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 RESEARCH ARTICLE Can a knee sleeve influence ground reaction forces and knee joint power during a stepdown hop in participants following anterior cruciate ligament reconstruction? A secondary analysis Gisela Sole ID1*, Todd Pataky2, Niels Hammer3,4,5, Peter Lamb6 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand, 2 Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 3 Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria, 4 Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany, 5 Fraunhofer IWU, Dresden, Germany, 6 School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand * OPEN ACCESS Citation: Sole G, Pataky T, Hammer N, Lamb P (2022) 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 17(12): e0272677. https://doi.org/ 10.1371/journal.pone.0272677 Editor: Walid Kamal Abdelbasset, Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, SAUDI ARABIA Received: July 27, 2022 Accepted: November 30, 2022 Published: December 16, 2022 Copyright: © 2022 Sole et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are available through Zenodo (DOI: https://doi.org/10. 5281/zenodo.6859069). Funding: Funding and material (knee sleeves) were provided by Bauerfeind AG (Triebeser Straße, 07937 Zeulenroda-Triebes, Germany. The grant holders are Gisela Sole, Niels Hammer, Todd Pataky, Peter Lamb. The Funder had no role in 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 postsurgery) 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 PLOS ONE | https://doi.org/10.1371/journal.pone.0272677 December 16, 2022 1 / 19 PLOS ONE study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Abbreviations: ACL, anterior cruciate ligament; Fx, medio-lateral ground reaction force; Fy, anteriorposterior ground reaction force; Fz, vertical ground reaction force; GRF, ground reaction forces; IKDCSKF, International Knee Documentation Committee Subjective Knee Form; RCT, randomised controlled trial; RFD, rate of force development; SPM, Statistical parametric mapping. Influence of a knee sleeve on ground reaction forces and knee joint power following ACL reconstruction 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. Background Rupture of the anterior cruciate ligament (ACL) is a debilitating knee injury with potentially devastating short-term and long-term consequences. Rehabilitation following ACL reconstruction includes individualised progressive exercise prescription to improve range of motion, muscle strength, sensori-motor control and sports- and work-specific skills, as well as physical fitness [1]. Strategies are also included to address potential psychosocial factors, such as fear of re-injury, and to improve knee-related confidence and self-efficacy for return to physical activity [2–4]. Such strategies may include prescription of wearing a knee sleeve, or people with ACL reconstruction may intuitively use them [2, 5]. We have shown that individuals with ACL reconstruction may have immediate improved jump-related performance when wearing a knee sleeve [6]. Besides focussing on the distance or height of jumping, considering movement patterns during landing are also important [7, 8]. In our initial analysis of movement patterns during a step-down hop, participants with ACL reconstruction landed with greater knee flexion when wearing a knee sleeve [9]. Wearing a sleeve for at least one hour over a 6-week period resulted in no differences in knee flexion and moments compared to participants who did not wear the sleeve, but those with the sleeve jumped faster, evidenced with shorter stance duration [9]. Wearing a knee sleeve may influence sensorimotor control [10– 12], however, the mechanisms whereby a knee sleeve might improve jump distance or enhance knee flexion during jump landing are unclear. Jump-landing strategies have received substantial attention as a risk factor for ACL rupture and as outcomes following such injury [13, (...truncated)