TEMPLATE DESIGN © Benefits of Enhanced Knee Stability During Agility Testing in College Athletes Havel, S.K. & Bamman, M.R. Huntingdon College, Montgomery, AL Abstract Purpose: The purpose of this study was to demonstrate the benefits that enhanced knee stability has on agility for collegiate athletes. The goal of this study was to find statistical data that demonstrated how knee bracing or taping can increase stability of the knee during agile activities. Methods: A questionnaire was given to 5 collegiate athletes with previous Anterior Cruciate Ligament (ACL) repairs after completing a modified version of the agility T-Test. The subjects performed the T-Test three times, once without any knee enhancement, once with taping, and once with bracing. The questionnaire considered the following: the amount of time since the surgery, how stable their knee currently felt, and which method increased or decreased stability the most and least. Results: ANOVA (one-way analysis of variance) was used to find any significant differences between the means of three independent groups. The mean scores of the three timed agility trials were taken along with the standard deviation of the entire sample group; once without knee enhancement, second with taping, and third with bracing. It was calculated that there was no relationship between agility times and enhanced knee stability. A significant score of was found indicating that there were no significant differences between the 3 levels of stability (control, tape, and brace) and agility times. However, results from the stability questionnaire showed that although there was no increase in agility times, the subjects gained more stability with the taping and bracing. Conclusions: Both methods of testing for testing stability each lead to different conclusions; therefore neither hypotheses were accepted nor rejected and more research is needed. Introduction Methods Instruments: For the purpose of this study, participants were subjected to agility testing which was measured by a modified T-Test. Materials used for the T-Test included: 4 cones, a whistle, and a stopwatch. Johnson & Johnson athletic taping, along with adhesive tape and pre-wrap were used for the taping process. Subjects were instructed to bring their own personalized braces during the bracing assessment. Procedures: For the purpose of this study, a modified version of Joel W. Beam’s Collateral “X” technique was used during the taping portion of the test. This method is used for medial and lateral collateral ligament injuries by focusing on patella positioning as the main source of stability, which has been proven to help to protect against valgus and varus forces, and to reduce stress on soft tissues, to limit excessive range of motion, and aids in the prevention and maintenance of the knee. (Beam, 2006) The procedure for taping begins with 2 middle tension anchors around the mid-thigh and slightly under the joint line of the knee. Starting from the lower anchor, a strip of tape is applied from the posterior medial aspect and with an upward motion and is attached to the thigh anchor. The same maneuver, along with a longitudinal strip, is applied to the anterior medial aspect of the knee. This technique may also be used on the lateral side of the knee. (Beam, 2006) (Beam, 2006) The purpose of the T-test was to evaluate how quickly an individual can change directions during lateral, forward, and backward motions. The test was set up by placing four cones in the shape of a “T”. Three cones were labeled in the order “C, B, D” and were placed five yards apart at the top of the “T”, and a cone labeled “A” was placed ten yards underneath the middle cone “B”. (topendsports.com, 2013) The original test included 3 trials, a whistle, a stopwatch, and instructed the individual to touch each cone. The subjects performed the T test three times, once without any knee enhancement, once with taping, and once with bracing. After receiving an assigned method of either no enhancement, or taping or bracing enhancements, each individual began at cone “A” and the tester initiated the test by blowing a whistle and simultaneously starting the stopwatch. The subject began at cone “A” and then immediately sprinted to cone “B” after hearing the whistle. Immediately after reaching cone “B”, the participant shuffled to cone “C”, then shuffled across to cone “D”, then shuffled back to cone “B”, and sprinted backwards finishing at cone “A”. Time was ended and documented when the participant ran by cone “A”. Individuals would have to repeat the trial if they crossed their feet during the shuffle. (topendsports.com, 2013) (topendsports.com, 2013) Results ANOVA- An F-value of was found indicating that there were no significant differences between the 3 levels of stability (control, tape, and brace) and agility times. Questionnaire- 3 of the 5 subjects stated that the brace provided the most stability; however, they felt slower because the brace felt heavier and would slide from the original position. 2 of the 5 subjects stated that they received the most stability from the taping method because it relieved stress from the MCL (medial collateral ligament), provided a springy sensation with movements, and it was lighter than the brace. It was also stated that the tape pulled on the skin and that they weren’t familiar with the compression from the tape along the knee joint. Relationship of independent and dependent variable: The above data shows that there is no difference between enhanced stability and non enhanced stability. As stated previously the independent variable is the 3 levels of stability (control, taping, and bracing) and the dependent variable is agility. An F-value of was found indicating that there were no significant differences between the 3 levels of stability (control, tape, and brace) and agility times. The probability of this result, assuming the null hypothesis, is P-value of 0.696, which also indicates that there is no difference between the independent variables. Conclusions References Intro: The anterior cruciate ligament is one of the most common injuries found among the young athletic population. Although there are numerous methods to treating this injury, the biggest concern about the injury is how to decrease pain and damage while increasing stability for the knee. Recent studies have begun to discover that one way to manage an injured knee is by taping and/or bracing the joint, especially along the medial aspect of the knee. (Murray, 2000) Purpose of Study: The purpose of this study was to demonstrate the benefits that enhanced knee stability has on agility for collegiate athletes. The goal of this study was to find statistical data that demonstrated how knee bracing or taping can increase stability of the knee during agile activities. Hypothesis: To address the purpose of the study, the following hypotheses were tested. Hµ: There is a significant difference in agility and enhanced stability for the anterior cruciate ligament. Ho: There is no significant difference in agility and enhanced stability for the anterior cruciate ligament. Operational Definitions: Agility- refers to the ability to change directions quickly. Post-Operative- for the proposed study, post-operative refers to an individual who has recently had surgery. Valgus Force- is a force that generates from a lateral force. Varus Force- is a force that generates from a medial force. Delimitations and Limitations: The study relied on the individual’s opinion on taping and bracing effects. The subjects were limited to undergraduate students that did not have significant knee injuries. There was limited access to functional braces. Significance of Study: This study demonstrates the benefits that enhanced knee stability provides to athletes and their agility. The proposed study will also create opportunities to develop more research regarding knee enhancements by constructing a guideline of important factors for future researchers. This study will also help to establish a deeper understanding of knee instabilities and will also help to establish a basic knowledge for developing more efficient stability methods. Levels of StabilityAgility Times (Seconds) Control Mean N Std. Deviation Tape Mean N Std. Deviation Brace Mean N Std. Deviation Although there was no significant difference between agility times and knee enhancement, feedback from the questionnaire suggested that the knee stability methods used did in fact increase their stability during the T-Test. All of the subjects suggested that they may have felt more stability if the tape method and the knee brace were combined. The T-Test showed that the body’s physiological response demonstrated no difference between agility and enhanced stability; however the self- report (psychological response) from the questionnaire demonstrated that there was a difference between agility and enhanced stability. The data collected would have been more reliable with a larger sample size per group. Another trial for the agility test should be added to test the results of combining tape and the brace. The T-Test may have been too short which may have caused a difference in agility times; therefore the T-Test should have more time added or a different agility test that includes a longer time span should be used to test for the longevity of the tape or brace. Beam, Joel W. (2006). Orthopedic Taping, Wrapping, Bracing, & Padding: Knee. F.A. Davis Company Murray, H. (2000). Kinesio Taping, Muscle Strength and ROM after ACL Repair. Journal of Orthopedic and Sports Physical Therapy, 30, 1. Topendsports.com. Tests of Agility. Topend Sports Network. Web. (2014, February 20).