Effects of a prophylactic knee sleeve on anterior cruciate ligament and lower extremity biomechanics: an examination using musculoskeletal simulation

Abstract

The current study aimed using a two-experiment musculoskeletal simulation-based approach, measuring ACL biomechanics, knee joint kinematics and lower extremity joint loading to examine the effects of both a prophylactic knee sleeve on 1. a sport specific change of direction movement in female footballers and 2. a single leg landing in male footballers. Experiment 1 examined 12 female university first team level footballers (age 20.2 ± 1.34 years, height 1.61 ± 0.06 m, body mass 57.2 ± 5.6 kg) undertaking a 45° cutting movement in sleeve and no-sleeve conditions. Experiment 2 examined 10 male university first team level footballers (age 21.1 ± 1.13 years, height 1.77 ± 0.1 m, body mass 71.9 ± 8.6 kg) undertaking a single leg drop jump landing in sleeve and no-sleeve conditions. In each experiment, data was collected in a biomechanics laboratory and three-dimensional motion capture and ground reaction force information was collected. Three-dimensional kinematics, three-dimensional knee kinetics and ACL ligament forces/ strains were measured using musculoskeletal simulation, and participants were also asked to subjectively rate the knee sleeve in terms of both comfort and stability. Experiment 1 showed that the sleeve condition was associated with greater ACL strain (sleeve = 13.57% and no-sleeve = 10.26%) and forces (sleeve = 1.19BW and no-sleeve = 0.94BW). In addition, the brace condition also enhanced lateral compressive tibiofemoral (sleeve = 4.70BW and no-sleeve = 4.20BW) and total compressive tibiofemoral force (sleeve = 11.73BW and no-sleeve = 11.08BW). Finally, for the subjective ratings, participants indicated that the knee sleeve significantly improved perceived comfort and stability. Experiment 2 did not reveal and statistical differences between knee sleeve and no-sleeve conditions, nor any effects of the knee sleeve on subjective ratings of comfort or stability. Therefore, the findings from the current investigation suggest that the prophylactic knee sleeve examined in the current investigation does not appear to reduce the biomechanical parameters linked to the aetiology of knee pathologies in male/ female footballers.