Semi-rigid Brace Research Articles

Attitudes and practices of Australian healthcare and sports workers on the use of ankle supports for management and prevention of lateral ankle sprains: a cross-sectional survey

Explore attitudes and practices of Australian professionals using ankle taping or bracing for the management and prevention of lateral ankle sprains. Cross-sectional study. Anonymous online survey. Australian healthcare or athletic workers, registered with an official governing body, involved in the management and/or prevention of lateral ankle sprains. Quantitative data was collected from 20 close-ended questions. Qualitative data from 14 open-ended questions were categorized into topics using inductive thematic analysis. Data was analysed using descriptive statistics and presented in figures and tabular format. A total 160 respondents answered the survey; the majority were podiatrists (42.5%), physiotherapists (23%), or sports/athletic trainers (13.8%). Ankle supports were overwhelmingly recommended and considered to be effective in the management (95% and 89% bracing and taping, respectively) and prevention (96% and 92% bracing and taping, respectively) of lateral ankle sprains. For management, semi-rigid brace with straps (26%) and figure eight taping technique (42%) were the most frequently used. For prevention, the most commonly used were soft brace with straps (30%) and the figure eight taping technique (37%). Australian professionals expressed a positive attitude towards using ankle supports in the management and prevention of lateral ankle sprains.

Effect of a semirigid ankle brace on the in vivo kinematics and muscle activity of patients with functional ankle instability during simulated ankle sprain.

Ankle braces can effectively decrease the incidence of recurrent ankle sprain; however, whether the brace can decrease the severity of sprain and its related mechanism during sprain remain unknown. Twenty-two patients with functional ankle instability (FAI) (12 males and 10 females) and 16 healthy subjects (8 males and 8 females) were enrolled in this study. All of the subjects walked on a custom-built tilting platform that offered a 30° inversion (IV) to mimic the IV of ankle sprain. We collected the kinematic and surface electromyography data of patients with FAI with or without ankle brace and normal controls 6 times. The FAI without brace group showed significantly higher maximum IV angles and average IV velocities than the control group (P < .001). The FAI with brace group revealed significantly lower maximum IV angles and average IV velocities than the FAI without brace group (P < .001); this group also showed significantly higher maximum external rotation (ER) angle and average ER velocities than the FAI with brace (P < .001) and control (P < .001) groups. The FAI with brace group indicated significantly lower average EMGPrep (P = .047), EMGTilt (P = .037), and EMGafterTilt (P = .004) of the peroneus longus than the FAI without brace group. The ankle brace could effectively decrease IV angles and their velocities and increase ER angles and their corresponding velocities during ankle sprain in patients with FAI. It could also decrease the activity of the peroneus longus muscle during ankle sprain.

Trends in Spinal Orthosis Utilization Among Patients Insured Through Medicare Part B.

Retrospective population-based database analysis from the Physician/Supplier Procedure Summary Medicare/Medicaid Data Set. To provide a comprehensive analysis of trends in spinal orthosis utilization over a 12-year period. Widespread prescription of spinal orthosis persists, despite evidence suggesting equivocal efficacy in many spinal conditions. The utilization of spinal orthosis on a national level, including prescribing specialty data, has not been previously analyzed. Health care common procedure coding system codes for cervical (CO), thoracic-lumbar-sacral (TLSO), lumbar (LO), lumbar-sacral (LSO), and cervical-thoracic-lumbar-sacral (CTLSO) orthosis were used to determine spinal orthosis utilization from 2010 to 2021. Provider specialty codes were utilized to compare trends between select specialties. In addition, a neurosurgical CO analysis based on subclassifications of cervical bracing was performed. Linear trendlines were implemented to elucidate and present trends by slope (β). Among 332,241 claims, decreases in CO (β=-0.3387), TLSO (β=-0.0942), LO (β=-0.3485), and LSO (β=-0.1545) per 100,000 Medicare Part B enrollees and CTLSO (β=-0.052) per 1,000,000 Medicare Part B enrollees were observed. Decreases among neurosurgery (β=-7.9208), family medicine (β=-1.0097), emergency medicine (β=-2.1958), internal medicine (β=-1.1151), interventional pain management (β=-5.0945), and chiropractic medicine (β=-49.012), and increases among orthopedic surgery (β=5.5891), pain management (β=30.416), physical medicine and rehabilitation (β=4.6524), general practice (β=79.111), and osteopathic manipulative medicine (β=45.303) in total spinal orthosis use per 100,000 specialty claims were observed. Analysis of subclassifications of cervical orthosis among neurosurgeons revealed decreases in flexible (β=-1.7641), semirigid (β=-0.6157), and collar bracing (β=-2.7603), and an increase in multipost collar bracing (β=2.2032) per 100 neurosurgical cervical orthosis claims. While utilization of spinal orthosis decreased between 2010 and 2021, increased utilization was observed among a subset of specialties. Identifying these specialties allows for focused research and educational efforts to minimize unnecessary durable medical equipment use for effective health care spending.

Mixed Comparison of Intervention with Assistive Devices for Plantar Pressure Distribution and Anatomical Characteristics in Adults with Pes Cavus: Systemic Review with Network Meta-Analysis

Background: Pes cavus is a multiplanar foot deformity with an abnormal plantar pressure distribution and an overhigh medial longitudinal arch (MLA). Its causes are complex. In the past, people have usually focused on clinical surgery for pes cavus. However, this is not necessarily the best choice for some patients with non-ongoing or mild symptoms. In the 21st century, studies have just begun to focus on assistive devices intervention for pes cavus, which has been proven to be an effective non-surgical treatment. However, the effectiveness of assistive devices for patients with arched feet of any etiology has not been evaluated and evidence-based guidelines for clinical treatment options are lacking. Methods: A systematic review and network meta-analysis were performed, employing a comprehensive search across the databases of Web of Science, PubMed, as well as Scopus. The selected studies adhered to specific eligibility criteria, which included: (1) involving patients with pes cavus; (2) interventions with assistive devices; and (3) outcome measures of plantar pressure distribution and anatomical characteristics (MLA). Meanwhile, the standard mean difference was selected as the effect size. Results: A total of three studies were selected, and the authors achieved an agreement on the risk of bias with a kappa value equal to 0.74. According to the results of network meta-analysis, customized foot orthotics compared to other devices (lace-up ankle-support brace, semirigid brace) demonstrated the highest likelihood of being the most effective in optimizing plantar-pressure distribution among pes cavus patients. On the other hand, wearing hard custom foot orthotics compared to other devices (soft custom foot orthotics, off-the-shelf orthotics) showed the greatest potential in improving the medial longitudinal arch (MLA) of pes cavus patients. Discussion: Although becoming better than wearing regular footwear, wearing lace-up ankle-support braces or semirigid braces might not be optimal choices for treatments of pes cavus with the potential mechanism that the internal force created by the fixation of the proximal joint might be much less than the ground reaction force loaded on the distal segments that touch the ground. It could be concluded that foot orthotics show great potential in treating pes cavus under non-surgical conditions. This systematic review could provide valuable evidence for future research and clinical practice. Other: The PROSPERO Registration Number is CRD42022349687.

A prophylactic lumbosacral brace and the biomechanics of parachute landing.

Lumbar injuries are common among paratroopers during landing maneuvers. Although bracing is widely advocated to increase spine stability, the effect of lumbar bracing on parachuting has yet to be quantified and the Chinese parachutist does not have a uniform prophylactic brace. The aim is to compare the effects of a novel, self-designed and self-manufactured lumbosacral brace with two ordinary lumbar braces based on biomechanical assessment of the lumbar and lower extremity joints during parachute landing. The study cohort consisted of 30 elite male paratroopers. Each participant was instructed to jump off a platform at two different heights (60 and 120 cm, respectively) and land on the force plate in a half-squat posture. Participants at each height were tested under four different conditions (no brace, elastic brace, semi-rigid brace, and lumbosacral brace). The Vicon 3D motion capture system and force plate were used to record and calculate biomechanical data, such as vertical ground reaction forces (vGRFs), joint angles, moments, and energy absorption. After the experiment, every participant completed the study questionnaires. The increase of the jumping height raised all the parameters significantly (P<0.01). The use of all three braces slightly decreased vGRF, and reduced the lumbar angle, moment, and angular velocity in the sagittal plane. The use of lumbosacral and semi-rigid braces restricted lumbar flexion more efficiently (P<0.05), and significantly increased the energy absorption of the hip joints (P<0.01) and hip flexion (P<0.01) at 120 cm. No significant effect of braces was found on the motion of knee and ankle joints. The subjective scores suggested that the lumbosacral brace was softer and more comfortable than the semi-rigid brace, and more effective than the elastic brace. The lumbosacral brace markedly restricted the lumbar motion in the sagittal plane than the elastic brace and was more comfortable than the semi-rigid brace. Therefore, the innovative design, high efficiency, and comfortable landing of the lumbosacral brace represent a reliable option for parachute jumping and training.

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

BackgroundThe 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. MethodsA 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. ResultsWhether 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). ConclusionSoft 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.

Effect of Braces on Performance in the Context of Chronic Ankle Instability

Ankle braces are commonly recommended for prevention of ankle sprains, especially secondary sprains, rehabilitation, and return to normal activity or sport after injury. One common resistance to use is the feeling that braces will impede functional performance. For people with chronic ankle instability, the limited research indicates that the use of semirigid, lace-up, or soft-shell braces will not affect, and in some cases, may enhance performance. Activities that could be enhanced are jumping, hopping, and dynamic balance.

What's New in Adult Reconstructive Knee Surgery.

What's New in Adult Reconstructive Knee Surgery.

Development of a bespoke 3D-printed spinal brace for lumbar support

Low back pain (LBP) is a significant contributor to disabilities in the UK. Many factors cause LBP, including poor posture, obesity, and spinal fractures, all resulting in spiralling healthcare costs. If spinal fractures are not properly braced, they can lead to weakened vertebrae in the spine and larger risks that can reoccur. There are many problems with flexible, semi-rigid and rigid braces currently available on the market. We present the user-centred design approach undertaken by a multidisciplinary design team consisting of product designers, design engineers, technical specialists, and healthcare professionals to develop a bespoke 3D-printed spinal brace using a digital design workflow.

EFFECTS OF A SEMI-RIGID KNEE BRACE ON MOBILITY AND PAIN IN PEOPLE WITH KNEE OSTEOARTHRITIS.

ObjectiveOsteoarthritis is one of the most common chronic conditions leading to disability among older people (age 60+ years). Knee osteoarthritis has a significant impact on daily functioning. Pain, stiffness, reduced strength, changes in posture, and reduced knee stability may result in reduced mobility. The aim of this study is to evaluate the short- and long-term effects of conservative therapeutic use of a semi-rigid knee brace for management of patients with knee osteoarthritis, using patient-reported outcomes.DesignPatients with osteoarthritis using a semi-rigid knee brace were asked to complete a questionnaire about the effectiveness of the brace after wearing it for 3 weeks. The primary outcome measure was mobility, assessed using an ordinal scale with and without use of the knee brace. Secondary outcome measures were pain symptoms and overall daily functioning.ResultsA total of 381 patients completed the questionnaire. The results show considerably improved mobility while using a knee brace in different mobility groups. In the group of respondents who were limited to their home environment mobility decreased by 74% while using a knee brace. In the group of respondents who were able to walk to a nearby shop mobility increased by 50%, and the group experiencing no mobility restrictions increased from 3% without using a knee brace to 13% while using a knee brace. In addition, 54% of respondents reported a reduction in pain symptoms and 62% of respondents reported an improvement in overall daily functioning while using a knee brace.ConclusionThe results of this large-scale patient-reported outcome measure (PROM) study show that the use of a semi-rigid knee brace appears to provide suitable joint support, offering pain relief and freedom of movement and should be considered a useful non-surgical treatment method for use in patients with knee osteoarthritisClinical trialThis study does not include a clinical trial.LAY ABSTRACTThis study of patient-reported outcome measures regarding the use of stabilizing knee braces for knee osteoarthritis provides insight into the additional care and quality of life provided by the use of these orthopaedic aids. The aims of this study are to measure the effectiveness of knee braces in daily life and to validate the efficacy of using orthopeadic medical aids.In the study, 381 patients with knee Osteoarthritis were provided with knee braces and were asked about the effectiveness of the braces 3 weeks after they first started wearing them. This large-scale study found that the use of knee braces contributed to user-mobility, reduced pain, and increased the possibility to perform daily activities. Knee braces appear to serve as a suitable support for knee joints, providing pain relief and freedom of movement, and should be considered a useful non-surgical treatment method for knee Osteoarthritis.

Effect of joint immobilization using extension splint immediately after total knee arthroplasty on post-operative knee function and pain: a randomized clinical trial.

Investigate the effect of semirigid extension bracing after total knee arthroplasty (TKA) on articular pain and function. The present randomized clinical trial included 72 patients undergoing unilateral primary TKA. Patients in the case group received eight days of post-operative semirigid extension-locked knee bracing, whereas controls did not. The outcomes assessed preoperatively and on the first, ninth, 30th day, and oneyear post-operatively included the knee society score (KSS), functional KSS (FKSS), VAS pain score, amount of postoperative opiate painkiller usage (tablet oxycodone 5mg), and knee ROM. The case group had a significantly lower flexion ROM on postoperative day nine compared to the control group (95.3° vs. 100.8°, p=0.03), while it became significantly higher 1 month (114.1° vs. 104.7°, p=0.03) and one year post-operative (128.0° vs. 120.5°, p=0.002). Also, FKSS was significantly higher in the case group than in the controls in the onemonth post-operative assessment (37.0 vs. 32.6, p=0.009) but not in the oneyear post-operative assessment. The case group patients had a significantly lower pain than the controls on days one (5.8 vs. 7.2, p=0.02) and nine post-operative (4.1 vs. 5.2, p=0.048), but not at later assessments. The amount of onemonth post-operative opium (oxycodone) consumption was significantly lower in the brace group (12.4 vs. 14.1 tablets, p=0.03). The KSS were not significantly different between the groups after the surgery. Extension-locked splinting immediately after TKA is a noninvasive, non-pharmacological, and inexpensive intervention with possible promising effects on knee ROM, short-term functional improvement, and acute post-operative pain management.

Efficacy of a semirigid ankle brace in reducing mechanical ankle instability evaluated by 3D stress-MRI

BackgroundNovel imaging technologies like 3D stress-MRI of the ankle allow a quantification of the mechanical instability contributing to chronic ankle instability. In the present study, we have tested the efficacy of a semirigid ankle brace on joint congruency in a plantarflexion/supination position with and without load.MethodsIn this controlled observational study of n = 25 patients suffering from mechanical ankle instability, a custom-built ankle arthrometer implementing a novel 3D-stress MRI technique was used to evaluate the stabilizing effect of an ankle brace. Three parameters of joint congruency (i.e., 3D cartilage contact area fibulotalar, tibiotalar horizontal and tibiotalar vertical) were measured. The loss of cartilage contact area from neutral position to a position combined of 40° of plantarflexion and 30° of supination without and with axial load of 200 N was calculated. A semirigid ankle brace was applied in plantarflexion/supination to evaluate its effect on joint congruence. Furthermore, the perceived stability of the brace during a hopping task was analyzed using visual analogue scale (VAS).ResultsThe application of a semirigid brace led to an increase in cartilage contact area (CCA) when the foot was placed in plantarflexion and supination. This effect was visible for all three compartments of the upper ankle joint (P < 0.001; η2 = 0.54). The effect of axial loading did not result in significant differences. The subjective stability provided by the brace (VAS 7.6/10) did not correlate to the magnitude of the improvement of the overall joint congruency.ConclusionsThe stabilizing effect of the semirigid ankle brace can be verified using 3D stress-MRI. Providing better joint congruency with an ankle brace may reduce peak loads at certain areas of the talus, which possibly cause osteochondral or degenerative lesions. However, the perceived stability provided by the brace does not seem to reflect into the mechanical effect of the brace.Trial registration The study protocol was prospectively registered at the German Clinical Trials Register (#DRKS00016356).

Foot Posture and Plantar Loading With Ankle Bracing.

Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading. To evaluate the effects of ankle braces on plantar loading during athletic tasks. Cross-sectional study. Laboratory. A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study. Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace. We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05). Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049). Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.

Lumbar Bracing for Chronic Low Back Pain: A Randomized Controlled Trial.

We performed this study to evaluate the effect of back bracing to treat patients with chronic low back pain. This was a prospective, unblinded, randomized controlled trial of 61 adults with uncomplicated chronic low back pain (>12 wks) and imaging findings of degenerative spondylosis, to assess the effectiveness of a semirigid back brace. All study participants received back school instruction. The treatment group also received a lumbar orthosis and was instructed to wear it as needed for symptom relief. At baseline, 6 wks, 12 wks, and 6 mos after intervention, we collected: Numerical Rating Scale to measure pain intensity, Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EuroQol 5-Dimension (EQ-5D) to measure patient-reported function and quality of life. An interim analysis at the halfway point in enrollment (61 of 120 planned participants) revealed the Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EQ-5D scores in the treatment group to be worse than in the control group, but no significant group differences in Numerical Rating Scale scores. Outcome differences between groups analyzed over time revealed (effect [P]): Pain Disability Questionnaire = 0.84 (0.04); Patient-Reported Outcome Measurement Information System = 0.78 (0.005); EQ-5D = 0.06 (0.01); and Numerical Rating Scale = 0.02 (0.6). We halted the study because continuation was unlikely to produce significant changes to the results. In patients with uncomplicated chronic low back pain, a back brace when combined with education and exercise instruction did not provide any pain relief compared with education and exercise instruction alone. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to: (1) Describe the effect of lumbar back bracing on pain intensity in patients with chronic low back pain; (2) Discuss the effects of lumbar back bracing on pain-related disability, function, and quality of life in patients with chronic low back pain; and (3) Understand the role of lumbar back bracing in the treatment of patients with chronic low back pain. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

A novel prophylactic Chinese parachute ankle brace.

BackgroundThe objective is to compare the effects of a self-designed and self-manufactured novel prophylactic ankle brace [Chinese parachute ankle brace (CPAB)] and two ordinary ankle braces on the ankle joint during a half-squat parachute landing (HSPL) via biomechanical assessment.MethodsTwenty elite paratroopers were in four different conditions: no brace, elastic brace, semi-rigid brace, and CPAB. Each participant was instructed to jump off a platform with three different heights, 40, 80, and 120 cm, and land on the force plate in a half-squat posture. The vertical ground reaction forces (vGRFs), joint angles, moments, powers, and works were calculated. After the experiment, every participant completed the questionnaires designed for this study.ResultsIncreasing the dropping height increased all of the parameters significantly (P<0.01), except for time to peak vGRF (T-PvGRF). Applying three braces can all slightly increase vGRF (P=0.237) and reduce T-PvGRF by 6–10 ms, as well as decrease the joint angles, velocities, and moments on the sagittal and coronal planes. Wearing CPAB and a semi-rigid brace more efficiently restricted dorsiflexion and inversion (P<0.05), and they both significantly reduced ankle work (t=5.107, P<0.01; t=3.331, P<0.01) and peak power (t=7.237, P<0.01; t=6.711, P<0.01) at 120 cm. The total scores from low-to-high were semi-rigid brace (19.20±2.99), elastic brace (21.91±3.25), and CPAB (23.37±3.08).ConclusionsThe CPAB was more effective at restricting ankle joint motion on the coronal and sagittal planes than the other two prophylactic ankle braces. Therefore, the CPAB had the advantages of a novel appearance, high efficiency, and superior comfort, providing a reliable choice for parachute jumping and training in China.

People with chronic ankle instability benefit from brace application in highly dynamic change of direction movements

BackgroundThe application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability.MethodsFifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated.ResultsMaximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found.ConclusionsBased on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.

The effect of three different ankle braces on local dynamical stability of individuals with chronic ankle instability during Running

The purpose of this study was to determine the effect of three different ankle braces using the Maximum Lyapunov exponent on local dynamical stability of individuals with chronic ankle instability during running. Twelve subjects with chronic ankle instability as injured group and 12 healthy individuals participated in this study. Injured group performed 70 strides of treadmill running in shoe and rigid, semi-rigid and soft braces as well as no-brace conditions. The healthy group performed the test only in no-brace condition. Kinematics data were used to calculate the short time (λ_S) and long time (λ_L) maximum Lyapunov exponent. The results showed that λ_S of running in semi-rigid brace is significantly different with running in other braces in chronic ankle instability group; but it was not different with the control group. It seems running in semi-rigid brace in chronic ankle instability group provides stability like healthy control group.

Efficacy of Ankle Supports on Dynamic Postural Control in Patients with Chronic Ankle Instability

ABSTRACT Introduction The chronic ankle instability (CAI) that results from a lateral ankle sprain causes balance deficits during quiet standing. Dynamic postural control in patients with CAI can be improved using soft and semirigid braces. Objective This study was aimed at investigating the effects of soft and semirigid ankle supports on dynamic postural stability in subjects with CAI. Materials and Methods Fifteen subjects with unilateral CAI as the CAI group and 15 healthy control subjects as the control group were recruited for participation in the study. Stability indexes (SIs), including overall SI, anteroposterior SI, and mediolateral SI, were determined using the Biodex Balance System (BBS), and lower-limb reach was ascertained using the Star Excursion Balance Test (SEBT). These indicators were measured under three conditions: without orthosis, with soft orthosis, and with semirigid orthosis. Results Significant differences in overall SI were found between the affected and healthy feet of the CAI group (P = 0.009) and between the affected feet of the CAI group and the healthy feet of the control group (P = 0.031). The SEBT revealed significant differences between the injured and uninjured sides of the CAI group in the anterior, anterior-medial, and anterior-lateral directions. With the use of soft ankle supports, no significant differences were found between the affected and unaffected limbs of the CAI group in the overall and mediolateral SIs of BBS test and the anterior-medial (P = 0.057) and anterior-lateral (P = 0.07) directions of SEBT. Conclusions The soft ankle support has more effect on the balance of the CAI patients in comparison with the semirigid orthosis.

Non-Invasive Treatment of Adolescent Idiopathic Scoliosis: Systematic Literature Review by Using Citation Network Analysis

There are many nonsurgical treatment options from adolescent idiopathic scoliosis (AIS) to control the progression of the spinal curvature. However, the existing studies are so diverse and diffuse that it is challenging to find potential trends for further studies without a more comprehensive review in place for reference purposes. Thus, the objective of this review article is to conduct a systematic literature review on the noninvasive treatment of AIS with a citation network analysis. The Web of Science (WoS) was searched using 9 reference keywords to collect published articles in English on nonsurgical treatment options for AIS from 1979 to 2019. Each eligible article focused on the nonsurgical options for treating AIS. In addition, the HistCite and the UCINet softwares were referred to for article distribution and citation network analysis. Only non-invasive treatment options of AIS were included. Studies that estimated the amount of spinal curvature, causes of or risk factors for AIS and any invasive treatments, such as surgery, were not focused on. The articles were independently extracted by 3 authors based on the predefined eligibility criteria. The title, authors, year of publication, country or region of publication, reference list, keywords and other bibliographic information from each article was extracted and analyzed purely based on the data with the HistCite and UCINet programs. At last, a total of 146 articles out of 1594 articles were selected for the literature review after the exclusion of 1357 irrelevant articles and 91 inappropriate studies, such as letters and proceedings papers. Of these 146 articles, the majority were empirical studies (74.0%). There was also a lack of meta-analyses in this research field. Based on the results of the citation network analysis, most of the top 10 articles with the highest local citation scores (LCSs) focused on bracing as a treatment. The popularity of bracing as a research topic was also supported by the citation network structure, as brace treatment was in the largest of the five research clusters; this cluster also included posture training through exercise, managing the corrective forces of braces, 3D analysis of braces and quality of life during brace treatment. However, most of these studies focused on rigid braces. A few studies on non-rigid braces and other types of nonsurgical treatment were available in the current literature, which might indicate potential research areas for future studies. To conclude, noninvasive treatment for AIS has been on the academic radar recently; but there are still research gaps, such as the lack of research on semi-rigid and flexible braces or posture training exercises with biofeedback systems. Further studies could explore these research directions.

Gait Biomechanics Following Taping and Bracing in Patients With Chronic Ankle Instability: A Critically Appraised Topic.

Clinical Scenario: Approximately 30% of all first-time patients with LAS develop chronic ankle instability (CAI). CAI-associated impairments are thought to contribute to aberrant gait biomechanics, which increase the risk of subsequent ankle sprains and the development of posttraumatic osteoarthritis. Alternative modalities should be considered to improve gait biomechanics as impairment-based rehabilitation does not impact gait. Taping and bracing have been shown to reduce the risk of recurrent ankle sprains; however, their effects on CAI-associated gait biomechanics remain unknown. Clinical Question: Do ankle taping and bracing modify gait biomechanics in those with CAI? Summary of Key Findings: Three case-control studies assessed taping and bracing applications including kinesiotape, athletic tape, a flexible brace, and a semirigid brace. Kinesiotape decreased excessive inversion in early stance, whereas athletic taping decreased excessive inversion and plantar flexion in the swing phase and limited tibial external rotation in terminal stance. The flexible and semirigid brace increased dorsiflexion range of motion, and the semirigid brace limited plantar flexion range of motion at toe-off. Clinical Bottom Line: Taping and bracing acutely alter gait biomechanics in those with CAI. Strength of Recommendation: There is limited quality evidence (grade B) that taping and bracing can immediately alter gait biomechanics in patients with CAI.