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Recreational Injury Interventions
Taping
Background
Prophylactic ankle taping has been used in
a variety of sports to prevent ankle sprains. While there is some evidence that
taping is effective,20 it tends to be expensive over the course of the season,
and should be done properly by a certified athletic trainer. Tape will loosen over
the course of a game or practice and lose its ability to restrict lateral motion.
Ankle stabilizers have been suggested as an alternative to taping. They have the
advantages of being self-applied, inexpensive and rapidly adjustable over the course
of a game or practice.
Review of taping studies:
Author | Rovere et al., 1988 |
Study design and target population | Retrospective cohort study.
Population: Collegiate football players 1980-1986,
Wake Forest University, North Carolina |
Intervention | Laced ankle stabilizers vs ankle taping. Players selected
both method of ankle protection and shoe type. |
Outcomes | Ankle injuries: Ligamentous (inversion and eversion
sprains) or bone insult (fractures) causing an athlete to miss at least 1 game
or practice session. |
Results | 224 injuries (7 fractures, 217 sprains); 90% of sprains
were inversion sprains. Injury rate differed by shoe type and playing position.
RR=0.5 (0.42-0.85) comparing stabilizers to
taping, stratified by player position.
Stabilizers: 2.1 per 1000 for low top
shoes, 3.5 per thousand for high top. Tape: 4.2 per 1000 vs 6.8 per 1000 for
low vs high top shoes. No significant interaction between shoe type and type
of ankle support (p=0.5) |
Study quality and conclusions | Laced ankle stabilizer is more effective then taping
and less expensive ($64 per player per year vs $400 per player per year for
taping).
Best protective combination was stabilizer
with low top shoes.
Data carefully collected. Analysis
would be improved by using stratified analysis to adjust for both type of
shoe and player position. |
Author | Fumich et al., 1981 |
Study design and target population | Before/after laboratory study
Population: 16 college football players |
Intervention | Measured restriction of 6 different ankle motions before
and after taping and with taping following 3 hours of practice. |
Outcomes | Degree of motion possible under 3 conditions (untaped,
taped and taped post-exercise) for the following ankle motions: plantar flexion,
dorsiflexion, eversion neutral, inversion neutral, plantar flexion inversion,
plantar flexion eversion. |
Results | Taping restricts ankle motion immediately but loosens
after exercise. Average residual restriction post-exercise 50% of initial restriction
for 3 ankle motions; 3 other ankle motions loosened significantly greater than
50% post exercise.
Jumping ability unchanged for all conditions. |
Study quality and conclusions | Study did not evaluate whether ankle taping was associated
with injury.
Taping technique used was more rigorous (tape
over benzoin) than the more common practice of using tape over foam underwrap. |
Author | Greene et al., 1990 |
Study design and target population | Before/after laboratory study
Population: 7 female volleyball players |
Intervention | Semirigid orthosis vs ankle taping |
Outcomes | Tested how each method restricted ankle range of motion
(inversion/eversion and jumping ability) in 5 different situations:
(1) before support
(2) before exercise
(3) 20 during exercise
(4) 60 minutes during exercise
(5) after exercise. |
Results | Taped ankles restricted inversion-eversion range of
motion 41% pre-exercise but only 15% after 3 hours of exercise. Braced ankles
demonstrated 42% initial range of motion restriction which was reduced to 37%
after exercise.
Maximal loss in mechanical restriction for taping occurred
after 20 minutes of practice. |
Study quality and conclusions | Orthosis more effective method of restricting ankle
movement than taping. Study does not address the question, "Is ankle range
restriction a reliable predictor of decreased ligmentous injury?" |
Summary of taping interventions
The only study which directly evaluated the
function of ankle braces versus taping found that stabilizers were more effective
and economical than taping. The two laboratory studies22,23 provide support for the conclusions reached by Rovere and colleagues.21
Recommendations on taping
Present evidence indicates that braced ankle
stabilizers are effective in preventing ankle sprains in football. There is no evidence
available pertaining to sprain prevention in other sports.
Recommendations for future
research
A potentially useful study would
be a randomized trial of laced ankle stabilizers to evaluate the effectiveness in
preventing injury recurrence in a population of children participating in a variety of sports.
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