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Mitchell L Cordova - One of the best experts on this subject based on the ideXlab platform.
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cryotherapy and Ankle bracing effects on peroneus longus response during sudden inversion
Journal of Electromyography and Kinesiology, 2010Co-Authors: Mitchell L Cordova, Lance W Bernard, Timothy J Demchak, Marcus B Stone, Joellen M. SeftonAbstract:Cryotherapy and Ankle bracing are often used in conjunction as a treatment for Ankle injury. No studies have evaluated the combined effect of these treatments on reflex responses during inversion perturbation. This study examined the combined influence of Ankle bracing and joint cooling on peroneus longus (PL) muscle response during Ankle inversion. A 2x2 RM factorial design guided this study; the independent variables were: Ankle Brace condition (lace-up Brace, control), and treatment (ice, control), and the dependent variables studied were PL stretch reflex latency (ms), and PL stretch reflex amplitude (% of max). Twenty-four healthy participants completed 5 trials of a sudden inversion perturbation to the Ankle/foot complex under each Ankle Brace and cryotherapy treatment condition. No two-way interaction was observed between Ankle Brace and treatment conditions on PL latency (P=0.283) and amplitude (P=0.884). The Ankle Brace condition did not differ from control on PL latency and amplitude. Cooling the Ankle joint did not alter PL latency or amplitude compared to the no-ice treatment. Ankle bracing combined with joint cooling does not have a deleterious effect on dynamic Ankle joint stabilization during an inversion perturbation in normal subjects.
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modulation of soleus h reflex by presynaptic spinal mechanisms during varying surface and Ankle Brace conditions
Neurophysiologie Clinique-clinical Neurophysiology, 2007Co-Authors: Joellen M. Sefton, Charlie A Hickslittle, David M. Koceja, Mitchell L CordovaAbstract:Abstract Aims Reflex excitability is modulated in part by presynaptic spinal mechanisms. Presynaptic inhibition may prevent an over-response of the motoneuron pool to afferent information. A paired-reflex depression (PRD) conditioning protocol can be used to monitor reflex plasticity. Manipulation of stance, surface, and external bracing are common methods of rehabilitating and treating lower extremity musculoskeletal injuries. The intent of this study was to evaluate changes in PRD of the soleus H-reflex during single-leg stance under varying stability conditions. Methods Seven trials were completed for each condition in ten healthy volunteers (age = 23 ± 1.8 yr, weight 65.0 ± 11.3 kg, height = 168.7 ± 28.0 cm). The conditioning stimuli were composed of soleus H-reflex pairs evoked 80 ms apart at an equal intensity. The mean percent decrease of the second H-reflex relative to the first represented PRD. Results A 2×2 repeated measures ANOVA (P Conclusion The increase in soleus PRD during the foam condition suggests depression of the motoneuron pool. This may lessen postural over-corrections while maintaining upright stance during less stable conditions. No change in PRD during the Ankle Brace condition suggests that mechanical reinforcement provided an increase in Ankle stability, decreasing the demand on the motoneuron pool.
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effect of inversion and Ankle bracing on peroneus longus hoffmann reflex
Scandinavian Journal of Medicine & Science in Sports, 2006Co-Authors: Joellen M. Sefton, Charlie A Hickslittle, David M. Koceja, Mitchell L CordovaAbstract:This study examined peroneus longus (PL) Hoffmann reflex (H-reflex) during sudden inversion perturbation of the Ankle/foot complex under an Ankle Brace and non-Brace condition. Ten healthy subjects volunteered. H-reflexes were tested on the up-sloping portion of the recruitment curve, utilizing a control trial M-wave above motor threshold to maintain consistency between subjects and conditions. The PL H/maximum M-wave (M(max)) ratio was established using the PL H-reflex and PL M(max) peak-to-peak measures. The mean ratio across five trials for each subject under each Ankle Brace (Brace, no Brace) and surface (flat, inversion) conditions was utilized for analysis. The 1 x 4 repeated measures ANOVA revealed a significant main effect for treatment condition (P<0.0001). The PL H/M(max) ratio significantly increased during sudden inversion-no Ankle Brace condition compared with the flat surface no-Ankle Brace condition (P=0.04). Application of an Ankle Brace had no effect on PL H/M(max) ratio during inversion (P=0.78). During this study PL H/M(max) ratios increased during an inversion perturbation in healthy Ankles. This is believed to occur due to heightened sensorimotor demand placed on the nervous system during this motion. Moreover, application of an Ankle Brace during inversion does not appear to affect PL H/M(max) ratio.
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peroneus longus stretch reflex amplitude increases after Ankle Brace application
British Journal of Sports Medicine, 2003Co-Authors: Mitchell L Cordova, Christopher D IngersollAbstract:Background: The use of external Ankle support is widespread throughout sports medicine. However, the application of Ankle bracing to a healthy Ankle over a long period has been scrutinised because of possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus. Objective: To investigate the immediate and chronic effects of Ankle Brace application on the amplitude of peroneus longus stretch reflex. Methods: Twenty physically active college students (mean (SD) age 23.6 (1.7) years, height 168.7 (8.4) cm, and mass 69.9 (12.0) kg) who had been free from lower extremity pathology for the 12 months preceding the study served as subjects. None had been involved in a strength training or conditioning programme in the six months preceding the study. A 3 x 3 x 2 (test condition x treatment condition x time) design with repeated measures on the first and third factor was used. The peroneus longus stretch reflex (% of maximum amplitude) during sudden foot inversion was evaluated under three Ankle Brace conditions (control, lace up, and semi-rigid) before and after eight weeks of Ankle Brace use. Results: A 3 x 3 x 2 repeated measures analysis of variance showed that peroneus longus stretch reflex amplitude increased immediately after application of a lace up Brace (67.1 (4.4)) compared with the semi-rigid (57.9 (4.3)) and control (59.0 (5.2)) conditions (p<0.05). Peroneus longus stretch reflex also increased after eight weeks of use of the semi-rigid Brace compared with the lace up and control conditions (p<0.05). Conclusions: Initial application of a lace up style Ankle Brace and chronic use of a semi-rigid Brace facilitates the amplitude of the peroneus longus stretch reflex. It appears that initial and long term Ankle Brace use does not diminish the magnitude of this stretch reflex in the healthy Ankle.
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long term Ankle Brace use does not affect peroneus longus muscle latency during sudden inversion in normal subjects
Journal of Athletic Training, 2000Co-Authors: Mitchell L Cordova, Christopher D Ingersoll, C V Cardona, Michelle A SandreyAbstract:Objective External Ankle supports are widely used in sports medicine. However, Ankle bracing in a healthy Ankle over a sustained period has been scrutinized due to possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus muscle. Although this claim is anecdotal in nature, we sought to investigate the effects of long-term Ankle bracing using 2 commonly available appliances on peroneus longus latency in normal subjects. Our second purpose was to evaluate the effects of Ankle bracing on peroneus longus latency before a period of extended use. Design and setting A 3 x 3 x 2 design with repeated measures on the first and third factors was used in this study. All data were collected in the Sports Injury Research Laboratory. Subjects Twenty (12 men and 8 women) physically active college students (age = 23.6 +/- 1.7 years; height = 168.7 +/- 8.4 cm; weight = 69.9 +/- 12.0 kg) free of Ankle or lower extremity injury in the 12 months before the study and not involved in a strength-training or conditioning program in the 6 months before the study. Measurements We evaluated peroneus longus latency by studying the electromyogram of the muscle after sudden foot inversion. Results Application of a lace-up or semirigid Brace did not affect peroneus longus latency. Additionally, 8 weeks of longterm Ankle appliance use had no effect on peroneus longus latency. Conclusions The duration of the peroneus longus stretch reflex (latency) is neither facilitated nor inhibited with extended use of an external Ankle support. Proprioceptive input provided by the muscle spindles within the peroneus longus does not appear to be compromised with the long-term use of Ankle Braces.
Garron G Weiker - One of the best experts on this subject based on the ideXlab platform.
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Effect of an Ankle Orthosis and Ankle Ligament Anesthesia on Ankle Joint
2016Co-Authors: Garron G WeikerAbstract:The purposes of this study were to determine the effect of a rigid Ankle orthosis (Aircast Air-Stirrup) and lateral Ankle ligament anesthesia on Ankle joint proprioception. Twelve noninjured subjects attempted to match nine reference Ankle joint positions with their eyes closed before and after application of the Ankle Brace and be-fore and after one or two of the lateral Ankle ligaments (anterior talofibular and calcaneofibular) were anesthe-tized. Three-dimensional Ankle joint orientations were recorded with a Motion Analysis system. No significant differences in the constant, variable, or absolute error were seen between subjects in the non-anesthetized and anesthetized conditions (P> 0.05), regardless of whether one or two ligaments were anes
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effect of an Ankle orthosis and Ankle ligament anesthesia on Ankle joint proprioception
American Journal of Sports Medicine, 1994Co-Authors: Jon W Feuerbach, Mark D Grabiner, Timothy J Koh, Garron G WeikerAbstract:The purposes of this study were to determine the effect of a rigid Ankle orthosis (Aircast Air-Stirrup) and lateral Ankle ligament anesthesia on Ankle joint proprioception. Twelve noninjured subjects attempted to match nine reference Ankle joint positions with their eyes closed before and after application of the Ankle Brace and be fore and after one or two of the lateral Ankle ligaments (anterior talofibular and calcaneofibular) were anesthe tized. Three-dimensional Ankle joint orientations were recorded with a Motion Analysis system.No significant differences in the constant, variable, or absolute error were seen between subjects in the non- anesthetized and anesthetized conditions (P > 0.05), regardless of whether one or two ligaments were anes thetized. Thus, it appears that ligament mechanorecep tors contributed little to Ankle joint proprioception, and that the afferent feedback from skin, muscle, and other joint receptors was adequate for the positioning task of the present study. Both the variable...
Christopher D Ingersoll - One of the best experts on this subject based on the ideXlab platform.
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peroneus longus stretch reflex amplitude increases after Ankle Brace application
British Journal of Sports Medicine, 2003Co-Authors: Mitchell L Cordova, Christopher D IngersollAbstract:Background: The use of external Ankle support is widespread throughout sports medicine. However, the application of Ankle bracing to a healthy Ankle over a long period has been scrutinised because of possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus. Objective: To investigate the immediate and chronic effects of Ankle Brace application on the amplitude of peroneus longus stretch reflex. Methods: Twenty physically active college students (mean (SD) age 23.6 (1.7) years, height 168.7 (8.4) cm, and mass 69.9 (12.0) kg) who had been free from lower extremity pathology for the 12 months preceding the study served as subjects. None had been involved in a strength training or conditioning programme in the six months preceding the study. A 3 x 3 x 2 (test condition x treatment condition x time) design with repeated measures on the first and third factor was used. The peroneus longus stretch reflex (% of maximum amplitude) during sudden foot inversion was evaluated under three Ankle Brace conditions (control, lace up, and semi-rigid) before and after eight weeks of Ankle Brace use. Results: A 3 x 3 x 2 repeated measures analysis of variance showed that peroneus longus stretch reflex amplitude increased immediately after application of a lace up Brace (67.1 (4.4)) compared with the semi-rigid (57.9 (4.3)) and control (59.0 (5.2)) conditions (p<0.05). Peroneus longus stretch reflex also increased after eight weeks of use of the semi-rigid Brace compared with the lace up and control conditions (p<0.05). Conclusions: Initial application of a lace up style Ankle Brace and chronic use of a semi-rigid Brace facilitates the amplitude of the peroneus longus stretch reflex. It appears that initial and long term Ankle Brace use does not diminish the magnitude of this stretch reflex in the healthy Ankle.
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long term Ankle Brace use does not affect peroneus longus muscle latency during sudden inversion in normal subjects
Journal of Athletic Training, 2000Co-Authors: Mitchell L Cordova, Christopher D Ingersoll, C V Cardona, Michelle A SandreyAbstract:Objective External Ankle supports are widely used in sports medicine. However, Ankle bracing in a healthy Ankle over a sustained period has been scrutinized due to possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus muscle. Although this claim is anecdotal in nature, we sought to investigate the effects of long-term Ankle bracing using 2 commonly available appliances on peroneus longus latency in normal subjects. Our second purpose was to evaluate the effects of Ankle bracing on peroneus longus latency before a period of extended use. Design and setting A 3 x 3 x 2 design with repeated measures on the first and third factors was used in this study. All data were collected in the Sports Injury Research Laboratory. Subjects Twenty (12 men and 8 women) physically active college students (age = 23.6 +/- 1.7 years; height = 168.7 +/- 8.4 cm; weight = 69.9 +/- 12.0 kg) free of Ankle or lower extremity injury in the 12 months before the study and not involved in a strength-training or conditioning program in the 6 months before the study. Measurements We evaluated peroneus longus latency by studying the electromyogram of the muscle after sudden foot inversion. Results Application of a lace-up or semirigid Brace did not affect peroneus longus latency. Additionally, 8 weeks of longterm Ankle appliance use had no effect on peroneus longus latency. Conclusions The duration of the peroneus longus stretch reflex (latency) is neither facilitated nor inhibited with extended use of an external Ankle support. Proprioceptive input provided by the muscle spindles within the peroneus longus does not appear to be compromised with the long-term use of Ankle Braces.
Marques Junior, Nelson Kautzner - One of the best experts on this subject based on the ideXlab platform.
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Efeito do estabilizador de tornozelo no joelho do atleta de voleibol: um estudo de revisão
2017Co-Authors: Marques Junior, Nelson KautznerAbstract:ABSTRACT Effect of the Ankle Brace on the knee of the volleyball player: a study of reviewThe objective of the review was of explain the effect of the knee of the volleyball player. We found four studies about this theme and it was not conclusive to affirm that the Ankle Brace cause knee injury of the athlete, principally the semi-rigid Brace – the lace up, the sleeves and the tape. However, these assertions deserve caution because the author found little studies about this theme, requiring more research, principally in volleyball players during the game situations and/or practicing the skills for scientific information become more robust about the effect of the Ankle Brace on the knee of the volleyball player. O objetivo da revisão foi de explicar o efeito do estabilizador de tornozelo no joelho do atleta de voleibol. Foram encontrados quatro estudos sobre esse tema, não podendo ser conclusivo para afirmar que o estabilizador de tornozelo causa lesão no joelho do atleta, principalmente o semirrígido, ou seja, o de suporte, o de compressão ou o tape. Entretanto, essas afirmações merecem cautela porque foram achadas poucas pesquisas sobre esse tema, sendo necessárias mais investigações, principalmente em voleibolistas em situações de jogo e/ou praticando os fundamentos para as informações científicas serem mais robustas sobre o efeito do estabilizador de tornozelo no joelho do jogador de voleibol.
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Importância do estabilizador para prevenir a entorse de tornozelo do jogador de voleibol: Um estudo de revisão
2015Co-Authors: Marques Junior, Nelson KautznerAbstract:Importance of the Ankle Brace for prevent the Ankle sprain of the volleyball player: a study of reviewThe volleyball is a sport without physical contact, but because their characteristics, can cause several injuries in volleyball player. One of the most common injuries in volleyball player, especially after of the jump, is the Ankle sprain. The objective of the review was to present the scientific evidence about Ankle Brace. The study demonstrated in the literature that the Ankle Brace increases the stability of the Ankle movements and of the foot, the Ankle muscles are less required during the step, the time of stabilization is shorter, the impact in the lower limbs after the jump is smaller and the medial and lateral forces occurring in the knee after the jump are reduced. In conclusion, the Ankle Brace is an essential equipment to practice of the volleyball.O voleibol é um esporte sem contato físico, mas por causa das suas características, podem acarretar diversas lesões no voleibolista. Uma das lesões mais comuns no jogador de voleibol, principalmente após a queda do salto, é a entorse de tornozelo. O objetivo da revisão foi apresentar as evidências científicas sobre o estabilizador de tornozelo. Foi evidenciado na literatura que o estabilizador aumenta a estabilidade dos movimentos do tornozelo e até do pé, os músculos do tornozelo são menos exigidos durante um passo, o tempo de estabilização é mais breve, o impacto nos membros inferiores após o salto é menor e as forças lateral e medial sofridas pelo joelho no momento da queda do salto são reduzidas. Em conclusão, o estabilizador é um equipamento imprescindível para a prática do voleibol.
Sarah E Lamb - One of the best experts on this subject based on the ideXlab platform.
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treatment of severe Ankle sprain a pragmatic randomised controlled trial comparing the clinical effectiveness and cost effectiveness of three types of mechanical Ankle support with tubular bandage the cast trial
Health Technology Assessment, 2009Co-Authors: Matthew Cooke, Jennifer Marsh, Jane L Hutton, Rachel A Nakash, R M Jarvis, Michael Clark, Susan R. Wilson, Ala Szczepura, Sarah E LambAbstract:OBJECTIVE To estimate the clinical effectiveness and cost-effectiveness of three methods of Ankle support compared with double layer tubular compression bandage. DESIGN A randomised controlled trial, designed to reflect practice in UK hospital emergency departments. SETTING Eight emergency departments in England. PARTICIPANTS Aged 16 or over with acute severe Ankle sprain, unable to weight bear, no fracture. INTERVENTIONS 584 participants were randomised to one of four treatment arms: tubular bandage, below knee cast, Aircast Ankle Brace or Bledsoe boot, all applied 2-3 days after presentation to allow swelling to resolve. MAIN OUTCOME MEASURES Response to treatment was assessed using the Foot and Ankle Outcome Score and generic measures (Functional Limitations Profile, SF-12 and EQ-5D). RESULTS When adjusted for age, sex and baseline scores, the below knee cast offered a small but statistically significant benefit at 4 weeks in terms of pain (FAOS pain difference 5.1; 95% CI 0.4-9.8), foot- and Ankle-related quality of life (QoL) (FAOS QoL difference 5.9; 95% CI 0.1-11.8) and the physical component of the SF-12 (SF-12 score difference 2.2; 95% CI 0.0-4.4). Neither the Aircast Brace nor the Bledsoe boot was statistically or clinically better. At 12 weeks the below knee cast was significantly better than tubular bandage in terms of pain (FAOS pain difference 5.1; 95% CI 0.3-10.0), activities of daily living (FAOS ADL difference 3.5; 95% CI 0.4-6.6), sports (FAOS sports difference 8.7; 95% CI 1.6-15.7) and QoL (FAOS QoL difference 8.7; 95% CI 2.4-15.0), and the Aircast Brace was better only in terms of Ankle-related QoL and mental health. The Bledsoe boot conferred no significant advantage over tubular bandage. By 9 months there were no significant differences. Based on mean direct health-care costs per participant, the Bledsoe boot was the most expensive (215 pounds) and tubular bandage the least so (1 pound 44 pence). Inclusion of indirect costs (sick leave) raised overall costs substantially and removed any significant differences between the therapies. Cost-utility analysis demonstrated that the Aircast Brace [301 pounds per quality-adjusted life-year (QALY)] and below knee cast (339 pounds per QALY) were more cost-effective than the Bledsoe boot (2116 pounds per QALY). However, inclusion of indirect costs produced different rank orders, depending on the assumptions made, and results should be treated with caution. CONCLUSIONS The below knee cast and the Aircast Brace offered cost-effective alternatives to tubular bandage for acute severe Ankle sprain, the former having the advantage in terms of overall recovery at 3 months. As there were no differences in long-term outcome, practitioners should consider likely compliance and acceptability to patients when choosing a Brace.