1. 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

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

3. 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)

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

5. Ligaments of the Talocrural- Subtalar Joint Complex

6. Ligaments Talocrural Joint

7. Ligaments of Subtalar Joint

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

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

10. 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) ((

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

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

13. 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)

14. 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

15. Methods

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

17. Subjects UTC IRB approved 15 subjects from UTC student population  mean age: 25 + 3.6 years  mean height: 173 + 11.6cm  mean weight: 77 + 11.4kg Participants received all conditions

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

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

20. Exercise Program 1 - Half mile jog 2 - 300 yard shuttle runs 4 - figure-of-eight patterns ran in each direction 2 - one legged hop pattern for each leg

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

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

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

24. Results

25. Repeated Measures ANOVA Trial x Condition 2x3 (trial x condition) repeated measures ANOVA was significant for inversion tilt F 2,28 = 8.24, p =.002 1-  =.96

26. Main Effects for Inversion Tilt Significant difference b/t trials F 1,14 = 40.67, p =.001 1-  = 1.00

28. Main Effects for Inversion Tilt Significant difference b/t conditions F 2, 28 = 6.08, p =.006 1-  =.85

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

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

31. 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

32. Repeated Measures ANOVA by Condition Inversion Tilt Significant difference b/t mean displacement for post-exercise inversion tilt F 3,42 = 87.26, p =.001 1-  =.86

33. Pairwise Comparison Inversion Tilt Post-exercise

35. 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

36. 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

37. Discussion

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

39. 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)

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

41. Comparison of Tape Procedures Post-Exercise WILKERSON ET ALCURRENT STUDY Inversion Tilt Untaped 32.66 + 9.1Untaped 3.21 + 9.2 Standard 10.20 + 2.4Non-elastic 12.93 + 3.0 Modified (STS) 7.19 + 1.8Cohesive Elastic16.27 + 4.8 Adhesive Elastic15.23 + 2.5 Anterior Translation Untaped 9.25 + 2.3Untaped8.45 + 1.9 Standard 6.19 + 1.6Non-elastic8.52 + 2.0 Modified (STS) 4.92 + 1.3Cohesive Elastic8.65 + 1.9 Adhesive Elastic8.71 + 2.4

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

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

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

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