Effects of Different Ankle Supports on the Single-Leg Lateral Drop Landing Following Muscle Fatigue in Athletes with Functional Ankle Instability

Effectiveness of functional or biomechanical bandages with athletic taping and kinesiotaping in subjects with chronic ankle instability: a systematic review and meta-analysis

Purpose

The aim of the study was to analyze the effects of functional or biomechanical bandages, whether elastic or inelastic, in Chronic Ankle Instability (CAI).

Methods

This review used PubMed, WoS, SCOPUS, and CINAHL following PRISMA and registering in Prospero. Main PICOS: (1) CAI; (2) intervention, functional/biomechanical bandages; (3) comparison, taping effect versus placebo/no taping, or another functional taping; (4) outcomes, improvement of CAI functionality (dynamic/static balance, ankle kinematic, perception, agility and motor control, endurance and strength; (5) experimental and preexperimental studies. The meta-analyses considered mean and s.d. of the results per variable; effect size (ES) of each study and for each type of intervention. Homogeneity (Q), heterogeneity (H 2 and I 2), and 95% CI were calculated.

Results

In total, 28 studies were selected. Significant differences were found for dynamic balance (66.66%) and static balance (87.5%), ankle kinematics (75.00%), perceptions (88.88%), plantar flexor strength (100%), muscle activity (66.6%), endurance (100%), functional performance (100%), and gait (66.6%). The main results of meta-analyses (eight studies) are as follows - h/M ratio soleus, ES: 0.080, 95% CI: -5.219-5.379; h/M ratio peroneus, ES: 0.070, 95% CI: -6.151-6.291; posteromedial KT, ES: 0.042 95% CI: -0.514-0.598; posteromedial-overall, ES: -0.006 95% CI: -1.071-0.819; mSEBT-KT, ES: 0.057 95% CI: -0.281-0.395; mSEBT-overall, ES: -0.035 95% CI: -0.190-0.590.

Conclusions

All biomechanical or functional bandages, whether elastic or inelastic, applied in CAI were favorable, highlighting patient perception, dynamic and static balance, kinematics and agility and motor control, for its effectiveness and evidence. Thus, bandages increase ankle functionality. The meta-analyses found no statistical significance. Clinically, soleus muscle activity, h-reflex/M-responses using fibular reposition with rigid tape, and dynamic balance with combined kinesiotaping during the modified star excursion balance test and with the posteromedial direction found improvements.

Level of evidence

Level of evidence according to Scottish Intercollegiate Guidelines Network: 1+. Level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011: 1.

Effects of Kinesio taping on lower limb biomechanical characteristics during unexpected jumping in patients with chronic ankle instability

PURPOSE

The current biomechanical research on the application of Kinesio taping (KT) to patients with chronic ankle instability (CAI) has focused on testing the expected movements. However, unexpected movements are more common in actual sports. Therefore, the present study aimed to investigate the effects of KT on the biomechanical characteristics of the knee and ankle joints during unexpected jumping movements.

METHODS

Twenty-one patients with unilateral CAI were recruited to capture the biomechanical parameters during unexpected jumping movements under different interventions: no taping (NT), placebo taping (PT), and KT. A one-way repeated measures analysis of variance was used to compare the differences in knee and ankle biomechanical characteristics among patients with CAI between the three intervention conditions.

RESULTS

At initial contact, the KT group demonstrated a significant decrease in ankle plantarflexion and knee flexion angles compared to the NT group (p < 0.05). At the early landing phase, the KT group had a significant increase in peak ankle dorsiflexion angle, peak ankle eversion angle, peak ankle dorsiflexion moment, and peak ankle eversion moment compared to the NT and PT groups (p < 0.05). Furthermore, the KT group had a significantly reduced peak knee flexion angle, peak knee eversion angle, and peak vertical ground reaction force (p < 0.05) compared to the NT and PT groups.

CONCLUSION

KT significantly improves the sprain-prone touchdown posture of patients with CAI. And reducing the risk of ankle sprains during the early landing phase by promoting ankle dorsiflexion and eversion angles and moments.

Effects of textured insoles and elastic braces on dynamic stability in patients with functional ankle instability

BACKGROUND

Functional ankle instability (FAI) is a common condition that affects individuals who have experienced previous ankle sprains. Textured insoles and elastic ankle braces have been previously used as interventions to improve stability in FAI patients. However, the optimal combination of these interventions has not been fully explored. The objective of this study was to investigate the effects of different types of textured insoles and elastic ankle braces on the dynamic stability of individuals diagnosed with FAI.

METHODS

The study involved 18 FAI patients who performed single-leg landing tasks with and without wearing an eight-band elastic ankle brace while wearing textured insoles with protrusion heights of 0 mm, 1 mm, and 2 mm. The dynamic posture stability index (DPSI) and its components in the anterior-posterior (APSI), mediolateral (MLSI) and vertical (VSI) directions were calculated from the ground reaction force collected from the Kistler force plate during the first three seconds of the landing tasks.

RESULTS

A significant interaction was found between textured insole type and ankle brace for DPSI (P = 0.026), APSI (P = 0.001), and VSI (P = 0.021). However, no significant interaction was observed for MLSI (P = 0.555). With elastic ankle braces, textured insoles with 1-mm protrusions significantly enhanced anterior-posterior, mediolateral, vertical, and overall stability compared to textured insoles with no and 2 mm protrusions (P < 0.05). Without elastic ankle braces, textured insoles with 1-mm protrusions significantly improved the anterior-posterior (P = 0.012) and overall stability (P = 0.014) of FAI patients compared to smooth insoles.

CONCLUSIONS

The combination of textured insoles with 1-mm protrusion heights and an elastic ankle brace could enhance the dynamic stability of individuals with FAI, potentially mitigating the risk of ankle sprains.

External Ankle Support and Ankle Biomechanics in Chronic Ankle Instability: Systematic Review and Meta-Analysis

OBJECTIVE

To systematically review the literature to determine whether external ankle supports influence ankle biomechanics in participants with chronic ankle instability (CAI) during sport-related tasks.

DATA SOURCES

A literature search of MEDLINE, SPORTDiscus, and CINAHL databases was conducted in November 2021.

STUDY SELECTION

Included studies were randomized crossover or parallel-group controlled trials in which researchers assessed ankle biomechanics during landing, running, or change of direction in participants with CAI using external ankle supports compared with no support.

DATA EXTRACTION

Two authors independently identified studies, extracted data, and assessed risk of bias (Cochrane risk-of-bias tool version 2) and quality of evidence (Grading of Recommendations Assessment, Development and Evaluation). Random-effects meta-analysis was used to compare between-groups mean differences with 95% CIs. Grading of Recommendations Assessment, Development and Evaluation recommendations were used to determine the certainty of findings.

DATA SYNTHESIS

A total of 13 studies of low to moderate risk of bias were included. During landing, very low-grade evidence indicated external ankle supports reduce frontal-plane excursion (mean difference [95% CI] = -1.83° [-2.97°, -0.69°], P = .002), plantar-flexion angle at initial contact (-3.86° [-6.18°, -1.54°], P = .001), and sagittal-plane excursion (-3.45° [-5.00°, -1.90°], P < .001) but not inversion angle at initial contact (-1.00° [-3.59°, 1.59°], P = .45). During running, very low- to low-grade evidence indicated external ankle supports reduce sagittal-plane excursion (-5.21° [-8.59°, -1.83°], P = .003) but not inversion angle at initial contact (0.32° [-2.11°, 1.47°], P = .73), frontal-plane excursion (-1.31° [-3.24°, 0.63°], P = .19), or plantar-flexion angle at initial contact (-0.12° [-3.54°, 3.29°], P = .94). Studies investigating changes of direction were insufficient.

CONCLUSIONS

Very low-grade evidence indicated external ankle supports reduce frontal-plane excursion but not inversion angle at initial contact in participants with CAI during landing. Limiting frontal-plane excursion may reduce ankle-sprain risk. Frontal-plane ankle kinematics were not influenced by external ankle supports during running. Sagittal-plane reductions were observed with external ankle supports during landing and running with low to very low certainty, but their influence on ankle-sprain risk is undetermined.

Effect of different ankle braces on lower extremity kinematics and kinetics following special-induced fatigue for volleyball players with functional ankle instability

Background

The aim of this study is to examine the effects of different ankle braces on functional ankle instability (FAI) participants following special-induced fatigue, which will provide advice for preventing ankle sprains in volleyball game.

Methods

A total of 18 male collegiate volleyball players with FAI were recruited. The kinematics and kinetics data were acquired from the participants during single-leg drop landing using the infrared motion capture system (Mars2H, Nokov, China) and the force platform (Bertec, USA). A 2 × 2 within subjects design ANOVA was adopted to analyze the data.

Results

Whether fatigue or not, soft and semi-rigid brace reduced the ankle inversion (P = 0.025). Moreover, soft brace reduced the sagittal range of motion (ROM) of the ankle joint before fatigue (P = 0.05). In addition, the semi-rigid brace shortened the time to stability in the medial and lateral directions (P = 0.039) as well as the vertical directions (P < 0.001). The semi-rigid brace reduced the ground reaction force post-fatigue (P = 0.001).

Conclusion

Soft ankle brace reduced the sagittal range of motion pre-fatigue. Since volleyball requires athletes to jumping and landing repeatedly, and the ankle sagittal ROM was an important cushion during landings. Thus, soft ankle brace might result in overuse injury for lower extremity. However, the semi-rigid ankle brace increased the dynamic stability in the medial and vertical directions, and reduced the ankle inversion angle and forward ground reaction force post-fatigue. This ensured that the volleyball player's ankle was in a neutral position during landing, reducing the risk of excessive inversion caused by contact with the opposing player during spike and block.

Acute effect of kinesio tape on postural control in individuals with functional ankle instability following ankle muscle fatigue

Background: Kinesio taping (KT) is one of the therapeutic interventions in sports medicine practice. The study aims to assess the acute effect of different KT methods on postural control in individuals with functional ankle instability (FAI) after ankle muscle fatigue.

Methods: Twenty-eight participants with FAI were recruited to complete maximum voluntary isometric contraction (MVIC) and proprioception of ankle using isokinetic dynamometer, dynamic postural control using Y-balance test and static postural control using a force platform after a fatigue protocol in four taping conditions: facilitatory KT (FKT), ankle balance taping (ABT), sham taping (ST) and no taping (NT).

Results: No significant difference was observed for the data MVIC and proprioception after ankle muscle fatigue amongst the four taping treatments. A significant difference in Y-Balance Test was observed amongst the four taping treatments at posterolateral direction (p < 0.001) and posteromedial direction (p < 0.001), suggesting that KT may significantly improve dynamic postural control following ankle muscle fatigue. For Center of pressure (COP) measurements, the mediolateral COP sway range of NT was significantly larger than that of FKT (p = 0.003) and ST (p < 0.001), suggesting that the placebo effect of KT was inevitable.

Conclusion: The effect of KT seems increased dynamic postural control in individuals with FAI after ankle muscle fatigue, and this effect is not strongly related to the taping methods. By preventing fatigue-related impairments of postural control, KT may help reduce the risk of injury in individuals with FAI.

Is Kinesio Taping Effective for Sport Performance and Ankle Function of Athletes with Chronic Ankle Instability (CAI)? A Systematic Review and Meta-Analysis

Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.

The Influence of Kinesio Tape and an Ankle Brace on the Lower Extremity Joint Motion in Fatigued, Unstable Ankles during a Lateral Drop Landing

BACKGROUND

An unstable ankle along with plantar flexor muscle fatigue may exacerbate landing performance. External support may be an option to control the ankle motion and protect joints from injuries. Research goal: To investigate the immediate changes in the joint motion of a lower extremity under ankle plantar flexors fatigue conditions in athletes with unstable ankles using different external supports.

METHODS

A total of 44 participants were allocated to a control (Cn) group, an ankle brace (AB) group, and a kinesio tape (KT) group, and were asked to perform a lateral drop landing before and after a fatigue protocol. The outcome measures were fatigue-induced changes in the maximal joint angle and changes in the angle ranges of the hip, knee, and ankle.

RESULTS

Smaller changes in the maximal hip abduction were found in the AB group (p = 0.025), and the KT group exhibited smaller changes in the maximal ankle dorsiflexion (p = 0.009). The AB group landed with a smaller change in the range of hip flexion and knee flexion (p = 0.008 and 0.006). The Cn group had greater fatigue-induced changes in the COM range than AB and KT group (p = 0.002 and 0.028).

SIGNIFICANCE

Despite the beneficial effect in the postural control in the frontal plane, the use of AB might constrain the distal joint motion which might lead to an extended knee landing posture resulting in secondary injuries to the knee joint. Therefore, the use of AB in conjunction with an additional training of landing strategy might be recommended from the injury prevention perspective.

Kinesio taping does not improve ankle functional or performance in people with or without ankle injuries: Systematic review and meta-analysis

OBJECTIVE

To investigate whether Kinesio taping technique, applied to ankles of healthy people as a preventive intervention and people with ankle injuries, is superior to sham or alternative interventions on ankle function.

DATA SOURCES

Medline, Embase, Amed, CINAHL, SPORTDiscus, Cochrane Library and Web of Science, from inception to August 2020.

REVIEW METHODS

The terms "ankle" and "kinesio taping" were used in the search strategy. Included studies were randomized controlled trials (including crossover design) investigating Kinesio taping effects on ankle functional performance compared to any alternative or control/sham technique.

RESULTS

From 5,572 studies, 84 met the eligibility criteria which evaluated 2,684 people. Fifty-eight meta-analyses from 44 studies were performed (participants in meta-analyses ranging from 27 to 179). Fifty-one meta-analyses reported ineffectiveness of Kinesio taping: moderate evidence for star excursion balance test (anterior direction), jump distance, dorsiflexion range of motion, and plantar flexion torque for healthy people (effect size = 0.08-0.13); low to very-low evidence for balance, jump performance, range of motion, proprioception, muscle capacity and EMG for healthy people; balance for older people; and balance and jump performance for people with chronic instability. Seven meta-analyses reported results favoring Kinesio taping (effect size[95% CI]): low to very-low evidence for balance (stabilometry, ranging from 0.42[0.07-0.77] to 0.65[0.29-1.02]) and ankle inversion (0.84[0.28-1.40]) for healthy people; balance for older people (COP velocity, 0.90[0.01-1.78]); and balance for people with chronic instability (errors, 0.55[0.06-1.04]).

CONCLUSIONS

Current evidence does not support or encourage the use of Kinesio taping applied to the ankle for improvements in functional performance, regardless the population.