SLR - December 2023 - Pincock
Title: A Multidimensional Assessment of a Novel Adaptive Versus Traditional Passive Ankle Sprain Protection SystemsReference: Willwacher, Steffen, et al. "A multidimensional assessment of a novel adaptive versus traditional passive ankle sprain protection systems." The American Journal of Sports Medicine 51.3 (2023): 715-722.
Level of Evidence: Level 3 prospective study
Reviewed by: Caleb Pincock, DPM
Residency Program: John Peter Smith Hospital, Fort Worth, TX
Podiatric Relevance: A common injury that is seen and evaluated by podiatrists are ankle sprains, particularly with the athletic population. The most common mechanism of injury for ankle sprains is inversion, causing damage to the anterior talofibular ligament. Prevention of ankle injury with sport activity is a widely debated topic with constantly evolving research and recommendations. This article is relevant clinically to reinforce to patients that prevention is more effective than treating ankle sprains. Traditionally, passive ankle brace systems restrict motion relatively equally with slow and high angular velocities. Novel adaptive braces may allow improved sports performance and increased subjective comfort levels by allowing greater freedom to move during low velocity activities, while effectively protecting during high angular velocity activities. Establishing the patient relationship with an adequate discussion of prevention will ensure that when or if surgical intervention is recommended for lateral ankle ligament instability repair, the patient will trust and continue to follow the recommendations given to them perioperatively.
Methods: The researchers analyzed and compared one adaptive ankle brace to two different passive braces worn with identical low cut shoe gear in 20 male athletes. 3D motion was measured during sport specific activities including vertical counter jump movement, linear acceleration, 90-degree change of direction, and single leg hopping. Materials of the different braces were also tested with an artificial ankle joint system at low and high inversion velocities.
Results: Subjective stability ratings were no different between the adaptive and passive systems. The adaptive brace increased in stiffness by roughly 400% during fast compared to slow inversion velocities. The adaptive brace was found to improve active ankle range of motion and subjective comfort and restriction ratings reported by participants.
Conclusions: It was determined that the novel adaptive ankle brace offers similar protective effects in high-velocity inversion mechanism injuries compared to those of passive protection technologies. The adaptive brace improved active ankle range of motion, as well as subjective comfort and restriction ratings reported by participants compared with the passive braces. A significant factor that contributes to the results is the subjective perception of comfort and range of motion restriction felt by the subject being evaluated. The data from this study aids in tailoring clinical discussions with athletic patients in the future focusing more on their personal comfort level and perceived athletic mobility and stability while wearing either an adaptive or traditional passive ankle brace. With this study in consideration, it is valuable to encourage athletic patients to take precautions using a brace for high velocity athletic activities, but allowing them the flexibility to explore a variety of different braces to fit their personal comfort and performance level without feeling restricted to one type of ankle brace for activity.