Ionic aggregates induced room temperature autonomous self-healing elastic tape for reducing ankle sprain.

Traditional kinesiology tape (KT) is an elastic fabric tape that clinicians and sports trainers widely use for managing ankle sprains. However, inadequate mechanical properties, adhesive strength, water resistance, and micro-damage generation could affect the longevity of the tape on the skin during physical activity and sweating. Therefore, autonomous room-temperature self-healing elastomers with robust mechanical properties and adequate adhesion to the skin are highly desirable to replace traditional KT. Ionic aggregates were introduced into the polymer matrix via electrostatic attraction between polymer colloid and polyelectrolyte to achieve such elastic tape. These ionic aggregates act as physical crosslink points to enhance mechanical properties and dissociate at room temperature to provide self-healing functions. The obtained elastic tape possesses a tensile strength of 3.7 MPa, elongation of 940 %, toughness of 16.6 MJ∙m-3, and self-healing efficiency of 90 % for 2 h at room temperature. It also exhibits adequate reversible adhesion on the skin via van der Waals force and electrostatic interaction in both dry and wet conditions. The new elastic tapes have great potential in biomedical engineering for preventing and rehabilitating ankle sprain.

The impact of a 10-week Nordic hamstring exercise programme on hamstring muscle stiffness, a randomised controlled trial using shear wave elastography.

Hamstring strain injuries (HSIs) remain a burden with high prevalence rates. The Nordic Hamstring exercise (NHE) has been found to be effective in preventing HSIs. However, the preventive mechanisms are not fully understood. Changes in stiffness are postulated as a possible protective mechanism. Surprisingly, the effect of the NHE on the stiffness of different hamstring muscles has never been investigated before. Therefore, the aim of this Randomised controlled trial was to investigate the impact of a 10-week NHE programme on the eccentric strength and the shear wave velocity (proxy of stiffness) of the hamstrings. Thirty-six soccer players were randomly assigned to either the control or the experimental group. The experimental protocol consisted of the incorporation of a 10-week NHE programme within the normal training routine. The hamstring stiffness and eccentric strength were assessed before and after. Within-group analyses showed a significant increase in strength, only for the experimental group. However, no significant effect of the NHE was found on the stiffness of each hamstring muscle. A 10-week NHE programme does not affect hamstring stiffness, despite an increase in eccentric strength, indicating that the preventive mechanism of the NHE is probably not (co-)explained by alterations in hamstring muscle stiffness.

The 11+ injury prevention programme decreases rate of hamstring strain injuries in male collegiate soccer players.

OBJECTIVES: To investigate if the 11+ injury prevention programme decreases the risk of hamstring injury and improves recovery time and determine whether compliance with the 11+ affects hamstring injury risk. METHODS: This study is a secondary analysis from a prospective cluster randomised controlled trial that included 65 National Collegiate Athletic Association (NCAA) division I and II men's soccer teams over the fall 2012 season. Thirty-one teams were randomised to the intervention group that were using the 11+ as their warm-up and 35 teams to the control group that continued to use their traditional warm-up. Each certified athletic trainer (ATC) collected data on demographics, hamstring injury (HSI), mechanism of injury, position, playing surface, time lost due to injury and compliance to the 11+ programme. RESULTS: The 11+ decreased the risk of HSI by 63% compared with the control group (RR=0.37, 95% CI 0.21 to 0.63). Difference in return to play after HSI between the control (9.4±11.2 days) and intervention groups (10.2±11.3 days) was not significant (p=0.8). High compliance (>2 or more doses on average per week) reduced the risk of HSI by 78% (RR=0.22, 95% CI 0.06 to 0.87) compared with low compliance (<1 dose on average per week), and moderate compliance (1 to <2 doses on average per week) decreased the risk of HSI by 67% (RR=0.33, 95% CI 0.11 to 0.97) compared with low compliance. There was no significant difference between high and moderate compliance. CONCLUSION: The 11+ decreased the risk of HSI by 63% but did not improve recovery time. High to moderate compliance is essential and makes the programme more effective at reducing HSI.

E-health intervention for preventing recurrent ankle sprains: a randomised controlled trial in general practice.

BACKGROUND: Ankle sprains are frequent injuries in general practice. However, no effective treatment is available yet. AIM: To examine the effectiveness of an unsupervised e-health-supported neuromuscular training programme in combination with usual care compared with usual care alone in patients with acute lateral ankle sprains in general practice. DESIGN AND SETTING: Randomised controlled trial with 1-year follow-up among patients (14-65 years) who visited the GP with an acute lateral ankle sprain within 3 weeks of injury. METHOD: The intervention group received, in addition to usual care, an unsupervised e-health-supported neuromuscular training programme and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery, and return to the same type and level of sport. RESULTS: In total, 165 participants (mean age 38.3 years and 69 [41.8%] male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83) (hazard ratio 1.14, 95% confidence interval = 0.59 to 2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the programme was low (6.1%, 5/82). CONCLUSION: The rate of re-sprains was relatively high and an unsupervised e-health-supported neuromuscular training programme does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients.

Preventive interventions for lateral ankle sprains: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the effect of preventive interventions for lateral ankle sprain in the general population. DATA SOURCES: A search of PubMed, EMBASE, Cochrane CENTRAL, Medline, CINAHL, and ClinicalTrials.gov was conducted up to August 2022. REVIEW METHODS: Randomized controlled trials and prospective cohort studies that evaluated any interventions for preventing lateral ankle sprain were included. Two reviewers independently conducted the search, screening, and data extraction. The methodological quality of each study was assessed using the revised Cochrane risk-of-bias tool for randomized trials or using the Cochrane Risk Of Bias In Non-Randomized Studies tool for prospective cohort studies. RESULTS: Seventeen studies met the inclusion criteria. Proprioceptive training exhibited better effects on preventing future lateral ankle sprain compared with the control group (risk ratio = 0.59, p < 0.001), and a stronger preventive effect was observed in participants with a history of lateral ankle sprain in the subgroup analysis (risk ratio = 0.49, p = 0.02). Compared with no bracing, ankle bracing had no significant better effect in preventing lateral ankle sprain (risk ratio = 0.43, p = 0.05). Proprioceptive training and ankle bracing had similar preventive effects (risk ratio = 0.98, p = 0.97). Limited evidence hindered the synthesis of data on pain, swelling, costs, and time loss. CONCLUSION: Proprioceptive training is recommended for preventing lateral ankle sprain, especially for people with a history of lateral ankle sprain. Bracing seems to have an ambiguous preventive effect and requires more further investigation.

A New Zealand regional work-related sprains and strains surveillance, management and prevention programme: study protocol.

BACKGROUND: The impact and costs associated with work-related sprains and strains in New Zealand and globally are substantial and a major occupational and public health burden. In New Zealand around one-third of all sprains and strains workers compensation (ACC) claims (2019) are for back injuries, but shoulder and arm injuries are increasing at a faster rate than other sprain and strain injuries (ACC, 2020). A need exists for a change to current approaches to sprains and strains prevention, to more effectively manage this significant and persistent problem in workplaces. Designing out hazards is one of the most effective means of preventing occupational injuries and illnesses. This paper outlines the study protocol of the surveillance, management and prevention programme and describes the utilisation of prevention through design principles in the prevention of work-related sprains and strains in agriculture/horticulture/food production in the Hawkes Bay region of New Zealand. METHODS: This is a prospective mixed methods study incorporating the collection of quantitative data to describe the epidemiology of work related sprains and strains injuries presenting to the regional health centre (Hastings Health Centre) over a period of 24 months and qualitative data from participants presenting at the health centre to identify high risk industry sectors/ occupations/ workplaces and tasks and design, develop and apply prevention through design principles/ solutions/interventions to critical features of the work and work environment and undertake an outcome evaluation during the last 6 months of the project. DISCUSSION: The purpose of this project is to establish an epidemiological surveillance programme to assess the incidence and prevalence of work-related sprains and strains according to age, sex, industry sector and occupation to target efforts to prevent work-related sprains and strains, by applying prevention through design (PtD) principles in selected workplaces in agriculture. The collection of more detailed case, occupational and work history data from a sample of patients presenting at the HHC clinic will identify high risk industry sectors/occupations/workplaces and tasks. Assessment techniques will include comprehensive design, design thinking and human factors/ergonomics methodologies through co-design and participatory ergonomics techniques. The PtD solutions/ interventions implemented will be evaluated using a quasi-experimental design consisting of a pre-test/ post-test with-in subjects design with control groups that do not receive the intervention.

Obstacle Course Events: Hazards and Prevention Measures.

This article reviews hazards associated with obstacle course events (OCEs) like the Spartan Race and Tough Mudder, which are becoming increasingly popular, and provides strategies to mitigate these hazards. In seven studies, the overall weighted incidence of participants seeking medical care during OCEs was only 1.4% with ~6% of these requiring higher level medical care at a hospital. Nonetheless, 27% of participants self-reported =1 extremity injury. Common OCE medical problems included sprains/strains and dermatological injuries (abrasions/laceration/blisters); the ankle and knee were common injury locations. There are reports microorganism infections during OCEs, associated with ingestion of contaminated water and mud. On military obstacle courses, ~5% were injured, but this activity has the highest injury rate (injuries/hour of training) of all major testing or training activities. Ankle sprain risk can be reduced with proprioceptive training and prophylactic ankle bracing. Knee injury risk can be reduced with exercise-based programs that incorporate various components of proprioceptive training, plyometrics, resistance exercises, stretching, and shuttle/bounding running. Reducing abrasions and lacerations involve wearing low friction clothing, gloves, and prophylactic covering of skin areas prone to abrasions/lacerations with specific protective materials. Reducing blister likelihood involves use of antiperspirants without emollients, specialized sock systems, and covering areas prone to blisters with paper tape. Reducing infections from microorganism can be accomplished by protective covering open wounds, rinsing off mud post-race, and avoiding ingestion of food and drink contaminated with mud. These chiefly evidence-based injury and illness prevention measures should minimize the risks associated with OCEs.

Playing surface traction influences movement strategies during a sidestep cutting task in futsal: implications for ankle performance and sprain injury risk.

This descriptive laboratory crossover trial study examined the intervention of high friction synthetic vs lower friction natural sport surfaces on the ankle joint biomechanics in a sidestep cutting task. Twenty-nine male futsal players performed 5 trials of sidestep cutting task in a laboratory, recorded by an 18-camera motion capture system to obtain the ankle joint orientation, velocity and moment. Utilised friction was obtained by the peak ratio of the horizontal to vertical ground reaction force during the stance. Repeated measures (MANOVA) suggested a significant effect of the playing surface and post hoc paired t-tests revealed significantly higher utilised coefficient of friction, higher peak plantarflexion angle, lower peak eversion angle, higher peak inversion velocity, lower peak inversion moment and higher peak internal rotation moment. In performing a sidestep cutting task, futsal players demonstrated higher utilised ground friction when available friction from the playing surface was higher, resulting in higher peak inversion velocity and higher peak internal rotation moment, which may make the ankle joint more prone to sprain injury. Floorings for futsal should have an adequate coefficient of friction for agility and avoidance of the risk of slipping. Increasing the coefficient of friction may not only enhance performance but also endanger the ankle joint.

Intubation Biomechanics: Clinical Implications of Computational Modeling of Intervertebral Motion and Spinal Cord Strain during Tracheal Intubation in an Intact Cervical Spine.

BACKGROUND: In a closed claims study, most patients experiencing cervical spinal cord injury had stable cervical spines. This raises two questions. First, in the presence of an intact (stable) cervical spine, are there tracheal intubation conditions in which cervical intervertebral motions exceed physiologically normal maximum values? Second, with an intact spine, are there tracheal intubation conditions in which potentially injurious cervical cord strains can occur? METHODS: This study utilized a computational model of the cervical spine and cord to predict intervertebral motions (rotation, translation) and cord strains (stretch, compression). Routine (Macintosh) intubation force conditions were defined by a specific application location (mid-C3 vertebral body), magnitude (48.8 N), and direction (70 degrees). A total of 48 intubation conditions were modeled: all combinations of 4 force locations (cephalad and caudad of routine), 4 magnitudes (50 to 200% of routine), and 3 directions (50, 70, and 90 degrees). Modeled maximum intervertebral motions were compared to motions reported in previous clinical studies of the range of voluntary cervical motion. Modeled peak cord strains were compared to potential strain injury thresholds. RESULTS: Modeled maximum intervertebral motions occurred with maximum force magnitude (97.6 N) and did not differ from physiologically normal maximum motion values. Peak tensile cord strains (stretch) did not exceed the potential injury threshold (0.14) in any of the 48 force conditions. Peak compressive strains exceeded the potential injury threshold (-0.20) in 3 of 48 conditions, all with maximum force magnitude applied in a nonroutine location. CONCLUSIONS: With an intact cervical spine, even with application of twice the routine value of force magnitude, intervertebral motions during intubation did not exceed physiologically normal maximum values. However, under nonroutine high-force conditions, compressive strains exceeded potentially injurious values. In patients whose cords have less than normal tolerance to acute strain, compressive strains occurring with routine intubation forces may reach potentially injurious values.

Effects of wearing an ankle brace on ground reaction forces during jumps in basketball game simulation / Efectos del uso de órtesis de tobillo sobre las fuerzas de reacción del suelo durante los saltos en simulación de juego de baloncesto / Efeitos do uso de órtese de tornozelo sobre as forças de reação do solo durante saltos em simulação do jogo de basquetebol

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .

RESUMEN Introducción: El uso de órtesis de tobillo reduce el riesgo de lesiones en el tobillo en jugadores de baloncesto. Sin embargo, los mecanismos de protección de lesión proporcionados por las órtesis durante el juego de baloncesto aún son desconocidos. Objetivos: Analizar el efecto del uso de órtesis de tobillo lace-up (con cordón) y de un protocolo de ejercicio que simuló la intensidad del juego de baloncesto sobre la fuerza de reacción del suelo (FRS) durante saltos verticales específicos del baloncesto. Métodos: Once jugadores de baloncesto del sexo masculino con menos de 18 años realizaron 48 saltos verticales, con y sin órtesis de tobillo, durante un protocolo de ejercicios compuesto por cuatro períodos de 10 minutos, que simularon el perfil de actividad e intensidad del juego de baloncesto, así como los intervalos típicos entre los períodos. Las FRS mediolaterales (variables: mayores picos medial y lateral) y verticales (variables: pico vertical, pico de impulso, impulso en 50 ms de aterrizaje, tasa de sobrecarga y altura del salto) fueron medidas durante las fases de despegue y aterrizaje de todos saltos realizados en el protocolo de ejercicio. Resultados: El uso de órtesis redujo la FRS mediolateral en todos los períodos analizados, durante las fases de despegue y aterrizaje (P < 0,05), sin afectar la FRS vertical (P > 0,05). La FRS mediolateral y vertical (picos mediolateral y vertical de despegue, picos mediolaterales de aterrizaje, pico de impulso de aterrizaje, tasa de sobrecarga en el despegue y aterrizaje) aumentaron significativamente durante cuatro períodos subsiguientes de 10 minutos (P < 0,05). Sin embargo, para la FRS mediolateral, el aumento a lo largo del tiempo fue mayor sin el uso de órtesis. Conclusiones: El uso de órtesis de tobillo redujo la FRS mediolateral en el miembro inferior, mientras que hubo un aumento progresivo de la carga externa aplicada al cuerpo durante los saltos en los períodos subsiguientes del protocolo de ejercicios con la misma intensidad del juego de baloncesto. Nivel de evidencia I; Ensayo clínico aleatorizado.

RESUMO Introdução: O uso de órtese de tornozelo reduz o risco de lesões no tornozelo em jogadores de basquetebol. No entanto, os mecanismos de proteção de lesão fornecidos pelas órteses durante o jogo de basquetebol ainda são desconhecidos. Objetivos: Analisar o efeito do uso de órtese de tornozelo lace-up (com cordão) e de um protocolo de exercício que simulou a intensidade do jogo de basquetebol sobre a força de reação do solo (FRS) durante saltos verticais específicos do basquetebol. Métodos: Onze jogadores de basquetebol do sexo masculino com menos de 18 anos realizaram 48 saltos verticais, com e sem órtese de tornozelo, durante um protocolo de exercícios composto por quatro períodos de 10 minutos, que simularam o perfil de atividade e intensidade do jogo de basquetebol, assim como os intervalos típicos entre os períodos. As FRSs mediolaterais (variáveis: maiores picos medial e lateral) e verticais (variáveis: pico vertical, pico de impulso, impulso em 50 ms da aterrissagem, taxa de sobrecarga e altura do salto) foram medidas durante as fases de decolagem e aterrissagem de todos os saltos realizados no protocolo de exercício. Resultados: O uso de órtese reduziu a FRS mediolateral em todos os períodos analisados, durante as fases de decolagem e aterrissagem (P < 0,05), sem afetar a FRS vertical (P > 0,05). A FRS mediolateral e vertical (picos mediolateral e vertical de decolagem, picos mediolaterais de aterrissagem, pico de impulso de aterrissagem, taxa de sobrecarga na decolagem e aterrissagem) aumentaram significativamente durante quatro períodos subsequentes de 10 minutos (P < 0,05). No entanto, para a FRS mediolateral, o aumento ao longo do tempo foi maior sem o uso de órtese. Conclusões: O uso de órtese de tornozelo reduziu a FRS mediolateral no membro inferior, enquanto houve um aumento progressivo da carga externa aplicada ao corpo durante os saltos nos períodos subsequentes do protocolo de exercícios com mesma intensidade do jogo de basquetebol. Nível de evidencia I; Estudo clínico randomizado .

Prevention of strain-induced impairments of patellar tendon micromorphology in adolescent athletes.

High-level patellar tendon strain may cause impairments of the tendon's micromorphological integrity in growing athletes and increase the risk for tendinopathy. This study investigated if an evidence-based tendon exercise intervention prevents high-level patellar tendon strain, impairments of micromorphology and pain in adolescent basketball players (male, 13-15 years). At three time points over a season (M1-3), tendon mechanical properties were measured using ultrasound and dynamometry, proximal tendon micromorphology with a spatial frequency analysis and pain and disability using VISA-P scores. The control group (CON, n = 19) followed the usual strength training plan, including sprint and change-of-direction drills. In the intervention group (INT, n = 14), three sessions per week with functional exercises were integrated into the training, providing repetitive high-magnitude tendon loading for at least 3 s per repetition. The frequency of high-level strain (ie, ≥9%) continuously decreased in INT, while tending to increase in CON since tendon force increased in both (p < 0.001), yet tendon stiffness only in INT (p = 0.004). In CON, tendon strain was inversely associated with tendon peak spatial frequency at all time points (p < 0.05), indicating impairments of tendon micromorphological integrity with higher strain, but not at M2 and M3 in INT. Descriptively, the fraction of asymptomatic athletes at baseline was similar in both groups (~70%) and increased to 100% in M3 in INT, while remaining unchanged in CON. We suggest that functional high-load tendon exercises could reduce the prevalence of high-level patellar tendon strain and associated impairments of its micromorphology in adolescent athletes, providing new opportunities for tendinopathy prevention.

Does the Spraino low-friction shoe patch prevent lateral ankle sprain injury in indoor sports? A pilot randomised controlled trial with 510 participants with previous ankle injuries.

BACKGROUND: Lateral ankle sprains are common in indoor sports. High shoe-surface friction is considered a risk factor for non-contact lateral ankle sprains. Spraino is a novel low-friction patch that can be attached to the outside of sports shoes to minimise friction at the lateral edge, which could mitigate the risk of such injury. We aimed to determine preliminary effectiveness (incidence rate and severity) and safety (harms) of Spraino to prevent lateral ankle sprains among indoor sport athletes. METHODS: In this exploratory, parallel-group, two-arm pilot randomised controlled trial, 510 subelite indoor sport athletes with a previous lateral ankle sprain were randomly allocated (1:1) to Spraino or 'do-as-usual'. Allocation was concealed and the trial was outcome assessor blinded. Match and training exposure, number of injuries and associated time loss were captured weekly via text messages. Information on harms, fear-of-injury and ankle pain was also documented. RESULTS: 480 participants completed the trial. They reported a total of 151 lateral ankle sprains, of which 96 were categorised as non-contact, and 50 as severe. All outcomes favoured Spraino with incidence rate ratios of 0.87 (95% CI 0.62 to 1.23) for all lateral ankle sprains; 0.64 (95% CI 0.42 to 0.98) for non-contact lateral ankle sprains; and 0.47 (95% CI 0.25 to 0.88) for severe lateral ankle sprains. Time loss per injury was also lower in the Spraino group (1.8 vs 2.8 weeks, p=0.014). Six participants reported minor harms because of Spraino. CONCLUSION: Compared with usual care, athletes allocated to Spraino had a lower risk of lateral ankle sprains and less time loss, with only few reported minor harms. TRIAL REGISTRATION NUMBER: NCT03311490.

One in four trail running race entrants sustained an injury in the 12 months training preceding the 2019 SkyRun race.

OBJECTIVE: To determine the epidemiology and clinical characteristics of RRIs among trail runners who entered the 2019 SkyRun races. DESIGN: Descriptive cross-sectional study. SETTING: 2019 SkyRun races. PARTICIPANTS: Consent for data analysis was given by 305 of 412 (74%) race entrants. MAIN OUTCOME MEASURES: Retrospective annual incidence (RRIs/1000 h), point prevalence (%), frequency (%), characteristics (anatomical region, body area, tissue type, pathology type) and injury severity (mean severity score; 95% CI) of RRIs. RESULTS: 28.2% of participants reported at least one RRI. The retrospective annual incidence was 49.5 RRIs per 1000h and the point prevalence was 1.3%. Most injuries occurred in the lower limb (87.3%), with the knee (26.5%), ankle (21.6%), and foot (16.7%) reported as the most frequently injured body areas. Muscle/tendon accounted for 44.1% of tissue type injuries. Tendinopathy (27.5%), joint sprain (19.6%), and muscle injury (15.7%) were the most common pathology types reported. The mean injury severity score was 31.6. CONCLUSIONS: One in 4 trail runners reported at least one RRI in the 12 months leading up to a race. RRIs mostly affected the lower limb specifically the knee, ankle and foot. Future research should establish injury risk factors to ultimately develop specific injury prevention strategies.

Dynamic Balance Measures in Healthy and Chronic Ankle Instability Participants While Wearing Ankle Braces: Systematic Review With Meta-Analysis.

CONTEXT: Ankle braces have been theorized to augment dynamic balance. OBJECTIVES: To complete a systematic review with meta-analysis of the available literature assessing the effect of ankle braces on dynamic balance in individuals with and without chronic ankle instability (CAI). EVIDENCE ACQUISITION: Electronic databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus) were searched from inception to October 2019 using combinations of keywords related to dynamic balance, ankle braces, Star Excursion Balance Test (SEBT), Y-Balance Test (YBT), and Time to Stabilization. Inclusion criteria required that studies examined the effects of ankle braces on dynamic balance. Studies were excluded if they evaluated other conditions besides CAI, did not access dynamic balance, or did not use an ankle brace. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The level of evidence was assessed using the Strength of Recommendation Taxonomy. The magnitude of brace effects on dynamic balance was examined using Hedges g effect sizes (ESs) and 95% confidence intervals (CIs). Random-effects meta-analysis was performed to synthesize SEBT/YBT and Time to Stabilization data separately. DATA SYNTHESIS: Seven studies were included with a median Physiotherapy Evidence Database score of 60% (range 50%-60%), and 4 were classified as high quality. Overall meta-analysis indicated a weak to no effect of braces on SEBT/YBT (ES = 0.117; 95% CI, -0.080 to 0.433; P = .177) and Time to Stabilization (ES = -0.064; 95% CI, -0.211 to 0.083, P = .083). Subanalysis of SEBT/YBT measures indicated a weak negative effect in healthy participants (ES = -0.116; 95% CI, -0.209 to -0.022, P = .015) and a strong positive effect in individuals with CAI (ES = 0.777; 95% CI, 0.418 to 1.136; P < .001). CONCLUSION: The current literature supports a strong effect of ankle braces on the SEBT/YBT in those with CAI. However, little to no dynamic balance changes were noted in healthy participants. Future research should include consistent ankle brace types, pathologic populations, and the examination of dynamic balance changes contribution to injury risk reduction.

Strength Conditioning Program to Prevent Adductor Muscle Strains in Football: Does it Really Help Professional Football Players?

Coaches at the professional level are often concerned about negative side effects from testing and intensive resistance training periods, and they are not willing to base their training prescriptions on data obtained from semiprofessional or amateur football players. Consequently, the purpose of this study was to analyze the reliability and effectiveness of two adductor injury active prevention programs using the adductor/abductor ratio and deficit between legs, on the basis of adduction-abduction power output during the exercises proposed, in professional football players. Forty-eight professional football players undertook complementary strength training for the adductor and abductor muscles in their dominant and non-dominant legs, once or twice a week throughout the playing season. The volume of the session was determined by the adductor/abductor ratio and the deficit between legs in the last session training measured. The number and severity of muscle injuries per 1000 h of exposure were recorded. Both prevention programs showed a very low rate of adductor injury (0.27 and 0.07 injuries/1000 h) with mild-to-moderate severity, maintaining a balance in percentage asymmetry between dominant and non-dominant legs for adductor (10.37%) and in the adductor/abductor ratio (0.92) in top professional football players throughout the season. The strength conditioning program proposed can help to prevent adductor muscle injuries in top professional football players.