C omparative Effects of Tape Material Characteristics on Talocrural-Subtalar Joint Motions Meredith A. Atwood, ATC, LAT Graduate Athletic Training Program University of Tennessee-Chattanooga

Objective Determine if elastic tape can restrain talocural-subtalar joint displacement or angular motion as effectively as standard non-elastic tape

Background 23,000 ankle sprains occur per day in the U.S. (Hartel, 2002) That’s 16 ankle sprains per minute Ankle sprains take one week to six weeks to heal (Hockenburg, 2001)

Anatomy of the Ankle Talocrural joint Subtalar joint Talocrural-subtalar joint complex

Ligaments of the Talocrural- Subtalar Joint Complex

Ligaments Talocrural Joint

Ligaments of Subtalar Joint

Movement of the Talocrural- Subtalar Joint Complex Anterior translation Posterior translation

Movement of the Talocrural- Subtalar Joint Complex Inversion tilt Eversion tilt

Ankle Taping Non-elastic tape  Most widely used  Most widely debated (Alt, 1999; Cordova, 2002; Myburgh, 1984; Rarick, 1962) Elastic Tape  gaining favor (Firer, 1990; Passerallo, 1994) ((

Tape Non-elastic  Standard white athletic tape  Cloth  Zinc Oxide adheres to skin

Tape Elastic tape  Cohesive adheres to itself, but not to skin  Adhesive adheres to skin - (Andover, 2002; Leuko, 2005)

Protection Protect ligaments by decreases excessive motion (Callaghan, 1997; Greene, 1990; Rarick, 1962; Ricard, 2000) Provide mechanical stability (Karlsson, 1993; Laughman, 1980) Despite loosening does provides support (Alt, 1999; Fumich, 1981; Greene, 1990; Larsen, 1984; Mayburgh, 1984; Ricard, 2000; Rovere, 1988)

Research Hypothesis Non-elastic tape will restrict inversion tilt more effectively than elastic tape. Non-elastic tape will restrict anterior translation more effectively than elastic tape

Methods

Tape Conditions Four conditions  non-elastic taped condition  cohesive elastic taped condition  adhesive elastic taped condition  Untaped condition

Subjects UTC IRB approved 15 subjects from UTC student population  mean age: years  mean height: cm  mean weight: kg Participants received all conditions

Instrument Ankle Arthrometer (Kovaleski, 2002; Kovaleski, 1999)

Measurements Anteroposterior translation (mm) Inversion-eversion tilt (deg) Pre-exercise & post-exercise

Exercise Program 1 - Half mile jog yard shuttle runs 4 - figure-of-eight patterns ran in each direction 2 - one legged hop pattern for each leg

Exercise Program Figure-of-eight run One legged hop pattern

Statistical Analysis Separate Repeated Measures ANOVAs  inversion tilt  anterior translation 2x3 (trial x condition )  significance  main effect Bonferroni adjustment: alpha level =.025

Statistical Analysis Separate Repeated Measures ANOVAs  inversion tilt  anterior translation  post-exercise Significant difference Pairwise comparison

Results

Repeated Measures ANOVA Trial x Condition 2x3 (trial x condition) repeated measures ANOVA was significant for inversion tilt F 2,28 = 8.24, p =  =.96

Main Effects for Inversion Tilt Significant difference b/t trials F 1,14 = 40.67, p =  = 1.00

Main Effects for Inversion Tilt Significant difference b/t conditions F 2, 28 = 6.08, p =  =.85

Loosening of Inversion (post-exercise minus pre-exercise)

Repeated Measures ANOVA Trial x Condition Repeated measures trial x condition was not significant for anterior translation (F 2,28 =.449), p =.643

Main Effects for Anterior Translation There was not a significant difference b/t trials  F 1, 14 =.131, p =.722 There was not a significant difference b/t conditions  F 2, 28 =.449, p =.643

Repeated Measures ANOVA by Condition Inversion Tilt Significant difference b/t mean displacement for post-exercise inversion tilt F 3,42 = 87.26, p =  =.86

Pairwise Comparison Inversion Tilt Post-exercise

Repeated Measures ANOVA by Condition Anterior Translation There was not a significant difference b/t the mean displacement for post-exercise anterior translation F 3,42 =.062, p =.980

Pairwise Comparison of Anterior Translation Post-exercise Taped Comparison p-value Non-elastic x Cohesive.871 Non-elastic x Adhesive.810 Non-elastic x Untaped.920 Cohesive x Adhesive.933 Cohesive x Untaped.768 Adhesive x Untaped.704

Discussion

Results demonstrate that:  non-elastic tape restricts inversion tilt more effectively than elastic tape  anterior translation not affected by tape material

Increase in Displacement for Inversion Tilt All tape conditions showed an  in displacement Non-elastic had smallest  in displacement Adhesive elastic has greatest  in displacement Similar to previous research (Alt, 1999; Fumich, 1981; Greene, 1990; Larsen, 1984; Mayburgh, 1984)

Anterior Translation Anterior translation  no significant difference  taped conditions equivalent to untaped condition  tape configuration is more important (Wilkerson,2005)

Comparison of Tape Procedures Post-Exercise WILKERSON ET ALCURRENT STUDY Inversion Tilt Untaped Untaped Standard Non-elastic Modified (STS) Cohesive Elastic Adhesive Elastic Anterior Translation Untaped Untaped Standard Non-elastic Modified (STS) Cohesive Elastic Adhesive Elastic

Conclusion Elastic tapes do not restrict inversion as effectively as non-elastic tape Tape material is not a factor in preventing anterior translation

Future Research Little done on injured ankles More research on tape configuration for anterior translation More research using ankle arthrometer for objective measurements

My Appreciation Dr. Wilkerson Dr. Colston Dr. Whittle Dr. Kovaleski & Dr. Hollis Phil Heywood

Questions? Thank You for Your Time. Graduate Athletic Training Program