Rajiv Gandhi University of Health Sciences, Karnataka
Bangalore
ANNEXURE II
1. / Name of the Candidate and Address (in block letters) / HOSABETTU RONAK UMESHDR.M.V. SHETTY COLLEGE OF PHYSIOTHERAPY VIDYANAGAR
KULOOR, MANGALORE.
2. / Name of the Institution / DR.M.V.SHETTY COLLEGE OF PHYSIOTHERAPY
3. / Course of Study and Subject / MASTER OF PHYSIOTHERAPY
MUSCULO SKELETAL DISORDERS AND SPORTS PHYSIOTHERAPY
4. / Date of Admission to Course / 18 June 2009
5. / Title of the Topic / EFFECTIVNESS OF EXTERNAL ANKLE SUPPORT ON THE PERFORMANCE OF VERTICAL JUMP IN BASKETBALL PLAYERS.
6.
7.
8. / BRIEF RESUME OF THE INTENDED WORK:
6.1) INTRODUCTION AND NEED OF THE STUDY:
In basketball, ankle injuries are among the most common injuries sustained and they are also amongst the most severe .1-3 A basketball study determine that over half (53.7%) of the total time missed because of an injury in basketball was through an ankle injury . Ankle injury may result in player experiencing disability and residual symptoms, the most common being pain, sense of instability, crepitus and weakness. However, arthroscopic surgery of 31 ankles found that chondral lesions were evident in 95% of chronic ankle injuries and 89% of recently injured ankles. As ankle injury is a common occurrence , often with residual symptoms affecting performance and chondral lesions, preventive strategies need to be developed, but risk factor associated with ankle injuries must first be identified and understood4-6
Previous studies of risk factors for ankle injury have been carried out in either the laboratory, with emphasis on biomechanical assessment, or the sporting environment as a field/ clinical study.7
Recurrence of ankle sprains and chronic ankle instability, which could be either mechanical or functional are the most frequent and most disturbing complication of acute ankle sprains. Although easy return to sports occurs after every ankle sprains; dysfunction however persists in 40% of patients for as long as 6 months.8 Reccurence of sprains is 4 times more likely to occur than a first time injury. For most basketball players preparation for competition itself is stressful, injury brings an added set of pressure. Braces and support are said to prevent injury to healthy joints and support unstable joints. Hence, the prophylactic use of external ankle supports to reduce the risk of injury recurrence, when individuals return to basketball participation, is fairly common. 9-10
Ankle braces can be classified as lace-up, stirrup or elastic type configuration.11 The primary aim of the supports is to restrict the ankle movement without severely handicapping the normal biomechanics of motion and to enhance the neuromuscular response at the ankle. Evidence suggest that external ankle support is effective in fulfilling the desired goal of reducing the incidence of ankle injury.12-13 Although, these device are beneficial in preventing sprains, studies have suggested some detrimental effects on joint mechanics, thereby causing related injuries14 and on postural control12 by reducing the effectiveness of surrounding musculature and decreasing the performance among the basketball players.15,16,17
Need of the study :
There are many studies which revealed that the external ankle support such as elastic slip on support and elastic wrap were used to prevent ankle sprain in basketball as well as high school football players. But not many studies have been done to evaluate the specific effects in terms of performance in basketball players along with application of external ankle support.
The purpose of this study is to check whether there will be any detrimental effect on the performance in basketball players with the application of external ankle support devices like the elastic slip on support and elastic wrap support on vertical jump test.
Research Question:
Is there any significant difference in the performance of vertical jump test with application of external ankle support like elastic slip on and elastic wrap support in basketball players?
Hypothesis:
Alternative hypotheses:
There will be significant difference in the performance of vertical jump test with application of external ankle support like elastic slip on and elastic wrap support in basketball players.
Null hypotheses:
There will be no significant difference in the performance of vertical jump test with application of external ankle support like elastic slip on and elastic wrap support in basketball players.
6.2) REVIEW OF LITERATURE:
Robinson JR, et al noted an inverse relationship between performance times on an obstacle course
and ankle range of motion when braces with different amount of restriction were tested.18 Greene TA and Wight CR demonstrated that only the most restrictive braces interfered with the ability to run bases in soft ball, while the less restrictive braces had no effect.19
A similar study was conducted by David Pienkowshi, et al, which compared the effect of 3 ankle braces designs on performance amongst men. The authors also hypothesized that specific braces were better for specific athletic activities. Data showed that performance did not change with the use of braces and it was concluded that prophylactic ankle bracing did not inhibit athletic performance.15
Semi-rigid Air cast Stirrup bracing with adhesive ankle taping on motor performance was compared by Verbruggae JD among males and the results suggest that both braces did not impede performance.20 Similarly, Jerosh J et al stated that external stabilizing devices did not have any negative effect on sports specific capabilities.21
A study was done on the influence of basketball shoes with increased ankle support on shock attenuation and performance in running and jumping by Brizuela G et al. It was concluded that the increased support in sports shoes reduces ankle eversion range but increases shock transmission and reduces both jumping and running performance.22
External ankle support has been reported to have no effect on performance or to have an adverse effect on performance in a variety of movement tasks. No prophylactic external ankle support has been shown to improve performance, was stated by Hume PA, Gerrad DF in their study. The review outlines research evidence relating to the effects of external ankle support by means of bracing and taping, on the incidence of ankle injuries, how performance is affected by support, how support may act at the joint to prevent injury and how exercise changes the effectiveness of support.23
Twenty-one subjects with functional ankle instabilites were provided with an ankle support for all athletic and other physical activities for 3 months to study the effect of ankle support on sensomotor and sport-specific capabilities, by Jerosch J and Schoppe R. They demonstrated that even after 3 months there were no detrimental effects on sport-specific skills that require joint stabilization.24
The effect of external stabilization aids of the upper ankle joint on sports-specific performance with reference to isokinetic strength measurements was evaluated. The ankle were tested with three different orthosis, ankle taping and without any device. Taping and other ankle devices showed restriction of performance, which was noted by Holl S, Thorwesten L, Jerosch.25
Richie DH Jr in his study found that proprioception and eversion muscle strength improves with the use of passive supportive devices. It was stated that ankle braces are an effective means of reducing recurrent ankle sprains, but role in primary prevention is less evident.10
Stasinopoulus D, et al, compared three preventive methods in order to reduce incidence of ankle inversion sprains. They found that technical and proprioception training are effective methods of
preventing ankle sprain in those who have suffered injury more than four times and orthosis appears to be effective only in those with less than four times.26
A study done by McCaw ST and Cerullo JF compared the effects of various ankle stabilizers on the
ankle joint kinematics during soft and stiff landings. The authors reported that compared with the no
stabilizers condition, most stabilizer conditions significantly reduce the ankle dorsiflexion range of
motion and angular velocity during landing. Hence it was concluded that some stabilizers adversely
affect joint kinematics during landing.27
6.3) OBJECTIVES OF STUDY:
1) To find out the difference in the performance of vertical jump with application of elastic wrap support and elastic slip on support in basketball players.
2) To find out the difference in the performance of vertical jump without the application of elastic wrap and elastic slip on support in basketball players.
3) To compare the difference in the performance of vertical jump with and without the application of elastic wrap support and elastic slip on support in basketball players.
MATERIALS AND METHODS :
7.1) Study Design:
Comparative Study. Quasi Experimental
7.2) Source of data:
100 healthy college level basket ball players aged 18-30 years male and female years from
Around the Mangalore.
7.2(I) Definition of Study Subjects:
Sample size of 100 college level basket ballplayers in the age group of 18-30 years male and
female years with 50 subjects in each of the 2 groups will be recruited for the study.
7.2(II) Inclusion and Exclusion Criteria:
Inclusion Criteria:
· Informed consent
· Subjects in the age group of 18-26
· Both male and female basketball players
· Co-operative players
· Subjects with BMI not more than 25
Exclusion Criteria:
· Any joint problems
· History of fracture
· Neurological condition
· Any deformities
· Ankle sprains
· History of cardio-respiratory disease
7.2(III) Study Sampling Design, Method and Size:
Sample design:
Purposive random sampling
Sample size:
100 subjects fulfilling the inclusion and exclusion criteria.
7.2(IV) Follow Up:
Post test will be conducted immediately after the intervention.
7.2(V) Parameters used for comparison and statistical analysis used:
Collected data will be analyzed by paired and unpaired‘t’ test.
7.2(VI) Duration of study:
The study will be conducted over duration of 12 months.
7.2(VII) Methodology:
100 normal, healthy male and female basketball players in the age group 18-26 years in and around Mangalore who meet the inclusion and exclusion criteria will be selected for the study.
One ankle of each subject was selected randomly for testing with the ankle supports (elastic slip on support, elastic wrap) and was applied according to the technique selected for the respective supports. The subjects wore the supports inside the shoe (low top) during testing.
Pre test will be conducted on group A and group B by vertical jump test.
Group A subjects will receive elastic slip-on support.
Group B subjects will receive elastic wrap.
Post test will be conducted on group A and group B by vertical jump test.
The results will be recorded and analyzed.
PROCEDURE:
ELASTIC SLIP- ON SUPPORT :
An elastic slip-on support was pulled onto the bare foot and also fitted for size according to manufacturer’s instruction. The support extends approximately from the lower 1/3rd of the leg to the mid foot covering the whole ankle joint except the heel where it is open. This support is available in three sizes viz, Small, medium, large.
ELASTIC WRAP SUPPORT :
Elastic wrap, which was tied on the bare foot in a figure of 8 manner around the ankle joint, the direction of pull being from medial to lateral ( for lateral ligament support ) and secured with Velcro straps. The elastic wraps are also available in three sizes viz, small, medium, large for Indian standard.
OUT COME MEASURE
VERTICAL JUMP:
Patient Stands with his side adjacent to a wall, reaching up (but not to step up on toes), extending his arm and reaching up as high as he can on the wall. The spot is marked where he reaches with a tape, chalk. Standing in the same spot, The subject is asked to do a vertical jump as high as he can, keeping his hand extended high. Another mark is made where the subjects hand extends to. To measure the vertical jump correctly we take a measurement between the first measurement and the second measurement.
7.3) Does the study require any investigations to be conducted on patients or other human or animal? If so, please describe briefly.
YES, Vertical jump test
7.4) Has ethical clearance been obtained from your institution in case of 7.3.
YES
List of References:
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