Clinician Recommendations and Perceptions of Factors Associated With Ankle Brace Use.
ABSTRACT: Little information is available regarding the ankle braces orthopaedic sports medicine clinicians recommend or clinicians' concerns that may influence their decisions to recommend use of an ankle brace.(1) Clinicians most frequently recommend lace-up braces with straps. (2) Clinicians who are concerned about potential adverse side effects from ankle brace use are less likely to recommend an ankle brace to prevent ankle sprain injuries.Descriptive survey study.Level 3.Surveys were sent via e-mail to 1000 randomly selected members of the Orthopaedic Section of the American Physical Therapy Association (APTA) and 1000 randomly selected members of the National Athletic Trainers' Association (NATA). A total of 377 individuals responded to the survey.Lace-up braces, specifically lace-up braces with straps, were the most frequently recommended type of ankle brace. Regression analyses indicated that the only perceived adverse side effect significantly related to frequency of ankle brace recommendation was a potential negative influence on ankle strength.Based on our sample, clinicians recommend lace-up ankle braces with straps most frequently to prevent ankle sprain injuries. Clinicians who are concerned about weakness of ankle musculature may be less likely to recommend use of an ankle brace.Clinicians may effectively reduce the number of ankle sprain injuries by recommending an ankle brace use after an initial ankle sprain injury.
Project description:BACKGROUND:The efficacy of external ankle braces to protect against sudden inversion sprain has yet to be determined while taking into account the possible placebo effect of brace application. PURPOSE:To assess the protective effect of an external ankle brace on ankle kinematics during simulated inversion sprain and single-legged drop landings among individuals with a history of unilateral lateral ankle sprain. HYPOTHESIS:The primary hypothesis was that active and placebo external braces would reduce inversion angle during simulated inversion sprain. STUDY DESIGN:Controlled laboratory study. METHODS:Sixteen participants with ankle instability and previous sprain performed single-legged drop landings and sudden inversion tilt perturbations. Kinematics of the affected limb were assessed in 3 conditions (active bracing, passive placebo bracing, and unbraced) across 2 measurement days. Participators and investigators were blinded to the brace type tested. The effect of bracing on kinematics was assessed with repeated measures analysis of variance with statistical parametric mapping, with post hoc tests performed for significant interactions. RESULTS:Only active bracing reduced inversion angles during a sudden ankle inversion when compared with the unbraced condition. This reduction was apparent between 65 and 140 milliseconds after the initial fall. No significant differences in inversion angle were found between the passive placebo brace and unbraced conditions during sudden ankle inversion. Furthermore, no significant differences were found among all tested conditions in the sagittal plane kinematics at the knee and ankle. CONCLUSION:During an inversion sprain, only the actively protecting ankle brace limited inversion angles among participants. These results do not indicate a placebo effect of external bracing for patients with ankle instability and a history of unilateral ankle sprain. Furthermore, sagittal plane knee kinematics appear to remain unaffected by bracing during single-legged landing, owing to the limited effects of bracing on sagittal ankle kinematics. These results highlight the role of brace design on biomechanical function during sports-related and injury-prone movements. CLINICAL RELEVANCE:Athletes prone to reinjury after lateral ankle sprain may benefit from brace designs that allow for full sagittal range of motion but restrict only frontal plane motion.
Project description:Although ankle injuries occur frequently in high school football players, no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence and severity of ankle and other lower extremity injuries in these athletes.This study was conducted to determine if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players.Randomized controlled trial; Level of evidence, 1.A total of 2081 players from 50 high schools were randomly assigned to a braced or control group. Braced group players wore lace-up ankle braces during the 2010 football season. Athletic trainers recorded brace compliance, athlete-exposures, and injuries. Cox proportional hazards models were utilized to compare injury rates between groups. Injury severity (days lost) was tested with Wilcoxon rank sum.The rate of acute ankle injury (per 1000 exposures) was 0.48 in the braced group compared with 1.12 in the control group (Cox hazard ratio [HR] = 0.39; 95% confidence interval [CI], 0.24-0.65; P < .001). The severity (median days lost) of acute ankle injuries was the same (5 days) in both groups (P = .985). The rate of acute knee injury was 0.70 in the braced group compared with 0.69 in the control group (HR = 0.92; 95% CI, 0.57-1.47; P = .721). There was no difference (P = .242) in the severity of knee injuries between the groups (controls = 11.5 days, braced = 17 days). The rate of other lower extremity injuries was 0.95 in the braced group and 1.32 in the control group (HR = 0.72; 95% CI, 0.48-1.09; P = .117), while the severity was similar in both groups (6 days vs 7 days; P = .295).Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee, or other lower extremity injuries.
Project description:Functional treatment is the optimal non-surgical treatment for acute lateral ankle ligament injury (ALALI) in favour of immobilization treatment. There is no single most effective functional treatment (tape, semi-rigid brace or lace-up brace) based on currently available randomized trials.This study is designed as a randomized controlled trial to evaluate the difference in functional outcome after treatment with tape versus semi-rigid versus lace-up ankle support (brace) for grades II and III ALALIs. The Karlsson score and the FAOS were evaluated at 6-month follow-up.One hundred and ninety-three patients (52% males) were randomized, 66 patients were treated with tape, 58 patients with a semi-rigid brace and 62 patients with a lace-up brace. There were no significant differences in any baseline characteristics between the three groups. Mean age of the patients was 37.3 years (35.1-39.5; SD 15.3). Ninety-five males (49%) were included. One hundred and sixty-one (59 + 50 + 52) patients completed the study through final follow-up; 32% lost at follow-up. In two patients treated with tape support, the treatment was changed to a semi-rigid brace because of dermatomal blisters. Except for the difference in Foot and Ankle Outcome Score sport between the lace-up and the semi-rigid brace, there are no differences in any of the outcomes after 6-month follow-up.The most important finding of current study was that there is no difference in outcome 6 months after treatment with tape, semi-rigid brace and a lace-up brace.I.
Project description:Ankle orthoses are commonly used for prevention of recurrent ankle sprains. While there are some data on their functional performance or restriction of range of motion, there is little knowledge on the quantifiable passive mechanical effectiveness of various devices. This study aimed to determine the prophylactic stabilization effect for commonly prescribed ankle orthoses in a simulated recurrent ankle sprain. Eleven anatomic lower leg specimens were tested in plantar flexion and hindfoot inversion in a simulated ankle sprain in a quasi-static and dynamic test mode at 0.5°/s and 50°/s internal rotation, respectively. Tests included intact specimens, same specimens with the ruptured anterior talofibular ligament (ATFL), followed by stabilization with five different semi-rigid orthoses: AirGo Ankle Brace, Air Stirrup Ankle Brace, Dyna Ankle 50S1, MalleoLoc, and Aequi. Compared to the injured and unprotected state, two orthoses (AirGo and Air Stirrup) significantly reinforced the ankle. The Aequi ankle brace restored stability comparable to an intact joint. Dyna Ankle 50S1 and MalleoLoc provided insufficient resistance to applied internal rotation compared to the ankle with ruptured ATFL. Ankle orthoses varied significantly in their ability to stabilize the unstable ankle during an ankle sprain in both testing modes. Presented objective data on passive stabilization reveal a lack of supporting evidence for clinical application of ankle orthoses.
Project description:Purpose:The purpose of this study was to determine whether ankle brace use in university-level varsity volleyball athletes affected their 3-step spike jump height and whether certain types of ankle braces have a greater effect on jump height. Methods:Nine male university-level varsity volleyball athletes participated in a repeated-measures design study in which each athlete performed three 3-step volleyball spike jumps in 3 ankle brace conditions (soft, rigid, and no brace). Vertical jump height was measured by the Vertec device and video motion analysis at a university biomechanics research laboratory. Results:Vertical jump heights were significantly lower in both brace conditions (soft, 2.3 cm, standard deviation [SD] 1.2 cm, P < .001; rigid, 1.7 cm, SD 0.9 cm, P < .003) compared with the no-brace condition, and no differences in vertical jump height were observed between the brace conditions (0.6 cm, SD 0.3, P = .3). There was a negative correlation between body fat percentage and vertical jump height (r = -0.075, P = .02). The Vertec device reliably measured vertical jump in all 3 conditions. The no-brace vertical ground reaction forces during the loading phase were significantly greater than brace conditions. Ankle range of motion was greatest in the no-brace condition. Conclusions:Results from this study suggests that high-performance athletes wearing ankle braces experience a significant decrease in vertical jump height independent of the type of ankle brace worn. Clinical Relevance:Sports physicians and health care providers caring for high-level athletes should counsel athletes on the trade-offs of wearing protective equipment in sport, as potential decreases in sports performance can lead to increased injury prevention. Level of Evidence:III.
Project description:<h4>Background</h4>The use of soft braces to treat scoliosis has been described by Fischer as early as 1876. With the help of elastic straps, as the authors suggested, a corrective movement for individual curve patterns should be maintained in order to inhibit curve progression. Today this concept has been revived besides soft 3 point pressure systems. Some shortcomings have been revealed in literature in comparison with hard braces, however the concept of improving quality of life of a patient while under brace treatment should furtherly be considered as valuable. Purpose of this review is to gather the body of evidence existent for the use of soft braces and to present recent developments.<h4>Method</h4>A review of literature as available on Pub Med was performed using the key words 'scoliosis' and 'soft brace' at first. The search was expanded using 'scoliosis' and the known trademarks (1) 'scoliosis' and 'SpineCor', (2) 'scoliosis' and 'TriaC', (3) 'scoliosis' and 'St. Etienne brace', (4) 'scoliosis' and 'Olympe'. The papers considered for inclusion were new technical descriptions, preliminary results, cohort studies and controlled studies.<h4>Results</h4>When searching for the terms 'scoliosis' and 'SpineCor': 20 papers have been found, most of them investigating a soft brace, for 'scoliosis' and 'TriaC': 7 papers displayed, for 'scoliosis' and 'St. Etienne brace': one paper displayed but not meeting the topic and for 'scoliosis' and 'Olympe': No paper displayed. Four papers found on the SpineCor™ were of prospective controlled or prospective randomized design. These papers partly presented contradictory results. Two papers were on soft Boston braces used in patients with neuromuscular scoliosis.<h4>Discussion</h4>There is a small but consistent body of evidence for the use of soft braces in the treatment of scoliosis. Contradictory results have been published for samples treated during the pubertal growth spurt. In a biomechanical analysis the reason for the lack of effectiveness during this period has been elaborated. Improved materials and the implementation of corrective movements respecting also the sagittal correction of the scoliotic spine will hopefully contribute to an improvement of the results achievable.<h4>Conclusions</h4>The treatment of scoliosis using soft braces is supported by some papers providing a small body of evidence. During the growth spurt the use of soft braces is discussed contradictory. There is insufficient evidence to draw definite conclusions about effectiveness and safety of the intervention.
Project description:An ankle brace is commonly used by patients after they suffer from initial ankle sprains, reducing the incidents of recurrent sprain or limiting laxity in joints with functional ankle instability (FAI). However, whether the application of a semirigid ankle brace can improve the abnormal ankle gait kinematics of patients with FAI remains unknown. This study aimed to determine the effect of a semirigid ankle brace on the gait kinematics of ankle joints through 3D-2D fluoroscopy image registration. A total of 8 subjects with FAI (3 males and 5 females, 10 feet) as FAI group and 10 subjects without FAI (6 males and 4 females, 10 feet) as control group were enrolled in this study. Three-dimensional bone models created from computed tomography images were matched to fluoroscopic images to compute the 6 degrees of freedom (DOF) talocrural, subtalar, and ankle joints complex kinematics for control and FAI group with or without brace during the stance phase of walking. FAI patients had significantly less ROMs in inversion/eversion rotation of the talocrural and subtalar joint after wearing semirigid ankle brace. Laxity was observed in most of the displacements of the talocrural and subtalar joints in FAI group. The brace partly altered the ankle joints movement in opposite directions, especially joint rotation, and restricted the talocrural and subtalar joints in the dorsiflexion position during the touch down phase of walking.
Project description:BACKGROUND:Ankle support has been utilized for athletes with functional ankle instability (FAI), however, its effect on the landing performance during muscle fatigue is not well understood. This study aimed to examine the effects of ankle supports (ankle brace vs. Kinesio tape) on athletes with FAI following fatigued single-leg landing. METHODS:Thirty-three young FAI athletes (CAIT scores < 24) were randomly allocated to control (Cn), ankle brace (AB) and Kinesio tape (KT) groups. All athletes performed single-leg lateral drop landings following ankle fatigue protocol. The fatigue-induced changes in kinetic parameters were measured among three groups. RESULTS:A significant increase in peak vertical ground reaction force (vGRF) was found in the AB group (0.12% body weight (BW)) compared to that of the KT (0.02% BW) and Cn (median = 0.01% BW) groups. Significant decrease in both COP medial-lateral (ML) and anterior-posterior (AP) ranges were also found in the KT group (median = -0.15% foot width (FW) & median = -0.28% foot length (FL)) than those of the Cn group (median = 0.67% FW& median = 0.88% FL). CONCLUSIONS:Ankle braces might hamper the ability to absorb the impact force during landing. On the other hand, Kinesio tape might be beneficial for the postural control during landing.
Project description:Background/Objective: We investigated whether custom-made hinged knee braces can facilitate knee extensor and flexor strength and influence functional performance as compared with other knee braces. Methods:We enrolled 28 healthy young participants with no history of physical activity or brace use. The participants executed functional performance tests under the following 5 conditions: 1) without a knee brace, 2) wearing a knee sleeve, 3) wearing a hinged knee brace without assistance, 4) wearing a knee brace with extension support (KBE), and 5) wearing a knee brace with flexion support (KBF). The KBE and KBF were custom-made hinged knee braces equipped with rubber tubes. The functional performance tests performed assessed maximal isokinetic strength, single-leg jumping height/distance, anterior and posterior reach distance on a single leg, and dynamic balance ability. Results:The benefit of the custom-made hinged knee brace was observed only during the anterior reach distance on a single leg. The KBE allowed a significantly greater single-leg anterior reach distance when compared to that in the no brace condition. There was a significant relationship between the improvement in the single leg anterior reach distance with KBE and the changes in isokinetic knee extension with KBE compared to the no brace condition. With regard to other parameters, there were no differences compared with the use of other knee braces and thus no apparent benefit. Conclusion:Our findings suggest that using a KBE enhances performance during dynamic balance activity in individuals who benefit from improved knee extension strength.
Project description:BACKGROUND: Bracing concepts in use today for the treatment of scoliosis include symmetric and asymmetric hard braces usually made of polyethylene (PE) and soft braces. A new asymmetric Chêneau style CAD/CAM derivate has been designed to overcome problems the author experienced with other Chêneau CAD/CAM systems over the recent years. BRACE DESCRIPTION: This CAD/CAM Chêneau derivate has been called Gensingen brace™, a brace available to address all possible curve patterns. Once the patients' trunk is scanned with the help of a whole trunk optical 3D-scan and the patients' data from the clinical measurements are recorded, a model of the brace can be created by (1) modifying the trunk model of the patient 'on screen' to achieve a very individual brace model using the CAD/CAM tools provided or by (2) choosing a brace model from our library and re-size it to the patients' properties 'on screen'. RESULTS: End-result studies have been published on the Chêneau brace as early as 1985. Cohort studies on the Chêneau brace are available as is a prospective controlled study respecting the SRS criteria for bracing studies, demonstrating beneficial outcomes, when compared to the controls using a soft brace. Sufficient in-brace correction effects have been demonstrated to be achievable when the Chêneau principles of correction are used appropriately. As there is a positive correlation between in-brace correction and the final outcome, the Chêneau concept of bracing with sufficient in-brace corrections as published can be regarded as being efficient when applied well. Case reports with high in-brace corrections, as shown within this paper using the Gensingen brace™ promise beneficial outcomes when a good compliance can be achieved. CONCLUSIONS: The use of the Gensingen brace™ leads to sufficient in-brace corrections, when compared to the correction effects achieved with other braces, as described in literature.According to the patients' reports, the Gensingen brace™ is comfortable to wear, when adjusted properly.Further studies are necessary (1) in order to evaluate brace comfort and (2) effectiveness using the SRS inclusion criteria.