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Sole G, Pataky T, Hammer N, Lamb P. Can a knee sleeve influence ground reaction forces and knee joint power during a step-down hop in participants following anterior cruciate ligament reconstruction? A secondary analysis. PLoS One 2022; 17:e0272677. [PMID: 36525413 PMCID: PMC9757553 DOI: 10.1371/journal.pone.0272677] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Elastic knee sleeves are often worn following anterior cruciate ligament (ACL) reconstruction. The study aimed to define immediate and 6-week effects of wearing a knee sleeve on ground reaction forces (GRF) and knee joint power during a step-down hop task. METHODS Using a cross-over design, we estimated GRF and knee kinematics and kinetics during a step-down hop for 30 participants following ACL reconstruction (median 16 months post-surgery) with and without wearing a knee sleeve. In a subsequent randomised clinical trial, participants in the 'Sleeve Group' (n = 9) wore the sleeve for 6 weeks at least 1 hour daily, while a 'Control Group' (n = 9) did not wear the sleeve. We compared the following outcomes using statistical parametric mapping (SPM): (1) GRF and knee joint power trajectories between three conditions at baseline (uninjured side, unsleeved injured and sleeved injured side); (2) GRF and knee joint power trajectories within-participant changes from baseline to follow-up between groups. We also compared discrete peak GRFs and power, rate of (vertical) force development, and mean knee joint power in the first 5% of stance phase. RESULTS SPM showed no differences for GRF for the (unsleeved) injured compared to the uninjured sides; when wearing the sleeve, injured side mean power in the first 5% of stance increased significantly from a concentric to an eccentric power. Discrete variables showed lower peak anterior (propulsive) GRF, mean power in the first 5% of stance, peak eccentric and concentric power for the injured compared to the uninjured sides. After six weeks, a directional change for vertical GRF differed showed slightly decreased forces for the Control Group and increased forces for the Sleeve Group. CONCLUSION Wearing a knee sleeve on the anterior cruciate ligament injured knee improved knee power during the first 5% of stance during the step-down hop. No consistent changes were observed for ground reaction forces for SPM and discrete variable analyses. Wearing the knee sleeve at least one hour daily for 6-weeks lead to a directional change of increased vertical GRF for the Sleeve Group at follow-up. TRIAL REGISTRATION The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28/06/2018. https: //anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375347&isClinicalTrial=False.
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Affiliation(s)
- Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
- * E-mail:
| | - Todd Pataky
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Fraunhofer IWU, Dresden, Germany
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
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2
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Sole G, Lamb P, Pataky T, Pathak A, Klima S, Navarre P, Hammer N. Immediate and six-week effects of wearing a knee sleeve following anterior cruciate ligament reconstruction on knee kinematics and kinetics: a cross-over laboratory and randomised clinical trial. BMC Musculoskelet Disord 2022; 23:560. [PMID: 35689284 PMCID: PMC9186011 DOI: 10.1186/s12891-022-05488-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Elastic knee sleeves are often worn following anterior cruciate ligament reconstruction (ACLR) but their effects on movement patterns are unclear. Aim To determine the immediate and six-week effects of wearing a knee sleeve on biomechanics of the knee during a step-down hop task. Methods Using a cross-over design, we estimated sagittal plane knee kinematics and kinetics and stance duration during a step-down hop for 31 participants (age 26.0 [SD 6.6] years, 15 women) after ACLR (median 16 months post-surgery) with and without wearing a knee sleeve. In a subsequent randomised clinical trial, participants in the ‘Sleeve Group’ (n = 9) then wore the sleeve for 6 weeks at least 1 h daily, while a ‘Control Group’ (n = 9) did not wear the sleeve. We used statistical parametric mapping to compare (1) knee flexion/extension angle and external flexion/extension moment trajectories between three conditions at baseline (uninjured side, unsleeved injured side and sleeved injured side); (2) within-participant changes for knee flexion angles and external flexion/extension moment trajectories from baseline to follow-up between groups. We compared discrete flexion angles and moments, and stance duration between conditions and between groups. Results Without sleeves, knee flexion was lower for the injured than the uninjured sides during mid-stance phase. When wearing the sleeve on the injured side, knee flexion increased during the loading phase of the stance phase. Discrete initial and peak knee flexion angles increased by (mean difference, 95% CIs) 2.7° (1.3, 4.1) and 3.0° (1.2, 4.9), respectively, when wearing the knee sleeve. Knee external flexion moments for the unsleeved injured sides were lower than the uninjured sides for 80% of stance phase, with no change when sleeved. The groups differenced for within-group changes in knee flexion trajectories at follow-up. Knee flexion angles increased for the Control group only. Stance duration decreased by 22% for the Sleeve group from baseline to follow-up (-89 ms; -153, -24) but not for the Controls. Conclusions Application of knee sleeves following ACLR is associated with improved knee flexion angles during hop landing training. Longer term (daily) knee sleeve application may help improve hop stance duration, potentially indicating improved hop performance. Trial registration The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28/06/2018. ANZCTR Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05488-2.
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Affiliation(s)
- Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Todd Pataky
- Graduate School of Medicine, Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - Anupa Pathak
- School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | | | - Pierre Navarre
- Southland Hospital, Invercargill, New Zealand and Clinical Senior Lecturer, University of Otago, Dunedin, New Zealand
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.,Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.,Fraunhofer IWU, Medical Branch, Dresden, Germany
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3
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Milner J, Hartnettt D, DeFroda SF. Alternatives to Knee Braces. J Knee Surg 2022; 35:266-272. [PMID: 34600439 DOI: 10.1055/s-0041-1736198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Knee braces continue to be a widely utilized piece of medical equipment, ranging from simple over the counter sleeves to more complex functional braces, with the ability to provide electrical stimulation to muscle groups. Despite their popularity, alternatives to knee braces exist for patients who find braces to be ineffective, uncomfortable, cumbersome, or overly expensive. While high-quality studies are lacking for modalities such as neoprene sleeves, compression stockings, and kinesiotaping, there is promising evidence that these interventions can confer an element of stability and pain relief for a variety of knee pathologies both with regard to acute and chronic injuries as well as in the postoperative rehabilitation period. While no "holy grail" exists for the ideal brace, or bracing alternative, it is important for providers to be aware of the options available to patients as well as the current evidence for these various modalities, so that the provider can best guide musculoskeletal care.
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Affiliation(s)
- John Milner
- Department of Orthopedic Surgery, Brown University, Providence, Rhode Island
| | - Davis Hartnettt
- Department of Orthopedic Surgery, Brown University, Providence, Rhode Island
| | - Steven F DeFroda
- Department of Orthopedic Surgery, University of Missouri System, Columbia, Missouri
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4
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Althomali OW. Influence of using knee sleeve and lateral wedge insole on knee loading among healthy individuals during stair negotiation. Gait Posture 2022; 92:103-109. [PMID: 34839204 DOI: 10.1016/j.gaitpost.2021.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND For individuals with knee osteoarthritis (OA), stair negotiation is a challenging task and the first task during which they report pain due to the high knee loading required. The use of lateral wedge insole (LWI) has been found to reduce loading in patients with OA but not to reduce pain, whereas the use of knee sleeve has been shown to result in good pain reduction. Understanding the effect of combining LWI and knee sleeve use on healthy individuals before testing on individuals with knee OA is an important step. RESEARCH QUESTION The current study aimed to evaluate the effect of combining the use of LWI and knee sleeve and compare the results with the application of each treatment separately and with the control condition. METHODS This randomised cross-over study included 17 healthy participants who underwent 3D gait analysis. Participants performed ascending and descending stair activities with the following four treatment conditions: five-degree LWI, off-the-shelf knee sleeve, both LWI and knee sleeve and control condition. External knee adduction moment (EKAM) and knee frontal plane range of motion (ROM) were evaluated as primary outcomes. Repeated measure ANOVA or the Friedman test was selected based on meeting the assumption followed by multiple pairwise comparisons with Bonferroni correction. RESULTS In general, the use of LWI reduced the first peak EKAM significantly (p < 0.001) compared to the control condition in stir ascending (12% reduction) but not in stair descending (p > 0.05). Interestingly, knee sleeve use did not result in any reduction in the first peak EKAM compared to the control or any other condition. However, knee sleeve use led to a significant reduction in the knee frontal plane ROM during stair descending. The combined treatment was not superior to the LWI use when compared to control in the EKAM reduction. SIGNIFICANCE Combined knee sleeve and LWI use was not superior to LWI use alone in reducing the knee loading, but it may be beneficial for individuals with knee OA since it helped in reduction of the knee frontal plane ROM during stair descending. Importantly, the effect of LWI use or any other treatment must be investigated for each different activity, and the results found in one activity must not be generalised across other activities.
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Affiliation(s)
- Omar W Althomali
- Department of Physiotherapy, College of Applied Medical Sciences, University of Hail, Saudi Arabia.
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Lower-Limb Exosuits for Rehabilitation or Assistance of Human Movement: A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: The aim of this review is to provide a comprehensive overview of the technological state-of-the-art of exosuits and the clinical results obtained when applied to users with mobility impairment. Methods: Searches are carried out in the COCHRANE, PubMed, IEEE Xplore and MEDLINE databases. Titles, abstracts and full texts are screened for inclusion criteria. Technological and clinical data are extracted. The quality of the studies is evaluated via a study quality assessment tool. Results: 19 studies are identified as relevant. Active (47%) and passive exosuits (53%) are used. Most are used untethered (84%), accommodating the demand of mobility. No study reports power consumption, which is important for dimensioning power systems. Fields of applications are post-stroke (79%), osteoarthritis (16%) and post-trauma (5%). Mostly the ankle joint is addressed (57%), while less studies address multiple joints (21%). The outcomes of clinical evaluations of lower-limb exosuits with patients suffering from mobility impairments are positive in the correction of gait pattern and reducing metabolic energy consumption during hemiparetic walking. Conclusions: Lower-limb exosuits for clinical applications are still facing technological challenges. Fields of application are limited to stroke, osteoarthritis and trauma. While clinical outcomes are overall positive, improvements in the study protocols are suggested.
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Sole G, Lamb P, Pataky T, Klima S, Navarre P, Hammer N. Immediate and 6-week effects of wearing a knee sleeve following anterior cruciate ligament reconstruction: a cross-over laboratory and randomised clinical trial. BMC Musculoskelet Disord 2021; 22:655. [PMID: 34348704 PMCID: PMC8336666 DOI: 10.1186/s12891-021-04540-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/22/2021] [Indexed: 01/13/2023] Open
Abstract
Background Rehabilitation following anterior cruciate ligament (ACL) reconstructions is based mainly on comprehensive progressive exercise programmes using a multi-dimensional approach. Elastic knee sleeves may be useful adjuncts to rehabilitation. The aim of this study was to determine the immediate and 6-week effects of wearing a knee sleeve on person-reported outcomes and function in participants who had undergone an ACL reconstruction and who had residual self-reported functional limitations. Methods Individuals with ACL reconstruction in the previous 6 months to 5 years were recruited. Immediate effects of a commercially-available elastic knee sleeve on single-leg horizontal hop distance were explored using a cross-over design. Following this first session, participants were randomised into a Control Group and a Sleeve Group who wore the sleeve for 6 weeks, at least 1 h daily. Outcome measures for the randomised clinical trial (RCT) were the International Knee Documentation Classification Subjective Knee Form (IKDC-SKF) score, the single-leg horizontal hop distance, and isokinetic quadriceps and hamstring peak torque. Linear mixed models were used to determine random effects. Where both limbs were measured at multiple time points, a random measurement occasion effect nested within participant was used. Results Thirty-four individuals (16 women) with ACL reconstruction completed the cross-over trial. Hop distance for the injured side during the sleeve condition increased by 3.6 % (95 % CI 0.4–6.8 %, p = 0.025). There was no evidence of differential changes between groups for the IKDC-SKF (Sleeve Group n = 15; Control Group n = 16; p = 0.327), or relative improvement in the injured side compared to the uninjured side for the physical performance measures (Sleeve Group n = 12, Control Group n = 12; three-way interaction p = 0.533 [hop distance], 0.381 [quadriceps isokinetic peak torque], and 0.592 [hamstring isokinetic peak torque]). Conclusions Single-leg hop distance of the ACL reconstructed side improved when wearing a knee sleeve. Wearing the knee sleeve over 6 weeks did not lead to enhanced improvements in self-reported knee function, hop distance and thigh muscle strength compared to the control group. Trial registration The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28 June 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04540-x.
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Affiliation(s)
- Gisela Sole
- Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Todd Pataky
- Graduate School of Medicine, Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | | | - Pierre Navarre
- Orthopaedic Surgeon, Southland Hospital, Invercargill, New Zealand.,University of Otago, Dunedin, New Zealand
| | - Niels Hammer
- Department of Macroscopic and Clinical Anatomy, Medical University of Graz, Graz, Austria.,Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.,Fraunhofer IWU, Dresden, Germany
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7
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Gourlay ML, Gourlay LL. Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review. Clin Rheumatol 2020; 39:3105-3113. [PMID: 32458240 PMCID: PMC7497332 DOI: 10.1007/s10067-020-05181-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 12/04/2022]
Abstract
Because the pathophysiology of knee osteoarthritis is poorly understood, optimal evidence-based clinical management is uncertain. Sibling comparison studies can help inform a clinical model to guide preventive care. We compared the 8-year clinical outcomes in 2 sisters with a family history of osteoarthritis, normal BMI, and absence of knee pain at baseline. Both patients had Kellgren–Lawrence grade 1 in the affected knee at the time of twisting knee injuries leading to osteoarthritis diagnoses at age 50 (patient 1) and 51 (patient 2). Patient 1 developed a chronic right knee effusion, and progressed to Kellgren–Lawrence grade 3 bilaterally by the time she had a right total knee replacement at age 58. Patient 2 had subchondral fractures of the right knee with transient effusion, which healed after 1 year of partial weight-bearing with crutches and subsequent daily use of knee sleeves. Patient 2 had Kellgren–Lawrence grade 0 bilaterally upon surveillance imaging at age 58. The terms “osteoarthritis and knee and diagnostic imaging and subchondral bone and pathophysiology” were searched in the PubMed database to identify original research articles to inform a clinical model consistent with the patients’ outcomes. A fluid model of osteoarthritis was the best explanatory model for the discordant clinical trajectories of the age-matched siblings. Patient recommendations are presented based on these findings.
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Affiliation(s)
- Margaret L Gourlay
- Boston Scientific Corporation, Marlborough, MA, USA. .,Department of Family Medicine, University of North Carolina, Chapel Hill, Manning Drive, CB #7595, Chapel Hill, NC, 27599-7595, USA.
| | - Linda L Gourlay
- College of Nursing, University of Massachusetts, Amherst, MA, USA.,Department of Psychiatry, Baystate Medical Center, Springfield, MA, USA
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8
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Mohd Sharif NA, Usman J, Wan Safwani WKZ, Siew Li G, Abdul Karim S, Mohamed NA, Khan SS, Khan SJ. Effects of simple knee sleeves on pain and knee adduction moment in early unilateral knee osteoarthritis. Proc Inst Mech Eng H 2019; 233:1132-1140. [PMID: 31597554 DOI: 10.1177/0954411919874614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Knee sleeves are often prescribed to alleviate pain in people with early knee osteoarthritis. However, the biomechanics underlying their pain-relieving effect are still not well understood. This pre-post study aims at evaluating and comparing the effects of two different types of knee sleeves on knee adduction moment. Patients with clinically diagnosed knee osteoarthritis were recruited from the University of Malaya Medical Centre and were randomly assigned to two test groups using (1) a simple knee sleeve and (2) a simple sleeve with patella cutout. Knee adduction moment was collected using the Vicon motion capture system with two Kistler force plates. Pain, stiffness and physical functions were recorded using the Western Ontario and McMaster Universities Osteoarthritis Index. All measurements were taken before, immediately after and at the completion of 6 weeks of application (primary time point). In total, 17 participants with early unilateral knee osteoarthritis (47.7 (9.7) years) completed the study. Overall results show significant reduction in pain, early stance and late stance knee adduction moment and increased walking speed after 6 weeks of both knee sleeves application. This study results suggest that knee sleeves can reduce knee adduction moments in early unilateral knee osteoarthritis by 14.0% and 12.1% using the simple sleeve and the sleeve with patella cutout, respectively, and can potentially delay disease progression. In addition, knee sleeve with patella cutout does not provide additional benefits when compared to the simple knee sleeve.
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Affiliation(s)
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Applied Biomechanics, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Goh Siew Li
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Samihah Abdul Karim
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Anisah Mohamed
- Institute of Mathematical Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Soobia Saad Khan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Saad Jawaid Khan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Department of Biomedical Engineering, Faculty of Engineering Science and Technology, Ziauddin University, Karachi, Pakistan
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9
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Moon J, Kim H, Lee J, Panday SB. Effect of wearing a knee brace or sleeve on the knee joint and anterior cruciate ligament force during drop jumps: A clinical intervention study. Knee 2018; 25:1009-1015. [PMID: 30121150 DOI: 10.1016/j.knee.2018.07.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 06/19/2018] [Accepted: 07/18/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Knee braces are considered to be extremely useful tools in reducing the shear force of knee joints for non-contact anterior cruciate ligament (ACL) injury prevention. However, the effectiveness of sports knee braces and sleeves remains to be identified. Therefore, the purpose of this study was to evaluate the effectiveness of wearing commercialized sports knee braces and sleeves on knee kinematics, kinetics, and ACL force during drop jumps using musculoskeletal modeling analysis. METHODS Musculoskeletal modeling analysis was conducted on 19 male alpine skiers who performed drop jump motions from a 40-cm box under three conditions: without a brace/sleeve, with a brace, and while wearing a neoprene sleeve. RESULTS The physical performance (i.e., the center of mass of the jumping height) was not affected by the type of brace or sleeve. However, wearing a brace or sleeve during drop jump tasks reduced the knee joint's maximum flexion, abduction angles, and adduction moment. The knee joint shear force when wearing the brace or sleeve exhibited no statistical differences. Further, the ACL load estimated in this study did not exhibit any statistical differences in relation to wearing a brace or sleeve. CONCLUSIONS The knee braces and sleeves reduced flexion and abduction movement, and adduction moment but did not reduce the knee joint shear force, internal rotation moment, or the ACL force. Therefore, if a sports knee brace that controls the knee joint's shear force and internal rotation moment is developed, it may aid in preventing ACL injuries.
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Affiliation(s)
- Jeheon Moon
- Department of Sports Science, Korea Institute of Sport Science, Seoul, Republic of Korea
| | - Hyeyoung Kim
- Division of Liberal Arts and Science, Korea National Sport University, Seoul, Republic of Korea
| | - Jusung Lee
- Department of Leisure Sports, Kangwon National University, Samcheok, Republic of Korea
| | - Siddhartha Bikram Panday
- Department of Sport and Leisure Studies, Keimyung University, Daegu, Republic of Korea; Department of Physical Education, Seoul National University, Seoul, Republic of Korea.
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10
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Robadey J, Staudenmann D, Schween R, Gehring D, Gollhofer A, Taube W. Lower between-limb asymmetry during running on treadmill compared to overground in subjects with laterally pronounced knee osteoarthritis. PLoS One 2018; 13:e0205191. [PMID: 30335784 PMCID: PMC6193626 DOI: 10.1371/journal.pone.0205191] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/28/2018] [Indexed: 11/19/2022] Open
Abstract
Subjects with knee osteoarthritis (KOA) show gait asymmetries evidenced by lower knee flexion and shorter contact times for the affected leg. Interestingly, running on a treadmill compared to running overground is also associated with lower knee flexion and shorter contact times. Thus, it is of particular interest how gait patterns are influenced by the type of ground in subjects with KOA. The aim of the current study was therefore to measure the overground asymmetry of kinematic parameters in KOA subjects while running and to investigate whether this asymmetry is altered on a treadmill. Nine patients diagnosed with KOA underwent overground and treadmill running with 3D-motion analysis. The symmetry analysis was performed using Symmetry Angles for five selected gait parameters: contact and step time, heel-toe delay, maximal knee flexion during stance and vertical speed variance. For all parameters, the values were significantly lower for the affected compared to the non-affected leg (p≤0.023). Post-hoc analyses revealed significant differences between legs only overground and not on the treadmill. The asymmetry was lower on the treadmill, as indicated by significant Symmetry Angle reductions for contact time (p = 0.033), knee flexion (p = 0.001) and vertical speed variance (p = 0.002). The symmetry increase on the treadmill was mainly due to changes of the non-affected leg towards the affected leg values leading to smaller steps and less impact load in general. The present results suggest therefore that a) an assessment of symmetry may differ depending on the ground type (treadmill versus overground) and b) treadmill running may be more suitable for patients with KOA related gait asymmetries.
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Affiliation(s)
- Jacques Robadey
- Movement and Sport Science, Department of Medicine, University of Fribourg, Fribourg, Switzerland
- ICT Department, University of Applied Sciences and Arts, Western Switzerland, Fribourg, Switzerland
- * E-mail:
| | - Didier Staudenmann
- Movement and Sport Science, Department of Medicine, University of Fribourg, Fribourg, Switzerland
| | - Raphael Schween
- Department of Sport Sciences, University of Freiburg, Freiburg, Germany
- Institute of Sport Sciences, University of Giessen, Giessen, Germany
| | - Dominic Gehring
- Department of Sport Sciences, University of Freiburg, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport Sciences, University of Freiburg, Freiburg, Germany
| | - Wolfgang Taube
- Movement and Sport Science, Department of Medicine, University of Fribourg, Fribourg, Switzerland
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11
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Cudejko T, van der Esch M, Schrijvers J, Richards R, van den Noort JC, Wrigley T, van der Leeden M, Roorda LD, Lems W, Harlaar J, Dekker J. The immediate effect of a soft knee brace on dynamic knee instability in persons with knee osteoarthritis. Rheumatology (Oxford) 2018; 57:1735-1742. [PMID: 29931372 DOI: 10.1093/rheumatology/key162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Indexed: 11/12/2022] Open
Abstract
Objectives Wearing a soft knee brace has been shown to reduce self-reported knee instability in persons with knee OA. There is a need to assess whether a soft knee brace has a beneficial effect on objectively assessed dynamic knee instability as well. The aims of the study were to evaluate the effect of a soft knee brace on objectively assessed dynamic knee instability and to assess the difference in effect between a non-tight and a tight soft knee brace in persons with knee OA. Methods Thirty-eight persons with knee OA and self-reported knee instability participated in a laboratory study. A within-subject design was used comparing no brace vs brace and comparing a non-tight vs a tight brace. The primary outcome measure was dynamic knee instability, expressed by the perturbation response (PR). The PR reflects deviation in the mean knee varus-valgus angle during level walking after a controlled mechanical perturbation. Linear mixed-effect model analysis was used to evaluate the effect of a brace on dynamic knee instability. Results Wearing a brace significantly reduced the PR compared with not wearing a brace (B = -0.16, P = 0.01). There was no difference between a non-tight and a tight brace (B = -0.03, P = 0.60). Conclusion This study is the first to report that wearing a soft knee brace reduces objectively assessed dynamic knee instability in persons with knee OA. Wearing a soft brace results in an objective improvement of knee instability beyond subjectively reported improvement. Trial registration Nederlands Trial register (trialregister.nl) NTR6363.
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Affiliation(s)
- Tomasz Cudejko
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Martin van der Esch
- Amsterdam Rehabilitation Research Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Jim Schrijvers
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands
| | - Rosie Richards
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands
| | - Josien C van den Noort
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Musculoskeletal Imaging Quantification Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Tim Wrigley
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Willem Lems
- Jan van Breemen Research Institute, VU University Medical Center, Amsterdam.,Amsterdam Rheumatology & Immunology Centre, Amsterdam Medical Center, Reade, VU University Medical Center, Amsterdam
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands.,Delft University of Technology, Delft, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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12
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Zamporri J, Aguinaldo A. The Effects of a Compression Garment on Lower Body Kinematics and Kinetics During a Drop Vertical Jump in Female Collegiate Athletes. Orthop J Sports Med 2018; 6:2325967118789955. [PMID: 30140709 PMCID: PMC6096693 DOI: 10.1177/2325967118789955] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The use of compression garments has spread rapidly among athletes, largely because of marketing and perceived benefits. Upon review, it is unclear whether compression garments have a significant effect on performance and recovery, although they have been found to enhance proprioception. Further, it is reported that compression of the knee joint improves both dynamic and static balance. However, there is currently a paucity of data demonstrating the effects of compression garments on the biomechanical risk factors of knee-related injuries in female athletes. Purpose To evaluate the ability of a directional compression garment to alter hip and knee kinematics and kinetics during a drop vertical jump (DVJ) in healthy college-aged female athletes. Study Design Controlled laboratory study. Methods A sample of 23 healthy female collegiate athletes (mean age, 19.6 ± 1.3 years) participating in jumping sports (volleyball, basketball, and soccer) was included in this analysis. Each athlete performed 2 sets of 3 DVJs with and without a directional compression garment. Three-dimensional hip and knee kinematics and kinetics were collected using a standard Helen-Hayes 29-marker set, which was removed and reapplied after the garment was fitted, as well as 8 visible-red cameras and 2 force platforms. Each participant was tested in a single session. Results Hip abduction range of motion was significantly reduced from 12.6° ± 5.5° to 10.2° ± 4.6° (P = .002) while performing DVJs without and with the compression garment, respectively. No statistically significant differences between conditions were found in peak hip abduction, knee valgus range of motion, peak valgus, peak hip abduction moment, and peak knee valgus moment. Conclusion The results of this study show that wearing compression garments does have minimal effects on lower body mechanics during landing from a DVJ, partially supporting the idea that compression garments could acutely alter movement patterns associated with the knee injury risk. However, further research should focus on muscle activation patterns and adaptations over time. Clinical Relevance The use of specifically designed compression garments could aid in the prevention of knee injuries by inducing changes in jumping mechanics.
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Affiliation(s)
- Jacobo Zamporri
- Department of Kinesiology, Point Loma Nazarene University, San Diego, California, USA
| | - Arnel Aguinaldo
- Department of Kinesiology, Point Loma Nazarene University, San Diego, California, USA
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13
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Cudejko T, van der Esch M, van der Leeden M, Roorda LD, Pallari J, Bennell KL, Lund H, Dekker J. Effect of Soft Braces on Pain and Physical Function in Patients With Knee Osteoarthritis: Systematic Review With Meta-Analyses. Arch Phys Med Rehabil 2018; 99:153-163. [DOI: 10.1016/j.apmr.2017.04.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 04/24/2017] [Indexed: 01/01/2023]
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14
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Cudejko T, van der Esch M, van der Leeden M, van den Noort JC, Roorda LD, Lems W, Twisk J, Steultjens M, Woodburn J, Harlaar J, Dekker J. The immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence in patients with knee osteoarthritis. Arthritis Res Ther 2017; 19:260. [PMID: 29191237 PMCID: PMC5709997 DOI: 10.1186/s13075-017-1456-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/18/2017] [Indexed: 01/12/2023] Open
Abstract
Background We aimed to (i) evaluate the immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence, and (ii) to assess the difference in effect between a non-tight and a tight soft brace in patients with knee osteoarthritis (OA). Methods Forty-four patients with knee OA and self-reported knee instability participated in the single-session, laboratory, experimental study. A within-subject design was used, comparing a soft brace with no brace, and comparing a non-tight with a tight soft brace. The outcome measures were pain, self-reported knee instability and knee confidence during level and perturbed walking on the treadmill and activity limitations (10-m walk test and the get up and go (GUG) test). Linear mixed-effect model analysis for continuous outcomes and logistic generalized estimating equations for categorical outcomes were used to evaluate the effect of wearing a soft brace. Results Wearing a soft brace significantly reduced pain during level walking (B − 0.60, P = 0.001) and perturbed walking (B − 0.80, P < 0.001), reduced the time to complete the 10-m walk (B − 0.23, P < 0.001) and the GUG tests (B − 0.23, P = 0.004), reduced self-reported knee instability during level walking (OR 0.41, P = 0.002) and perturbed walking (OR 0.36, P < 0.001), and reduced lack of confidence in the knees during level walking (OR 0.45, P < 0.001) and perturbed walking (OR 0.56, P < 0.001), compared with not wearing a soft brace. There was no difference in effects between a non-tight and tight brace, except for the 10-m walk test. Wearing a tight brace significantly reduced the time to complete the 10-m walk test in comparison with wearing a non-tight brace (B − 0.11, P = 0.03). Conclusion The results of this study indicate that a soft brace is an efficacious intervention targeting pain, activity limitations, self-reported knee instability, and knee confidence in the immediate term in patients with knee OA. Further studies are needed evaluating the mode of action based on exerted pressure, and on the generalization to functioning in daily life. Trial registration trialregister.nl, NTR6363. Retrospectively registered on 15 May 2017.
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Affiliation(s)
- Tomasz Cudejko
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - Martin van der Esch
- Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands.
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - Josien C van den Noort
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Musculoskeletal Imaging Quantification Center (MIQC), Academic Medical Center, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - Willem Lems
- Amsterdam Rheumatology & Immunology Center, Amsterdam Medical Center, Reade, VU University Medical Center, Amsterdam, The Netherlands.,Jan van Breemen Research Institute, Reade, Amsterdam, The Netherlands
| | - Jos Twisk
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn Steultjens
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - James Woodburn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Delft University of Technology, Delft, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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15
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Ko CY, Chang Y, Jeong B, Kang S, Ryu J, Kim G. Effects of knee sleeves on coordination of lower-limb segments in healthy adults during level walking and one-leg hopping. PeerJ 2017; 5:e3340. [PMID: 28533981 PMCID: PMC5438577 DOI: 10.7717/peerj.3340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/21/2017] [Indexed: 11/20/2022] Open
Abstract
The evaluation of multisegment coordination is important in gaining a better understanding of the gait and physical activities in humans. Therefore, this study aims to verify whether the use of knee sleeves affects the coordination of lower-limb segments during level walking and one-leg hopping. Eleven healthy male adults participated in this study. They were asked to walk 10 m on a level ground and perform one-leg hops with and without a knee sleeve. The segment angles and the response velocities of the thigh, shank, and foot were measured and calculated by using a motion analysis system. The phases between the segment angle and the velocity were then calculated. Moreover, the continuous relative phase (CRP) was calculated as the phase of the distal segment subtracted from the phase of the proximal segment and denoted as CRPTS (thigh–shank), CRPSF (shank–foot), and CRPTF (thigh–foot). The root mean square (RMS) values were used to evaluate the in-phase or out-of-phase states, while the standard deviation (SD) values were utilized to evaluate the variability in the stance and swing phases during level walking and in the preflight, flight, and landing phases during one-leg hopping. The walking velocity and the flight time improved when the knee sleeve was worn (p < 0.05). The segment angles of the thigh and shank also changed when the knee sleeve was worn during level walking and one-leg hopping. The RMS values of CRPTS and CRPSF in the stance phase and the RMS values of CRPSF in the preflight and landing phases changed (p < 0.05 in all cases). Moreover, the SD values of CRPTS in the landing phase and the SD values of CRPSF in the preflight and landing phases increased (p < 0.05 in all cases). These results indicated that wearing a knee sleeve caused changes in segment kinematics and coordination.
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Affiliation(s)
- Chang-Yong Ko
- Research Team, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Yunhee Chang
- Research Team, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Bora Jeong
- Research Team, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Sungjae Kang
- Research Team, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Jeicheong Ryu
- Research Team, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Gyoosuk Kim
- Research Team, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
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Mohd Sharif NA, Goh SL, Usman J, Wan Safwani WKZ. Biomechanical and functional efficacy of knee sleeves: A literature review. Phys Ther Sport 2017; 28:44-52. [PMID: 28673759 DOI: 10.1016/j.ptsp.2017.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 04/26/2017] [Accepted: 05/06/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Knee sleeves are widely used for the symptomatic relief and subjective improvements of knee problems. To date, however, their biomechanical effects have not been well understood. OBJECTIVE To determine whether knee sleeves can significantly improve the biomechanical variables for knee problems. METHOD Systematic literature search was conducted on four online databases - PubMed, Web of Science, ScienceDirect and Springer Link - to find peer-reviewed and relevant scientific papers on knee sleeves published from January 2005 to January 2015. Study quality was assessed using the Structured Effectiveness Quality Evaluation Scale (SEQES). RESULTS Twenty studies on knee sleeves usage identified from the search were included in the review because of their heterogeneous scope of coverage. Twelve studies found significant improvement in gait parameters (3) and functional parameters (9), while eight studies did not find any significant effects of knee sleeves usage. CONCLUSION Most improvements were observed in: proprioception for healthy knees, gait and balance for osteoarthritic knees, and functional improvement of injured knees. This review suggests that knee sleeves can effect functional improvements to knee problems. However, further work is needed to confirm this hypothesis, due to the lack of homogeneity and rigor of existing studies.
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Affiliation(s)
- Nahdatul Aishah Mohd Sharif
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siew-Li Goh
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia; Centre for Applied Biomechanics, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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