Comparative 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 Tapegaining favor

(Firer, 1990; Passerallo, 1994)

(

Tape

Non-elasticStandard white athletic tape

Cloth

Zinc Oxide adheres to skin

Tape

Elastic tapeCohesive

adheres to itself, but not to skin

Adhesiveadheres 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 conditionsnon-elastic taped conditioncohesive elastic taped conditionadhesive elastic taped conditionUntaped condition

Subjects

UTC IRB approved

15 subjects from UTC student populationmean age: 25 + 3.6 yearsmean height: 173 + 11.6cmmean weight: 77 + 11.4kg

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

2 - 300 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 runOne legged hop pattern

Statistical Analysis Separate Repeated Measures ANOVAs

inversion tiltanterior translation

2x3 (trial x condition )significancemain effect

Bonferroni adjustment: alpha level = .025

Statistical Analysis

Separate Repeated Measures ANOVAs inversion tiltanterior 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 = .002

1- = .96

Main Effects for Inversion Tilt

Significant difference b/t trials

F 1,14 = 40.67, p = .001

1- = 1.00

Restriction of Inversion Tilt

8

9

10

11

12

13

14

15

16

17

Pre PostTrial

Inve

rsio

n T

ilt (

deg

)

non-elastic

cohesive

adhesive

Main Effects for Inversion Tilt

Significant difference b/t conditions

F 2, 28 = 6.08, p = .006

1- = .85

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

In

versio

n D

isp

lacem

en

t

Non Elastic Cohesive Adhesive

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

trialsF 1, 14 = .131, p = .722

There was not a significant difference b/t conditions F2, 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 = .001

1- = .86

Pairwise Comparison Inversion Tilt Post-exercise

Tape Comparison p-value Non-elastic to Cohesive elastic

.006

Non-elastic to Adhesive elastic

.004

Cohesive elastic to Adhesive elastic

.167

Tape comparison p-value Non-elastic to Untaped condition

.001

Cohesive elastic to Untaped condition

.001

Adhesive elastic to Untaped condition

.001

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

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 translationno significant difference

taped conditions equivalent to untaped condition

tape configuration is more important (Wilkerson,2005)

Comparison of Tape Procedures Post-Exercise

WILKERSON ET AL CURRENT STUDY

Inversion Tilt Untaped 32.66 + 9.1 Untaped 3.21 + 9.2 Standard 10.20 + 2.4 Non-elastic 12.93 + 3.0 Modified (STS) 7.19 + 1.8 Cohesive Elastic 16.27 + 4.8 Adhesive Elastic 15.23 + 2.5

Anterior Translation Untaped 9.25 + 2.3 Untaped 8.45 + 1.9 Standard 6.19 + 1.6 Non-elastic 8.52 + 2.0 Modified (STS) 4.92 + 1.3 Cohesive Elastic 8.65 + 1.9 Adhesive Elastic 8.71 + 2.4

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