Protection by Ankle Brace for Lower-Extremity Joints in Half-Squat Parachuting Landing With a Backpack

Half-squat parachuting landing is a kind of activity with high impact force. Injuries on lower-extremity joints are common in half-squat parachuting landing and would be increased with a backpack. An ankle brace was used to prevent ankle injuries in landing. However, few quantitative studies reported about the protection of an ankle brace for lower-extremity joints in half-squat parachuting landing with a backpack. This study focused on evaluating the protective effects of an ankle brace in half-squat parachuting landing with a backpack. Seven male participants landed from 120 cm with a backpack and an ankle brace. Each participant performed three landing trials on every experimental condition. Kinetics and kinematics of the hip, knee, and ankle were analyzed. It was found that the ankle brace did not significantly affect the ground reaction force with backpack but increased the ground reaction force from 14.7 ± 2.0 bodyweight to 16.2 ± 1.9 bodyweight (p = 0.017) without the backpack. The ankle brace significantly (p < 0.05) decreased the angular displacement, angular velocity, and angular acceleration of the ankle both without and with the backpack. In conclusion, the ankle brace could restrict ankle motion and significantly increase ground reaction force without the backpack. However, the ankle brace did not significantly influence ground reaction force and still restricted ankle motion with the backpack. Therefore, the ankle brace was more effective in half-squat parachuting landing with the backpack than no-backpack landing.

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

Background Novel 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. Methods In 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). Results The 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. Conclusions The 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).

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.

EFFECTS OF WEARING AN ANKLE BRACE ON GROUND REACTION FORCES DURING JUMPS IN BASKETBALL GAME SIMULATION

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .

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

Background The 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. Methods Fifteen 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. Results Maximum 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. Conclusions Based 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.

Incorporating regenerative medicine into rehabilitation programmes: a potential treatment for ankle sprain

Ankle sprain has a great effect on morbidity and complications of chronic diseases. Experts have come to a consensus where ankle sprain can be managed by rest, ice, compression and elevation, non-steroidal anti-inflammatory drugs, immobilisation, functional support such as the use of an ankle brace, exercise, surgery and other therapies that include physiotherapy modalities and acupuncture. However, the time required for healing is still relatively long in addition to post-operative complications. Because of the challenges and setbacks faced by interventions to manage ankle sprains and in view of the recent trend and development in the field of regenerative medicine, this article discusses future treatments focusing on a personalised and holistic approach for ankle sprain management. This narrative review provides a novel idea for incorporating regenerative medicine into conventional therapy as an intervention for ankle sprain based on theoretical concepts and available evidence on regenerative medicine involving ligament injuries.

Ankle Bracing Alters Coordination and Coordination Variability in Individuals With and Without Chronic Ankle Instability

Context: Ankle bracing is an effective form of injury prophylaxis implemented for individuals with and without chronic ankle instability, yet mechanisms surrounding bracing efficacy remain in question. Ankle bracing has been shown to invoke biomechanical and neuromotor alterations that could influence lower-extremity coordination strategies during locomotion and contribute to bracing efficacy. Objective: The purpose of this study was to investigate the effects of ankle bracing on lower-extremity coordination and coordination dynamics during walking in healthy individuals, ankle sprain copers, and individuals with chronic ankle instability. Design: Mixed factorial design. Setting: Laboratory setting. Participants: Forty-eight recreationally active individuals (16 per group) participated in this cross-sectional study. Intervention: Participants completed 15 trials of over ground walking with and without an ankle brace. Main Outcome Measures: Coordination and coordination variability of the foot–shank, shank–thigh, and foot–thigh were assessed during stance and swing phases of the gait cycle through analysis of segment relative phase and relative phase deviation, respectively. Results: Bracing elicited more synchronous, or locked, motion of the sagittal plane foot–shank coupling throughout swing phase and early stance phase, and more asynchronous motion of remaining foot–shank and foot–thigh couplings during early swing phase. Bracing also diminished coordination variability of foot–shank, foot–thigh, and shank–thigh couplings during swing phase of the gait cycle, indicating greater pattern stability. No group differences were observed. Conclusions: Greater stability of lower-extremity coordination patterns as well as spatiotemporal locking of the foot–shank coupling during terminal swing may work to guard against malalignment at foot contact and contribute to the efficacy of ankle bracing. Ankle bracing may also act antagonistically to interventions fostering functional variability.

The Effect of the TayCo External Ankle Brace on Multidirectional Reach Distance, Balance, and Motion in Collegiate Athletes

Ensuring ankle stability while allowing for functional movement is important when returning patients to physical activity and attempting to prevent injury. The purpose of this study was to examine the effectiveness of the TayCo external and a lace-up ankle brace on lower extremity function, dynamic balance, and motion in 18 physically active participants. Significantly greater range of motion was demonstrated for the TayCo brace compared with the lace-up brace for dorsiflexion and plantar flexion, as well as less range of motion for the TayCo brace compared to the lace-up brace for inversion and eversion. The TayCo brace provided restricted frontal plane motion while allowing increased sagittal plane motion without impacting performance measures.