The effect of ankle Kinesio™ taping on ankle joint biomechanics during unilateral balance status among collegiate athletes with chronic ankle sprain

ObjectivesTo determine the effects of ankle Kinesio-taping (KT) on postural sway, lower limb ROM, and muscle activity during a unilateral balance tasks.DesignCase control study design.SettingData were collected at the human movement analysis laboratory.Participants30 collegiate athletes with chronic ankle sprain (11 females and 19 males, 23.91 ± 2.58 years).Main outcome measureHip, knee and ankle joints ranges of motion (ROMs); postural sway area and velocities in both anteroposterior and mediolateral directions; and muscular activity amplitudes (% peak) of lateral and medial gastrocnemius, tibialis anterior and peroneus longus in a 20s single leg balance test in two non-taped (control) and KT (intervention) conditions.ResultsSignificant decrease observed in ankle lateral ROM (p = 0.048, d = 0.52), mediolateral postural sway velocity (p = 0.029, d = 1.25), and peroneus longus activity amplitudes (p = 0.042, d = 0.55) after KT application.ConclusionAcute application of KT among athletes with chronic ankle instability could provide lateral mechanical support to the ankle, potentially decreasing the velocity of frontal plane sway, and decreasing the magnitude of muscle activation. These data suggest that KT may be beneficial for improving static joint stability among individuals with chronic ankle sprain, and thus could be considered an option to allow safe return-to-activity.     

The effects of swimming fatigue on shoulder strength,range of motion,joint control,and performance in swimmers

PurposeTo investigate the effects of training induced fatigue on shoulder strength, ROM, joint position sense, and stroke length in elite competitive swimmers.MethodsSeventeen national level swimmers performed maximum isometric strength (internal and external rotation), ROM, and joint position sense tests before and after a fatiguing 8 × 100 m training set. Stroke length, heart rate, blood lactate and blood glucose levels were recorded throughout.ResultsPeak blood lactate, blood glucose levels, and heart rate increased significantly (P < 0.001) post-training confirming fatigue. Reductions were observed in stroke length of both arms (P < 0.001), external rotation range of motion (P < 0.001, −5.29°, Right shoulder; P = 0.04, −3.18°, Left shoulder) and joint position sense in their dominant (breathing side) arm (P = 0.03).ConclusionsThis investigation revealed a reduction in stroke length across both arms and also an arm bias in swimming whereby a greater reduction in both external rotation range and joint position sense was observed in the dominant arm when fatigued. This has highlighted a relationship between fatigue and potential mechanism of shoulder pathology in swimmers.     

Influence of Kinesio Taping applied over biceps brachii on isokinetic elbow peak torque. A placebo controlled study in a population of young healthy subjects

ObjectivesTo investigate the effect of Kinesio Taping (KT) applied over the biceps brachii on maximal isokinetic elbow torque.DesignThis study followed a single-blinded, placebo controlled, repeated measures design.MethodsIsokinetic eccentric and concentric elbow peak torques were evaluated without taping (NT), with KT or placebo taping (PT) in 20 healthy participants. Furthermore, all the participants were required to perform a proprioceptive task of elbow joint position sense (JPS) in the same experimental conditions.ResultsA significant effect of taping condition was found for concentric elbow peak torque (p = 0.01). Post hoc analysis revealed a statistically significant concentric elbow peak torque improvement between NT and KT (p < 0.05) but not between NT and PT. As regards eccentric elbow peak torque, we found a significant effect of taping condition (p < 0.0001). Significant eccentric elbow peak torque differences were observed between NT and PT (p < 0.01) and between KT and PT (p < 0.001), while the increase observed from NT to KT conditions failed to reach significance at a post hoc analysis.ConclusionsWhen applied over the biceps brachii, KT increases concentric elbow peak torque in a population of healthy participants, if compared with a PT.     

Kinesio taping effect on quadriceps strength and lower limb function of healthy individuals: A blinded,controlled, randomized,clinical trial

ObjectivesTo analyze kinesio taping (KT) effect on quadriceps strength and lower limb function over a 7-day period.DesignBlind randomized clinical trial.SettingHospital's Physical Therapy Department.ParticipantsSixty healthy individuals (30 men and 30 women) were randomly distributed into three groups: Control – without KT application; Placebo – placebo KT application and Experimental - A KT application designed to stimulate quadriceps femoris activity.Main outcome measuresThe quadriceps strength was measured using a manual dynamometer whereas lower limb function was assessed using the Single Hop Test for Distance. Evaluations occurred at five time-points: baseline; immediately, 3 and 5 days after KT application; and 72 h post KT withdrawal.ResultsThere was no significant interaction between time-points and groups for muscle strength: dominant (P = 0.13) and non-dominant (P = 0.41) and lower limb function: dominant (P = 0.09) and non-dominant (P = 0.53); but lower limb function within-group comparisons showed improvements in all groups at the evolution of all time-points analyzed for both limbs (P = 0.001). This is possibly due to a learning effect as the participants became more familiar with executing the assessment tests.ConclusionKT did not improve quadriceps strength and lower limb function of healthy individuals and its application with these objectives should be reconsidered.     

The effects of foot orthosis and low-dye tape on lower limb joint angles and moments during running in individuals with pes planus

BackgroundPes Planus or Flat feet is one of the most common lower limb abnormalities. When runners with this abnormality participate in recreational running, interventional therapies could help in pain alleviation and enhance performance. To determine the most effective treatment, however, a biomechanical examination of the effects of each treatment modality is required.Research questionThe aim of the present study was to investigate the effects of Foot Orthoses (FOs) and Low-Dye Tape (LDT) on lower limb joint angles and moments during running in individuals with pes planus.Methodskinematic and kinetic data of 20 young people with pes planus were measured during running in three conditions: (1) SHOD (2) with shoes and FOs (3) with shoes and LDT. One-way repeated measure ANOVA was used to investigate the impacts of the FOs and LDT on the lower limb joint angles and moments throughout the stance phase of the running cycle.ResultsThe results showed that FOs reduced ankle eversion compared to SHOD and LDT (P < 0.001) and decreased the dorsiflexion angle (P = 0.005) and the plantarflexor moment compared to the SHOD (P < 0.001). FOs increased knee adduction angle (P = 0.021) and knee external rotator moment (P < 0.001) compared to both conditions and increased knee extensor and abductor moments compared to SHOD (P < 0.001). At the hip joint, FOs only increased hip external rotation compared with the LDT condition (P = 0.031); and LDT increased hip extensor moment compared to SHOD and FOs (P = 0.037) and also increased hip adduction angle compared to SHOD (P = 0.037).SignificanceFOs with a medial wedge appears to increase the external knee adduction moment and knee adduction angles, which are risk factors for the development and progression of knee osteoarthritis. Further, usage of FOs seems to reduce the ankle joint role in propulsion as it impacts the ankle sagittal angles and moments.     

The effects of Kinesiology Tape on static postural control in individuals with functional ankle instability

ObjectiveTo investigate if applying Kinesiology Tape (KT) on the unstable ankle may improve static postural control in individuals with Functional ankle instability.DesignA repeated measured study. Participants performed a series of static quiet bipedal and unipedal stances on a force platform. Measurements were taken at three different times: baseline or no tape, immediately and 24 h after the taping application with the tape remaining on the ankle.SettingA university’s psychomotor laboratory.ParticipantsTwenty young adults with Functional ankle instability aged from 18 to 30 years old. Outcome measures: Postural control was assessed by four measures derived from the centre of pressure data: Area of 95% Confidence ellipse, standard deviation of displacements, mean velocity and mean power frequency. The analysis of variance (ANOVA) was performed to determine any significant improvement in postural control over time due to KT.ResultsOnly minor changes in mean velocity and MPF in unipedal stances were observed immediately after KT application. However, the overall results indicated statistically insignificant improvements in postural control neither immediately after KT application nor after 24 h.ConclusionResults suggest that the use of KT did not affect bipedal and unipedal stances of individuals with functional ankle instability.     

Ankle laxity affects ankle kinematics during a side-cutting task in male collegiate soccer athletes without perceived ankle instability

ObjectivesTo investigate whether ankle joint laxity alone influences lower limb kinematics during a side-cutting task.DesignA cross-sectional study.SettingSports medicine research laboratory.ParticipantsIn total, 66 male collegiate soccer players with history of ankle sprains with no perceived ankle instability were categorised into three groups: no-laxity copers (n = 26), laxity copers (n = 23), and severe-laxity copers (n = 17).Main outcome measuresThe hip, knee, ankle, rearfoot, midfoot, and forefoot kinematic data during the stance phase (0%–100% indicated initial contact to take-off) of a 45° side-cutting task were analysed using one-dimensional statistical parametric mapping.ResultsThe horizontal plane kinematics of the rearfoot differed significantly among the three groups during 30%–91% of the stance phase (P < .05). Severe-laxity copers exhibited a greater external rotation angle than no-laxity copers during 6%–14% and 32%–92% of the stance phase (P < .05).ConclusionOur data suggest that severe ankle joint laxity affects rearfoot horizontal plane kinematics in individuals without perceived ankle instability performing a 45° side-cutting task. These findings could be used by clinicians in developing rehabilitation programs to prevent further ankle sprains in patients with severe ankle joint laxity.     

A comparison of the efficacy of textured insoles on balance performance in older people with versus without plantar callosities

BackgroundTextured insoles have been suggested to enhance foot sensation, which contributes to controlling upright balance. However, the interaction between plantar callosity and the textured surface has not been studied.Research questionFirstly, to compare the efficacy of textured insoles on balance performance and foot position sense between two groups of older people: one group had plantar callosity, and the other did not. Secondly, to investigate the efficacy of textured insoles within each study group.MethodsThirty older people with a history of falls (15 with plantar callosity and 15 without callosity) participated in this study. All participants underwent assessments of postural sway on a force plate, joint position sensation of the ankle with a slope box, and mobility using the "Timed Up and Go" test under three insole surface conditions: 1) smooth (control), 2) placebo and 3) textured surface. Two-way analyses of variance were used to compare the outcomes of the two groups and three conditions.ResultsOlder people with plantar callosity had worse ankle joint position sense and slower antero-posterior and mediolateral postural sway velocity than their peers who did not have plantar callosity. The textured insoles improved ankle joint position sense and mobility regardless of callus status in the plantar surface of older peoples’ feet. The insole-callosity interaction was not significant for any study outcome.SignificanceTextured insoles could be beneficial to older people with and without callosity as they have shown immediate improvements in ankle joint position sense and mobility.     

The effects of gluteus medius and tibialis anterior kinesio taping on postural control,knee kinematics,and knee proprioception in female athletes with dynamic knee valgus

ObjectivesThis study aimed to investigate the effects of Kinesio taping on postural control, kinematics, and knee proprioception in female athletes with dynamic knee valgus (DKV).Design: a single-blind randomized clinical trial.Participants40 female athletes between the age of 18 and 28 years with DKV in single-leg drop landing (>13°) participated in this study. They were randomly classified into the Kinesio taping (KT) and placebo control (PC) groups.Main outcome measuresAll the evaluations and measurements were performed on each subject in the pre-test and post-test stages (with an interval of 72 h). The dynamic balance (Y balance test), proprioception (Knee position sense error), and knee kinematics (flexion and DKV angles) of the subjects were measured, prior and post gluteus medius and tibialis anterior KT.ResultsThe results of study demonstrate that the DKV angle and knee position sense error significantly decreased and YBT increased in the KT group from pre-test to post-test (p < 0.05). Nevertheless, there was no significant difference in knee flexion angle (p > 0.05).ConclusionThe results of the present study indicated that KT improves dynamic balance and proprioception and reduces the DKV angle. Therefore, KT is recommended for female athletes with DKV.     

Evidence of sensorimotor deficits in functional ankle instability: A systematic review with meta-analysis

Functional ankle instability (FAI) has been associated with impaired sensorimotor function; however individual studies have produced conflicting results. In an attempt to reduce this ambiguity, a systematic review with meta-analysis was undertaken to determine which sensorimotor deficits exist with FAI. Fifty-three studies assessing sensorimotor factors in subjects with FAI were included from 465 identified articles. Studies were rated for methodological quality and data were pooled for peroneal reaction time, joint position sense, and postural sway during single-leg stance and time to stabilisation from a single-leg jump. Data on joint movement sense were unable to be pooled. When subjects with unstable ankles were compared to healthy controls, sensorimotor impairments were demonstrated for passive joint position sense (mean difference (MD) = 0.7°, 95% confidence interval (CI): 0.2–1.2°, p = 0.004), active joint position sense (MD = 0.6°, 95% CI: 0.2–1.0°, p = 0.002), postural sway in single-leg stance (standardised MD (SMD) = 0.6, 95% CI: 0.2–1.0, p = 0.002), the star excursion balance test (SMD = 0.4, 95% CI: 0.1–0.7, p = 0.009), and time to stabilisation from a single-leg jump in a medio-lateral (MD = 0.6 ms, 95% CI: 0.4–0.8, p < 0.0001) and an antero-posterior direction (MD = 0.7 ms, 95% CI: 0.4–1.0, p < 0.0001). Peroneal reaction time was not affected. Sensorimotor deficits occur for joint position sense and postural control in subjects with FAI. Deficits in peroneal muscle reaction time following perturbation are not evident.     

Assessing the concurrent validity and reliability of an iPhone application for the measurement of range of motion and joint position sense in knee and ankle joints of young adults

ObjectiveTo analyze the concurrent validity and reliability of an iPhone application for assessing range of motion (ROM) and joint position sense (JPS) in ankle and knee joints.DesignCross-sectional study.SettingSport laboratory.ParticipantsTwenty healthy and physically active volunteers.InterventionsAll participants performed a ROM and a JPS test in ankle and knee joints, which were simultaneously evaluated with photo-analysis and the iPhone application.Main outcomes measuresA total of 80 angles were obtained with the iPhone app and the photo-analysis and compared for concurrent validity. Reliability was evaluated through re-scoring of images with the iPhone app by two different testers.ResultsVery high correlation was observed between both methods for ankle and knee ROM and knee JPS (r > 0.90), and high correlation for ankle JPS (r = 0.71–0.90), while Bland–Altman plots showed absolute agreement for all the variables. Inter- and intra-tester reliability was perfect for all the variables (ICC > 0.81), except for the inter-tester reliability of ankle JPS, which was substantial (ICC = 0.61–0.81).ConclusionsThis new iPhone application is valid and reliable for measuring ankle and knee ROM and JPS, although special attention is needed during ankle evaluation to avoid errors.     

An exploratory study into the effects of a 20 minute crushed ice application on knee joint position sense during a small knee bend

ObjectivesThe effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play or activity immediately following cryotherapy application at the knee. The aim of this study was to investigate whether a 20 min application of crushed ice at the knee immediately affects knee joint position sense during a small knee bend.DesignPre- and post-intervention.SettingUniversity movement analysis laboratory.ParticipantsEleven healthy male participants.Main outcome measuresKinematics of the knee were measured during a weight bearing functional task pre and post cryotherapy intervention using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden). Tissue cooling was measured via a digital thermometer at the knee.ResultsResults demonstrated significant reductions in the ability to accurately replicate knee joint positioning in both sagittal (P = .035) and coronal (P = .011) planes during the descent phase of a small knee bend following cryotherapy.ConclusionIn conclusion a 20 min application of crushed ice to the knee has an adverse effect on knee joint repositioning. Team doctors, clinicians, therapists and athletes should consider these findings when deciding to return an athlete to functional weight bearing tasks immediately following ice application at the knee, due to the potential increase risk of injury.     

Development of supine and standing knee joint position sense tests

ObjectivesWe aimed to assess the test-retest reliability of a supine and standing knee joint position sense (JPS) test, respectively, and whether they discriminate knees with anterior cruciate ligament (ACL) injury from asymptomatic knees.DesignRepeated measures and cross-sectional.SettingResearch laboratory.ParticipantsFor test-retest reliability, 24 persons with asymptomatic knees. For discriminative analysis: 1) ACLR - 18 persons on average 23 months after unilateral ACL reconstruction, 2) CTRL - 23 less-active persons, and 3) ATHL - 21 activity level-matched athletes.Main outcome measuresAbsolute error (AE) and variable error (VE).ResultsTest-retest reliability was generally highest for AE of the standing test (ICC 0.64–0.91). Errors were less for the standing compared to the supine test across groups. CTRL had greater knee JPS AE (P = 0.005) and VE (P = 0.040) than ACLR. ACLR knees showed greater VE compared to the contralateral non-injured knees for both tests (P = 0.032), albeit with a small effect size (η_p² = 0.244). Conclusions: Our standing test was more reliable and elicited lesser errors than our supine test. Less-active controls, rather than ACLR, produced significantly greater errors. Activity level may be a more predominant factor than ACLR for knee JPS ∼2 years post-reconstruction.     

Effect of Kinesio Taping on gastrocnemius activity and ankle range of movement during gait in healthy adults: A randomized controlled trial

ObjectiveTo examine the effect of KT on gastrocnemius surface electromyography (SEMG) activity and ankle range of motion during walking in healthy subjects.DesignRandomized controlled trial, with concealed allocation and assessor blinding.SettingUniversity Biomechanics Laboratory.ParticipantsThirty six healthy physiotherapy students were randomized to KT or control group.Outcome MeasuresAt baseline and immediately after 72 h with the tape in situ: amplitude of LG SEMG activity during the stance phase, duration of the LG activity, onset and offset times of LG activity, ankle plantar- and dorsiflexion peaks, and the cadence of gait.ResultsANOVA revealed a significant time × intervention interaction effect across two variables: duration of LG activation, F(1, 33) = 4.71, p = .037, η = .015; and onset F(1, 33) = 7.92, p = .008, η = .037. KT group showed significantly shorter duration of the LG activity as compared with control, and similar results were observed when comparing the onset of LG activation. No statistically significant differences between both groups were noted in the rest of the outcomes.ConclusionKT does significantly shorten the duration of the LG activity during gait when applied 72 h in healthy adults. However, this result was not accompanied by a significant reduction in the amplitude of LG SEMG activity.     

The effects of hip- and ankle-focused exercise intervention on lower limb mechanics during single leg squat among physically active females

ObjectivesThere are two types of kinetic chain in dynamic knee valgus (DKV) namely top-down (proximal origins) and bottom-up (distal origins). This study compared the influence of four-week hip- and ankle-focused exercises on lower limb mechanics during single-leg squat (SLS) among physically active females.MethodsThirty-six physically active females with excessive DKV were divided into either HIP, ANKLE, or control groups. The intervention groups completed exercises that focused either on the hip or ankle musculature for 12 sessions over four weeks. The SLS test protocol was performed with 3D motion capture at pre- and post-intervention. Data were analyzed with two-way ANOVA test.ResultsHIP group showed increased dominant knee (F (2.66) = 9.437, P = .001) and ankle (F(2.66) = 16.465, P = .001) sagittal moment during 45° SLS at post-intervention compared to ANKLE and Control groups. HIP group also showed increased hip flexion angle for dominant (F(2.66) = 12.032, P = .001) and non-dominant leg (F(2.66) = 3.618, P = .032) compared to other groups during 60° SLS. No other significant differences were observed on other variables.ConclusionDKV did not show any significant changes during SLS after a four-week exercise intervention focusing on hip and ankle joints.     

Performance of high school male athletes on the Functional Movement Screen™

Objectives(1) Describe the performance of the Functional Movement Screen™ (FMS™) by reporting the proportion of adolescents with a score of ≤14 and the frequency of asymmetries in a cross-sectional sample; (2) explore associations between FMS™ to age and body mass, and explore the construct validity of the FMS™ against common postural stability measures; (3) examine the inter-rater and test-retest reliability of the FMS™ in adolescents.DesignCross-sectional.SettingField-setting.Participants94 male high-school athletes.Main outcome measureThe FMS™, Y-Balance Test (YBT) and Balance Error Scoring System (BESS).ResultsThe median FMS™ composite score was 16 (9–21), 33% of participants scored below the suggested injury risk cutoff composite score of ≤14, and 62.8% had at least one asymmetry. No relationship was observed between the FMS™ to common static/dynamic balance tests. The inter-rater reliability of the FMS™ composite score suggested good reliability (ICC = 0.88, CI 95%:0.77, 0.94) and test-retest reliability for FMS™ composite scores was good with ICC = 0.83 (CI 95%:0.56, 0.95).ConclusionsFMS™ results should be interpreted cautiously with attention to the asymmetries identified during the screen, regardless of composite score. The lack of relationship between the FMS™ and other balance measures supports the notion that multiple screening tests should be used in order to provide a comprehensive picture of the adolescent athlete.     

Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability

ObjectiveTo study postural control and muscle activity during the limit of stability test (LOS) in subjects with chronic ankle instability.DesignObservational study.SettingUniversity laboratory.Participants10 healthy subjects were included in the control group and 10 subjects in the CAI group (age between 18 and 30 years, with history of the multiple ankle “giving way” episodes in the last six months and score ≤24 in the Cumberland Ankle Instability Tool).Main outcome measuresA computerized dynamic posturography equipment was used for assessing the LOS. The electromyography activity of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG) and peroneus longus (PL) was registered.ResultsSubjects with CAI had a greater activation in TA to forward (p < .01), forward affected (p = .001), backward affected (p = .007) and backward directions (p < .01); in PL to forward affected (p < .01) and affected directions (p = .001); in MG to forward (p = .023) and affected directions (p < .01) and in SOL to the affected direction (p = .009). We observed restricted excursions and less directional control in subjects with CAI.ConclusionsSubjects with CAI exhibited poorer ability to move their center of gravity within stability limits. In addition, they have an altered ankle muscle activity during LOS test toward the affected ankle joint.     

Balance dysfunction in hereditary and spontaneous spastic paraparesis

ObjectiveTo determine how postural sway is affected in people with spastic paraparesis (pwSP) and the impact of different impairments.MethodsIn 20 pwSP and 18 matched healthy controls standing postural sway was measured with eyes open and closed. Vibration threshold, isometric ankle and hip muscle strength and ankle stiffness with the participant at rest or preactivating the muscle was measured.ResultsAntero-posterior (AP) and medio-lateral (ML) sway was higher in pwSP. Muscle strength was reduced and ankle stiffness increased in pwSP. Increased vibratory threshold was seen in 35% of participants. Higher total ankle stiffness (R² = 0.44) was associated with lower AP sway with eyes open whilst hip abductor weakness was associated with increased ML sway with eyes open (R² = 0.36) or closed (R² = 0.47) or AP sway with the eyes closed (R² = 0.48).ConclusionsThe degree of postural sway was related to muscle paresis of the hip abductors particularly in the ML direction and under conditions of reduced sensory input. People with higher total ankle stiffness have less AP sway suggesting that this may help to stabilise the body.     

The effects of visual cognitive tasks on landing stability and lower extremity injury risk in high-level soccer players

BackgroundVisual cognition plays a pivotal role in sports. It is widely recognized that there is an intriguing coupling that they could affect each other through interaction between visual cognition and motor control, but few studies linked the effects of visual cognitive tasks on landing stability to postural control and injury risk.Research questionWhether visual cognitive tasks affect the landing stability and lower limb injury risk of professional soccer players?MethodsThe current study used a three-dimensional Multiple Object Tracking (MOT) task to simulate visual cognitive difficulties experienced in soccer matches. Fifteen male high-level soccer athletes (height: 181.43 ± 7.36 cm, weight: 75.37 ± 10.67 kg, training years: 10.07 ± 2.98 yr) from our school team were recruited and completed a landing action from a high platform with and without MOT tasks. Vicon infrared high-speed motion capture system and three-dimensional force measuring platform were used to collect various outcomes simultaneously.ResultsThe Time to Stabilization (TTS) during landing was significantly prolonged, while the Medial-Lateral Stability Index (MLSI), Anterior-Posterior Stability (APSI), Dynamic Postural Index Stability Index (DPSI), the trajectory lengths, and envelope area of COP during landing were also increased during MOT dual-task.DiscussionThe decline of these indicators reflected the deterioration in postural stability and greater requirements for maintaining balance which could increase the risk of injury in soccer athletes. We advocate that adequate visual attention and visual information processing might play critical roles in maintaining dynamic balance through the supraspinal neural network.