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Title: Closing the Wearable Gap—Part VIII: A Validation Study for a Smart Knee Brace to Capture Knee Joint Kinematics
Background: Wearable technology is used by clinicians and researchers and play a critical role in biomechanical assessments and rehabilitation. Objective: The purpose of this research is to validate a soft robotic stretch (SRS) sensor embedded in a compression knee brace (smart knee brace) against a motion capture system focusing on knee joint kinematics. Methods: Sixteen participants donned the smart knee brace and completed three separate tasks: non-weight bearing knee flexion/extension, bodyweight air squats, and gait trials. Adjusted R2 for goodness of fit (R2), root mean square error (RMSE), and mean absolute error (MAE) between the SRS sensor and motion capture kinematic data for all three tasks were assessed. Results: For knee flexion/extension: R2 = 0.799, RMSE = 5.470, MAE = 4.560; for bodyweight air squats: R2 = 0.957, RMSE = 8.127, MAE = 6.870; and for gait trials: R2 = 0.565, RMSE = 9.190, MAE = 7.530 were observed. Conclusions: The smart knee brace demonstrated a higher goodness of fit and accuracy during weight-bearing air squats followed by non-weight bearing knee flexion/extension and a lower goodness of fit and accuracy during gait, which can be attributed to the SRS sensor position and orientation, rather than range of motion achieved in each task.  more » « less
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Author(s) / Creator(s):
; ; ; ; ; ; ; ; ;
Date Published:
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Page Range / eLocation ID:
152 to 162
Medium: X
Sponsoring Org:
National Science Foundation
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    Quadriceps weakness is common after anterior cruciate ligament (ACL) reconstruction and can alter gait mechanics. Functional resistance training (FRT) is a novel approach to retraining strength after injury, but it is unclear how it alters gait mechanics. Therefore, we tested how 3 different types of FRT devices: a knee brace resisting extension (unidirectional brace), a knee brace resisting extension and flexion (bidirectional brace), and an elastic band pulling backwards on the ankle (elastic band)–acutely alter gait kinetics in this population.


    The type of FRT device will affect ground-reaction forces (GRFs) during and after the training. Specifically, the uni- and bidirectional braces will increase GRFs when compared with the elastic band.

    Study Design:

    Crossover study.

    Level of Evidence:

    Level 2.


    A total of 15 individuals with ACL reconstruction received FRT with each device over 3 separate randomized sessions. During training, participants walked on a treadmill while performing a tracking task with visual feedback. Sessions contained 5 training trials (180 seconds each) with rest between. Vertical and anterior-posterior GRFs were assessed on the ACL-reconstructed leg before, during, and after training. Changes in GRFs were compared across devices using 1-dimensional statistical parametric mapping.


    Resistance applied via bidirectional brace acutely increased gait kinetics during terminal stance/pre-swing (ie, push-off), while resistance applied via elastic band acutely increased gait kinetics during initial contact/loading (ie, braking). Both braces behaved similarly, but the unidirectional brace was less effective for increasing push-off GRFs.


    FRT after ACL reconstruction can acutely alter gait kinetics during training. Devices can be applied to selectively alter gait kinetics. However, the long-term effects of FRT after ACL reconstruction with these devices are still unknown.

    Clinical Relevance:

    FRT may be applied to alter gait kinetics of the involved limb after ACL reconstruction, depending on the device used.

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