before and three times after induced functional fatigue.

Outcome measures were time to stabilisation in both anterior-posterior and medial-lateral directions using a single leg jump onto a force plate. Results showed that the lace-up ankle brace demonstrated faster anterior-posterior time to stabilisation that the active ankle brace and no brace conditions during fatigue. No significant findings were demonstrated for medial-lateral time to stabilisation.

The study concludes that wearing a lace-up ankle brace is the best bracing option for improving dynamic ankle stability.

J Athl Train, 2008; 43 (2):164-71 18345341

Tiggelen, Damien Van; Coorevits, Pascal; Witvrouw, Erik

The aim of this study is to determine the effectiveness of wearing a neoprene knee sleeve to improve proprioceptive function in fatigued and non-fatigued knees.

64 subjects underwent 4 consecutive assessments of the same active joint-repositioning test in the following conditions: braced; non-braced; fatigued; non-fatigued. The contra-lateral limb acted as control.

Results showed that only subjects with poor proprioception sense benefited from brace use when not fatigued. However, subjects with a good baseline proprioceptive sense benefited equally from bracing when fatigued. These results and results from other studies support the use of neoprene knee sleeves as prevention and treatment in individuals to improve proprioceptive sense in fatigued knees.

Clinical Journal of Sport Medicine. 18(3):259-265, May 2008

Cetin, Nuri MD; Aytar, Aydan PT, MSc; Atalay, Ayce MD; Akman, Mahmut Nafiz MD

The purpose of this study was to compare the effects of short-wave diathermy, TENS, ultrasound and hot packs on isokinetic knee extension strength, associated pain and function in women with knee osteoarthritis.

100 women were divided into 5 groups: Group1 - short-wave diathermy and hot packs; Group 2 - TENS and hot packs; Group 3 - ultrasound and hot packs; Group 4 - hot packs only; Group 5 - control group - no intervention.

The results demonstrated improvements in all four treatment groups for both pain and disability. Improvements in strength were also noted at all angles of knee extension, compared to the control group. In most outcome measures, improvements were greatest in group 1 (short-wave diathermy) or 2 (TENS).

American Journal of Physical Medicine & Rehabilitation. 87(6):443-451, June 2008.

Samuel K. Van de Velde, Thomas J. Gill, Louis E. DeFrate, Ramprasad Papannagari and Guoan Li

This study looked at the affect ACL tears, with and without reconstruction have on Patellofemoral joint biomechanics.

MRI and dual-orthogonal fluoroscopic imaging techniques were used to compare function between ACL deficient, reconstructed and healthy knees during a single leg lunge. 8 patients were assessed prior to reconstruction surgery and 6 months post-operatively with results compared also to the uninjured knee.

Results showed that deficiency caused a significant elongation and change in orientation of the patella tendon. It also reduced flexion and limited patella tilt and valgus rotation. ACL deficiency also caused a proximal and lateral shift in the point of contact for the patella cartilage.

Following reconstruction, the elongation of the patella tendon was reduced although orientation remained altered. Patella flexion and the altered point of contact were also corrected. However, Patella tilt and valgus rotation persisted.

The study concludes that altered patella positioning and tracking which occur in ACL deficient knees is not corrected following ACL reconstruction surgery. This suggests that following ACL injury, whether reconstruction is performed or not, the individual may be predisposed to patellofemoral cartilage degeneration.

The American Journal of Sports Medicine 36:1150-1159 (2008)

Wilco C Peul, Wilbert B van den Hout, Ronald Brand, , Ralph T W M Thomeer, Bart W Koes

This article is a two year follow-up from a previous research project into the effects of surgery on sciatica as a result of lumbar disc herniation.

283 patients with sciatica symptoms over a period of 6-12 weeks were divided randomly into two groups. 141 patients underwent early microdiscectomy surgery and 142 were consigned to a conservative treatment group for a period of 6 months.

62 of the conservative treatment group eventually required surgery. Follow-up assessment demonstrated no considerable difference between surgery and conservative groups at the two year point. An early improvement in leg pain in the surgery group was no longer present. Patient satisfaction also decreased over the two year period with 20% now reporting an unsatisfactory outcome.

Over the two year period, this research has shown that although surgery may show beneficial early effects in comparison to conservative treatment, following 1 and 2 years the outcome of the two groups were very similar.

BMJ, doi:10.1136/bmj.a143