The effects of ankle guards and taping on joint motion before, during, and after a squash match

Forefoot and heel take-off strategies result in different distribution of lower extremity work during landings

Previous research suggests that landing mechanics may be affected by the mechanics of the preceding jump take-off. The purpose of the present study was to investigate whether jump take-off mechanics influence the subsequent landing mechanics. Female volleyball (n = 17) and ice hockey (n = 19) players performed maximal vertical jumps with forefoot and heel take-off strategies. During forefoot and heel jumps, participants were instructed to shift their weight to their forefoot or heel, respectively, and push through this portion of the foot throughout the jump. Jump mechanics were examined using 3D motion analysis, where lower extremity net joint moment (NJM) work, NJM, and segment angles were compared between forefoot and heel jumps using multivariate ANOVA. During jump take-off, participants performed more positive ankle plantar flexor and knee extensor NJM work in forefoot compared to heel jumps (P < 0.05). From initial foot contact to foot flat, participants performed more negative ankle plantar flexor and hip extensor NJM work during heel compared to forefoot jumps (P < 0.05). The present results demonstrate that using a heel take-off strategy results in a different distribution of lower extremity NJM work and NJM during landing compared to landings following forefoot jumps.

Collegiate Football Players' Ankle Range of Motion and Dynamic Balance in Braced and Self-Adherent-Taped Conditions

CONTEXT

  Ankle sprains are one of the most common injuries in the physically active population. Previous researchers have shown that supporting the ankle with taping or bracing is effective in preventing ankle sprains. However, no authors have compared the effects of self-adherent tape and lace-up ankle braces on ankle range of motion (ROM) and dynamic balance in collegiate football players.

OBJECTIVE

  To examine the effectiveness of self-adherent tape and lace-up ankle braces in reducing ankle ROM and improving dynamic balance before and after a typical collegiate football practice.

DESIGN

  Crossover study.

SETTING

  Collegiate athletic training room.

PATIENTS OR OTHER PARTICIPANTS

  Twenty-nine National Collegiate Athletic Association Division I football athletes (age = 19.2 ± 1.14 years, height = 187.52 ± 20.54 cm, mass = 106.44 ± 20.54 kg).

INTERVENTION(S)

  Each participant wore each prophylactic ankle support during a single practice, self-adherent tape on 1 leg and lace-up ankle brace on the other. Range of motion and dynamic balance were assessed 3 times for each leg throughout the testing session (baseline, prepractice, postpractice).

MAIN OUTCOME MEASURE(S)

  Ankle ROM for inversion, eversion, dorsiflexion, and plantar flexion were measured at baseline, immediately after donning the brace or tape, and immediately after a collegiate practice. The Y-Balance Test was used to assess dynamic balance at these same time points.

RESULTS

  Both interventions were effective in reducing ROM in all directions compared with baseline; however, dynamic balance did not differ between the tape and brace conditions.

CONCLUSIONS

  Both the self-adherent tape and lace-up ankle brace provided equal ROM restriction before and after exercise, with no change in dynamic balance.

The effect of ankle muscle strength and flexibility on dolphin kick performance in competitive swimmers

The velocity of a swimmer is determined by biomechanical and bioenergetics factors. However, little is known about the effect of ankle flexibility on dolphin kick performance. Next to this, scientific evidence is lacking concerning the influence of ankle muscle strength. Therefore, the aim of this study was to investigate the effect of ankle flexibility and muscle strength on dolphin kick performance in competitive swimmers. Ankle range of motion (ROM) and ankle muscle strength were measured in 26 healthy competitive swimmers. The effect of both was assessed on the swimmer's velocity and lower extremity joint angles during three maximal dolphin kick trials. Additionally, the effect of a flexibility restriction by a tape on the dolphin kick performance was assessed. Correlations were calculated between the flexibility, muscle strength and dolphin kick performance and differences were investigated between the unrestricted and restricted condition. Muscle strength of dorsal flexors and internal rotators were positively significantly correlated with the velocity. Active and passive plantar flexion ROM and internal rotation ROM were not significantly correlated. A plantar flexion-internal rotation restriction during the dolphin kick showed a significant decrease in velocity. This restriction was associated with a changed movement pattern in the knee towards more flexion. The results suggest that dolphin kick velocity might be enhanced by ankle muscle strength exercises and that subjects with a restricted ankle flexibility might profit from a flexibility program.

Residual mechanical effectiveness of external ankle tape before and after competitive professional soccer performance

OBJECTIVE

To evaluate the presupposed preventive residual mechanical effectiveness of the widespread use of adhesive elastic ankle tape after a nonlaboratory, realistic soccer-specific outfield intervention reflecting a soccer halftime.

DESIGN

A prospective nonrandomized test-retest design was used.

SETTING

Laboratory.

PARTICIPANTS

Seventeen professional male outfield players (mean age, 25.5) without any signs of chronic ankle instability.

INTERVENTION

Participants were investigated before and after a 45-minute soccer-specific field intervention.

MAIN OUTCOME MEASURES

The passive inversion range of motion (ROM) of the ankle was tested unloaded on a self-developed inversion device with and without a standardized ankle tape before and after the intervention. Additionally, electromyography signal was taken to assure the inactivity of the protective evertor muscles, and reliability tests for the inversion device (test-retest and trial to trial) were conducted in 12 healthy controls.

RESULTS

Tape restricted the maximum passive inversion ROM of the uninjured ankle significantly to 50.3%. The protection declined nearly completely after 45 minutes of outfield soccer performance to a negligible nonsignificant ROM restriction of 9.7%. Pearson correlation coefficient for the reliability was 0.931 (P ≤ 0.001) for the test-retest and 0.983 (P ≤ 0.001) for the trial-to-trial test.

CONCLUSIONS

The initial significant protection of external ankle-tape support declines almost completely without relevant remaining residual mechanical effect after 45 minutes, reflecting a soccer halftime. The so far presupposed residual mechanical effectiveness of tape to prevent injury is increasingly irrelevant during soccer performance and consequently antidromic to the increasing injury risk toward the end of a soccer halftime.

A composite athletic tape with hyperelastic material properties improves and maintains ankle support during exercise

STUDY DESIGN

Controlled laboratory testing using a single-group, prospective, repeated-measures design.

OBJECTIVES

To compare the material properties of a hyperelastic athletic tape to a conventional tape and to compare the passive ankle support of these tapes before and after exercise.

BACKGROUND

The near-linear material properties of conventional athletic tape may interfere with ankle motion, resulting in reduced athletic performance. Conventional athletic tape is also known to lose much of its initial support during exercise. It was assumed that a tape constructed of Kevlar fibers embedded in a silicon matrix would possess hyperelastic material properties that would improve ankle support.

METHODS

A tensile testing machine was used to determine the tensile material properties of 11 samples of conventional and hyperelastic tape. The ankles of 11 young, healthy athletes were taped, one ankle with conventional tape and the other ankle with hyperelastic tape. The passive ankle support of each tape was measured with an instrumented linkage (the ankle flexibility tester) before and after 30 minutes of exercise.

RESULTS

The composite tape had a significantly higher load to failure than the conventional tape. It had significantly lower initial stiffness and higher late stiffness than conventional tape, thus demonstrating highly hyperelastic behavior. The hyperelastic tape maintained a significantly higher portion of its support during the 30 minutes of exercise than the conventional tape.

CONCLUSIONS

Composite athletic tape with highly hyperelastic properties can be constructed and maintains a larger portion of its support during short-duration exercises (less than 30 minutes) than conventional athletic tape.

Effect of ankle taping on mechanical laxity in chronic ankle instability

BACKGROUND

The high percentage of re-injury after an initial ankle sprain necessitates examination of preventative methods. The purpose of this project was to investigate the effect ankle tape has on mechanical laxity in subjects with CAI.

MATERIALS AND METHODS

Twenty subjects with unilateral CAI (seven males and 13 females; age, 20.6 +/- 1.8 years; mass, 69.9 +/- 13.7 kg; height, 172.3 +/- 9.3 cm) and 20 healthy subjects (seven males and 13 females; age, 21.9 +/- 4.3 years; mass, 72.0 +/- 14.6 kg; height, 171.1 +/- 6.7 cm) participated in the study. Both ankles of each subject were tested under two conditions: 1) before the application of tape; and 2) immediately after 30 minutes of exercise with the ankle taped. Mechanical laxity was measured with an instrumented ankle arthrometer. Two (group) x two (time) repeated measures ANOVA analysis was used for analysis.

RESULTS

There were significant group by time interactions (p = 0.014) for anterior displacement with significantly increased anterior displacement in the involved ankle of the CAI group relative to the matched control limb both before and after tape application. Similarly, there were significant time main effects for posterior displacement (p = 0.004), inversion (p = 0.001) and eversion (p = 0.043) rotation. Specifically, tape application decreased posterior displacement, inversion and eversion rotation only in the CAI group. Additionally, a significant group main effect for inversion rotation (p = 0.001) was also noted. Followup testing indicated significantly greater inversion rotation for the CAI ankle compared to the matched healthy ankle before tape application.

CONCLUSION

Mechanical laxity significantly decreased in CAI subjects after tape application. Although there was still a significant difference in mechanical laxity between the involved ankle vs. the uninvolved ankle of the CAI group, as well as the matched healthy group, laxity decreased in the CAI ankle after the application of tape.

CLINICAL RELEVANCE

Ankle taping may be able to improve mechanical instability in those with CAI.

Mechanical stability of the subtalar joint after lateral ligament sectioning and ankle brace application: a biomechanical experimental study

BACKGROUND

The roles of each ligament supporting the subtalar joint have not been clarified despite several biomechanical studies. The effects of ankle braces on subtalar instability have not been shown.

HYPOTHESIS

The ankle brace has a partial effect on restricting excessive motion of the subtalar joint.

STUDY DESIGN

Controlled laboratory study.

METHODS

Ten normal fresh-frozen cadaveric specimens were used. The angular motions of the talus were measured via a magnetic tracking system. The specimens were tested while inversion and eversion forces, as well as internal and external rotation torques, were applied. The calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament were sectioned sequentially, and the roles of each ligament, as well as the stabilizing effects of the ankle brace, were examined.

RESULTS

Complete sectioning of the ligaments increased the angle between the talus and calcaneus in the frontal plane to 51.7 degrees + or - 11.8 degrees compared with 35.7 degrees + or - 6.0 degrees in the intact state when inversion force was applied. There was a statistically significant difference in the angles between complete sectioning of the ligaments and after application of the brace (34.1 degrees + or - 7.3 degrees ) when inversion force was applied. On the other hand, significant differences in subtalar rotation were not found between complete sectioning of the ligaments and application of the brace when internal and external rotational torques were applied.

CONCLUSION

The ankle brace limited inversion of the subtalar joint, but it did not restrict motion after application of internal or external rotational torques.

CLINICAL RELEVANCE

In cases of severe ankle sprains involving the calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament injuries, application of an ankle brace might be less effective in limiting internal-external rotational instabilities than in cases of inversion instabilities in the subtalar joint. An improvement in the design of the brace is needed to restore better rotational stability in the subtalar joint.

Duration of strength retention of ankle taping during activities of daily living

BACKGROUND AND PURPOSE

Taping has been used for the prevention and treatment of ankle injuries. The change in tape strength has not been specifically quantified during activities of daily living (ADL) by any investigation so far. Therefore the primary aim of this study was to investigate the change in ankle tape strength over a 24-h period, while subjects performed their ADL.

SUBJECTS

Twenty-four healthy subjects (mean age: 24.3+/-7.4) participated in this study.

METHODS

Ankle taping was applied to all subjects for a 24-h period. Outcome measures were recorded at six different time intervals and are as follows: before and immediately after taping, 15, 30, 60 min, and 24h post taping. Strength of tape was quantified as the moment required to rotate the foot passively into inversion, measured using a handheld dynamometer. The range of motion (ROM) was also measured using a goniometer. The muscle activity of the ankle evertors were monitored while recording the outcome measures to ensure that the passive rotation of the ankle into inversion by the investigator was not impeded by their contraction.

RESULTS

A significant change in the moment required to rotate the foot into inversion and ROM was found between all time intervals tested (p<0.001). There was a 58% reduction in MOM and a 155% increase in ROM after 24h.

DISCUSSION AND CONCLUSION

This study has quantified for the first time the reduction in the support provided by ankle taping while subjects performed their ADL. This can assist clinicians on deciding the frequency of tape reapplication that may required to provide adequate support to the ankle.

Differences in ankle range of motion before and after exercise in 2 tape conditions

BACKGROUND

Athletic tape has been used on the ankle to decrease range of motion and to prevent injuries. Results from previous research found that with physical exercise athletic tape loses some of its restricting properties; recently, a new self-adherent taping product was developed that may restrict range of motion regardless of exercise.

HYPOTHESIS

Self-adherent tape will maintain ankle range of motion restriction more than traditional white cloth tape both before and after activity.

STUDY DESIGN

Controlled laboratory study.

METHODS

Twenty volunteers participated in testing procedures on 3 separate days, 1 for each taping condition (self-adherent, white cloth, and no tape). The participant's ankle range of motion was measured with an electrogoniometer before application of the tape, immediately after application of the tape, and after 30 minutes of physical exercise. Range of motion was measured in 2 planes of motion: inversion to eversion and dorsiflexion to plantar flexion.

RESULTS

White cloth tape and self-adherent tape both restricted inversion to eversion range of motion immediately after application, but with 30 minutes of exercise only the self-adherent tape maintained the decreased range of motion. For dorsiflexion to plantar flexion range of motion, the white tape and self-adherent tape both significantly decreased range of motion immediately after application and after the exercise protocol.

CONCLUSIONS AND CLINICAL RELEVANCE

The self-adherent tape maintained range of motion restriction both before and after exercise. Conversely, the white cloth tape lost some of its restrictive properties after 30 minutes of exercise.

The influence of ankle support on postural control

Postural control assessments are commonly administered to athletes as part of a pre-season screening. Establishing a baseline level of function permits the clinician to compare post-injury results to normal functioning during the return to play decision-making process. In the athletic setting, follow-up tests may be completed on the sideline immediately following injury. We sought to examine the effect of commonly administered external ankle joint support on postural control using the balance error scoring system (BESS) and the NeuroCom sensory organization test (SOT). Nineteen volunteers free from balance issues completed three sessions with varied ankle support: bilateral prophylactic ankle taping, laced bracing device, or barefoot. Each session included an initial balance assessment on the BESS and SOT, a 20 min treadmill walk, and post-walk balance test. Fewer errors, indicating improved balance, were committed on the BESS during the barefoot condition than the braced ankle condition (p=0.044) at the pre-walk assessment. During the post-walk assessment, fewer errors were committed during the barefoot condition compared to the braced ankle condition (p=0.034) and the taped ankle condition (p=0.037). All ankle support conditions showed similar improvements in balance between the pre and post-walk assessments on the BESS (p<0.001) and SOT composite balance score (p=0.009). These findings indicate that ankle support devices may influence postural control on the BESS, but not on the NeuroCom SOT. Clinicians using the BESS as a balance assessment device at multiple time points should be consistent in the application of ankle support devices.

Prophylactic bracing versus taping for the prevention of ankle sprains in high school athletes: a prospective, randomized trial

Prophylactic ankle taping has been considered the mainstay of ankle injury prevention and has been used at all levels of competitive football. An alternative to taping is a semirigid ankle orthosis. This study prospectively compared the incidence of ankle sprains in high school football players during a single season, after randomization to either prophylactic bracing or taping of both ankles. Of 83 athletes followed up for an entire season, 6 ankle sprains occurred, 3 in each treatment group; and there was no statistically significant difference in the incidence of ankle sprains between the 2 groups. The time required to tape an athlete averaged 67 seconds per ankle, resulting in a total of 97 minutes per ankle during an entire season, and the average cost to tape each ankle during an entire season was greater than the cost of the commercially available brace. The projected cost savings for an athletic program using prophylactic bracing could be substantial when compared with the use of prophylactic taping of the ankle.

Contralateral force sense deficits are related to the presence of functional ankle instability

Residual symptoms that often follow lateral ankle sprains can lead to functional ankle instability. Proprioceptive deficits have been identified as one factor that may contribute to the presence of functional ankle instability. Sixty participants were recruited to participate in the study. Seven questions were used to determine the presence of functional ankle instability in each participant. A point was added for each "yes" response to produce an index that represents an interval data scale of functional ankle instability. Contralateral force sense and active joint reposition sense were measured in all participants. Pearson product moment correlations were calculated to determine the relationship between functional ankle instability and force sense and active joint reposition sense. We found a significant relationship with force sense and functional ankle instability. Specifically, force sense variable error at both test forces (10 and 30% of maximal voluntary isometric contraction) were positively correlated to the presence of functional ankle instability, r=0.26; p<or=0.05 and r=0.25; p<or=0.05, respectively. All other force sense correlations were not statistically significant. No significant correlations were identified between active joint reposition sense and functional ankle instability. This study indicates that participants with functional ankle instability have deficits in low load force sense, but not active joint reposition sense.

Prophylactic ankle bracing reduces rearfoot motion during sudden inversion

The purpose of this study was to evaluate the effects of ankle bracing on rearfoot angular displacement and angular velocity during a sudden inversion movement. A 1 x 3 factorial design was used. The single independent variable was ankle brace condition with three levels: semi-rigid, lace-up and control. The two dependent variables were rearfoot average angular displacement and average angular velocity. Twenty-four healthy volunteers participated in this study. A motion analysis system was used to capture, model and calculate two-dimensional rearfoot motion while the subjects' ankle/foot complex was inverted to 35 degrees on a platform device. All subjects performed five trials of each ankle brace condition, and the average of these trials was used for statistical analysis. The semi-rigid brace significantly reduced rearfoot angular displacement and angular velocity compared with the lace-up (P<0.05) and control conditions (P<0.05). Additionally, the lace-up style brace demonstrated significantly less rearfoot angular displacement and angular velocity compared with the control condition (P<0.05). These results demonstrate that a semi-rigid ankle brace is more superior then a lace-up style brace in limiting rearfoot angular displacement and angular velocity. Moreover, the lace-up style brace offers significant restriction of these measures compared with no support.

Stabilizing effects of ankle bracing under a combination of inversion and axial compression loading

The combined effects of bracing, axial compression and inversion rotation on the ankle-subtalar complexes were evaluated. Ex vivo tests under the load-controlled condition were performed on six cadaver ankle specimens using a six degree-of-freedom fixture. Inversion rotation was measured while subjecting the ankle-subtalar complex to a 2.5 N-m inversion moment and a combination of the testing variables (brace type, no brace, 178 N axial compression load, no compression load, 0 degrees and 20 degrees of plantar flexion) for a total of 16 tests per specimen. Three commercially available braces (two semirigid types and one lace up type) were evaluated. An axial compression load significantly decreased ankle-subtalar motion in unbraced ankles for the tested inversion moment. The contribution of bracing to stabilization of the ankle was smaller in the axial loading condition than in the no axial loading condition. The semirigid braces had greater stabilizing effects in response to the inversion moment than the lace up brace. Stabilizing effects of bracing were significantly greater in 20 degrees of plantar flexion than in 0 degrees of plantar flexion. The most common mechanism for an ankle sprain injury is inversion rotation on a weight-bearing ankle. Therefore, we should not overestimate stabilizing effects of bracing from evaluations of bracing without axial compression loading.

The Effects of Calf-Muscle Fatigue on Sagittal-Plane Joint-Position Sense in the Ankle

Context:

There is limited information on the effect of dynamic fatiguing of the plantar flexors on joint-position sense (JPS).

Objective:

To examine the effects of fatigue on JPS for ankle plantar flexion (PF) and dorsiflexion (DF).

Design:

A 2 × 2 factorial design.

Setting:

Research laboratory.

Participants:

20 healthy subjects (10 men, 10 women; age 21.75 ± 1.48 years).

Interventions:

The subjects were tested at 10° DF and 20° PF in the nonfatigued and fatigued conditions on a custom-built JPS device. To induce fatigue, subjects stood with both feet in the plantar-flexed position until they could no longer hold the posture.

Main Outcome Measures:

JPS absolute error was measured at 10° DF and 20° PF.

Results:

There was no significant main effect for condition, measurement, or interaction between condition and measurement.

Conclusion:

With no difference between conditions, the main controller of conscious JPS of the lower extremity might be the tibialis anterior.

Effects of the subtalar sling ankle taping technique on combined talocrural-subtalar joint motions

BACKGROUND

The findings of research on the effectiveness of ankle taping for protection against ligament injury have been inconsistent, and the topic remains controversial. The precise orientation of the force vectors created by tension within the various tape strip components of an ankle taping procedure may be a critical factor influencing the degree of motion restraint that is provided. We hypothesized that the addition of the subtalar sling component to the widely recognized standard (Gibney) ankle taping procedure would enhance restraint of ankle motion. This was a controlled laboratory study, with fully repeated measures (subjects served as their own controls).

METHODS

An ankle arthrometer was used to quantify anteroposterior (AP) translation and frontal plane inversion-eversion (I-E) tilt of the talocrural-subtalar joints under untaped and taped conditions in normal subjects. A 15-minute exercise session was conducted to loosen the tape before measurement of its effect on motion restraint.

RESULTS

The ankle taping procedure that incorporated the subtalar sling provided significantly greater restriction of postexercise AP translation (p < 0.001, eta(2) = 0.63) and postexercise I-E tilt (p < 0.001, eta(2) = 0.66).

CONCLUSIONS

The subtalar sling ankle taping procedure provides greater restriction of motions associated with ankle instability than the more widely used Gibney procedure.

Acute ankle injury and chronic lateral instability in the athlete

Ankle injuries occur frequently in sports. The lateral ligamentous complex, specifically the anterior talofibular and calcaneofibular ligaments, are most commonly injured. In acute lateral ligament injuries, a functional ankle rehabilitation program is the mainstay of treatment. Chronic ankle instability develops in a minority of patients. Surgical procedures are broadly classified into anatomic ligament repairs versus reconstructive tenodeses. Commonly performed techniques include the Brostrom-Gould procedure,the modified Brostrum-Evans procedure, and the Chrisman-Snook procedure.

Effect of a modified, low-dye medial longitudinal arch taping procedure on the subtalar joint neutral position before and after light exercise

STUDY DESIGN

Single-group repeated measures design pre- and postintervention.

OBJECTIVES

To determine if the modified low-Dye medial longitudinal arch (MLA) taping procedure places the subtalar joint into the neutral position and maintains the subtalar joint neutral (STJN) position following 10 minutes of walking.

BACKGROUND

Subtalar malalignment in excessive pronation is commonly accepted as a contributing factor to a variety of musculoskeletal pathologies. The modified low-Dye MLA taping procedure is often used on the plantar surface of the foot as a short-term corrective tool for excessive foot pronation. However, research that evaluates the efficacy of this taping technique during light exercise is lacking. Measurement of navicular height is commonly used as a measure of subtalar position.

METHODS AND MEASURES

Prior to the study, one tester-established reliability in the navicular drop technique measurement by initially practicing the measurements on 400 feet, followed by a reliability study performed on 29 subjects. In this study, a screening procedure excluded subjects with ankle or foot pathology, supinated feet, or neutral feet, and included only subjects with pronated feet. The study, which included 40 subjects, involved four steps: (1) measuring navicular height in the relaxed position; (2) measuring navicular height in the STJN position; (3) measuring navicular height after application of the modified low-Dye MLA taping procedure; and (4) measuring navicular height after subjects had walked for 10 minutes with the taping.

RESULTS

Results indicated an intrarater intraclass correlation coefficient (ICC) for measuring navicular height of 0.96 for the right foot and 0.94 for the left foot. Repeated measures ANOVA revealed that significant differences existed (P < 0.05) among the 4 measures. A Bonferroni post hoc analysis showed a difference between relaxed stance measurements and all other measurements, and between taped-prewalking measurements and taped-postwalking measurements. In addition, no significant difference was observed between navicular height measured in STJN and the taped-prewalking and taped-postwalking conditions. The average navicular height for the taped-prewalking condition was 1.6 mm higher than that for the STJN position. For the taped-postwalking condition, the average height of the navicular was 1.2 mm lower than that of the STJN position.

CONCLUSION

These results demonstrate that the modified low-Dye MLA taping procedure places the subtalar joint near the neutral position. Despite a significant reduction in the height of the navicular after the subjects walked for 10 minutes with the tape on, the height of the navicular was still not significantly different than that of the STJN position.

Effectiveness of taping and bracing in balance

Taping and bracing are thought to be effective methods in restricting the ankle's joint motion and assisting prevention of injuries. Research evidence suggests that taping and bracing enhance both the mechanical support and the proprioception of the ankle. However, there is little research concerning the influence of taping and bracing on sport performance. Research has mainly examined tasks with demands on the frontal plane. Therefore, the present study examined the effect of taping and bracing on the performance of a task with demands on the frontal plane. A sample of 30 physical education students (Mage=21.9 yr.) performed a balance task requiring estimation of balance and both right and left deviations. The subjects performed the balance task on four different conditions, with tape, with Swede-O (a lace-up, boot style stabilizer), with Aircast (an inflatable cast), and without any stabilizer. There were no significant differences among the conditions. These findings indicate that taping and bracing do not have negative effects on balance in the frontal plane. This study created concerns regarding the appropriate stabilizer for different tasks, bilateral coordination after the application of a stabilizer, and the influence of psychological factors on prevention of injury.

Conservative treatment of acute lateral ankle sprains

Lateral ankle sprains are among the most common sports injuries. Although ankle sprains are treated conservatively at the present time, for years the treatment was based on acute repair of the ruptured ligaments. Several differing opinions currently exist as to the treatment of lateral ankle sprains. A review of the literature and explanation of the benefits and risks of each treatment protocol is undertaken.

Failure and fatigue characteristics of adhesive athletic tape

PURPOSE

Athletic tape has been commonly reported to lose much of its structural support after 20 min of exercise. Although many studies have addressed the functional performance characteristics of athletic tape, its mechanical properties are poorly understood. This study examines the failure and fatigue properties of several commonly used athletic tapes.

METHODS

A Web-based survey of professional sports trainers was used to select the following three tapes for the study: Zonas (Johnson & Johnson), Leukotape (Beiersdorf), and Jaylastic (Jaybird & Mais). Using a hydraulic material testing system (MTS), eight samples of each tape were compared in three different mechanical tests: load-to-failure, fatigue testing under load control, and fatigue testing under displacement control. Differences in tape microstructure were used to interpret the results of the mechanical tests.

RESULTS

Significant differences (P < 0.001) in failure load, elongation at failure, and stiffness were found from failure tests. Significant differences were also found (P < 0.001) in fatigue behavior under both modes of control. As a representative example, in one normalized displacement control fatigue test after 20 min of cycling, 21% (Zonas), 29% (Leukotape), and 57% (Jaylastic) of the mechanical support was lost. After cycling, all tapes loaded to failure showed increased stiffness (P < 0.001), indicating significant energy absorption during cycling. Observed differences in the tapes' microstructure were qualitatively consistent with the measured differences in their mechanical properties.

CONCLUSION

In understanding the shortcomings of currently available tapes, the results of these tests can now be used as benchmarks with which to compare and develop future tape designs. Ultimately, these improved tapes should reduce ankle injuries among athletes.

The effect of tape, braces and shoes on ankle range of motion

Sport injuries are unwanted adverse effects accompanying participation in sports. In a wide variety of sports the most common location of injury is the ankle, frequently resulting from a forced plantar flexed inversion of the foot exceeding the physiological range of motion (ROM). Historically the purpose of external support systems is to prevent acute ankle injuries by restricting abnormal ankle ROM. It is believed that a superior restrictive effect also implies a superior preventive effect. The purpose of this review was to examine the literature regarding the restricting effect of adhesive taping, prophylactic ankle stabilisers (PAS) and high-top shoes on ankle ROM. It has been found that tape restricts ankle eversion and inversion ROM significantly following application. However, tape loosens significantly following standardised exercise and sports activities. Studies regarding PAS reported that both semi-rigid and nonrigid stabilisers give a significant post-application restriction of ankle inversion motion. The nonrigid stabilisers show loosening over time during exercise, while the semi-rigid stabilisers maintain their restrictive effect over the same time span. High-top shoes in comparison to low-top shoes are more effective in restricting mechanically imposed ankle inversion ROM. Low-top shoes, however, also limit mechanically imposed ankle inversion stress with the ankle in the position in which ankle injury occurs most frequently. One must keep in mind, however, that a superior mechanical restriction of ankle ROM does not necessarily imply a superior preventive effect. Only well-controlled randomised studies can show such an effect, and these studies have shown a reduction of ankle injury incidence for all 3 prophylactic measures reviewed.

The effect of preventive measures on the incidence of ankle sprains

OBJECTIVE

To critically review the current data concerning the efficacy of preventive measures described in the literature, on the incidence of lateral ankle ligament injuries.

DATA SOURCES

MEDLINE, Sportdiscus, and EMBASE were searched for papers published between 1980 and December 1998. Keywords used in the search were "prevention" in combination with "ankle," "ankle taping," "ankle bracing," "orthosis," "shoes," and "proprioception." Additional references were reviewed from the bibliographies of the retrieved articles.

STUDY SELECTION

A study was included if: 1) the study contained research questions regarding the prevention of lateral ankle ligament injuries; 2) the study was a randomized controlled trial, a controlled trail, or a time intervention; 3) the results of the study contained incidence rates of lateral ankle ligament injuries as study outcome; and 4) the study met the cut-off score set for quality.

DATA EXTRACTION AND SYNTHESIS

Two reviewers reviewed relevant studies for strengths and weaknesses in design and methodology, according to a standardized set of predefined criteria. Eight relevant studies met the criteria for inclusion and were analyzed.

MAIN RESULTS

Overall, all studies reported a significant decrease in incidence of ankle sprains using the studied preventive measure. There was a great variety in methodology and study design between the eight analyzed studies, and every study had one or more drawbacks. Therefore, between studies only general results could be compared.

CONCLUSIONS

The use of either tape or braces reduces the incidence of ankle sprains. Next to this preventive effect, the use of tape or braces results in less severe ankle sprains. However, braces seem to be more effective in preventing ankle sprains than tape. It is not clear which athletes are to benefit more from the use of preventive measures: those with or those without previous ankle sprains. The efficacy of shoes in preventing ankle sprains is unclear. It is likely the newness of the footwear plays a more important role than shoe height in preventing ankle sprains. Proprioceptive training reduces the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains.

Influence of ankle support on joint range of motion before and after exercise: a meta-analysis

STUDY DESIGN

Meta-analysis.

OBJECTIVE

To evaluate the effects of different types of ankle support on ankle and foot joint range of motion before and after activity using meta-analysis procedures.

BACKGROUND

The effects of ankle support on joint range of motion before and after exercise has been extensively studied, but the results among studies are not consistent. Obtaining knowledge from synthesizing the available literature with a meta-analysis can provide a greater understanding of these effects.

METHODS AND MEASURES

A total of 253 cases from 19 studies were examined and included in this analysis. The treatment variables were ankle support with 3 levels (tape, lace-up, and semirigid) and time with 2 levels (before exercise and after exercise). Standardized effect sizes were computed for inversion, eversion, dorsiflexion, and plantar flexion range of motion to measure the difference between control and treatment groups at each point in time. Effect sizes were analyzed using a mixed-model factorial analysis of variance.

RESULTS

Before exercise, the semirigid condition (-2.97 +/- 0.63) demonstrated greater restriction compared with the tape (-2.33 +/- 0.38) and lace-up conditions (-2.18 +/- 0.86) for inversion range of motion. After exercise, the semirigid condition (-3.85 +/- 0.64) restricted inversion range of motion more than the tape (-1.07 +/- 0.20) and lace-up (-1.56 +/- 0.29) conditions. No differences were found between the mean effect sizes for the tape and lace-up conditions before and after exercise. With respect to eversion range of motion, the semirigid support (-2.69 +/- 0.43) provided greater restraint compared with the tape (-1.00 +/- 0.21) and lace-up (-1.40 +/- 0.47) conditions. The lace-up condition also displayed greater support compared with tape alone. For dorsiflexion range of motion, greatest overall support was provided by the tape condition (-0.94 +/- 0.06) compared with the lace-up condition (-0.51 +/- 0.06).

CONCLUSIONS

The greatest restriction of motion in the frontal plane was offered by the semirigid support condition, whereas taping offered the most support for limiting dorsiflexion range of motion. The results of this study may help clinicians make rational decisions concerning the selection of ankle appliances for preventing acute or chronic reinjury.

The prevention of ankle sprains in sports. A systematic review of the literature

To assess the published evidence on the effectiveness of various approaches to the prevention of ankle sprains in athletes, we used textbooks, journals, and experts in the field of sports medicine to identify citations. We identified 113 studies reporting the risk of ankle sprains in sports, methods to provide support, the effect of these interventions on performance, and comparison of prevention efforts. The most common risk factor for ankle sprain in sports is history of a previous sprain. Ten citations of studies involving athletes in basketball, football, soccer, or volleyball compared alternative methods of prevention. Methods tested included wrapping the ankle with tape or cloth, orthoses, high-top shoes, or some combination of these methods. Most studies indicate that appropriately applied braces, tape, or orthoses do not adversely affect performance. Based on our review, we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to practice or competition, and those athletes suffering a moderate or severe sprain should wear an appropriate orthosis for at least 6 months. Both coaches and players must assume responsibility for prevention of injuries in sports. Methodologic limitations of published studies suggested several areas for future research.

Functional properties of adhesive ankle taping: neuromuscular and mechanical effects before and after exercise

The purpose of the study was to investigate effects of adhesive ankle taping. Using electromyographic, goniometric, and thermologic methods, different ankle tapes were tested before and after athletic exercise in simulated inversion trauma. Twelve subjects with stable ankle joints performed five trials: with two different materials, with two taping techniques, and one trial without tape as control. After the simulated inversion trauma, approximately 35% of the initial maximum inversion amplitude was decreased by ankle taping. Depending on the technique, there was a loss of tape stability < or =14% after 30 min of athletic exercise. Thermologic analysis revealed a postexercise 6 degrees C temperature increase in the foot, especially under the tape. Initially, interpreted as the primary effect, the improved joint stabilization is based on mechanical stiffness caused by the adhesive tape. Joint stability was influenced positively by neuromuscular proprioceptive and physiological processes, characterized by relatively increased electromyographic activation.

Static and dynamic roentgenographic analysis of ankle stability in braced and nonbraced stable and functionally unstable ankles

Patients suffering from functional ankle instability were selected based on a structured interview. Talar tilt was measured using supine ankle stress roentgenographs and standing talar tilt was measured using erect ankle stress roentgenographs. A digital roentgenocinematographic analysis of a 50 degrees ankle sprain simulation was performed to measure dynamic talar tilt and inversion distance between two video images (inversion speed). A significant decrease in pathologic supine talar tilt in unstable ankles was found in the braced compared with the nonbraced situation (talar tilt = 13.1 degrees versus 4.8 degrees with brace). The talar tilt with the brace after activity was still significantly lower than the initial value without the brace. The standing talar tilt of unstable ankles was shown to be significantly lower with the orthosis than without (standing talar tilt = 16.6 degrees versus 12.0 degrees with brace). Roentgenocinematographic evaluation of ankle sprain simulation showed that the mean dynamic talar tilt during simulated sprain decreased significantly in the braced ankles compared with the nonbraced ankles (dynamic talar tilt = 9.8 degrees versus 6.4 degrees braced). A significant decrease in the digital measurement of inversion distance (from 110.6 pixels to 92.4 pixels) was observed in the total sample of 39 ankles during the initial high-speed phase of the simulated sprain. The brace significantly slows down the inversion speed.

Effectiveness of external ankle support. Bracing and taping in rugby union

Ankle inversion sprain is common in rugby. This review outlines research evidence relating to the effects of external ankle support by means of bracing and taping, on the incidence of ankle injuries, how performance is affected by support, how support may act at the joint (with respect to end range of motion, strength, resistive torque, muscle activation patterns and proprioception) to prevent injury, and how exercise changes the effectiveness of support. In addition, the implications of the laws of rugby for the use of external support are discussed. Prospective epidemiological studies have shown a decrease in the incidence of ankle injury with external ankle support use. The effectiveness of external ankle support was dependent upon the material properties and application method of the tape or brace, and on the athlete's status of ankle stability or previous injury. Experimental studies have indicated that the degree of ankle inversion restriction provided, and the degree of loss of restriction after exercise, were dependent upon the external support tested. External ankle support has been reported to have no effect on performance, or to have an adverse effect on performance in a variety of movement tasks. No prophylactic external ankle support has been shown to improve performance. If an external support is to provide mechanical support to a ligament it should exceed the strength of the ligament, which for the anterior fibular ligament is a force limit of between 6 and 56 kg. Tape can provide only limited mechanical support of the ankle joint complex, but it may have proprioceptive effects. Taping may work as a psychological reminder, so that the athlete consciously moderates lower limb-loading behaviour. There is equivocal evidence of the effect of brace use on ground reaction force excursions, balance ability and ankle strength. It is concluded that while there have been many investigations of the effects of tape and some forms of brace on ankle range of motion with and without exercise, there is equivocal evidence regarding the mechanism by which an external support acts. It is recommended that future research address the effects of external ankle support during dynamic exercise and that brace manufacturers utilise the information in the development of future brace designs to help reduce the risk of ankle inversion sprain injury. As external support can decrease the incidence of ankle inversion sprain the International Rugby Board should consider the use of ankle braces in rugby, allowing for stiff lateral components of the brace.

The effect of strapping on the motor performance of the ankle and wrist joints

The purpose of this study was to examine the effect of strapping on different components of motor performance of wrist and ankle joints. The subjects were 14 healthy volunteers (12 females, two males), aged 21-33 years, with no known previous injuries of the ankle and wrist joints. The measurements were made with the HPM/BEP system and Isokinetic Lido Active Multi-joint system. First, the subjects performed the test without strapping and then, on the following day, with strapped right wrist and ankle joints. The strapping of the wrist increased the simple reaction time by 9%, choice reaction time by 9% and decreased the wrist tapping speed by 21%. Wrist strength decreased in flexion (180 degrees/s) by 14% and ulnar deviation (180 degrees/s) by 8%. The strapping of the ankle increased the simple reaction time by 12%, choice reaction time by 9% and decreased foot tapping speed by 14%. Ankle strength in plantar flexion decreased in 60 degrees/s by 22% and 180 degrees/s by 14% and in inversion in 60 degrees/s by 28% and 180 degrees/s by 15%. These results suggest the strapping of ankle and wrist joints reduces motor performance in the above-mentioned directions as measured by the following parameters: simple reaction time, choice reaction time, tapping speed, and muscle strength.

Long-Term Use of a Softshell Prophylactic Ankle Stabilizer on Speed, Agility, and Vertical Jump Performance

The purpose of this study was to determine the effect of a softshell prophylactic ankle stabilizer (PAS) on performance in events involving speed, agility, and vertical jump during long-term use. The events examined were the 24.384-m sprint, 12.192-m shuttle ran, and vertical jump. Subjects were high school basketball players who were randomly assigned to either a PAS (n = 11) or a nonbraced control (n = 13) group. Results of the study revealed that the softshell PAS had no significant effect on any of the three performance events tested over a 3-month basketball season. However, there was a significant difference in 24.384-m sprint and 12.192-m shuttle run times across test sessions regardless of treatment group. In conclusion, the softshell PAS neither enhanced nor inhibited performance in activities involving speed, agility, or vertical jump during long-term use.

Role of ankle taping and bracing in the athlete

Adhesive tape is often used to help athletes recover from ligament sprains of the ankle or to prevent further injury. The choice of taping technique or material is often decided by personal preference, superstition, or anecdote. More recently, the use of ankle braces has become more prevalent, but reasons for their use are similarly variable. As ankle sprains are a major cause of an athlete's disability and time off sport, the choice of the method of support should be more scientifically reasoned. This paper attempts to review the literature concerning the effects of various methods of ankle support on swelling, stability, range of movement, proprioception, muscle function, gait, and performance tests. There is still some contradiction in the literature about the effects of taping and braces in both the acute and chronic phases of ligament sprains of the ankle.

Restriction of foot supination by ankle braces in sudden fall situations

OBJECTIVE: To investigate the restriction of foot supination in different shoe orthotic combinations for unexpected ankle turns. DESIGN: A supination platform was used to experimentally induce sudden ankle turns. BACKGROUND: This study expanded on previous investigations of the effectiveness of different ankle braces and the influence of shoe material on foot supination. METHODS: For 21 male subjects pressure distribution data, achilles tendon angle, and supination velocity were collected. A comparison between a shoe with cut upper material and an intact shoe was done to show the influence of upper material on supination. The effectiveness of four different orthotics inside of an intact shoe were tested in comparison to the same shoe without ankle brace. Additionally, subjects rated their perceived supination movement of the foot. RESULTS: Between experimental conditions no large differences for the pressure distribution patterns were found. Three of the ankle braces reduced foot supination as well as supination velocities. More than two times lower supination values were measured for a footwear condition in which the upper material was cut away. Already during the free-fall most ankle braces caused a substantial reduction of foot inversion. CONCLUSION: The experiments demonstrated the influence of the upper material of a shoe and different orthotics on foot supination. Biomechanical measurements are necessary because of limited capabilities of subjects in detecting subtalar angular motions. RELEVANCE: This study investigated the effectiveness of different shoe conditions and ankle braces under experimental conditions that simulated unexpected ankle turns, the most frequent causes of sport injuries. The results of the study provide insights into which factors influence the amount of foot supination during unexpected ankle turns.

Effect of ankle orthoses on functional performance for individuals with recurrent lateral ankle sprains

Ankle orthoses are commonly used for protection against initial ankle sprain injuries and for protection against reinjury. The purpose of this study was to compare the effects of the DonJoy Ankle Ligament Protector (ALP) and the Aircast Sport-Stirrup (AS) on the functional performance tasks of a 40-meter sprint, a figure-of-eight run, and standing vertical jump. Subjects were 14 males and nine females who reported a history of two or more lateral ankle sprains of the same ankle and no sprains of the contralateral ankle. Each subject performed all functional tasks on the first test day with both ankles unbraced and with the recurrently sprained ankle braced with one of the two orthoses. Each subject returned for testing on a second day and performed all tasks with both ankles unbraced and with the other orthosis on the recurrently sprained ankle. Subjects also rated the orthoses for comfort and support. Analysis of variance indicated that braced data were not significantly different than unbraced data and that data for the two orthoses did not differ significantly for any of the functional performance tasks. Seventy-four percent of the subjects reported the AS was more comfortable than the ALP, and 61% of the subjects indicated that the AS provided more support than the ALP. Neither orthosis had an effect on functional performance. The results may assist clinicians in selecting either of these orthoses for use in protection against ankle sprain injury.

Ankle ligament injuries

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The effect of exercise, prewrap, and athletic tape on the maximal active and passive ankle resistance of ankle inversion

This investigation explored alternatives to the null hypotheses that maximal active and passive resistance to inversion developed by a near-maximally inverted and weightbearing ankle is not altered by 1) the use of prophylactic adhesive athletic tape, 2) the use of non-adhesive prewrap (underwrap), or 3) 40 minutes of vigorous exercise. Ten healthy men and 10 healthy women (mean age, 25 +/- 3 years) with no recent ankle injuries underwent testing to determine maximal ankle resistance to inversion under unipedal, weightbearing conditions. Tests were performed with and without the support of athletic tape, and before and after 40 minutes of exercise. Half the testing sessions were performed with prewrap under the tape. At 15 degrees of inversion, without any external ankle support, healthy young men and women could maximally resist a mean (SD) inversion moment of 52.9 (6.4) N-m and 28.3 (5.8) N-m, respectively. Although use of ankle tape provided a 10% increase in maximal resistance to inversion moments, this increase diminished to insignificant levels after 40 minutes of vigorous exercise. Use of prewrap improved maximal resistance to inversion by more than 10%.

The Effect of Ankle Bracing and Taping on Joint Position Sense in the Stable Ankle

The purpose of this study was to determine the proprioceptive effects of ankle bracing and taping. Proprioception was assessed in 26 subjects by evaluating ankle joint position sense, which was determined by the subjects' ability to actively reproduce a passively positioned joint angle. Testing was performed at positions of 30° of plantar flexion and 15° of inversion. Each subject underwent four trials at each test angle under three conditions: braced, taped, and control. For the plantar flexion test, both the braced condition and the taped condition significantly enhanced joint position sense when compared to the control condition. There was no significant difference between the braced and taped conditions. For the inversion test, the taped condition significantly enhanced joint position sense compared to the control condition. There was no significant difference between the braced and the control conditions or between the braced and the taped conditions. This study demonstrates that ankle bracing and taping improve joint position sense in the stable ankle.

Stability of the braced ankle. A biomechanical investigation

We measured the bare ankle and the braced angle-torque relationships in 12 uninjured volunteers under static and dynamic conditions within the full range of inversion motion. These relationships were measured with a specially designed mechanical device that allowed inversion movements with angular velocities up to 850 deg/sec. In testing the bare ankle under static conditions, the torque showed a 10-fold increase within the full range of motion (average, from 0.9 N-m at 7 degrees to about 8 N-m at 48 degrees of inversion). The slope of the angle-torque relationship increased under dynamic conditions giving higher torque values (up to 18 N-m on average). Both orthoses induced similar additional torques that increased linearly, up to about 6 N-m at 45 degrees, with higher angles of inversion. These additional torques are small compared with the amount of stress applied to the foot during a typical ankle sprain situation, such as recovering from a jump. Therefore, we propose that orthotic devices increase the ankle torque, counteracting the inversion movement, and also prevent the start of the inversion movement by preloading and maintaining the ankle in a proper anatomic position with optimal contact between the articular surfaces.

Is prophylactic bracing of the ankle cost effective?

The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested for their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used: the single-leg stance test, the single-leg jumping course test, and the angle-reproduction test. The influence of three stabilization devices--the lace-on brace (Mikros), the stirrup brace (Aircast), and taping--on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the single-leg jumping course test without any stabilizing device ("standard" category) ranged between 8.06 and 13.68 (10.65 + 1.29). In the Mikros (9.95 + 0.99) and Aircast (9.99 + 1.14) brace categories, as well as the tape bandage (10.27 + 0.81) category, better scores were achieved. The differences between "standard vs Mikros" and "standard vs Aircast" revealed a significant reduction of the scores with the orthoses (P < .01). The error rate in the single-leg stance test was within the range of 0 to 16 (5.12 + 2.85) for the standard category. It was lower for the Mikros (3.65 + 2.65) and Aircast (4.17 + 2.59) categories. The error rate was highest in the tape bandage group (5.79 + 3.53). There was a significant difference between "standard vs Mikros" and "standard vs Aircast" regarding injured and non-injured ankle joints (P < .01). The angle-reproduction test showed higher values for the standard (2.36 degrees + 0.97) category than the Mikros (1.46 degrees + 0.72), Aircast (1.62 degrees + 0.91), and taping (1.84 degrees + 0.41) categories. In the standard category, the reproduction error was lower when non-injured ankle joints (2.30 degrees + 1.04) were tested than when unstable ankle joints (2.44 degrees + 0.81) were tested, whereas in all other categories the reproduction error was higher in the group of non-injured joints. According to the literature, applying a prophylactic brace can prevent an estimated 30 ankle sprains per 1000 athletic exposures.

The effect of ankle stabilizers on athletic performance. A randomized prospective study

The ankle is the site of more than one third of all injuries that occur to male basketball players. Although ankle bracing may prevent injury, many players believe that braces restrict athletic performance. This belief discourages use of braces and obviates the injury protection that bracing provides. The objectives of this study were to 1) determine whether athletic performance (in four basketball-related activities) was affected by three ankle brace designs (Universal, Kallassy, and Air-Stirrup ankle training brace), 2) determine whether specific braces are better for specific athletic activities, and 3) determine whether athletic performance changes with brace use. Twelve high school basketball players wore each brace type while vertical jumping, standing long jumping, cone running, and 18.3-meter shuttle running at two test times (initially and after 1 week of acclimation). Our data showed that these braces had no significant effects on athletic performance. No brace affected athletic performance in one specific activity more than another, and athletic performance did not change with brace use. We concluded that prophylactic ankle bracing does not inhibit athletic performance.

Effects of a semirigid and softshell prophylactic ankle stabilizer on selected performance tests among high school football players

No prophylactic ankle stabilizer performance study has been conducted to date using high school football players, ie., players who are at risk of ankle sprains. In addition, the effect that prophylactic ankle stabilizer use has on performance by player position is unknown. The purpose of this study was to determine the effect of a semirigid and softshell prophylactic ankle stabilizer on performance by football player position in events testing vertical jump, speed, and agility. Twenty-five high school football players participated in the study. All subjects denied any history of ankle injury within 1 year of the study and previous experience with prophylactic ankle stabilizer use. Subjects completed three tests [vertical jump, 36.56-m (40-yd) sprint, and 18.28-m (20-yd) shuttle run] under three different ankle treatments: Aircast SportStirrup, DonJoy RocketSoc, and nonbraced control. Results of the study indicated that the Aircast SportStirrup and DonJoy RocketSoc, when compared with a nonbraced control, had no significant effect on vertical jump, 36.56-m (40-yd) sprint, and 18.28-m (20-yd) shuttle run performance. Skill players had faster 36.56-m (40-yd) sprint times than strength players regardless of ankle treatment. In conclusion, the Aircast SportStirrup and DonJoy RocketSoc did not facilitate or adversely affect performance involving vertical jump, speed, and agility of high school football players.

The differential effects of external ankle support on postural control

Ankle supports are commonly used in an attempt to decrease the risk of ankle injury during sport. However, their use may also impair postural control, which is an integral component of sports participation. The aim of this study was to investigate the effects of three different ankle supports (tape, brace, and elastic bandage) on postural control in 24 normal subjects with a mean age of 24.8 years (+/- 4.4). Two measures were used to evaluate postural control in one-legged stance with the eyes closed: variability of mediolateral ground reaction force (acquired from a force platform) and frequency of foot touchdowns by the nonsupport leg (assumed to indicate ability of the subject to maintain one-legged stance posture). Both measures revealed a differential effect for ankle support on postural control. The use of an elastic bandage had no significant effect on postural control (p > 0.05), while the use of tape or a brace had a significant detrimental effect (p < 0.05). While wearing the tape or a brace, subjects were less steady and touched down more frequently. Restriction of ankle movement was offered as a possible explanation for the results, since postural control was impaired only by the ankle supports which limited ankle motion. These findings may have implications regarding impaired athletic performance.

A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis

A study was undertaken to evaluate the effect of a semi-rigid ankle orthosis (Sport-Stirrup) on the incidence of ankle sprains in soccer players during 1 playing season. Senior soccer players were divided into 2 groups: players with previous ankle sprains (N = 258) and players without such history (N = 246). The players in these groups were each randomly allocated to either a semi-rigid orthosis or a control group at the start of the playing season. All subsequent injuries during the season and the total number of playing hours were documented. There was a significant reduction in the incidence of ankle sprains (injuries/1000 playing hours) by ankles in the orthosis group with previous sprains (0.14) compared with the nonbraced group with previous sprains (0.86). The incidence of ankle sprains was significantly higher in the nonbraced group with previous sprains (0.86) compared with the nonbraced group without previous sprains (0.46). Thus, in this study, a semirigid orthosis significantly reduced the incidence of recurrent ankle sprains in soccer players with previous history of ankle sprains.

The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball. A randomized clinical study at West Point

This randomized clinical study was designed to prospectively determine the efficacy of a semirigid ankle stabilizer in reducing the frequency and severity of acute ankle injuries in basketball. Athletic shoe, playing surface, athlete-exposure, ankle injury history, and brace assignment were either statistically or experimentally controlled. Participants in the study were 1601 United States Military Academy cadets with no preparticipation, clinical, functional, or radiographic evidence of ankle instability. Subjects experienced a total of 13,430 athlete-exposures in the 1990 and 1991 intramural basketball seasons. Ankle injury was defined as acute trauma to the ankle ligaments that resulted in an athlete's inability to participate in basketball 1 day after the injury. Use of ankle stabilizers significantly reduced the frequency of ankle injuries. Reduction in ankle injuries, however, depended on the nature of injury (fewer contact injuries occurred among those who wore braces). Injury severity was not statistically reduced, and wearing the ankle stabilizer did not affect the frequency of knee injuries. Attitude toward ankle stabilizer use improved as use of the stabilizer increased.