The effect of prophylactic knee bracing on performance: balance, proprioception, coordination, and muscular power.
Baltaci G, Aktas G, Camci E, Oksuz S, Yildiz S, Kalaycioglu T. Knee Surg Sports Traumatol Arthrosc. 2011 Apr 6. [Epub ahead of print]
The use of prophylactic knee braces to reduce the risk of ligamentous injuries in sports has increased in recent years. However, their effectiveness at reducing injury risk and influence on functional performance is controversial. It is unclear if the type of prophylactic brace differentially influences functional performance. Therefore, the purpose of this study was to evaluate the influence of five off-the-shelf braces on balance, proprioception, coordination, and muscular power.  Twenty-four healthy participants tested 6 conditions in a random order (each person completed every condition): 1) no brace, 2) brace 1 (Hinged Trupull Advanced System), 3) brace 2 (Hinged ‘‘H’’ buttress for support of the knee), 4) brace 3 (Butrs for support patella), 5) brace 4 (Drytex lat pat knee for support of the patella), and 6) brace 5 (Drytex economy–hinged knee) on behalf of Donjoy Defender (DJ; note: the authors declared no conflicts of interest except that the braces were provided by the company for free). The test protocol included dynamic balance, jump performance, proprioception, coordination, and maximal force. Proprioception (reproducing a joint angle), coordination, and maximal force were assessed with a functional squat system machine to assess the participants in a closed chain position. For dynamic balance assessments (Y balance test), the Hinged “H” buttress brace was the most effective compared to the other braces.  Drytex economy hinged knee brace had the best results for proprioception and maximal force. There were no significant differences in vertical jump and one-leg hop tests among braces. The authors suggest that the hinged “H” buttress brace and Drytex economy hinged knee brace produced the best results while the other three braces were less optimal and more variable.
The study is important for demonstrating that not all types of knee braces are equal. If you are considering prophylactic braces then it is important to review the literature and determine which braces are optimal for your athletic population (e.g., age group, sport, sex). The authors acknowledge that their study is limited because they did not test the short- and long-term effects of these braces. Some studies have suggested that long-term bracing could have detrimental effects but not all of the studies agree. Based on this study, it would be interesting to see a systematic review of studies reporting the long-term effects of bracing stratified by the types of braces. What are your thoughts and experiences with prophylactic knee bracing?
Written by: Jeffrey Driban
Reviewed by:  Stephen Thomas