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A Journal on Sports Medicine

Official Journal of the Italian Sports Medicine Federation
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Medicina dello Sport 2001 September;54(3):219-28

language: Italian

Effects on static and dynamic ankle stabilization while using orthoses

Astegiano P., Ganzit G. P., Gola P., Stefanini L.

Istituto di Medicina dello Sport FMSI-CONI, Torino


Background. Ankle ­sprains are the ­most fre­quent trau­mas in ­sports. The inci­dence var­ies great­ly depend­ing on the ­sport, ­being high­er in bas­ket­ball (inci­dence ­rate 21 to 45%), vol­ley­ball (25 to 54%) and soc­cer (17 to 31%). Furthermore, ­ankle ­sprains are ­prone to ­relapse- up to 80% in vol­ley­ball and 67% in soc­cer ­players.
Aim of ­this ­work was to eval­u­ate the per­for­manc­es of the grad­u­al ­GIBAUD Ortho ­brace in sta­bi­liz­ing the ­ankle ­joint and sub­ta­lar ­joint in ­both pre­ven­tion and reha­bil­i­ta­tion, ­thus improv­ing the pro­pri­o­cep­tive ­response.
Methods. 30 ­patients, ­both ­male and ­female, ­aged 18-45, ­were stud­ied. 10 ­patients ­had no report­ed ­pathol­o­gy con­cern­ing the low­er ­limbs (nor­mal); 10 ­patients report­ed one or ­more ­ankle ­sprains in ­their clin­i­cal his­to­ry but result­ed asymp­to­mat­ic ­while under­go­ing the ­test (chron­ic), 10 ­patients report­ed an ­acute ­ankle ­sprain in the reha­bil­i­ta­tion ­phase, ­such as to ­allow ­slow ­straight run­ning (­acute). The fol­low­ing func­tion­al ­tests ­have ­been ­were per­formed: a) Static ­tests: the uni­lat­er­al ­stance (Flamingo-­test) was eval­u­at­ed meas­ur­ing pos­tu­ral ­sway ­with a Kistler ­force plat­form. b) Dynamic ­tests: the com­po­nent in the ­three ­space ­planes of the resul­tant of the forc­es ­applied to the ­ground ­while walk­ing and run­ning on a Kistler ­force plat­form ­was eval­u­at­ed. In the ­case of walk­ing the ­test was per­formed at a ­speed of 6 km/h, and in run­ning at ­speeds of 12 and 18 km/h. For the stat­ic anal­y­sis of ­data, the var­i­ance anal­y­sis for repeat­ed meas­ures was adopt­ed.
Results. In the ­patients ­with ­acute ­ankle ­sprains, ­use of the grad­u­al ­brace cor­re­spond­ed to a signifi­cant ­decrease in ­both the pos­tu­ral ­sway ­area (­from 6080 to 4344 mm2) and the aver­age ­sway veloc­ity (­from 46 to 39 mm/s). In the ­case of walk­ing the ­time of ­foot con­tact to ­with the ­ground in ­acute ­patients is was ­reduced (­from 623 to 610 ms), as ­also was the com­po­nent of trans­ver­sal forc­es (from 213 to 133 N ­force ­peak). With run­ning, use of the grad­u­al ­brace con­firms ­only in ­part the changes ­noticed in walk­ing. In chron­ic ­patients chang­es ­were ­less evi­dent and in nor­mal ­patients none at all. All ­tests per­formed ­hint to a par­tic­u­lar ­effect ­derived ­from ­using the grad­u­al elas­tic ­GIBAUD ­brace, ­both in a stat­ic and dynam­ic pos­tu­ral ­phase, var­y­ing ­with ref­er­ence to the ­patients’ char­ac­ter­is­tics.
Conclusions. Part of the ­progress in the ­patients exam­ined ­seems to ­stem ­from a great­er ­sense of safety in ­patients ­using the ­brace. Using the grad­u­al ­brace ­seems to ­improve the pro­pri­o­cep­tive ­response by pos­sibly stim­u­lat­ing the mech­a­nor­e­cep­tors.

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