Ankle stabilizers affect agility but not vertical jump or dynamic balance performance

Ankle bracing's effects during a modified agility task: analysis of sEMG, impulse, and time to complete using a crossover, repeated measures design

This study explored the effects of no braces, softshell (AE), and semi-rigid (T1) ankle braces on time to complete a modified agility task, as well as lower extremity muscle activity and impulse during the change of direction component of the task. Thirty-nine healthy, active individuals completed a modified agility task under the three brace conditions. Time to complete the modified agility task, along with mean surface electromyographic activity (sEMG) and impulse during the deceleration and propulsive phases of the task were measured. There were no significant differences across conditions with respect to sEMG or impulse measures during the deceleration or propulsive phases. There was a significant change in time to complete the modified agility task, F(2,76) = 17.242, p< 0.001, ηp² = 0.312. Post-hoc analysis revealed a significant increase in time to complete the modified agility task when wearing the AE (0.16 (95% CI, 0.062 to 0.265) seconds, p< 0.001) and T1 (0.20 (95% CI, 0.113 to 0.286) seconds, p< 0.001) ankle braces compared to no braces. It appears that performance on a modified agility task may be diminished when wearing ankle braces, although sEMG activity and impulse are unaffected.

Weight, BMI and stability are risk factors associated with lateral ankle sprains and chronic ankle instability: a meta-analysis

IMPORTANCE

Lateral ankle sprains (LAS) are common in the general population and may lead to chronic ankle instability (CAI). If patients at risk could be identified, they could receive adequate and on-time treatment.

OBJECTIVE

The purpose of the current review was to identify all reported intrinsic factors associated with sustaining a LAS or progressing to CAI after an initial sprain.

EVIDENCE REVIEW

PubMed, Embase, MEDline, Cochrane and PEDro were searched for studies published until July 2019. Articles were selected if they included intrinsic factors related to LAS or CAI, subjects of at least 16 years old, and contained a minimum of 10 patients and 10 controls. Studies were excluded if they concerned reviews or case reports, included patients with previous surgical interventions, concomitant injuries or joint pathology other than ankle instability. Quality of included studies was assessed using the Quality in Prognostic Studies tool and quality of evidence was assessed using the GRADEpro tool. In case outcomes were described by at least three studies, data were pooled and assessed by performing a meta-analysis. Based on the pooled data, either a fixed-effects model or random-effects model was selected to correct for the degree of heterogeneity.

FINDINGS

The search resulted in a total of 4154 studies. After title and abstract screening and subsequent full-text screening, 80 relevant studies were included. Results of the meta-analyses indicated that, compared with healthy controls, patients with LAS had a higher mean body mass index (BMI). In patients with CAI, a higher weight and a longer time to stabilise after performing a task (eg, jumping) were found compared with healthy controls. Other outcomes could not be compared using a meta-analysis due to heterogeneity in outcome measurement and the great number of different outcomes reported. Identification of the risk factors when patients present themselves after a LAS may help to determine which patients are at risk of recurrent sprains or developing CAI.

CONCLUSIONS AND RELEVANCE

Based on the findings in this review, a higher BMI, and a higher weight and neuromuscular stability deficits may be regarded risk factors for sustaining a LAS or developing CAI, respectively.

LEVEL OF EVIDENCE

III.

The Influence of Ankle Braces on Functional Performance Tests and Ankle Joint Range of Motion

CONTEXT

The lateral ankle sprain is one of the most common lower-extremity injuries in sports. Previous research has found that some prophylactic ankle supports reduce the risk of recurrent ankle sprains and provide extra support to the joint. However, there is a continued concern that these supports may negatively influence performance.

OBJECTIVE

To determine if wearing an ankle brace influences athlete performance and ankle kinematics during functional performance tests.

DESIGN

Repeated measures.

SETTING

University gymnasium.

OTHER PARTICIPANTS

Male and female recreational or competitive athletes (n = 20).

INTERVENTION

Participants performed 3 trials of a standing long jump, vertical jump, 40-yard sprint, and T-drill under each of the following 3 conditions: wearing traditional lace-up brace (brace 1), modified lace-up brace (brace 2), and no-brace.

MAIN OUTCOME MEASURES

A 2-dimensional motion capture camera was used to measure ankle range of motion (ROM) in the sagittal plane during the vertical and standing long jumps and in the frontal plane during the cutting phase of the T-drill. Performance of each test and ankle ROM were compared between each of the braced conditions.

RESULTS

Ankle braces did not influence performance in speed or agility functional performance tests (P > .05). Ankle braces negatively affected performance of the standing long jump (P = .01) and vertical jump (P = .01). There was no significant difference between brace or no-brace conditions in ankle inversion ROM during the T-drill (P > .05). Both brace conditions restricted ROM in the sagittal plane during the vertical and standing long jumps (P < .05).

CONCLUSIONS

Braced conditions restricted sagittal plane ROM during the vertical jump and long jump. This decrease in ROM explains the decline in functional performance also seen during these tests.

EFFECTS OF ATHLETIC TAPING ON PERFORMANCE OF BASKETBALL ATHLETES WITH CHRONIC ANKLE INSTABILITY

ABSTRACT Introduction: Ankle sprains are recurrent injuries in basketball, hence more and more athletes are taping their ankles to promote joint stability, aiming at improving dynamic balance and, consequently, functional performance. Objective: To verify the effects of elastic and rigid athletic taping on the functional performance and level of comfort of basketball players with chronic ankle instability. Methods: Twenty-one athletes aged between 18 and 30 years (mean age 23.7 ± 3.2) with chronic ankle instability (CAI), verified using the Cumberland Ankle Instability Tool, were selected to take part in this study. The Star Excursion Balance Test (SEBT) and the Figure-of-8 hop test (F8) were applied unilaterally to assess functional performance, considering the ankle of greater instability in three situations: without athletic taping, with rigid athletic taping and with elastic athletic taping. A draw was held to determine the order in which the tests (held over a number of days) would be applied. A questionnaire was conducted to assess comfort on the same day the athletic tapes were applied. Results: There was no significant difference between the tests in any direction of the SEBT, but there was a significant difference in F8 between the rigid athletic taping x control and elastic athletic taping x control situations. In addition, the elastic athletic tape was considered significantly more comfortable than the rigid athletic tape. Conclusion: Athletic taping appears to effectively improve the dynamic balance and functional performance of athletes with CAI only in activities that cause considerable joint stress, as is the case in F8. Elastic athletic tape appears to be just as effective as rigid athletic tape in these situations, in addition to being a significantly more comfortable alternative. Levef of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

Effects of kinesiotaping and athletic taping on ankle kinematics during walking in individuals with chronic ankle instability: A pilot study

BACKGROUND

Individuals with chronic ankle instability (CAI) tend to walk with an overly inverted foot, which increases the risk of ankle sprains during stance phase. Clinicians could perform ankle taping using kinesiotape (KT) or athletic tape (AT) to address this issue. Because KT is elastic while AT is not, the techniques and underlying mechanisms for applying these tapes are different, which may lead to different outcomes.

RESEARCH QUESTION

To compare the effects of KT and AT interventions on foot motion in the frontal plane and tibial motion in the transverse plane during stance phase of walking.

METHODS

Twenty subjects with CAI were assigned to either KT or AT group, and walked on a treadmill in no tape and taped conditions. Their foot and tibial motions were captured by 3D motion analysis system. The main component of KT application was two pieces of tape applied from the medial aspect of the hindfoot to the lateral to generate a pulling tension towards eversion. AT was applied to the ankle using the closed basket weave approach. AT was not stretchable and not able to generate the same pulling tension as KT.

RESULTS

KT increased foot eversion during early stance, but showed no effect during late stance. AT increased tibial internal rotation during late stance, but showed no effect during early stance.

SIGNIFICANCE

Compared to AT, KT better provides a flexible pulling force that facilitates foot eversion during early stance, while not restricting normal inversion in late stance during walking. KT may be a useful clinical tool in correcting aberrant motion while not limiting natural movement in sports.

The Comparative Effects of Ankle Bracing on Functional Performance

Ankle sprains represent a common musculoskeletal injury that clinicians are tasked with preventing and treating. Because of the prevalence of this injury, ankle braces have been designed to prophylactically protect the joint and reduce the incidence of repetitive sprains. Although an abundance of literature exists focusing on the efficacy of braces in preventing ankle sprains in young, healthy, and physically active populations, there is a scarcity of evidence specific to the impact of these apparatuses on functional performance; therefore, the purpose of this critically appraised topic (CAT) is to investigate the effects of ankle braces on functional performance measures in such individuals. The outcomes of this CAT will assist sport rehabilitation specialists with informed clinical decision making in managing young, healthy, and physically active populations using ankle braces. Do ankle braces hinder functional performance measures when compared with an unbraced condition in a young, healthy, and physically active population? A minimum of level II evidence research studies were surveyed for this CAT. For this CAT, 1 randomized controlled trial and 3 prospective cohort studies were selected. One study found a statistically significant main effect of increased agility run times while participants wore ankle braces. Another study demonstrated a statistically significant decrease in vertical jump height and ankle range of motion while wearing braces. No other statistically significant findings were reported among studies comparing unbraced with braced conditions. Current data indicate that young, healthy, and physically active individuals may experience varied performance effects when executing specific functional performance tasks while wearing ankle braces. In general, bracing does not appear to significantly impair performance on most functional tasks; however, decrements were noted to increases in agility run time and decreases in vertical jump height. Subsequent analysis indicated that a brace may result in decreased ankle plantarflexion, dorsiflexion, eversion, and inversion range of motion, which may underpin noted performance deficits.

Early functional outcome of two different orthotic concepts in ankle sprains: a randomized controlled trial

INTRODUCTION

Purpose of the study was the evaluation of the early functional outcome of patients with an acute ankle sprain treated either with a semirigid, variable, phase-adapted modular ankle orthosis or an invariable orthotic reference device.

MATERIALS AND METHODS

Forty-seven patients with acute ankle sprain grade II or more were included. In addition, 77 healthy controls as a reference were investigated. The injured subjects were treated with one of the two devices by random for 6 weeks. Ankle scores (FAOS, AOFAS) were taken at baseline after injury, 1 and 3 months after injury. Functional performance tests (balance platform, zig zag run, shuttle run, vertical drop jump) were performed at 1 and 3 months after injury.

RESULTS

No significant score differences could be found between the two intervention groups except for achieving a preinjury activity level after 3 months only in the modular orthosis group. Postural functional performances (balance test) also showed no significant differences whereas the results of the agility tests revealed small but significant better results in the modular orthosis group in comparison to the invariable orthosis group. Cohen's effect sizes were high.

CONCLUSION

Differences between the two intervention groups were marginal and very small but significant and--regarding Cohen's effect sizes--effective. Especially relating to functional performance, this might be a careful indication that a more effective strategy for promoting a protected, rapid recovery to physical activity after ankle sprains might be achieved by applying a phase-adapted ankle orthosis. Especially in athletic patients, phase-adapted orthosis should be further investigated and considered to ensure fully protected ligament healing as well as to regain early functional recovery.

Balance comparisons between female dancers and active nondancers

PURPOSE

Female dancers have lower anterior cruciate ligament (ACL) injury rates compared with physically active women. Enhanced balance can decrease musculoskeletal injury risk. Dancers are proposed to have superior balance compared with physically active nondancers, and this may reduce their risk for ACL injury. However, whether female dancers actually have better balance than active nondancers is unclear.

METHOD

Thirty-three women (15 dancers, 18 nondancers) performed the Balance Error Scoring System (BESS; error scores), the Star Excursion Balance Test (SEBT; percent leg length), and the Modified Bass Test of Dynamic Balance (BASS; maximum score = 100).

RESULTS

Dancers had fewer errors on the BESS than did nondancers (p < .001, 12.0 +/- 6.9 vs. 25.3 +/- 9.1). Dancers also had greater SEBT reach distances in the medial (right, p = .03, 90.4 +/- 4.2% vs. 86.5 +/- 5.5%; left, p = .04, 90.7 +/- 4.5% vs. 86.7 +/- 5.9%) and posteromedial directions (right, p = .01, 92.6 +/- 5.6% vs. 87.0 +/- 6.4%; left, p = .01, 93.9 +/- 6.3% vs. 87.9 +/- 6.3%), but not in the anteromedial direction (right, p = .23, 84.5 +/- 4.4% vs. 86.2 +/- 3.5%; left, p = .51, 86.4 +/- 3.5% vs. 85.5 +/- 4.0%). BASS scores were similar between groups (p = .58, 90.6 +/- 5.5 vs. 91.7 +/- 56).

CONCLUSIONS

The novel findings of the study are that dancers had greater balance than did nondancers in some but not all tests. Although dancing may improve balance as compared with not dancing, it is not better than physical activity in improving balance. Thus, balance comparisons between dancers and nondancers may not fully explain why female dancers exhibit low ACL injury rates compared with physically active women. Other factors (e.g., anticipated/unanticipated movement demands) should be examined to understand the ACL injury disparity between dancers and physically active women.