Knee Brace Application Does Not Affect Thigh Muscle Strength and Knee Range of Motion After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
PURPOSE: To evaluate the effect of rehabilitative knee bracing on thigh muscle strength, knee mobility, subjective and objective performance, knee stability, and functional test outcomes following anterior cruciate ligament (ACL) reconstruction. METHODS: In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with INPLASY, we included randomized controlled trials and cohort studies comparing knee bracing versus no bracing after ACL reconstruction. Outcome measures were collected preoperatively and at defined study intervals of each study. Primary outcomes were thigh muscle strength and knee mobility, while secondary outcomes included International Knee Documentation Committee score, Tegner score, Lysholm score, visual analog scale for pain, knee anterior laxity, and the 1-legged hop test. Data were collected from multiple databases and analyzed using Comprehensive Meta-Analysis software, with bias assessed via the Cochrane Risk of Bias 2.0 tool and the Newcastle-Ottawa Scale. RESULTS: Fourteen studies with 1,199 patients were included, with follow-up ranging from 2 weeks to 4 years. Knee bracing showed no significant effect on isokinetic flexion (standardized mean difference [SMD] = -0.027; P = .935; 4 studies) or extension torque (SMD = -0.007; P = .980; 4 studies) within 2 years, flexion range of motion within 3 months (SMD = -0.001; P = .997; 4 studies), or extension deficits within 3 months (SMD = 0.355; P = .334; 3 studies) and 2 years (SMD = -0.439; P = .132; 3 studies). Secondary outcomes also showed no significant group differences. CONCLUSIONS: This systematic review and meta-analysis demonstrated that rehabilitative bracing after ACL reconstruction did not result in significant differences in thigh muscle strength or knee range of motion compared to nonbracing protocols. On the other hand, no significant differences were observed between the brace and nonbrace groups in terms of stability and functional outcomes. LEVEL OF EVIDENCE: Level III, systematic review and meta-analysis of Level I-III studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.020 | 0.034 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".