The effects of proprioceptive exercise and taping on proprioception in subjects with functional ankle instability: A review of the literature

Effects of proprioceptive training on sports performance: a systematic review

BACKGROUND

Proprioception, the ability to sense the body's position and movement, is essential for athletic performance and physical well-being. The literature highlights the importance of proprioceptive training in rehabilitation, sports performance, injury prevention, and motor function enhancement. Targeted training programs can improve balance, coordination, motor learning, and overall physical performance. This systematic review aimed to examine the effects of proprioceptive training methods on sports and athletic performance.

METHODS

A comprehensive search was conducted using the Web of Science, PubMed, and Scopus databases, and a literature review was performed based on the PICO criteria outlined in the abstract and title.

RESULTS

Following the search, 178 articles were identified using relevant keywords, of which 19 directly addressed sports performance and were included in this study. The findings revealed that proprioceptive training had a positive influence on various aspects of athletic performance, including physiological capacity, balance, explosive strength, speed, agility, postural stability, knee joint position sense, muscle activation, reduction of chronic joint instability, dribbling, passing, and technical ball-control skills.

CONCLUSIONS

These results indicate that proprioceptive training can be an effective strategy for experts and coaches to enhance athletes' physical performance. Primarily, proprioceptive exercises should be used inside and outside the training sessions to enable athletes to interact more effectively with their bodies, reduce the risk of injury, and improve power transfer.

Influence of taping on joint proprioception: a systematic review with between and within group meta-analysis

Taping is increasingly used to manage proprioceptive deficits, but existing reviews on its impact have shortcomings. To accurately assess the effects of taping, a separate meta-analyses for different population groups and tape types is needed. Therefore, both between- and within-group meta-analyses are needed to evaluate the influence of taping on proprioception. According to PRISMA guidelines, a literature search was conducted across seven databases (Web of Science, PEDro, Pubmed, EBSCO, Scopus, ERIC, SportDiscus, Psychinfo) and one register (CENTRAL) using the keywords "tape" and "proprioception". Out of 1372 records, 91 studies, involving 2718 individuals, met the inclusion criteria outlined in the systematic review. The meta-analyses revealed a significant between and within-group reduction in repositioning errors with taping compared to no tape (Hedge's g: -0.39, p < 0.001) and placebo taping (Hedge's g: -1.20, p < 0.001). Subgroup and sensitivity analyses further confirmed the reliability of the overall between and within-group analyses. The between-group results further demonstrated that both elastic tape and rigid tape had similar efficacy to improve repositioning errors in both healthy and fatigued populations. Additional analyses on the threshold to detection of passive motion and active movement extent discrimination apparatus revealed no significant influence of taping. In conclusion, the findings highlight the potential of taping to enhance joint repositioning accuracy compared to no tape or placebo taping. Further research needs to uncover underlying mechanisms and refine the application of taping for diverse populations with proprioceptive deficits.

The Significance of Proprioceptive Training in the Post-Operative Rehabilitation of Patients Undergoing Achilles Tendon Reconstruction

In the human anatomy, the Achilles tendon (AT) is the strongest and largest tendon. Also, it ruptures the most often. Because it impairs the patient's ability to function adequately, a ruptured AT injury is a serious clinical issue. Reconstruction of the tendon through surgical intervention is the preferred approach to treatment in the case of tendon rupture. Establishing an effective post-operative rehabilitation regimen that mostly consists of functional physiotherapy measures is crucial in the management of AT rupture. In this report, we have presented the case of an AT reconstruction patient who complained of pain in the ankle region, reduced strength and range of the ankle joint, and loss of proprioception. The tailor-made physiotherapy protocol was incorporated, which included strengthening exercises, proprioceptive retraining, cryotherapy, and ambulatory training, which were found to be effective in facilitating early functional recovery.

Effects of Ankle Orthoses, Taping, and Insoles on Postural Stability of Individuals with Chronic Ankle Instability: A Systematic Review

Chronic ankle instability (CAI) is a prevalent condition characterized by recurring instances of the ankle giving way and persistent symptoms, including pain and diminished function. Foot and ankle external supports are commonly used in clinical practice and research for treating CAI. This systematic review aimed to assess the effects of foot and ankle external supports on the postural stability of individuals with CAI to guide clinical practice and inform future research. A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google Scholar databases from 1 January 2012 to 1 November 2022. Eighteen studies involving individuals with CAI were chosen in this systematic review. The quality of the included studies and risk of bias were assessed using Cochrane Collaboration's tool for randomized controlled trials, the Newcastle-Ottawa Scale for case-control studies, and the DELPHl-list for crossover trial studies. The external supports included in this review were ankle orthoses (elastic, semi-rigid, and active orthoses), taping (kinesiotaping and fibular reposition taping), and insoles (textured and supportive insoles). The outcome measures included static and dynamic postural stability tests, such as the single-leg stance test, star excursion balance test, Y-balance test, single-leg landing test, lateral jump test, walking test, and running test. The results showed that elastic orthoses, Kinesiotaping, and textured insoles demonstrated potential benefits in improving postural stability in individuals with CAI. Elastic orthoses decreased ankle joint motion variability, kinesiotaping facilitated cutaneous receptors and proprioceptive feedback, while textured insoles increased tactile stimulation and foot position awareness. However, the effects of semi-rigid orthoses, fibular reposition taping, and arch support insoles were inconsistent across studies. Future research should explore the long-term effects of these external supports, analyze the effects of different characteristics and combinations of supports, and employ standardized outcome measures and testing protocols for assessing postural stability.

Study of EEG alpha wave response on the effects of video-guided deep breathing on pain rehabilitation

BACKGROUND

Athletes with chronic ankle pain (CAP) are more inclined to suffer from physical and psychological pain depending on the severity of the injuries, which might trigger the powerless feeling on future sports participation. Therefore, an efficient and simple method is useful to integrate into conventional physiotherapy (CP) for maintaining mental wellness.

OBJECTIVE

This research aimed to verify the effects and progress of video-guided deep breathing (DB) integrated into CP through study on the changes of alpha waves and pain scale.

METHODS

Alpha waves were recorded using an electroencephalogram (EEG) and a visual analogue scale (VAS) to assess pain intensity before and after the intervention (6 weeks). Thirty CAP participants were recruited and randomly assigned to two groups: group A for video-guided DB integration into their CP and group B for CP. The effects of pre and post intervention were analyzed using a paired t-test with statistical significance set at p< 0.05.

RESULTS

Profound results from the research have shown that the participants who received both the DB+CP revealed a significant increase in alpha wave (p< 0.05) at occipital region.

CONCLUSION

The significant result reveals an increase in alpha waves in the occipital region after 6 weeks and indicates that the video-guided DB with a smartphone application is able to produce a change in CAP participants. This supports the DB integration to the CP for altering the pain perception.

Effect of Integrated Training on Balance and Ankle Reposition Sense in Ballet Dancers

OBJECTIVE

To investigate the effects of a 6-week integrated training program on the ankle joint reposition sense and postural stability in ballet dancers.

METHODS

Sixteen female ballet dancers participated in the study and underwent a 6-week integrated training program consisting of plyometric, proprioception and core stability exercises along with a home program involving additional ankle muscle strengthening and stretching. The ankle joint reposition tests and the parameters of the center of pressure (COP) while performing grand-plie (deep squatting) and releve en demi-pointe (standing on balls of foot) movements were measured before and after training.

RESULTS

After 6 weeks, participants showed significantly smaller absolute ankle joint reposition errors in dorsiflexion (p = 0.031), plantarflexion (p = 0.003) and eversion (p = 0.019) compared to the pre-training measurement. Furthermore, after training, a significantly slower average COP speed at pre-equilibrium during grand-plie movement (p = 0.003) and pre-equilibrium phase of releve en demi-pointe (p = 0.023) were observed. In addition, the maximum COP displacement in the medial-lateral direction was significantly smaller at pre-equilibrium phase during grand-plie (p = 0.044) and releve en demi-pointe movements (p = 0.004) after training.

CONCLUSIONS

The 6-week integrated training program improved the ankle joint reposition sense and postural control in the medial-lateral direction during grand-plie and releve en demi-pointe movements.

Do external supports influence proprioception in patients with chronic ankle instability? A systematic review and meta-analyses

OBJECTIVE

Individuals with chronic ankle instability (CAI) experience recurring sprains and impaired proprioception, and the effect of external support in the proprioception of injured ankles is still inconsistent in existing studies. Therefore, this study aimed to investigate whether external support could enhance the proprioception of injured ankles in patients with CAI.

DESIGN

Systematic review and meta-analysis.

RESULTS

Eight studies from PubMed, Embase, Cochrane Library, Web of Science, SPORTDiscus, Scopus, and CINAHL were finally included after applying the exclusion criteria. Meta-analyses revealed a significantly higher joint position sense (JPS) on inversion with a weighted mean difference (WMD) of 1.25° and plantar flexion (WMD = 1.74°) and lower kinesthesia in eversion (WMD = -0.70°) with the application of external support in the injured ankles of patients with CAI.

CONCLUSION

Applying external support has statistically significant negative effects on kinesthesia and a positive effect on the active JPS in the injured ankles of patients with CAI. However, this study did not support the restoration of proprioception deficits as a mechanism of external support in preventing reinjuries, due to its potentially negative effect on kinesthesia, clinically small changes in proprioception, and poor methodological quality of existing studies.

Relationship Between Isokinetic Muscle Strength and Functional Tests in Chronic Ankle Instability

Isokinetic muscle strength measurements and functional tests are usually performed to evaluate ankle condition in chronic ankle instability (CAI), yet there is no clear demonstration of the relationship between isokinetic muscle strength and functional tests. The objective of this study was to evaluate the relationship between isokinetic muscle strength and functional tests in CAI. Between April 2014 and August 2016, 103 patients with unilateral CAI were studied. Single-leg balance, single-heel raise, and single-leg squat tests were performed for static balancing assessment. Single-leg hop, double-leg jump, and sidestep tests were performed for dynamic balancing assessment. The isokinetic muscle strength of both ankles was measured using a dynamometer. The involved ankle showed lower muscle strength in inversion than the uninvolved ankle, while eversion, dorsiflexion, and plantarflexion muscle strength had no significant differences between ankles. There were significant correlations between the isokinetic muscle strength of inversion and the single-leg balance test, single-heel raise test, and sidestep test (Pearson's r; 0.246, 0.514, and 0.229 at 30°/second; 0.288, 0.473, and 0.239 at 180°/second, respectively). The single leg balance, single heel raise, and sidestep tests are useful to assess not only ankle functional performance but also isokinetic muscle strength. Among these tests, the single heel raise test was the most reliable test to reflect muscle strength deficiency in CAI.

Effect of ankle taping on postural control measures during grasp and release task in patients with chronic ankle instability

OBJECTIVE

The aim of this study was to examine the effect of Mulligan ankle taping on center of pressure (COP) parameters during performance of a functional upper limb task in patients with chronic ankle instability (CAI).

METHODS

A clinical controlled trial study designed between 4 ankle conditions: untaped and taped, CAI and healthy subjects. Fifteen subjects with CAI and 15 healthy controls were asked to grasp an object at their waist level and release it above shoulder level in an oblique pattern during performance of single-leg stance balance test. All the subjects performed 3 trials of single-leg stance with eyes opened before and after Mulligan taping on a force plate during performance of functional upper limb task. The mean displacement (mdCOP), range of COP excursion (rangeCOP) and average speed of COP (velCOP) in anteroposterior (AP) and mediolateral (ML) directions were analysed for differences between groups.

RESULTS

mdCOP and rangeCOP in AP direction were significantly increased (P= 0.04 and 0.03, respectively) in the CAI group. Mulligan taping significantly reduced velCOP in AP and ML directions (P= 0.02).

CONCLUSION

In CAI patients Mulligan ankle taping can improve postural control by decreasing velCOP, therefore Mulligan taping can have immediate positive effects on postural parameters and maintenance of dynamic postural control.

Influence of Passive Joint Stiffness on Proprioceptive Acuity in Individuals With Functional Instability of the Ankle

Study Design Controlled laboratory study, cross-sectional. Background Deficits in ankle proprioceptive acuity have been reported in persons with functional instability of the ankle. Passive stiffness has been proposed as a possible mechanism underlying proprioceptive acuity. Objective To compare proprioceptive acuity and passive ankle stiffness in persons with and without functional ankle instability, and to assess the influence of passive joint stiffness on proprioceptive acuity in persons with functional ankle instability. Methods A sample of 18 subjects with and 18 without complaints of functional ankle instability following lateral ankle sprain participated. An isokinetic dynamometer was used to compare motion perception threshold, passive position sense, and passive ankle stiffness between groups. To evaluate the influence of passive stiffness on proprioceptive acuity, individuals in the lateral functional ankle instability group were divided into 2 subgroups: "high" and "low" passive ankle stiffness. Results The functional ankle instability group exhibited increased motion perception threshold when compared with the corresponding limb of the control group. Between-group differences were not found for passive position sense and passive ankle stiffness. Those in the functional ankle instability group with higher passive ankle stiffness had smaller motion perception thresholds than those with lower passive ankle stiffness. Conclusion Unlike motion perception threshold, passive position sense is not affected by the presence of functional ankle instability. Passive ankle stiffness appears to influence proprioceptive acuity in persons with functional ankle instability. J Orthop Sports Phys Ther 2017;47(12):899-905. Epub 7 Oct 2017. doi:10.2519/jospt.2017.7030.

Effect of the craniocervical brace on craniocervical angle, thoracic kyphosis angle, and trunk extensor muscle activity during typing in subjects with forward head posture

BACKGROUND

The relationship between forward head posture (FHP) and thoracic kyphosis has been a subject of interest in the rehabilitation field for visual display terminal workers.

OBJECTIVE

The aim of this study was to investigate the immediate effects of the craniocervical brace use on craniocervical angle (CCA), thoracic kyphosis angle (TKA), and trunk extensor muscle activity.

METHODS

Twelve young male subjects with forward head posture (21.6±1.9 years) participated in this study. We compared CCA & TKA and trunk extensor muscle activity between with and without application of the craniocervical brace during visual display terminal work.

RESULTS

When wearing the craniocervical brace, the subjects demonstrated significantly greater CCA at the start and the end of the task and less change in CCA during the task (p < 0.05). While non-significantly less TKA was seen at the start of the task, significantly less TKA was observed at the end of the task when using the craniocervical brace (p < 0.05). The craniocervical brace use also led to significantly less change in TKA (p < 0.05). There was no significant difference in the trunk extensor muscle activity.

CONCLUSIONS

Use of the craniocervical brace decreased FHP immediately, lessened thoracic kyphosis over time, and prevented the worsening of FHP and thoracic kyphosis during visual display terminal work.

Skin Cooling and Force Replication at the Ankle in Healthy Individuals: A Crossover Randomized Controlled Trial

CONTEXT

Proprioception of the ankle is determined by the ability to perceive the sense of position of the ankle structures, as well as the speed and direction of movement. Few researchers have investigated proprioception by force-replication ability and particularly after skin cooling.

OBJECTIVE

To analyze the ability of the ankle-dorsiflexor muscles to replicate isometric force after a period of skin cooling.

DESIGN

Randomized controlled clinical trial.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty healthy individuals (10 men, 10 women; age = 26.8 ± 5.2 years, height = 171 ± 7 cm, mass = 66.8 ± 10.5 kg).

INTERVENTION(S)

Skin cooling was carried out using 2 ice applications: (1) after maximal voluntary isometric contraction (MVIC) performance and before data collection for the first target force, maintained for 20 minutes; and (2) before data collection for the second target force, maintained for 10 minutes. We measured skin temperature before and after ice applications to ensure skin cooling.

MAIN OUTCOME MEASURE(S)

A load cell was placed under an inclined board for data collection, and 10 attempts of force replication were carried out for 2 values of MVIC (20%, 50%) in each condition (ice, no ice). We assessed force sense with absolute and root mean square errors (the difference between the force developed by the dorsiflexors and the target force measured with the raw data and after root mean square analysis, respectively) and variable error (the variance around the mean absolute error score). A repeated-measures multivariate analysis of variance was used for statistical analysis.

RESULTS

The absolute error was greater for the ice than for the no-ice condition (F1,19 = 9.05, P = .007) and for the target force at 50% of MVIC than at 20% of MVIC (F1,19 = 26.01, P < .001).

CONCLUSIONS

The error was greater in the ice condition and at 50% of MVIC. Skin cooling reduced the proprioceptive ability of the ankle-dorsiflexor muscles to replicate isometric force.

Semi-rigid brace and taping decrease variability of the ankle joint position sense

The present study investigated the effect of taping and the semi-rigid ankle brace on ankle joint position sense. Sixteen healthy women (20.8 ± 2.3 years old) actively placed the ankle in a target position. The experimental conditions were: 1) wearing no orthosis device, 2) using semi-rigid brace, and 3) wearing ankle taping. Absolute error (AE) and variable error (VE) were calculated to obtain the joint position sense. We found an interaction effect between condition and target angle at 15o of plantar flexion for the variable VE, which showed smaller errors during the use of taping and semi-rigid brace. In conclusion, the use of ankle joint orthoses, whether taping or semi-rigid brace, decrease the variability of the position sense at 15o of plantar flexion, potentially decreasing ankle sprains occurrence.

Ankle kinematics and muscle activity in functional ankle instability

OBJECTIVE

Following an ankle injury, many patients have functional ankle instability (FAI) with an increased predisposition to reinjury. The purpose of this study was to assess the effects of FAI on ankle kinematics and muscle activity during a lateral hop movement.

DESIGN

Cross-sectional and observational study; all data collection for each subject was performed on 1 day.

SETTING

Clinical biomechanics laboratory.

PATIENTS

Two groups were studied: (1) Control group-no ankle injury (n = 12), and (2) FAI group (n = 12).

INTERVENTIONS

The lateral hop movement consisted of multiple lateral and medial 1-legged hops over an obstacle (width, 72.5 cm; depth, 25.5 cm; height, 14.3 cm) onto adjacent force platforms. Each subject was instructed to perform as many lateral hops as possible during the 6-second trial. Means, SDs, 95% confidence intervals of the differences, and P-values were calculated.

MAIN OUTCOME MEASURES

Ankle kinematics and muscle activity throughout the lateral hop movement.

RESULTS

Significant differences existed between groups for mean (SD) dorsiflexion ankle positions--FAI 82.4 degrees (6.4) versus normal 75.2 degrees (10.1) and tibialis anterior normalized muscle activity--FAI 0.27 (0.21) versus normal 0.16 (0.13) at ground contact.

CONCLUSIONS

The FAI group revealed greater tibialis anterior muscle activity and dorsiflexion ankle position at contact moving in the lateral direction. These differences between groups may have been related to an inherent predisposition to ankle injuries, a preexisting difference in task performance, a consequence of injuries, or a compensatory adaptation to previous injuries.

The effect of repetitive passive and active movements on proprioception ability in forearm supination

[Purpose] This study was conducted in order to investigate the effect of repetitive passive movement and repetitive active movement on proprioception in forearm supination. [Subjects] This study had a cross-sectional design. Twenty-three right-handed healthy subjects were recruited. All subjects randomly received both repetitive passive movement and repetitive active movement (repetitive passive/active movement at 120°/s with 60 repetitions over a 0–80° range). Active and passive joint repositioning of all subjects was measured using the error score for position sense, both before and after repositioning intervention. [Results] In the repetitive passive movement test, there was a statistically significant decrease in the pre- versus post-repositioning error scores in the active and passive angle examinations. In the repetitive active movement test, there was a statistically significant increase in pre- versus post-repositioning error scores in the active and passive angle examinations. In the comparison of position sense, there was a statistically significant decrease in both active and passive angle repositioning error scores in repetitive passive movement versus repetitive active movement. [Conclusion] Repetitive passive movement improved the proprioception results for forearm supination, compared to repetitive active movement. Results of this study indicate that repetitive passive movement can be recommended to clinicians for rehabilitation therapy as it provides greater proprioception benefits.

The effect of ankle taping or bracing on proprioception in functional ankle instability: a systematic review and meta-analysis

OBJECTIVES

To determine if wearing an ankle brace or taping the ankle, compared to no brace or tape, improves proprioceptive acuity in people with a history of ankle sprain or functional ankle instability.

DESIGN

Systematic review and meta-analysis.

METHODS

Studies using controlled, cross-over designs whereby participants who had sprained their ankle at least once or had functional ankle instability, underwent some form of proprioceptive sensation testing with and without ankle brace or tape, were included. Proprioceptive acuity was reported for the ankle tape/brace condition and the condition where no tape or brace was worn. Meta-analysis was employed to compare proprioceptive acuity with and without ankle tape/brace.

RESULTS

Eight studies were included in the review. Studies measured either sense of movement or sense of joint position. The mean differences in 19 of 32 comparisons were not significant. Of the remaining mean differences, 10 were positive, indicating better proprioceptive acuity in the taped/braced condition and 3 were negative, indicating poorer proprioceptive acuity. Overall, there was no significant effect with ankle tape/brace compared to the no tape/brace condition (mean difference: 0.08°, 95% CI: -0.39 to 0.55). This finding was consistent when the two aspects of proprioception (sense of movement or joint position) were considered separately.

CONCLUSIONS

The pooled evidence suggests that using an ankle brace or ankle tape has no effect on proprioceptive acuity in participants with recurrent ankle sprain or who have functional ankle instability.

Effectiveness of proprioceptive exercises for ankle ligament injury in adults: a systematic literature and meta-analysis

The purpose of this study was to assess the effectiveness of such proprioceptive exercise following ankle ligament injury. A systematic review of the databases MEDLINE, EMBASE, CINHAL, AMED, the Cochrane library database and the PEDro database, in addition to unpublished literature databases was conducted to July 2011. When appropriate, meta-analysis was conducted to pool results from homogeneous studies. The methodological quality of the literature was reviewed using the Critical Appraisal Skills Programme tool. The results indicated that there is no statistically significant difference in recurrent injury between the addition of proprioceptive exercises during the rehabilitation of patients following ankle ligament injury (p = 0.68). The addition of proprioceptive training demonstrated a significant reduction in subjective instability and functional outcomes (p < 0.05). There was no consensus on the advantages of including proprioceptive training in the rehabilitation of this population for swelling, postural sway, joint position sense, ankle range of motion or return to sport outcomes. Further study is warranted to develop the rigour of the evidence-base and to determine the optimal proprioceptive training programme following ankle ligament injury with different populations.

Combined medial and lateral anatomic ligament reconstruction for chronic rotational instability of the ankle

BACKGROUND

This study aimed to extend knowledge on the arthroscopic evaluation of the unstable ankle joint and the outcome of ligament reconstruction on rotational instability. In contrast to previous studies, we investigated the combined repair of lateral and medial ligaments.

METHODS

Ninety-six patients underwent medial and lateral ligament reconstruction between 2006 and 2008, 81 of whom, with a mean age of 31.9 (range, 14 to 44) years, completed the 12-month followup and were therefore included in this study (Table 1). Clinical, radiographic, and concomitant arthroscopic examination was performed prior to the ligament stabilization. Postoperative followup included clinical and radiographic evaluation after 3, 6, and 12 months.

RESULTS

Arthroscopy showed a lesion of the anterior fibulotalar ligament (AFTL), calcaneofibular ligament (CFL), and tibiocalcanear ligament (TCL) (Deep part of deltoid ligament complex) in 67 patients. An avulsion of the proximal insertion point of the ATTL was additionally found in 14 cases. Clinical results 3 months after surgery showed a significant increase in the AOFAS-Hindfoot Score as well as a significant decrease of the Visual Analogue-Scale for pain (VAS) (p < 0.0001). This outcome persisted at the 12-month examination.

CONCLUSION

Rotational instability of the ankle joint in most cases has an injury of the lateral ligaments and a component of the deltoid, the TCL, but rarely with a combined lesion of the TCL and the anterior tibiotalar ligament (ATTL) (Superficial part of deltoid ligament complex). The combined lateral and medial ligament reconstruction with an anchor technique had a good clinical outcome with high patient satisfaction with few complications.

Treatment of peroneal tendon dislocation and coexisting medial and lateral ligamentous laxity in the ankle joint

PURPOSE

Acute dislocation of the peroneal tendon is caused by massive combined flexion-torsion trauma supported by preexisting ligamentous laxity of the ankle joint. This study aimed to investigate the clinical outcome of combined treatment of peroneal tendon dislocation and lateral and medial ligamentous laxity.

METHODS

Between 2005 and 2007, forty-two patients with peroneal tendon dislocation and coexisting ligamentous laxity were treated. The superior extensor retinaculum was reconstructed using anchor technique and periosteal flap repair, whereas the preexisting ligamentous laxity with regard to the extensor inferior retinaculum was addressed using anchor reconstruction. All patients underwent arthroscopy prior to surgery. Thirty-eight of a total of 42 patients (aged 17-31) completed the 24-month follow-up. Clinical and arthroscopic examination was accomplished consistently by always the same two surgeons. Postoperative follow-up comprised clinical evaluation after 3, 6, 12 and 24 months.

RESULTS

Clinical results showed a significant (P<0.0001) increase in the AOFAS-Hindfoot Score as an often used but not validated outcome measure, as well as a significant decrease in the Visual Analogue Scale and in the internal and external rotation, after 3 months. The clinical outcome was confirmed at the 6-, 12- and 24-months measuring points. No dislocation of the peroneal tendon recurred within the 24-month follow-up. Subjective patient satisfaction was stated as high.

CONCLUSIONS

Combined treatment of peroneal tendon dislocation and coexisting lateral and medial ligamentous laxity in the ankle joint following arthroscopy results in good clinical outcome and high patient satisfaction.

LEVEL OF EVIDENCE

Case series, Level IV.

Ankle taping can improve proprioception in healthy volunteers

BACKGROUND

Taping is a common technique to treat inversion ankle sprains, but the effects of tape on proprioception are still not clear. The purpose of this study was to establish whether proprioception would be modified by the use of ankle tape. To do so we studied joint position sense (JPS) in healthy volunteers using three-dimensional (3D) movement analysis systems.

MATERIAL AND METHODS

Forty healthy volunteers (mean age and SD = 23.2 ± 4.2) were asked to actively reproduce four different ankle positions: 10 degrees of dorsiflexion, neutral, 10 degrees and 20 degrees of plantarflexion. The absolute difference between the estimated angle and the target angle was used to assess JPS. This difference was named Error. Subjects were randomly assigned to the control (n = 21) or the intervention (n = 19) groups. Members of the intervention group received ankle tape for a lateral ligament sprain in the non-dominant leg. A t-test was used to evaluate the results.

RESULTS

Tape significantly improved JPS for the dorsiflexion position (p = 0.038). Neutral was the most accurately reproduced position, and the remaining positions were overestimated for both groups.

CONCLUSION

Taping improved proprioception in healthy volunteers, and 3D movement analysis was a useful method to accurately quantify joint position sense.

CLINICAL RELEVANCE

Because ankle proprioception is critical to the functional success of surgical and rehabilitation treatments, these results regarding proprioception are of particular importance because ankle taping is often used in preventing ankle sprains and it is a common treatment after ankle injuries.