***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To evaluate the effects of a rehabilitation brace locked in extension for the first week on the recovery of full extension after ACL reconstruction we compared two groups of subjects who underwent ACL bone-patellar tendon-bone reconstruction .  The brace was unlocked twice a day for assisted physiotherapy . In Group A , 18 male subjects wore a post-operative brace locked from 0 ° to 90 ° .  In Group B , 18 male subjects wore the same post-op brace locked in full extension for the first week . In both groups the brace was unlocked ( 0 ° -120 ° ) at the beginning of the second postoperative week , and then removed at the beginning of the third week . All the subjects followed the same rigorous , accelerated rehabilitation protocol . Each subject was evaluated pre and post-operatively ( at second , fourth and eighth week ) with bubble-level heel height difference ( HHD ) measurements and KT 1000 arthrometric assessment at the fourth postoperative month . Preoperative bubble-level HHD measurements of the two groups were statistically similar ( Group A 0.6 cm , Group B 1 cm ; not significant , n.s . ) . At the fourth week ( Group A 2.2 cm , Group B 0.6 cm ) and eighth week ( Group A 1.6 cm , Group B 0.1 cm ) follow-ups , bubble-level HHD measurements showed that the extension of the operated knees of Group B was significantly greater than in Group A. KT 1000 arthrometric scores showed no difference between the two groups ( Group A 1.8 mm , Group B 1.5 ; n.s . ) PURPOSE To evaluate the effects an  anterior cruciate ligament ( ACL ) brace  has on various measures of knee proprioception and postural control . METHODS Thirty subjects ( mean age 27 + /- 11 yr ) having undergone unilateral ACL reconstruction were tested with and without wearing their own custom-fit brace on their involved limb . Proprioception was assessed using joint angle replication tests completed on an isokinetic dynamometer . Postural control was assessed using a series of single-limb st and ing balance tests completed on a force platform . The balance tests included : 1 ) st and ing on the stable platform with eyes open , 2 ) st and ing on a foam mat placed over the platform with eyes open , 3 ) st and ing on the platform with eyes closed , and 4 ) st and ing on the platform after l and ing from a maximal single-limb forward hop . RESULTS The brace provided a small but statistically significant improvement in proprioception ( mean reduction in error scores between target and reproduced angles = 0.64 + /- 1.4 degrees , P = 0.02 ) . For the postural control tests , there was a significant brace condition by test situation interaction ( P = 0.02 ) , with the brace providing a small but statistically significant improvement during the test completed on the stable platform with eyes open ( mean reduction in center of pressure path length = 4.2 + /- 8.4 cm , P = 0.02 ) but not during the other more challenging test situations . Additional post hoc analyses indicated that the relationship between knee proprioception and postural control measures were low and not significant ( r = 0.003 to 0.19 , P > 0.32 ) , consistent with the suggestion that changes in knee proprioception can occur in the absence of substantial changes in postural control . Also , st and ing balance tests that challenged the somatosensory contribution to postural control ( i.e. , those completed on foam , or with eyes closed ) were significantly related to single-limb forward hop distances ( r = -0.4 , P < 0.05 ) , whereas performance during the proprioception test was not ( r = 0.1 , P > 0.50 ) . CONCLUSIONS In general , bracing appears to improve performance during tasks characterized by relatively limited somatosensory input but not during tasks characterized by increased somatosenory input . The small magnitude of the improvements , coupled with their apparent lack of carry over to more difficult and functionally relevant tasks , questions the clinical benefit of the present effects of bracing Abstract Despite changes in rehabilitation protocol s , an extension deficit remains an important potential cause of significant morbidity following anterior cruciate ligament ( ACL ) reconstruction . An extension-assisting brace was design ed using a limited motion brace and an elastic strap across a fulcrum on the anterior aspect of the knee joint . The effects of the brace were investigated in 40 patients undergoing primary ACL reconstruction using an autogenous central third patellar tendon graft .  The patients were r and omized either to use the brace in the first 6 weeks postoperatively or to undertake the same accelerated rehabilitation programme but without any brace , and they were review ed at 4 months postoperatively . The following data were recorded : passive and active extension and flexion deficits compared with the non-operated limb , KT-1000 assessment of anterior laxity and isometric quadriceps and hamstring strength . There was no difference between the two groups for any of the recorded variables . This was largely attributed to satisfactory tunnel placement and emphasis on the restoration of extension and quadriceps function during the early postoperative rehabilitation The prospect i ve study examined two different postoperative treatments on 46 patients with acute and isolated disruption of the anterior cruciate ligament ( acl ) , who were treated with reconstruction and augmentation using the semitendinosus-tendon .  The patients were r and omised and divided into two groups either to use a postoperative brace ( Donjoy Ind. ) set at full extension ( group A ) or to use the same brace set at a flexion of 20 degrees ( group B ) on the first 3 days after surgery . All patients undertook a st and ard " accelerated " rehabilitation protocol and were evaluated after 3 , 6 and 12 months after surgery . The results were as follow : the patients of group A reached the full extension faster than group B without any loss of knee stability . Postoperative extension even led to an earlier return to work and sport activities . The muscle strength side-to-side difference ( Cybex-measurement ) was lower in group A. The severity and intensity of postoperative pain , swelling and giving-way was reduced in group A as was the risk of arthrofibrosis . Evaluated with the scoring scales of the " Orthopädische Arbeitsgruppe Knie " ( OAK ) , the " International Knee Documentation Committee " ( IKDC ) , the Tegner activity score and the Lysholm score , the clinical outcome and activity-level were higher in group A than in group B. This prospect i ve study shows , that immediate postoperative extension , compared to the postoperative flexion of 20 degrees , reduces the term of rehabilitation and optimizes the operative results after acl-reconstruction Abstract Forty patients were prospect ively investigated to evaluate the effects of b and aging after reconstructive surgery of the anterior cruciate ligament ( ACL ) .  For the 6 weeks of the postoperative course , the operated knee was b and aged in 20 patients ( group A ) and braced in the other 20 patients ( group B ) . The  isokinetic torque for extension and flexion ( Cybex )  and the  range of motion ( ROM ) were investigated after 6 , 12 , 24 and 52 weeks postoperatively . At 24 weeks and 1 year postoperatively the stability of the knee joint ( KT-1000 ) as well as the clinical outcome ( ‘ Orthopädische Arbeitsgemeinschaft Knie ’ ) were evaluated . No statistically significant differences between the two groups were found for the extension and flexion strengths . Free ROM was achieved significantly earlier in group A than in group B. No statistically significant differences regarding the stability of the operated knee joint nor the early outcome were found between the two groups . This study demonstrated that the renunciation of using a brace had no adverse effect on the early outcome with respect to stability and function . On the contrary , bracing seems not to be m and atory after ACL reconstruction when the central third of the patellar tendon is used It has been our observation that post-operative anterior cruciate ligament ( ACL ) braces together with the post-operative b and ages do not always allow the knee to reach full extension . In ten uninjured knees with known hyperextension , the knees were b and aged in the same way as after an  ACL-reconstruction . The knees were then studied radiologically in a Hypex brace set at 0 ° , −5 ° and −10 ° of knee extension . Not a single knee was found to be straight in the brace set at 0 ° . At −5 ° most of the knees were straight or in slight hyperextension . It took −10 ° to get all knees straight or in hyperextension . In a prospect i ve r and omised study 44 patients who underwent an arthroscopic ACL-reconstruction with a bone patellar tendon bone graft  were r and omised to use either a brace set at −5 ° or a straight brace ( 0 ° ) for at least the first three postoperative weeks . Before and three months after surgery range of motion was determined , using a goniometer with long arms , and sagittal knee laxity was measured with a KT-2000 arthrometer at manual max . Pre- and post-operative pain was evaluated with the Visual Analogue Scale ( VAS ) . The same examiner ( blindfolded to what type of brace was used ) performed all the measurements . At three months , two of the 22 patients with the brace set at −5 ° and twelve of the 22 patients with the straight brace had a loss of full extension of 2 ° or more ( p<0.001 ) . No significant differences were found between the groups in terms of knee flexion , sagittal knee laxity or post-operative pain . Although extension deficit after ACL-reconstruction can be prevented also in other ways , a Hypex brace set at −5 ° seems to be an easy way of ensuring full knee extension Sixty patients were prospect ively r and omized  to  brace and no-brace groups after bone-tendon-bone patellar tendon anterior cruciate ligament ( ACL ) reconstruction .  The brace group wore a rehabilitation knee brace for 12 weeks post-operatively , while the no-brace  group was mobilized immediately , and crutches were discarded 2 weeks post-operatively . The groups were comparable with respect to age , gender , time from injury to surgery and concomitant injuries . There were no differences either pre-operatively or 5 years post-operatively ( 80 % of patients review ed ) between the groups in terms of the knee score ( Lysholm ) , activity level ( Tegner ) , degree of laxity or isokinetic peak muscle torque . Thus it appears that knee braces are not needed in the post-operative rehabilitation after ACL reconstruction with the patellar tendon graft The purpose of this study was to compare the clinical outcomes of rehabilitation after ACL reconstruction using a water-filled soft brace to those using a hard brace . The method used in this study was a prospect i ve r and omised clinical trial including 36 patients wearing a hard brace and 37 patients wearing a water-filled soft brace for 6 weeks after surgery . Preoperative and postoperative ( seven examinations ) clinical evaluation within a follow-up period of 1 year including effusion status , swelling and range of motion ( ROM ) , IKDC 2000 , KT1000 Arthrometer , Lysholm knee scoring scale and Tegner activity score . Mean values are presented with st and ard deviations . Data was analysed using descriptive statistics and Student 's t-test for unpaired sample s. Significantly less effusion was found in the soft brace group from 5 days ( p=0.002 ) to 12 weeks ( p<0.024 ) postoperative . Hard brace patients presented with significantly more extension deficit from 5 days ( p=0.036 ) to 12 months ( p=0.014 ) postoperative but no significant difference was detected in complete ROM , laxity or thigh atrophy at any follow-up examination . Patients treated with a soft brace had significantly higher IKDC subjective ratings at 6 weeks ( p=0.02 ) up to 12 months after operation ( p=0.002 ) and rated significantly higher in Tegner activity score ( p=0.004 ) and Lysholm knee scoring scale ( p=0.006 ) 6 and 12 months ( p<0.001 for both scores ) postoperatively . The water-filled soft brace was superior regarding effusion , swelling , extension deficit and patient-measured midterm outcome . The soft brace presents a safe , easy-to-use and effective alternative to the hard brace STUDY DESIGN R and omized clinical trial . OBJECTIVES To investigate the effects of functional knee braces on postural control in patients with anterior cruciate ligament ( ACL ) rupture . BACKGROUND ACL rupture leads to both mechanical knee instability and deficits in proprioception . Although elastic knee braces do not increase mechanical stability , patients report improved stability when wearing a brace . Elastic braces were found to reduce the loss of proprioception . It is , however , still unclear whether they also improve postural control , which involves the processing of proprioceptive input at a higher level . METHODS We studied 58 patients with isolated unilateral ACL rupture using computerized dynamic posturography and compared  overall stability index ( OSI ) scores for injured and uninjured legs with and without a knee brace .  In addition , patients were classified as copers and non-copers depending on knee function . RESULTS Within subjects , OSI scores were 3.0 ± 1.1 ° for uninjured legs when unbraced , 2.8±1.3 ° for uninjured legs when braced ( p=0.17 ) , 3.7 ± 1.5 ° for unbraced injured legs , and 2.9 ± 1.3 ° for braced injured legs ( p<0.001 ) . For the injured legs of copers and non-copers , 
    Output:
    
Although some articles in the literature are in favor of the use of a postoperative brace  after anterior cruciate ligament ( ACL ) reconstruction , this review found that several systematic review s and other reports on the topic do not support the use of a postoperative brace after ACL reconstruction .
There is no scientific evidence so far to support the routine use of a functional knee brace following a successful ACL reconstruction in the postoperative course .
Most authors believe that bracing is not necessary .
Postoperative bracing after ACL reconstruction does not seem to help with pain , function , rehabilitation , and stability .