International SportMed Journal - Volume 4, Issue 5, 2003
Volume 4, Issue 5, 2003
The role of proprioception in the secondary prevention of ankle sprains in athletes : review articleAuthor Kathryn M. RefshaugeSource: International SportMed Journal 4, pp 1 –14 (2003)More Less
Objective : To determine prevalence of proprioceptive deficit after ankle sprain and efficacy of interventions to restore proprioception and prevent recurrent sprain.
Data sources : Studies were identified by searching electronic databases including MEDLINE, CINAHL, SPORTDiscus, PEDro, Cochrane Reviews and Science Citation Index, and by searching bibliographies.
Study selection : Twelve studies investigating deficits in joint position sense (JPS) or movement detection were retrieved. Five randomised controlled trials of interventions, including proprioceptive retraining to prevent a recurrence of ankle sprains, were retrieved. Studies were included if they recorded long-term follow-up (>6 months) for recurrence of ankle sprains.
Data extraction : All studies that investigated JPS or movement detection after ankle sprain were included. Randomised controlled trials that fitted the selection criteria were assessed for methodological quality. Outcome measures included incidence of ankle sprain and proprioception. Wherever possible, results were pooled.
Data synthesis : Because methodological flaws existed in most studies, few definitive conclusions can be drawn. There appears to be a deficit in different proprioceptive tests in the inversion direction, but proprioceptive status is unclear in other directions. There is limited evidence that a programme of exercise aimed at improving neuromuscular control about the ankle reduces ankle sprain recurrence in subjects with previous sprains. Proprioception has not been used as an outcome measure, therefore the link between proprioception and ankle sprain is tenuous.
Conclusions : Selective proprioceptive deficits may exist after ankle sprain. There is some evidence that interventions to improve proprioception and / or neuromuscular control reduce ankle sprains in those with a history of previous sprain.
Author Eric EilsSource: International SportMed Journal 4, pp 1 –9 (2003)More Less
The objective of this review is to describe the role of proprioception in the primary prevention of ankle sprains in athletes. MEDLINE, SPORTDiscus and the Cochrane Library were searched for articles and reviews. The search strategy included the keywords "ankle" in combination with "prevention" or "prophylaxis" and in combination with "proprioception" or "braces" or "tape". In addition, references from the bibliographies of the retrieved articles were reviewed. Articles that focussed on the prevention of ankle sprains using external stabilising devices like braces, tape or shoes were excluded from the review. Studies that focussed on rehabilitation or secondary prevention of ankle sprains, as well as the use of patients with unstable ankles were also excluded. Finally, eight studies were included in this review. The results showed that, although a proprioceptive training programme has been favoured for the primary prevention of ankle sprains in healthy subjects, there is no evidence of the benefit of such a training programme in both laboratory-based studies and intervention programmes for the reduction of the incidence of ankle injuries.
The role of ankle bracing and taping in the secondary prevention of ankle sprains in athletes : review articleSource: International SportMed Journal 4, pp 1 –10 (2003)More Less
Objective: To critically review the current literature on the efficacy of ankle bracing and taping in the prevention of secondary ankle sprains.
Data sources: A literature search was performed utilising MEDLINE and EMBASE for papers published between 1966 to July 2003. The citations from the retrieved articles were also reviewed and obtained. Keywords used in the search were "ankle", "ankle bracing," "ankle taping," "ankle injury," "ankle instability," and "ankle sprain." The search was further limited by using the terms "prevention" and "control", and "treatment".
Study selection: A study was included if (1) it contained a research question on the prevention of secondary ankle sprains; (2) it contained an analysis of ankle range of motion reviewing the effects of bracing or taping; (3) the results of the study contained data regarding the incidence of ankle sprains.
Data extraction and synthesis: Two reviewers analysed the retrieved articles for strengths and weaknesses in study design and methodology. Eight articles met the criteria for a detailed results review.
Conclusions: Biomechanical evidence strongly supports the mechanical superiority of semi-rigid orthoses for restriction of ankle inversion and eversion after brief and prolonged periods of exercise. The current experimental data demonstrates that any external orthotic support (taping or bracing) is effective in reducing the incidence of secondary ankle sprains. There exists a need for further research into this subject in order to provide a more concrete database from which to derive an evidence-based treatment plan. Future studies must directly compare the different semi-rigid orthoses to cloth braces and taping. The type of tape, method of application, and duration of wear of both tape and braces must be controlled, as length of time may affect the proprioceptive feedback of the subject and alter results. The controversy over which type of external support provides the highest margin of safety requires further investigation before a conclusion can be drawn.
The effect of ankle bracing and taping on functional performance : a review of the literature : review articleSource: International SportMed Journal 4, pp 1 –14 (2003)More Less
The paper critically reviews the literature concerning the effect of ankle bracing and taping on vertical jump, agility, running speed, and broad jump performance. MEDLINE, CINAHL and SPORTDiscus were searched for papers published between 1988 and June 2003. The following keywords were used: performance, running, jump, agility, speed, brace, orthotic devices, tape, taping, ankle. References of retrieved articles were screened for additional relevant studies. Studies were eligible if they reported on the effect of an ankle support on vertical jump, running, agility or broad jump. Only studies that were written as full reports and had been published in the English language were included. Data on the effect of the ankle support on vertical jump, running speed, agility and/or broad jump performance were abstracted from the text and tables. Eighteen studies met the inclusion criteria. Of twelve studies looking at vertical jump, four found a negative effect on the vertical jump using different types of ankle braces or adhesive tape. One study found a negative effect on running speed; three studies found a negative effect on time to complete an agility course. In one study, broad jump performance was shown to be adversely affected while wearing a brace. In two studies subjects with ankle injuries completed the agility course faster when wearing an ankle brace. The majority of studies indicated that ankle bracing or taping has no effect or only a minor effect on vertical jump height, running speed, agility and broad jump in athletes with stable ankles. Further study is necessary to examine the effect of prolonged ankle brace use on athletic performance. In addition, more research is necessary to investigate the effect of an ankle support in subjects with an ankle injury.
Do proprioceptive training programmes reduce the risk of ankle sprains in athletes? : review articleSource: International SportMed Journal 4, pp 1 –8 (2003)More Less
Objective: To examine the role of proprioceptive training programmes in the primary prevention of ankle sprains in athletes.
Data sources: Electronic data bases MEDLINE, CINAHL, Current Contents, PreMedline, and SPORTDiscus were searched for papers published between 1966 and June 2003 using the subject terms: "proprioceptive training AND ankle sprain prevention in athletes." Additional references found in the bibliographies of sports medicine textbooks and in the papers retrieved from the database searches were also reviewed.
Study selection: Studies that focused on diagnosis, treatment, or rehabilitation of ankle sprains, and those that addressed prevention of ankle sprains by alternative methods to proprioceptive training techniques were excluded. Thus studies included in this review had to utilise a proprioceptive training programme that included one or more of the following elements: static balance training; hopping drills; ankle disk training; or training in safe side-to-side, take-off, and landing techniques.
Data extraction: Five studies were identified that met the inclusion criteria, and only the data relevant to the results of proprioceptive training as the primary intervention were analysed in this review.
Data synthesis: All five studies found that proprioceptive training was effective for significantly reducing the incidence of sprains in those ankles that had sustained prior injuries. However, in three of the five studies, there were other confounding variables, so that the effect of the proprioceptive training could not be clearly identified. There were no studies that examined its efficacy as the primary intervention for prevention of ankle sprains in athletes with healthy ankles.
Conclusions: The use of proprioceptive training reduces the incidence of ankle sprains in athletes who have sustained prior injuries to the same level as subjects without any history of ankle sprains. However, its efficacy as a single primary preventive measure has not been confirmed by current studies, nor has its role been determined for athletes without prior ankle injuries.