Semi-rigid braces reduce ankle inversion angles and velocities during highly dynamic turning movements in people with chronic ankle instability

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1 Semi-rigid braces reduce ankle inversion angles and velocities during highly dynamic turning movements in people with chronic ankle instability Fuerst, P., Gollhofer, A., Wenning, M., Lohrer, H., Gehring, D.

2 Ankle Injuries Verhagen et al., 1995 Borowski et al., Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 2

3 What is CAI? Chronic Ankle Instability Medical examination Mechanical Instability Functional Instability Questionnaire MFI FI cf. Hiller et al., 2011a Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 3

What is CAI? cf. Hiller et al., 2011b 28.09.

4 What is CAI? cf. Hiller et al., 2011b Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 4

5 How can we help? Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 5

6 Bracing: How much do we know? Reduction of ankle injury numbers Reduction of inversion angles & velocities Jump landing (Vanwanseele et al., 2014) Tilt platform (Gehring et al., 2014) Unclear: Role of braces in highly-dynamic, injury-relevant movements Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 6

7 Hypotheses 1. People with CAI exhibit increased inversion angles and velocities before, at and after foot strike. 2. Soft and semi-rigid braces reduce inversion angles and velocities in people with CAI. CAI BRACE Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 7

8 Experimental Setup MI FI CON vs. FI vs. MFI 180 turning movements approach run: 4 m/s SOFT SEMI-RIGID Without and with brace Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, patrick.fuerst@sport.uni-freiburg.de 8

9 Data Analysis 2 factor ANOVA with repeated measures on factor CONDITION Post-hoc t-tests 100ms before foot strike at foot strike maximum ankle inversion Ankle Inversion Angle Ankle Inversion Angle Ankle Inversion Angle Ankle Inversion Velocity Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, patrick.fuerst@sport.uni-freiburg.de 9

10 Results Influence of GROUP Without brace: No significant effects Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 10

11 Results - Bracing - Ankle Inversion Angle Without Soft Semi-rigid No effects No effects Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, patrick.fuerst@sport.uni-freiburg.de 11

12 Results - Bracing - Ankle Inversion Maxima Reduced maximum inversion angles with the semi-rigid brace in both FI- and MFI-Group Reduced maximum inversion velocities with the semi-rigid brace in FI-Group * * * * * * * Without Soft Semi-rigid

angles and velocities in FI-group CAI??? 28.09.

13 Discussion Influence of GROUP Without brace: no significant differences between groups However: slightly higher maximum inversion angles and velocities in FI-group CAI??? Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 13

14 Discussion Effects of bracing Effects only for semi-rigid brace Semi-rigid braces produce larger reductions of inversion angles on tilt platforms (Eils et al., 2002) Reduction in injury numbers has also mainly been shown with semi-rigid braces (Dizon & Reyez, 2010; Verhagen & Bay, 2010) The mechanical stiffness of a brace seems to be a critical factor in reducing inversion angles and velocities and in injury prevention Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, patrick.fuerst@sport.uni-freiburg.de 14

15 Discussion group-specific effects of bracing Only the FI- and MFI-groups showed decreased maximum angles and velocities With semi-rigid brace all groups show similar maxima External support has larger effects on injury numbers in people with a history of ankle sprains (Kaminski et al., 2013) Especially people with chronic ankle instability benefit from bracing Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, patrick.fuerst@sport.uni-freiburg.de 15

Summary CAI BRACE Semi-rigid braces seem to be effective in reducing maximum ankle inversion angles and velocities in people with FI or MFI, which may

16 Summary CAI BRACE Semi-rigid braces seem to be effective in reducing maximum ankle inversion angles and velocities in people with FI or MFI, which may explain their capability to reduce injury numbers Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, 16

17 Literature Borowski, L. A., Yard, E. E., Fields, S. K., & Comstock, R. D. (2008). The epidemiology of US high school basketball injuries, The American Journal of Sports Medicine, 36(12), Dizon, J. M. R., & Reyes, J. J. B. (2010). A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. Journal of Science and Medicine in Sport / Sports Medicine Australia, 13(3), Eils, E., Demming, C., Kollmeier, G., Thorwesten, L., Völker, K., & Rosenbaum, D. (2002). Comprehensive testing of 10 different ankle braces. Evaluation of passive and rapidly induced stability in subjects with chronic ankle instability. Clinical Biomechanics (Bristol, Avon), 17(7), Gehring, D., Wissler, S., Lohrer, H., Nauck, T., & Gollhofer, A. (2014). Expecting ankle tilts and wearing an ankle brace influence joint control in an imitated ankle sprain mechanism during walking. Gait & Posture, 39(3), Hiller, C. E., Kilbreath, S. L., & Refshauge, K. M. (2011). Chronic ankle instability: evolution of the model. Journal of Athletic Training, 46(2), Hiller, C. E., Nightingale, E. J., Lin, C.-W. C., Coughlan, G. F., Caulfield, B., & Delahunt, E. (2011). Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis. British Journal of Sports Medicine, 45(8), Kaminski, T. W., Hertel, J., Amendola, N., Docherty, C. L., Dolan, M. G., Hopkins, J. T., Richie, D. (2013). National Athletic Trainers Association position statement: conservative management and prevention of ankle sprains in athletes. Journal of Athletic Training, 48(4), Vanwanseele, B., Stuelcken, M., Greene, A., & Smith, R. (2014). The effect of external ankle support on knee and ankle joint movement and loading in netball players. Journal of Science and Medicine in Sport / Sports Medicine Australia, 17(5), Verhagen, & Bay, K. (2010). Optimising ankle sprain prevention: a critical review and practical appraisal of the literature. British Journal of Sports Medicine, 44(15), Verhagen, R. A, de Keizer, G., & van Dijk, C. N. (1995). Long-term follow-up of inversion trauma of the ankle. Archives of Orthopaedic and Trauma Surgery, 114(2), Patrick Fürst, IfSS, Albert-Ludwigs-Universität Freiburg, patrick.fuerst@sport.uni-freiburg.de 17

18 Semi-rigid braces reduce ankle inversion angles and velocities during highly dynamic turning movements in people with chronic ankle instability Fuerst, P., Gollhofer, A., Wenning, M., Lohrer, H., Gehring, D.

Clinical Characteristics of Active Individuals with Chronic Ankle Instability

Georgia Southern University Digital Commons@Georgia Southern Electronic Theses & Dissertations Graduate Studies, Jack N. Averitt College of Spring 2016 Clinical Characteristics of Active Individuals with