Fibular taping does not influence ankle dorsiflexion range of motion or balance measures in individuals with chronic ankle instability
Wheeler T, Basnett C, Hanish M, Miriovsky D, Danielson E, Barr J, Threlkeld J, Grindstaff T. Journal of Science and Medicine in Sport. 2013; 16: 488-492.
Take Home Message: Among patients suffering from chronic ankle instability, fibular taping increased ankle dorsiflexion range of motion and balance, but not enough to be clinically meaningful.
Chronic ankle instability (CAI) is defined as recurrent ankle sprains and repetitive episodes of the ankle “giving way”. Some patients with CAI have restricted ankle dorsiflexion range of motion (ROM) along with hypomobility of the posterior aspect of the talocrural joint and distal tibiofibular joint, which can cause mal-alignment of the talus and fibula. Fibular taping, which may prevent recurrent ankle sprains, is believed to simulate a distal tibiofibular posterior glide joint mobilization that is often used to promote ankle dorsiflexion ROM. If we can verify that fibular taping promotes ankle dorsiflexion ROM or balance then it may help us identify other uses for fibular taping and better educate our patients about why it works. Therefore, “the purpose of the study was to examine the immediate effects of fibular taping on ankle dorsiflexion ROM and dynamic balance in individuals with CAI”. Twenty three individuals with CAI and a dorsiflexion deficit randomly received a fibular taping or sham taping (tape applied without tension) on different days, which were separated by 1 to 7 days. An investigator who was blinded to the type of taping evaluated dorsiflexion during a weight-bearing lunge and balance with the Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions. The participants completed these tasks before and after each taping intervention. Compared with not being taped, both taping interventions resulted in greater ankle dorsiflexion ROM; however, the average improvement was only one degree. The two taping interventions had a similar influence on dorsiflexion ROM as well as dynamic balance when participants reached in an anterior or posteromedial direction. The only time participants performed better with the fibular taping compared with the sham taping was when they reached in the posterolateral direction during the balance test; however, the difference was small and within the possible range of measurement error.
This authors showed that fibular taping has very little influence dorsiflexion ROM and balance among patients who have CAI. Fibular taping may not be beneficial for ROM and dynamic balance but it has been beneficial in other ways. Other studies have shown that fibular taping may prevent ankle sprains, increase stability awareness, and make the patient feel more confident about their ankle. Since fibular taping provides positive effects for the patient, it should still be used as a treatment option for patients who have CAI. While the authors hoped to shed light on why this taping is beneficial they found that the benefit may not be related to improved dorsiflexion or balance. However, it would be helpful if future research would conduct these tests and then examine if individuals with or without improvement in dorsiflexion and balance actually have a reduced risk of ankle sprains. This could help us clarify that the benefit of fibular taping is not related to improved dorsiflexion or balance or if we can use the response to the taping to determine who might get benefit from the taping. From a clinical point-of-view, fibular taping provides benefits in so we should still use it to help prevent ankle sprains but we should be cautious and not attribute these benefits to changes in balance or ROM.
Questions for Discussion: How do you treat a patient with CAI? Have you used fibular taping with a patient with CAI? Do you believe fibular taping has a psychological effect on the patient to makes them feel more stable in their ankle? Do you think fibular taping should be used as a treatment option for patients suffering from CAI?
Written by: Callie Jedrzejek
Reviewed by: Lisa Chinn and Jeffrey Driban
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