A meta-analysis of existing research into the effects of bracing for the management of patellofemoral problems highlighted how only 7% of the recent research literature focusing on this modality compared to taping techniques.  This review* published in the scientific journal, Gait and Posture also highlighted that previous work on the use of knee bracing and taping had focused on sagittal plane movement when, in fact, most bracing and taping techniques aim to modify patella movement in the coronal and transverse planes.

This apparent lack of understanding of patellofemoral joint biomechanics during gait prompted researchers from the University of Central Lancashire to design a study to investigate the effect of patella bracing and taping on the three-dimensional mechanics of the knee during a controlled eccentric step down task. (Step descent is more challenging than step ascent due to the level of eccentric control required).

The twelve healthy subjects (with an average age of 28) participating in the comparative randomised study were asked to conduct a slow step down exercise, repeated five times. The step down was conducted under three randomised conditions: (1) no intervention, (2) neutral patella taping and (3) patellofemoral bracing. A step was constructed to accommodate a force platform with a standard step height of 20 cm. Kinematic and kinetic data were collected using a ten camera ProReflex motion analysis system to measure the sagittal, coronal and transverse planes. The researchers took into account two key hypotheses: that the introduction of patella bracing would alter the mechanics of the joint by reducing coronal and transverse plane movement and moments; and that the effect taping would have on the kinematics and kinetics of the knee would be due to proprioceptive mechanisms rather than mechanical changes.

The bracing and taping methods used in this study aim to reduce pain and improve the control of the knee joint. Both methods theoretically directly change the coronal and transverse plane kinematics and kinetics of the knee. This study showed a reduction in coronal plane movement and moments confirmed that bracing had a significant effect on the mechanics of the knee. Similarly the results from the transverse plane showed a reduction in the range of motion and moments at the knee. The overall reduction in the range of motion about the knee can infer an improvement in joint control. Both the brace and tape had a restrictive effect about the knee, by reducing the range of torsional moments and movements.

It is important to note, however, that only the brace had a statistically significant effect on all the variables. This suggests that the brace was more effective than the tape at improving control. There are two possible explanations of the improved control of the knee joint: neuromotor and mechanical. Both of these could be attributed to the brace. However, only neuromotor changes could be attributed to taping as a neutral technique was applied with no directional force. The greater effectiveness of the brace compared to taping may therefore be explained in two ways. The brace covered a much larger surface area of skin compared to the tape; it may be that the additional cutaneous stimulation from the brace is a significant factor in enhancing neuromotor control. Cutaneous stimulation from an elastic knee bandage has been previously suggested as an important factor in improving neuromotor control. Alternatively, the directional force component applied by the brace, which was absent in the neutral taping technique, may account for the greater control seen in the coronal and transverse planes in braced subjects.

Most bracing and taping techniques aim to control the patella in the coronal and transverse planes. This study was the first to identify that patellofemoral bracing and taping have a significant effect on the coronal and torsional mechanics of the knee, which had not been previously identified. This led to an eccentric step descent with considerably more control with bracing being more effective than taping.