Highlights Hop distance symmetry improves in the first three months following return to sport Hop distance symmetry improves while wearing a functional knee brace. Plantar loading symmetry does not improve with time following return to sport. Plantar loading symmetry improves while wearing a functional knee brace. Background: There is currently no consensus among orthopaedic surgeons as to when patients with anterior cruciate ligament reconstruction are ready to return to sport or whether or not patients should wear a functional knee brace during athletic activity. The purpose of the present study was to determine the effects of time since return to sport and of a functional knee brace on hop distance and loading symmetry during hop testing in patients with anterior cruciate ligament reconstruction. Methods: Twenty-eight patients with anterior cruciate ligament reconstruction completed hop testing after being released to return to sport and again 3?months later, both with and without wearing a custom fit extension constraint functional knee brace. The loadsol® captured plantar loading data (100?Hz) to quantify peak impact force, loading rate, and impulse during the final landing of every hop test. A limb symmetry index was calculated between surgical and non-surgical limbs for hop distance and loading measures. Findings: Wearing a knee brace increased hop distance symmetry during the single and crossover hop tests and peak impact force symmetry on each test (all p?<?0.05). While single (p = 0.022) and triple (p = 0.002) hop distance symmetry increased with time, there was no effect of time on any loading symmetry outcomes. Interpretation: These results support using a functional knee brace during athletic activities for improving symmetry in the early return to sport period. These results also support previous findings that while hop distance symmetry improves with time, asymmetrical landing mechanics do not and should be addressed clinically.
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