The effect of different skin–ankle brace application pressures with and without shoes on single-limb balance, electromyographic activation onset and peroneal reaction time of lower limb muscles

Abstract

Background Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin–brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin–ankle brace interface pressures, with and without shoes, on quiet single-limb balance and the electromyographic (EMG) activation sequence of four lower limb muscles. Methods Twelve male physical education students who volunteered to take part in the study were measured with and without shoes under three ankle brace conditions: (i) without brace, (ii) with brace and 30 kilopascals (kPa) application pressure and (iii) with brace and 60 kPa application pressure. Single-limb balance (anteroposterior and mediolateral parameter) was assessed on the dominant lower limb, with open and closed eyes, on a force platform, simultaneously with the EMG recording of four lower lower limb muscles’ (gastrocnemius, peroneus longus, rectus femoris and biceps femoris) activation onset. Peroneus longus reaction time was also measured by provoking a sudden subtalar inversion stress test using a trap-door. Results The results showed that the application of athletic footwear resulted in a significant difference between the condition with shoes and without shoes, with a significantly increased anteroposterior sway and sway velocity, in all three ankle brace application conditions with shoes ( F = 50.9, d.f. = 1, p < 0.001 and F = 58.4, d.f. = 1, p < 0.001), but had no effect in the mediolateral stability, or the total stability parameter. Shoes had no significant effect on the EMG activation sequence of the four lower limb muscles. Lastly, ankle brace application with 30 and 60 kPa application pressures, with and without athletic footwear, led to a significant delay in the peroneus longus reaction time ( F = 9.71, d.f. = 2, p < 0.001). Conclusions These findings suggest that different ankle brace application pressures may have an effect on single-limb balance, and peroneal reaction time. The application of athletic footwear, further adversely affects these parameters significantly. Further research is needed in this area with more dynamic and functional measurements, before the safe use of ankle bracing can be widely recommended.