Effect of Ankle Taping and Bandaging on Balance and Proprioception Among Healthy Volunteers
Condition: Ankle Injuries
MeSH terms: Ankle Injuries
Study type: Interventional

Summary: 
      Leg length was measured (right and left leg) while the participant lying supine, from the
      anterior superior iliac spine to the inferior border of the ipsilateral medial malleoli by
      using standard measure tape. The dominant leg was determined according to Vauhnik. & ark.
      modified version. The limb that was used in at least 2 of the 3 following activities: (1).
      Kicking a ball, (2). Drawing a diamond figure on the ground and (3).using his leg and step
      over a spider toy was considered as the dominant leg.30
    

Detailed description: 
      Participants

      Seventy-four healthy subjects participated in this study (37 male and 37 female). Healthy
      subjects were selected because ankle injuries frequently occur during normal locomotion; and
      most people, not only athletes, experience an ankle injury at least once during their entire
      life.25,27

      Before starting this study power test was performed to determine the number of participants.
      Participant's age range was 18 - 30 years old and participants were recruited from university
      population, Participants were divided randomly into two groups (Taping group n=37) and
      (Bandaging group n=37. Participant were excluded if he/she reports (a) previous hip/pelvis,
      knee, ankle, or foot surgery within the past year; (b) lower extremity amputation; (c) injury
      to the lower extremities six months; (d) known balance impairment due to neurological
      disorder, vestibular disorder, medication use, or other; (f) pregnancy; or (g) concussion
      within the previous three months. Standard clinical stability testing of the ankle
      ligamentous structures was performed to rule out anterior and lateral talocrural joint
      instability and lower extremity injuries during the previous 6 months. Each volunteer signed
      an informed consent form before participation. This study was approved by Dokuz E|ylul
      university ethics committee.

      Procedures Leg length was measured (right and left leg) while participant lying supine, from
      the anterior superior iliac spine to the inferior border of the ipsilateral medial malleoli
      by using standard measure tape. The dominant leg was determined according to Vauhnik. & ark.
      modified version. The limb that was used in at least 2 of the 3 following activities: (1).
      Kicking a ball, (2). Drawing a diamond figure on the ground and (3).using his leg and step
      over a spider toy, was considered as the dominant leg.30

      Ankle taping Procedures Zinc oxide tape has been was used, its hard - preventive tap. The
      taping procedure consists of three separate steps: The first step involved the application of
      the anchor tape, which achieved by applying the tape circumferentially just above the
      malleolar level at the lower end of the shank. The second step involved the application of
      the stirrup. During this step, the foot was held in neutral, and the tape applied to pass
      from the medial side of the ankle, under the foot just over the heel area (posterior
      one-third of the foot) and up along the lateral side of the ankle. The second step was
      repeated to apply the second stirrup. Both ends of the stirrups were firmly attached to the
      anchor tape applied during the first step and this attachment was reinforced with a locking
      tape during the third and final step by once again applying the tape circumferentially just
      above the malleolar level at the lower end of the shank. The taping was applied by a physical
      therapist according to the health association requirements.23

      Ankle bandaging Procedures Standard 10 cm width elastic bandage was used. The elastic bandage
      was wrapped around the ankle joint to form an 8-figure shape starting from the forefoot. Then
      the bandage is taken diagonally upwards, steeply enough to go well above the heel, then
      around the lower calf area to form an anchor, then diagonally down across the midfoot, again
      wrapped around the forefoot and going diagonally up to finish off around the lower calf,
      leaving the heel open.9 Then the participant was allowed to wear his/her sport shoes over the
      bandage during the measurement procedures.

      Balance measurement Procedures Star Excursion Balance Test (SEBT) is a field test and widely
      used to assess dynamic postural control, and has an excellent interrater reliability (ICC =
      0.86 - 0.92)12. In thıs study the SEBT was used to evaluate balance. 8 strips of athletic
      tape with a length of 6 feet were used. Then a '+' sign was formed. Then 'x' sign was formed
      with the other two strips. The lines were separated from each other by an angle of 45°. The
      participant was asked to wear sports clothes and take off the shoes, then to step on the
      center of the grid formed by eight lines using the dominant leg, the plantar aspect of the
      first metatarsophalangeal joint (ball of the foot) was positioned on the intersecting lines
      at the center of the grid to maintain consistency in foot placement. The participant starts
      to reach as possible as far in the eight lines, make a light touch on the line, and return
      the reaching leg back to the center, while maintaining a single-leg stance with the other leg
      in the center of the grid, starting from anterior direction and progressing clockwise. The
      order of the directional reaches was as follows: A, AM, M, PM, P, PL, L, AL. When reaching in
      the lateral and posterolateral directions, participants must reach behind the stance leg to
      complete the task.13

      The participant practiced 6 training attempts to reduce the learning effect, and then after
      5-min of rest period participant performed 3 trials in each of the 8 directions, 5-min of
      rest period was taken between each one of the three trials. The researcher recorded the
      reaching distance using standard tape measure by marking the tape as the distance from the
      center of the gird to the maximal reaching point, the average of these three attempts was
      calculated and then normalized to the leg length, the obtained result used in the statistical
      analysis. If the participant used the stance leg for a high amount of support, was unable to
      maintain balance on the stance leg, or removing his feet from the center any time while doing
      the trial, the attempt was canceled and repeated again. In the case of a rejected trial,
      verbal feedback was given to the participants so they attempt to correct the performance
      error(s) on the next trial.13

      The balance measurements were done 4 times, (before ankle taping, after 20 minutes while
      using ankle taping, after 24 hours while using ankle taping and immediately after removing
      the tap (after 24 hours).

      Proprioception measurement Procedures Invistigators used the measurement procedure which
      described in the study which was doneIris et al23. by The first step: volunteers were seated
      in a high chair, and while their eyes are closed, the researcher consecutively on different
      graduated surfaces (10° dorsiflexion, neutral position, 10° plantarflexion, and 20°
      plantarflexion) respectively, each position will be done for just one time and will be held
      for 5 seconds. The researcher told the volunteers that they have to memorize the positions
      because they have to do it again by themselves. Simultaneously, each joint position was
      recorded to obtain the target angle using the universal goniometer. This was the angle that
      the volunteer was instructed to reproduce during the testing part of the study. The second
      step: The volunteer was then encouraged to walk freely next to the researcher for 10 minutes,
      still blindfolded. The third step: Then the volunteer sat on a high chair that did not allow
      his or her feet to touch the floor (to avoid any information from the sole). Finally, the
      researcher encouraged the subject to reproduce the four memorized positions, starting from
      and finishing in the neutral position each time. The volunteer maintained each ankle
      position, announced by the researcher at random, for five seconds. The volunteer's ankle
      movement was recorded using the universal goniometer, and this reproduced ankle angle was
      called the estimated angle.

      The difference between the learned positions and the positions that were done by the
      volunteer was calculated and documented. Deviation from the learned angle (degrees) described
      the direction of Error when subjects tried to reproduce the requested position. Deviation was
      obtained by coding net Error, which was based on the correct position occurring when the
      learned and estimated angle were equal (±5 degrees)23.

      The position (ROM) measurements were done on four occasions, (before ankle external support,
      after 20 minutes while using external support, after 24 hours while using external support
      and immediately after removing the external support (after 24 hours).
    

Intervention name(s): Taping
Intervention type(s): Other
Intervention description(s): A hard-preventive Zinc oxide tape was used in this study. Taping procedure consists of three separate steps: First step involved application of the anchor tape, which achieved by applying the tape circumferentially just above the malleolar level at the lo
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention