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

Abstract

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.

Sprunggelenk-Instabilität: Wie unterscheide ich mechanisch von funktionell?

“…If adequate compensation cannot be achieved after this time, a change in the treatment model should be pursued. If a functional instability manifests only during sporting activities and the active treatment options have been exhausted, a brace or tape can be used for mechanical stabilisation [60]. However, long-term treatment with external stabilisers such as tape bandages or braces does not appear to be a sensible option.…”

Portable 3D Gait Analysis Assessment in MTT Treat Chronic Ankle Instability: A Retrospective Study

“…At present, the research on CAI mainly focuses on the biomechanical mechanisms such as muscle strength, balance function, and posture stability. As gait analysis helps to describe the characteristics of the gait of CAI patients, and quantitative analysis of the biomechanical changes of the ankle, we apply it to the treatment evaluation of CAI [17,18]. The kinematic characteristics of gait can be reflected by 5 BioMed Research International the following parameters: step length, pace, pace frequency, step width, step angle, gait cycle and the percentage of each phase in the total cycle, the movement angle and angular velocity of the three joints of lower limbs in three planes, etc.…”

Advances in Diagnosis and Management of Lateral Ankle Instability: A Review of Current Literature

“…28,29 In fact, when evaluating inversion angles and velocity at the ankle, there was a significant reduction in both parameters with the use of bracing treatment. 30 Physical therapy traditionally focuses on strengthening of the peroneal muscles prevent inversion injuries and closed chain activity to help optimize foot strike and mechanics. 26 In addition to physical therapy on the muscles surrounding the ankle, newer literature has also found benefit to strengthening the muscles proximally in the lower extremity as well, including the gluteal musculature.…”

“… 28 , 29 In fact, when evaluating inversion angles and velocity at the ankle, there was a significant reduction in both parameters with the use of bracing treatment. 30 …”