Effects Of External Ankle Support Research Articles

Effect of External Ankle Support on Ankle and Knee Biomechanics During the Cutting Maneuver in Basketball Players

Background: Despite the high prevalence of lower extremity injuries in female basketball players as well as a high proportion of athletes who wear ankle braces, there is a paucity of research pertaining to the effects of ankle bracing on ankle and knee biomechanics during basketball-specific tasks. Purpose: To compare the effects of a lace-up brace (ASO), a hinged brace (Active T2), and no ankle bracing (control) on ankle and knee joint kinematics and joint reaction forces in female basketball athletes during a cutting maneuver. Study Design: Controlled laboratory study. Methods: Twenty healthy, semi-elite female basketball players performed a cutting task under both ankle brace conditions (lace-up ankle brace and hinged ankle brace) and a no-brace condition. The 3-dimensional kinematics of the ankle and knee during the cutting maneuver were measured with an 18-camera motion analysis system (250 Hz), and ground-reaction force data were collected by use of a multichannel force plate (2000 Hz) to quantify ankle and knee joint reaction forces. Conditions were randomized using a block randomization method. Results: Compared with the control condition, the hinged ankle brace significantly restricted peak ankle inversion (mean difference, 1.7°; P = .023). No significant difference was found between the lace-up brace and the control condition (P = .865). Compared with the lace-up brace, the hinged brace significantly reduced ankle and knee joint compressive forces at the time of peak ankle dorsiflexion (mean difference, 1.5 N/kg [P = .018] and 1.4 N/kg [P = .013], respectively). Additionally, the hinged ankle brace significantly reduced knee anterior shear forces compared with the lace-up brace both during the deceleration phase and at peak ankle dorsiflexion (mean difference, 0.8 N/kg [P = .018] and 0.9 N/kg [P = .011], respectively). Conclusion: The hinged ankle brace significantly reduced ankle inversion compared with the no-brace condition and reduced ankle and knee joint forces compared with the lace-up brace in a female basketball population during a cutting task. Compared with the lace-up brace, the hinged brace may be a better choice of prophylactic ankle support for female basketball players from a biomechanical perspective. However, both braces increased knee internal rotation and knee abduction angles, which may be problematic for a population that already has a high prevalence of knee injuries.

The effect of external ankle support on the kinematics and kinetics of the lower limb during a side step cutting task in netballers.

BackgroundExcessive knee valgus moments are considered to be a risk factor for non-contact injuries in female athletes. Knee injuries are highly prevalent in netballers and are significant in terms of cost and disability. The aim of the study was to identify if changes in external ankle support mechanisms effect the range of motion and loading patterns at the ankle and knee joint during a sidestep cutting manoeuvre in high performance netball players.MethodsNetballers with no previously diagnosed ankle or knee injury (n = 10) were recruited from NSW Institute of Sport netball programme. Kinematic and kinetic data were collected simultaneously using a 3-D Motion Analysis System and a force platform to measure ground reaction forces. Players performed repeated side step cutting manoeuvres whilst wearing a standard netball shoe, the same shoe with a lace-up brace and a high-top shoe.ResultsThe brace condition significantly reduced ankle joint ROM in the sagittal plane by 8.9° ± 2.4 when compared to the standard netball shoe (p = 0.013). No other significant changes were seen between conditions for either kinematic or kinetic data. All shoe conditions did however produce knee valgus moments throughout the cutting cycle that were greater than those considered excessive in the previous literature (0.59 Nm/kg-Bwt).ConclusionsThe results show that an external ankle support brace can be used to reduce the ROM at the ankle in the sagittal plane without affecting the loading of the joints of the lower limb. Internal varus moments generated at the knee during the task were however greater than values reported in the literature to classify excessive knee joint moments, regardless of the condition. All netballers exhibited lower extremity patterns and alignments previously associated with increased peak external valgus moments including; increasing hip abduction, peak hip flexion and internal rotation during early contact and high laterally directed ground reaction forces. Increased external valgus knee loads have been strongly linked to the development of non-contact injuries at the knee in female athletes and could highlight a potential mechanism for the development non-contact knee injuries in netballers performing side step cutting tasks.

The effect of external ankle support on knee and ankle joint movement and loading in netball players

External ankle support has been successfully used to prevent ankle sprains. However, some recent studies have indicated that reducing ankle range of motion can place larger loads on the knee. The aim of this study was to investigate the effect of external ankle support (braces and high-top shoes) on the ankle and knee joint loading during a netball specific landing task. A repeated measure design. High performance netball players with no previously diagnosed severe ankle or knee injury (n=11) were recruited from NSW Institute of Sport netball programme. The kinematic and kinetic data were collected simultaneously using a 3-D Motion Analysis System and one Kistler force plate to measure ground reaction forces. Players performed a single leg landing whilst receiving a pass while wearing a standard netball shoe, the same shoe with a lace-up brace and a high-top shoe. Only the brace condition significantly reduced the ankle range of motion in the frontal plane (in/eversion) by 3.95 ± 3.74 degrees compared to the standard condition. No changes were found for the knee joint loading in the brace condition. The high-top shoes acted to increase the peak knee internal rotation moment by 15%. Both the brace and high-top conditions brought about increases in the peak ankle plantar flexion moment during the landing phase. Lace-up braces can be used by netball players to restrict ankle range of motion during a single leg landing while receiving a pass without increasing the load on the knee joint.

The effect of external ankle support on knee and ankle joint loading in netball players

Background External ankle support has been successfully used to prevent ankle sprains [1]. However, some recent studies [2,3] have indicated that reducing ankle range of motion can place larger loads on the knee and increase the risk of knee injuries. The aim of this study is to investigate the effect of external ankle support (braces and high top shoes) on ankle kinematics and knee kinetics in high performance netball players. Materials and methods Eleven high performance netball players were recruited from NSW Institute of Sport. A 14-camera motion analysis system was used to synchronously collect threedimensional video and force plate data. Twenty-four retro-reflective markers were attached to anatomical landmarks to allow the formation of rearfoot, forefoot, shank, thigh, and pelvis segments. Each player performed a single-leg-landing whilst receiving a chest pass.

The Effects of External Ankle Support on Dynamic Restraint Characteristics of the Ankle in Volleyball Players

To examine any changes in electromechanical delay and reaction time as a result of the use of external ankle supports over an entire season (3-5 months) in college volleyball players. A 2 x 3 pre-post factorial design. Biomechanics laboratory, Human Performance Research Center. Thirty healthy, active male and female intercollegiate volleyball players were recruited for this study (age, 20.4 +/- 2.3 years; height, 183.1 +/- 8.6 cm; weight, 74.0 +/- 9.5 kg). External supports consisted of the subjects wearing either tape or braces for practices and games for the duration of the volleyball season. Subjects in the control group wore nothing on their ankles for practices and games for the duration of the volleyball season. The electromechanical delay (EMD) of the peroneus longus was determined by the onset of force contribution after artificial activation, as measured by electromyographic (EMG) and forceplate data. Reaction time was measured after an inversion perturbation during walking. No significant (F2,27 = 0.141, P = 0.869) interaction was observed for reaction time between the groups over time. No significant (F2,27 = 0.236, P = 0.791) interaction was observed for EMD between groups over time. Use of an external ankle support over an entire season does not induce neuromuscular changes in the onset timing of the peroneus longus.

Effects of External Ankle Support on Plantar Flexed Inversion

PURPOSE: To prevent ankle injury, many athletes wear external ankle support. The majority of studies examining ankle support, however, have not tested braces at the position in which ankle injury most often occurs; plantar flexed inversion (Verhagen, et al. 2001; Wiley & Nigg, 1996). The purpose of this study was to test two non-rigid stabilizers, the McDavid Lightweight® brace (ML) and Bioskin TriLock® brace (BT), at two plantar flexion (PF) angles and determine the effects of the two braces on ankle inversion, both in pre and post exercise conditions. METHODS: Fourteen subjects were tested while standing at 20° and 30° of PF on an inversion platform, which inverted to 35°. All subjects performed all conditions, including a bare ankle condition (platform angles x brace x pre/post exercise). Ten trials were performed for each condition. A Biometrics twin axis electrogoniometer (1000 Hz) were used to record maximum inversion (ROM), maximum inversion velocity (Vmax) and time to maximum inversion (Trom) via Datapac Software (Run Technologies). Data were filtered at 18 Hz and analyzed via a 2 × 3 × 2 repeated measures ANOVA. IRB approval was obtained and participants signed consent forms. RESULTS: Statistically significant differences were noted between brace and angle conditions for ROM and Vmax. ROM was on average 12% lower for the two brace conditions, and Vmax was lower by 18%, at 30° PF in comparison to 20° PF. Both brace conditions had significantly lower Vmax than the bare ankle condition (24%), but not from each other. However, ROM was not significantly different between the braces and bare ankle, although the BT brace did decrease ROM by 12% and 9%, respectively, to the bare ankle and ML brace at the 20° angle. No significant differences were noted for pre to post exercise, nor for time to max inversion. CONCLUSION: The two braces appear equally effective in keeping the rate of inversion lower, for both PF angles. The differences noted between PF conditions were interesting, considering the ankle is considered to be less stable with greater PF, but the ROM and Vmax were less in the greater PF condition, regardless of brace or no brace. The BT brace may be slightly better at reducing ROM at 20° PF angle, but the actual change in ROM was small. Personal preference of brace style showed an even split PMong participants.

The Effect of External Ankle Support on Vertical Ground-Reaction Force and Lower Body Kinematics

Objective:To examine the effects of external ankle support on vertical ground-reaction forces (VGRF) and kinematic data.Methods:Subjects completed 2 braced and 2 nonbraced 0.61-m hanging drop landings onto a force platform. Kinematic data were collected with 8 digital-optical cameras sampling at 120 Hz.Subjects:12 Division I female volleyball players.Statistical Analysis:A repeated-measures ANOVA with Bonferroni correction (P < .05) was used to determine whether significant differences existed between test conditions for peak VGRF, loading rate, hip angle, knee angle, and ankle angle at right-foot contact for peak 1 and peak 2 of the VGRF curve over the first 100 milliseconds of the landing phase, as well as total hip range of motion (ROM), total knee ROM, and total ankle ROM for the entire landing phase.Results:There were significant increases in peak P1 and LR1 and a significant decrease in ankle-angle change at right-foot contact in braced trials compared with the nonbraced condition.

Effects of Ankle Support on Lower-Extremity Functional Performance: A Meta-Analysis

Clinicians surmise that the application of external ankle support reduces the ability to perform functional skills and movements, but the outcomes from some of these studies have been inconclusive. To meta-analyze studies regarding the effects of external ankle support on lower-extremity functional performance measures. A total of 93 effects from 17 randomized controlled trials utilizing predominantly crossover designs with recreationally active participants and competitive athletes were subjected to a random-effects meta-analysis. The treatment variable was external ankle support with three levels: adhesive tape, lace-up style, and semirigid style. Differences between mean changes in treatment and control groups were computed as standardized effect sizes for sprint, agility, and vertical jump performance with their 90% confidence intervals (CI). Effect sizes >0.20 were considered substantial. The greatest effect of ankle support on performance was a negative effect of lace-up style brace on sprint speed (effect size -0.22, 90% CI -0.47 to 0.03), equivalent to approximately 1% impairment of speed. The other effects of external ankle support on performance were insubstantial, though most were negative, and their lower confidence limits allowed for realistic chances of impaired performance. Substantial true variation between studies, although poorly defined, was also present for some effects, further increasing the likelihood of performance impairment in some settings. More research is needed to reduce the uncertainty in the effects of external ankle support on performance. In the meantime, it is our opinion that the benefit in preventing injury outweighs the possibility of substantial but small impairment of performance when athletes use external ankle support.

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 external ankle support in chronic lateral ankle joint instability

We examined the effect of ankle taping on ankle joint stability by measuring mechanical stability using stand ardized stress radiographs. Anterior talar translation and talar tilt, both with and without ankle tape, were examined. The reduction of anterior talar translation and talar tilt with tape as compared to without tape was insignificant.The reaction time of the peroneus muscles was measured by electromyographic signal after a simulated ankle sprain on a tilting trapdoor. The reaction time was significantly slower in the unstable ankles of 20 athletes with unilateral ankle instability than in the stable contra lateral ankles. With tape, the reaction time was signifi cantly shortened, although not back to normal. The greatest improvement in reaction time was achieved in ankles with the highest degree of mechanical instability. Thus, the mechanism behind the function of ankle tape may be to restrict the extremes of ankle motion and to help shorten the reaction time of the peroneus muscles by affecting ...

The effect of external ankle support in chronic lateral ankle joint instability. An electromyographic study.

We examined the effect of ankle taping on ankle joint stability by measuring mechanical stability using standardized stress radiographs. Anterior talar translation and talar tilt, both with and without ankle tape, were examined. The reduction of anterior talar translation and talar tilt with tape as compared to without tape was insignificant. The reaction time of the peroneus muscles was measured by electromyographic signal after a simulated ankle sprain on a tilting trapdoor. The reaction time was significantly slower in the unstable ankles of 20 athletes with unilateral ankle instability than in the stable contralateral ankles. With tape, the reaction time was significantly shortened, although not back to normal. The greatest improvement in reaction time was achieved in ankles with the highest degree of mechanical instability. Thus, the mechanism behind the function of ankle tape may be to restrict the extremes of ankle motion and to help shorten the reaction time of the peroneus muscles by affecting the proprioceptive function of the ankle.