Diagnostic accuracy of instrumented and manual talar tilt tests in chronic ankle instability populations

Diagnostic accuracy of the talar tilt test is not well established in a chronic ankle instability (CAI) population. Our purpose was to determine the diagnostic accuracy of instrumented and manual talar tilt tests in a group with varied ankle injury history compared with a reference standard of self‐report questionnaire. Ninety‐three individuals participated, with analysis occurring on 88 (39 CAI, 17 ankle sprain copers, and 32 healthy controls). Participants completed the Cumberland Ankle Instability Tool, arthrometer inversion talar tilt tests (LTT), and manual medial talar tilt stress tests (MTT). The ability to determine CAI status using the LTT and MTT compared with a reference standard was performed. The sensitivity (95% confidence intervals) of LTT and MTT was low [LTT = 0.36 (0.23–0.52), MTT = 0.49 (0.34–0.64)]. Specificity was good to excellent (LTT: 0.72–0.94; MTT: 0.78–0.88). Positive likelihood ratio (+ LR) values for LTT were 1.26–6.10 and for MTT were 2.23–4.14. Negative LR for LTT were 0.68–0.89 and for MTT were 0.58–0.66. Diagnostic odds ratios ranged from 1.43 to 8.96. Both clinical and arthrometer laxity testing appear to have poor overall diagnostic value for evaluating CAI as stand‐alone measures. Laxity testing to assess CAI may only be useful to rule in the condition.     

Reliability and discriminative validity of sudden ankle inversion measurements in patients with chronic ankle instability

BackgroundStudies investigating peroneal muscle reaction times in chronically unstable ankle joints present conflicting results. The degree of reliability and accuracy of these measurements is unknown in patients with chronic ankle instability (CAI).Methods40 patients with CAI and 30 healthy subjects were tested using a sudden ankle inversion of 50° while standing on a trapdoor device. Sudden ankle inversion measurements were registered using electromyography, accelerometry and electrogoniometry. For reliability testing, intra-class coefficients (ICCs; model 3,1) and standard errors of measurements of the latency time, motor response time and electromechanical delay of the peroneus longus muscle, the time and angular position of onset of decelerations, the mean and maximum inversion speed and the total inversion time were calculated in 15 patients with CAI. To assess between-group differences, t-tests for independent samples (p < .05) were used.ResultsICCs ranged from .20 (angular position of onset of the second deceleration) to .98 (electromechanical delay of the peroneus longus muscle). Significant between-group differences were observed in only 2 of the 12 variables (for the electromechanical delay of the peroneus longus muscle, p = .001; time of onset of the second deceleration, p = .040).ConclusionsThe latency time and motor response time of the peroneus longus muscle, the total inversion time and the mean inversion speed demonstrate acceptable reliability in healthy subjects and patients. The latency time and motor response time of the peroneus longus muscle are not delayed in patients with CAI. Ankle inversion measurements are not discriminative for CAI.     

Overuse of concomitant foot radiographic series in patients sustaining minor ankle injuries

Radiographic series of the foot are often obtained in conjunction with ankle X-rays when the clinical presentation is limited to trauma to the ankle. The Ottawa Ankle and Foot Rules were established in 1992 and serve as reliable guidelines to determine when an ankle or foot series is warranted in patients who have sustained minor ankle and/or foot injury. We retrospectively reviewed radiographic studies of all patients over a period of 18 months who simultaneously had ankle and foot plain radiographs performed for acute complaints limited to the ankle alone. Of the 243 patients who met our inclusion criteria, 55 patients had fractures, 46 in or near the ankle joint, and nine which were located at the base of the fifth metatarsal bone. No fractures or dislocations were noted elsewhere in the foot. All of the fifth metatarsal fractures were evident on adequately performed ankle series. Our findings suggest that films of the foot are not necessary when trauma is limited to the ankle and when an appropriately performed ankle series has been completed.     

New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test,stress radiography and stress ultrasound

Purpose

To diagnose chronic ankle instability, clinicians frequently use manual anterior drawer test and stress radiography. However, both exams can yield incorrect results and do not reveal the extent of ankle instability. The use of stress ultrasound during a manual anterior drawer stress procedure might enable the diagnosis of chronic ankle instability.

Methods

Seventy-three patients with chronic ankle pain or laxity after remote ankle sprain were included. The study population included 41 males and 32 females. The mean age of the patients at the time of the operation was 29 years. A standardized physical examination (manual anterior drawer test), stress radiography and stress ultrasonography were performed to assess the anterior talofibular ligament (ATFL). Ultrasound images were taken in the resting position and the maximal anterior drawer position. The statistical significance of stress ultrasound among the three groups according to manual anterior drawer test and a specific degree (5 mm) of anterior translation of stress radiography were analysed. Correlation coefficients between stress ultrasound, stress radiography and manual anterior drawer test were calculated.

Results

There was a significant difference for ATFL length (ATFL stress) and ATFL ratio (ATFL stress/ATFL resting) among the three groups (both p < 0.001). However, there was no significant difference for anterior translation of stress radiography among three groups according to manual anterior drawer test (p = 0.159). There was a significant difference for ATFL length (ATFL stress) and ATFL ratio between two groups with 5-mm anterior translation of stress radiography (p = 0.002 and p = 0.011, respectively). The mean value of grade of manual anterior drawer test between the two groups also differed (p = 0.021). There was a moderately positive linear relationship between stress ultrasound and manual anterior drawer test. Also, there was a positive linear relationship between stress ultrasound and stress radiography.

Conclusion

The results suggest that the value of ATFL length (ATFL stress) and ATFL ratio of stress ultrasound could be used for diagnosis of chronic ankle instability in addition to manual anterior drawer test and stress radiography.

Level of evidence

III.     

Continued validation and known groups validity of the Quick-FAAM: Inclusion of participants with chronic ankle instability and ankle sprain copers

ObjectiveTo examine the factor structure and validity of the Quick-FAAM in individuals with chronic ankle instability (CAI) and those classified as ankle sprain copers (ASC).DesignCross-sectional.SettingLaboratory.ParticipantsAdult participants were included in both groups based on previously established criteria.Main outcome measure(s)The 12-item Quick-FAAM is scored on a 5-point Likert scale were scores are converted to a percentage (0–100%), and greater scores indicate greater function. The Cumberland Ankle Instability Tool (CAIT) is a 9-item scale used to assess impairments in individuals with a history of ankle sprain. Scores range from 0 to 30, and greater scores indicate greater impairment levels. Confirmatory factory analyses, internal consistency, and concurrent validity were determined. Known-groups validity and differences in scores between groups were examined. Alpha was set at p < 0.05.ResultsThe instruments were strongly correlated (r = 0.76, p < 0.001), the Quick-FAAM internal consistency remained high (α = 0.94) and the single factor was confirmed. The cutoff score differentiating between the groups was 94.79%.ConclusionsThe Quick-FAAM is a valid, shortened version of the FAAM. It also has the ability to discriminate between individuals with CAI and those classified as ASC. The Quick-FAAM should be considered for future use with individuals who have ankle sprain history.     

Surgical treatment of concomitant chronic ankle instability and longitudinal rupture of the peroneus brevis tendon

Chronic lateral ankle instability can be associated with a longitudinal rupture of the peroneus brevis tendon. Patients with these problems have atypical posterolateral or retromalleolar pain, as well as clinical signs of ligamentous instability. This injury is frequently concomitant with lateral ligament injuries and the injury mechanism is similar; however, the tendon rupture is often missed. Laxity or insufficiency of the superior peroneal retinaculum allows the anterior part of the peroneus brevis tendon to ride upon the sharp posterior fibular edge, resulting in a longitudinal rupture of the tendon. We report on the results after surgical treatment in nine patients (10 ankles) with combined instability of the lateral ankle ligaments and longitudinal rupture of the peroneus brevis tendon. All these patients underwent surgical repair of the peroneus tendon, reconstruction of the superior peroneal retinaculum, removal of the sharp posterior edge of the fibula and correction of the ligamentous instability of the anterior talofibular and calcaneofibular ligaments. One constant finding at surgery was a longitudinal intratendineal rupture of the peroneus brevis tendon combined with insufficiency of the superior peroneal retinaculum and insufficiency of the lateral ligaments. At follow-up 3 (2–5) years postoperatively, the functional results were excellent or good in nine ankles and fair in one. All the patients with excellent or good results had resumed their preinjury activity level. We conclude that this lesion should be suspected in patients with lateral ligamentous instability, combined with retromalleolar pain. In these cases, it is important to address both the tendon rupture and the ligamentous insufficiency.     

Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test,stress radiography,magnetic resonance imaging,and arthroscopy

Purpose

Clinicians frequently diagnose chronic ankle instability using the manual anterior drawer test and stress radiography. However, both examinations can yield incorrect results and do not reveal the extent of ankle instability. Stress ultrasound has been reported to be a new diagnostic tool for the diagnosis of chronic ankle instability. The purpose of this study was to assess the diagnostic value of stress ultrasound for chronic ankle instability compared to the manual anterior drawer test, stress radiography, magnetic resonance imaging (MRI), and arthroscopy.

Methods

Twenty-eight consecutive patients who underwent ankle arthroscopy and subsequent modified Broström repair for treatment of chronic ankle instability were included. The arthroscopic findings were used as the reference standard. A standardized physical examination (manual anterior drawer test), stress radiography, MRI, and stress ultrasound were performed to assess the anterior talofibular ligament (ATFL) prior to operation. Ultrasound images were taken in the resting position and the maximal anterior drawer position.

Results

Grade 3 lateral instability was verified arthroscopically in all 28 cases with a clinical diagnosis (100 %). Twenty-two cases showed grade III instability on the manual anterior drawer test (78.6 %). Twenty-four cases displayed anterior translation exceeding 5 mm on stress radiography (86 %), and talar tilt angle exceeded 15° in three cases (11 %). Nineteen cases displayed a partial chronic tear (change in thickness or signal intensity), and nine cases displayed complete tear on MRI (100 %). Lax and wavy ATFL was evident on stress ultrasound in all cases (100 %). The mean value of the ATFL length was 2.8 ± 0.3 cm for the stressed condition and 2.1 ± 0.2 cm for the resting condition (p < 0.001).

Conclusion

Stress ultrasound may be useful for the diagnosis of chronic ankle instability in addition to the manual anterior drawer test and stress radiography.

Level of evidence

III.

     

半腱肌移植重建踝关节外侧副韧带及踝关节不稳

目的 探讨半腱肌移植修复陈旧性踝关节外侧副韧带损伤及踝关节不稳的有效性.方法 选择陈旧性踝关节外侧副韧带损伤患者2例,其中男1例,女1例;男25岁,女17岁.左侧1例,右侧1例.患者入院前均有2年以上反复踝部旋后位扭伤的病史.踝部损伤为Ⅲ度(美国足踝外科学院分度);前抽屉试验及距骨倾斜试验阳性.应力X线片显示距骨倾斜平均21°,且在侧位片显示距骨前脱位.2例均采用同侧自体半腱肌肌腱移植重建踝关节外侧副韧带.结果 2例平均随访8个月.患足局部无肿痛,行走正常,踝关节主动活动与被动活动良好,患足前抽屉试验及距骨倾斜试验阴性,应力X线片检查显示距骨无前脱位,距骨倾斜角＜5°.根据Mazur疗效评分标准,优1例,良1例.患者对踝关节功能主观满意.结论 (1)踝关节外侧副韧带损伤是导致慢性踝关节不稳,甚至踝关节骨性关节炎的常见原因;(2)Brostr(o)m法仍不失为修复新鲜踝关节外侧副韧带损伤的有效方法,但对陈旧性损伤无效.(3)采用自体半腱肌肌腱修复重建陈旧性踝关节外侧副韧带的方法简单,有效,对于治疗踝关节不稳、防止踝关节骨性关节炎的发生具有重要的作用.     

Diagnostic radiography students' perceptions of formative peer assessment within a radiographic technique module

IntroductionAssessment is a central part of student learning. Student involvement in peer assessment leads to significant improvement in students' performance, supports students' learning, promotes the development of evaluation skills and encourages reflection.AimThe aim of this study is to assess perceptions of the Formative Peer Assessment (FPA) initiative within a higher education setting for undergraduate radiography students.MethodsQualitative action research was conducted. Students were allowed to anonymously assess each other's assignments using a standardized evaluation sheet that they had been trained to use. Participants' perceptions were assessed through focus group discussion.ResultsThe findings showed that students' experiences with peer assessment were positive. Students acknowledged that they received valuable feedback and learned from assessing their peers. Students recommended the need for training and suggested using more than one evaluator.ConclusionThe FPA initiative in the study institution believed to be succeed as the students had a positive experience with the FPA. Students learnt from PA and from self-assessment. Implementation of PA will promote reflection and critical thinking and problem solving skills, that are important traits in radiography graduate profile as in radiography clinical practice the professional require to modify imaging techniques and critique images to ensure the quality of care.     

踝关节本体感受器损伤与慢性踝关节不稳定关系的初步研究

目的 从新鲜尸体和踝关节不稳患者手术中所切取的韧带周围组织入手,分析踝关节周围本体感受器的性质和分布,并进一步与临床病例的生物力学、本体感觉功能检验结果相比较,判断和分析本体感受器受损在功能性踝关节不稳定中的作用.方法18例踝关节不稳患者行韧带重建手术.术前、术后分别行功能评分[美国骨科足踝医师协会(AOFAS)评分],平衡系统评价其本体感觉功能.从2例新鲜冰冻尸体踝关节韧带组织和手术中获取韧带组织标本,应用组织学方法和免疫组化染色观察分析感觉小体的结构特征和分布特点.结果 (1)标本发现Ⅰ型小体、Ⅱ型小体和Ⅳ型游离无神经鞘的神经末梢;这些感受器主要分布于韧带的浅层和近骨附着部.(2)患者重心摆动距离术前、术后睁眼与闭眼检测差异均有统计学意义;患者AOFAS评分手术前后差异有统计学意义.结论(1)踝关节不稳患者本体感觉功能受损,病史越长,症状越严重,功能评分越低,其本体感受受损越严重.(2)韧带感受器受损,与踝关节不稳症状相关联,韧带重建是避免感受器反复损伤的有效方法.

Abstract：

Objective To analyze the effect of ankle joint proprioceptor injury on the functional ankle instability. Methods The study enrolled 18 ( 13 males) with chronic ankle instability treated with ligament reconstruction operation. The American Orthopaedic Foot and Ankle Surgeons (AOFAS)score was used for evaluation of the function before and after operation and the balance system evaluate the proprioception function. The two ankle ligament specimens from fresh frozen body and the tissue samples from operation were used for investigation of the structure and distribution of the sensory corpuscles by using histology and immunohistoehemical staining. Results The sections were evaluated with a microscope and an image analyzer. Labeled nerve endings were mapped, measured and categorized. Type Ⅰ ( Ruffini-like ending) , type Ⅱ ( Pacinin-like corpuscle ) and type Ⅳ- (noncorpuscular) nerve endings could be identified in all the lateral ankle ligaments, with majority of types Ⅰ and Ⅱ nerve endings.These receptors were distributed primarily over the superficial ligament and near the bony attachments.There was statistical difference between preoperative and postoperative sway distance as well as between preoperative and postoperative AOFAS score. Conclusions This study suggests that the longer history,severer symptoms and lower AOFAS score may lead to the severer injury of the mechanical proprioceptors.The proprioceptor injury is correlated with ankle joint instability and the ligament reconstruction is effective to avoid the repeated injury of the proprioceptor.     

踝关节本体感受器损伤与慢性踝关节不稳定关系的初步研究

Objective To analyze the effect of ankle joint proprioceptor injury on the functional ankle instability. Methods The study enrolled 18 ( 13 males) with chronic ankle instability treated with ligament reconstruction operation. The American Orthopaedic Foot and Ankle Surgeons (AOFAS)score was used for evaluation of the function before and after operation and the balance system evaluate the proprioception function. The two ankle ligament specimens from fresh frozen body and the tissue samples from operation were used for investigation of the structure and distribution of the sensory corpuscles by using histology and immunohistoehemical staining. Results The sections were evaluated with a microscope and an image analyzer. Labeled nerve endings were mapped, measured and categorized. Type Ⅰ ( Ruffini-like ending) , type Ⅱ ( Pacinin-like corpuscle ) and type Ⅳ- (noncorpuscular) nerve endings could be identified in all the lateral ankle ligaments, with majority of types Ⅰ and Ⅱ nerve endings.These receptors were distributed primarily over the superficial ligament and near the bony attachments.There was statistical difference between preoperative and postoperative sway distance as well as between preoperative and postoperative AOFAS score. Conclusions This study suggests that the longer history,severer symptoms and lower AOFAS score may lead to the severer injury of the mechanical proprioceptors.The proprioceptor injury is correlated with ankle joint instability and the ligament reconstruction is effective to avoid the repeated injury of the proprioceptor.     

The effect of ankle taping on functional performance in participants with functional ankle instability

ObjectiveTo investigate the effect of rigid ankle tape on functional performance, self-efficacy and perceived stability, confidence and reassurance during functional tasks in participants with functional ankle instability.DesignClinical measurement, crossover design.MethodsParticipants (n = 25) with functional ankle instability (Cumberland Ankle Instability Score < 25) were recruited from university students and sporting clubs. Participants performed five functional tests with and without the ankle taped. The tests were: figure-8 hopping test, hopping obstacle course, star excursion balance test (SEBT), single-leg stance and stair descent test. Secondary outcome measures were self-efficacy and perception measures.ResultsRigid tape significantly decreased the stair descent time by 4% (p = 0.014), but had no effect on performance in the other tests. Self-efficacy increased significantly (p < 0.001). Perceived stability, confidence and reassurance also increased with the ankle taped (p < 0.05) during the stair and two hopping tasks, but not during the SEBT or single-leg stance test.ConclusionAlthough taping the ankle did not affect performance, except to improve stair descent, it increased self-efficacy and perceived confidence in dynamic tasks. These findings suggest that taping may reduce apprehension without affecting functional performance in those with functional ankle instability and permit continued physical activity or sport participation.     

Effects of elastic ankle support on running ankle kinematics in individuals with chronic ankle instability and healthy controls

BackgroundIndividuals with chronic ankle instability (CAI) have an increased risk for recurrent injuries. The preventive effects of external ankle supports are not fully understood. This study aimed to examine the effect of elastic ankle support on running ankle kinematics.Methods3D running gait analysis of individuals with and without CAI was conducted at three-minute-running trials at 2.78 m/s with and without elastic ankle support in a randomised order. Ankle kinematics and intra-individual standard deviations (variability) were calculated at each percent of the running gait cycle. Group and ankle support effects were calculated using statistical parameter mapping.ResultsTwenty-seven individuals were analysed (CAI: n = 14, controls: n = 13). When wearing ankle support, CAI individuals showed significantly decreased plantarflexion angles at 43–47 % (p = 0.033) and 49–51 % (p = 0.043) of the running gait cycle compared to normal running. In healthy controls, no differences in ankle angles between both conditions were found. Comparisons between CAI individuals and healthy controls showed statistically significant differences in the plantar-/dorsiflexion angles at 38–41 % (p = 0.044) with ankle support and at 34–46 % (p = 0.004) without ankle support. Significant ankle angle variability differences were found for ankle in-/eversion between CAI individuals and healthy controls (p = 0.041) at 32–33 % of the running gait cycle.ConclusionsElastic ankle support reduces the range of sagittal plane running ankle kinematics of CAI individuals but not of healthy controls. Further research is needed to evaluate the association between ankle support effects and the risk for recurrent ankle sprains.     

Diagnostic value of stress radiography in lesions of the lateral ligaments of the ankle

The diagnostic accuracy of inversion and anterior stress radiography in rupture of the lateral ligaments of the ankle joint was assessed in 56 patients undergoing surgery. In inversion stress radiography, 58 per cent of the patients with confirmed rupture of the lateral ligaments of the ankle had a talar tilt of 10 degrees or more, allowing a predictive value of a positive test of 94 per cent. In anterior stress radiography, 53 per cent of the patients had a posterior tibiotalar distance of 9 mm or more, allowing a predictive value of a positive test of 81 per cent. In measurements of talar tilt and anterior displacement of the talus values higher than normal in the injured ankle may be a sign of a rupture of the lateral ligament.     

Unilateral jump landing neuromechanics of individuals with chronic ankle instability

ObjectivesTo assess the neuromechanical (kinematic, kinetic and electromyographic (EMG)) differences between individuals with and without chronic ankle instability (CAI) during unilateral jump landing.DesignCase-control study.MethodsKinematic, kinetic and EMG data of 32 participants with CAI and 31 control participants were collected during unilateral side jump landing (SIDE) and unilateral drop landing on three surfaces (even (DROP), unstable (FOAM) and laterally inclined (WEDGE)). Each participant had to complete five trials of each task in a randomised sequence. To compare the neuromechanical differences between groups, a one-dimensional statistical non-parametric mapping analysis was performed.ResultsCompared to the control group, the CAI group exhibited increased biceps femoris muscle activity during the preactivation and landing phases, decreased gluteus medius and peroneus longus muscles activity during the preactivation phase and increased knee extension moment during the landing phase of the WEDGE task. The CAI group also exhibited increased ankle dorsiflexion during the landing phase of the FOAM task and decreased vastus lateralis muscle activity during the preactivation phase of the DROP task. Finally, the CAI group exhibited decreased biceps femoris muscle activity during the preactivation and landing phases and decreased gluteus medius muscle activity during the preactivation phase of the SIDE task compared to the control group.ConclusionsIndividuals with CAI present neuromechanical differences during unilateral jump landing compared to healthy individuals. The results of this study will improve our understanding of underlying deficits associated with CAI and will help researchers and clinicians to better target them during rehabilitation.     

The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction

Purpose

Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability.

Methods

A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients.

Results

At 6 months after the operation, with the patients’ eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation.

Conclusions

Postural control was improved by reconstructing the lateral ligaments.

Level of evidence

IV.

     

Relationships between self-reported ankle function and modulation of Hoffmann reflex in patients with chronic ankle instability

ObjectiveTo examine relationships between self-reported ankle function and Hoffmann (H) reflex modulation during changes in body positions in patients with chronic ankle instability (CAI).DesignObservational.SettingLaboratory.ParticipantsThirty-one young adults with CAI (19 males, 12 females) participated.Main outcome measuresThere were two subscales of Foot and Ankle Ability Measure (FAAM) to quantify self-reported ankle function during activities of daily living (ADL) and sports activities. Maximum H-reflexes (H-max) and motor waves (M-max) from soleus and fibularis longus were recorded while participants lied prone and stood in bipedal and unipedal stances. For each muscle, percent change scores in H_max:M_max ratios were calculated between each pair of positions: prone-to-bipedal, bipedal-to-unipedal, and prone-to-unipedal, and used as a measure of H-reflex modulation. Pearson correlation coefficients were calculated between FAAM and H-reflex modulation measures.ResultsThere were significant correlations between: (1) FAAM-ADL and soleus prone-to-unipedal modulation (r = 0.384, p = 0.04), (2) FAAM-Sport and soleus prone-to-unipedal modulation (r = 0.505, p = 0.005), (3) FAAM-Sport and fibular bipedal-to-unipedal modulation (r = 0.377, p = 0.05), and (4) FAAM-Sport and fibular prone-to-unipedal modulation (r = 0.396, p = 0.04).ConclusionsCAI patients presented moderate, positive relationships between self-reported ankle function and H-reflex modulation during changes in body positions.     

The influence of Mulligan ankle taping during balance performance in subjects with unilateral chronic ankle instability

Objective: To determine whether Mulligan ankle tape influenced the performance in subjects with unilateral chronic ankle instability (CAI) during static balance; postural sway recovery patterns after hopping and dynamic tracking balance tasks.Design: A cross-sectional, within-subjects experimental study design between 4 ankle conditions (taped; untaped: injured and uninjured).Participants: 20 volunteer recreational athletes with unilateral CAI were recruited. Means and standard deviations highlighted the athletes' characteristics: age = 23 ± 1 years; height = 173.1 ± 2.4 cm; weight = 69.3±3 kg; Functional Ankle Disability Index (FADI) = 93.5 ± 5.1% and FADI Sport = 84.2 ± 9.4%.Interventions: Mulligan ankle taping.Main Outcome Measurements: Static balance (10 s); postural sway recovery patterns after a 30 s functional hop test (immediately, 30 and 60 s); dynamic tracking balance tasks (wandering, target overshoot and reaction-time).Results: Between the four conditions, static balance showed no significant differences (p = 0.792); significant changes occurred in postural sway over time (p < 0.001); no significant changes were reported for the dynamic tracking tasks. Wandering was highly correlated with reaction-time and overshooting (p < 0.01).Conclusion: Under resting and fatigued conditions, Mulligan ankle taping did not impact on the neuromuscular control during static and dynamic balance in subjects with healthy and unstable ankles.