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Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
Mar 18, 2025;

Exploring Predictors of Brace-Wearing Adherence in Non-Surgical Treatment of Acute Knee Medial Collateral Ligament Injuries.

Dana J Hunter, Amanda M Black, S Nicole Culos-Reed, Victor M Y Lun, Nicholas G Mohtadi
Author Information
  1. Dana J Hunter: Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
  2. Amanda M Black: Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.
  3. S Nicole Culos-Reed: Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
  4. Victor M Y Lun: Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
  5. Nicholas G Mohtadi: Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
PMID: 40126657 DOI: 10.1097/JSM.0000000000001315

Abstract

OBJECTIVES: (1) To estimate adherence to brace wearing for medial collateral ligament (MCL) injuries across 3 phases of conventional treatment and (2) to explore predictors of adherence for each phase.
DESIGN: Exploratory cohort study.
SETTING: Primary care center.
PATIENTS: Fifty-nine patients aged 18 to 65 (27 men, 32 women) from a randomized clinical trial examined the effectiveness of 2 bracing techniques (0-90 degrees or 30-90 degrees) for acute isolated MCL or combined anterior cruciate ligament injuries. Patients were prescribed a 6-week bracing protocol and were followed for 12 weeks.
INTERVENTIONS: Patients were prescribed constant brace wearing for 4 weeks (���23 h/d), then daytime wear only (���15 h/d) until brace discontinuation at 6 weeks. Rehabilitation exercises were prescribed from 2 weeks onward. Adherence to the protocol was assessed through daily self-reported logs. Clinical and patient-reported outcomes were collected throughout the randomized clinical trial (baseline, 2, 4, and 6 weeks). This study interpreted them as predictor variables of treatment adherence alongside patient and treatment characteristics.
MAIN OUTCOME MEASURES: Adherence to each 2-week phase, interpreted dichotomously (adherer or nonadherer). Adherers were identified as those who wore their brace according to the protocol.
RESULTS: Adherence and pain decreased, while overall knee ratings improved throughout the treatment. Pain, affected knee, and brace range-of-motion settings were significant predictors of adherence in the exploratory logistic regressions.
CONCLUSIONS: Pain, affected knee, and brace range-of-motion settings were the primary predictors of brace wearing in the first 4 weeks of treatment. This study is the first to provide insight into MCL bracing adherence, potentially aiding clinicians in treatment management.

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Grants

  1. 1/CSRD VA
  2. 1/CSRD VA
  3. /Simpson Family Endowment, University of Calgary, Sport Medicine Centre
  4. /In-kind Support, Sport Medicine Centre, University of Calgary
Journal Article

Word Cloud

Created with Highcharts 10.0.0bracetreatmentweeksadherence2AdherencewearingMCLpredictorsstudybracingprescribedprotocol4kneeligamentinjuriesphaserandomizedclinicaltrialdegreesPatientsh/d6throughoutinterpretedPainaffectedrange-of-motionsettingsfirstOBJECTIVES:1estimatemedialcollateralacross3phasesconventionalexploreDESIGN:ExploratorycohortSETTING:PrimarycarecenterPATIENTS:Fifty-ninepatientsaged186527men32womenexaminedeffectivenesstechniques0-9030-90acuteisolatedcombinedanteriorcruciate6-weekfollowed12INTERVENTIONS:constant���23daytimewear���15discontinuationRehabilitationexercisesonwardassesseddailyself-reportedlogsClinicalpatient-reportedoutcomescollectedbaselinepredictorvariablesalongsidepatientcharacteristicsMAINOUTCOMEMEASURES:2-weekdichotomouslyadherernonadhererAdherersidentifiedworeaccordingRESULTS:paindecreasedoverallratingsimprovedsignificantexploratorylogisticregressionsCONCLUSIONS:primaryprovideinsightpotentiallyaidingcliniciansmanagementExploringPredictorsBrace-WearingNon-SurgicalTreatmentAcuteKneeMedialCollateralLigamentInjuries

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