The Effect of Kinesiotape For Dynamic Balance of Chronic Ankle

Instability (CAI) in Youth Indonesian Athletes

Abdurrasyid

and Ayu Rahmayana

Faculty of Physiotherapy, Universitas Esa Unggul, Jl. Arjuna Utara No.9, Jakarta, Indonesia

Student Sport Education Center (SSEC), Ragunan, Jakarta, Indonesia

Keywords: Chronic Ankle Instability, Kinesiotape, Chronic Sprained Ankle, Dynamic Balance.

Abstract: The effect of kinesiotape (KT) to correction and facilitation techniques after ten minutes of dynamic balance

using the star excursion balance test (SEBT) on chronic ankle instability injury (CAI). One hundred eleven

(111) subjects were divided into group 1 correction techniques (n = 21), group 2 facilitation techniques (n =

26), and group 3 controls / normal (n = 64). Quasi experimental randomized controlled trial by testing the

SEBT percentage pre and post, and testing the SEBT percentage after 10 minutes in group 1 and group 2,

compared to normal 3-ankle group. Paired sample t-test pre (87,62% ± 9,631) and post (98,14% ± 10,556)

group 1 p = 0,000 (p <0,005) there is difference of dynamic balance, paired sample t-test pre (90, 12.5% ±

8,529) and post (96,5% ± 14,049) group 2 p = 0,015 (p <0,05) there is difference of dynamic balance,

independent sample t-test post group 1 and group 2 p = 0,659 (p> 0 , 05) and ANOVA group 1, group 2, &

group 3 (95,13% ± 11,31) p = 0,585 (p> 0,05) there is no difference of dynamic balance. Both techniques of

KT on ankle have a neurophysiological effect on dynamic balance same as normal ankle.

1 INTRODUCTION

Sprain lateral ligaments of the ankle joint are the

most commonly injured by active athletes. The

impairment found that this ligament will cause signs

and symptoms such as pain, swelling, and feel the

joints slack or unstable (Kobayashi and Gamada,

2014). Athletes who have already experienced this

injury will be the risk of recurrent or repetitive

injuries with symptoms not getting better or worst

(Bonnel et al., 2010). Some opinions suggest that

this injury occurs after repeated injuries more than

twice and more than 3 months (Gribble et al., 2014).

One data explains that during the 11-year league

UEFA Champions were 1080 occurrences of ankle

injuries with a ratio of 0.7-1 / 1000 hours (Walden et

al., 2013). Lateral sprain ankle is the most

commonly experienced limb injury in the athlete

with an incidence rate of 20% -40% in various sports

(Walden et al., 2013, Sawkins K, 2007). Ankle

injuries are more common in women and children

active in team sports.

A subjective complaint by some athlete who had

a history of ankle injuries, they will feel painful and

unstable when they practiced and played (Donovan

and Hertel, 2012). There is some athlete who

suffered repetitive injuries and some are not. Some

studies explained that chronic ankle instability (CAI)

is caused by instability of the ankle joint alongside a

single motion. In this case, there are two types of

joint instability, namely mechanical stability and

functional stability (Giannini et al., 2014, Kobayashi

and Gamada, 2014).

Individuals with CAI will be had hypermobility

and joint hypomobility, hypermobility due to

decreased joint stability and hypomobility due to

changes in the position of the distal talocrural and

tibiofibular joint (Hoch and Grindstaff, 2012,

Hubbard and Hertel, 2006). Hypomobility is

characterized by the limitations of dorsal flexion and

plantar flexion. This limitation will be decreased the

action of the joint mechanism and proprioceptors,

reduce muscle contraction, static and dynamic

control of postural, and the pattern of gait that affect

to recurrent injuries (Hoch and Grindstaff, 2012).

The x-ray observations in this condition and sub-

acute sprained ankle explained that this injury will

change the position of fibular bone shift to the

anterior of tibia (Hubbard et al., 2006, Hubbard and

Hertel, 2008). Furthermore, talus bone also shifts to

the anterior, this reasons why athlete felt pain at

140

, A. and Rahmayana, A.

The Effect of Kinesiotape For Dynamic Balance of Chronic Ankle Instability (CAI) in Youth Indonesian Athletes.

DOI: 10.5220/0009569201400144

In Proceedings of the 1st International Conference on Health (ICOH 2019), pages 140-144

ISBN: 978-989-758-454-1

anterior side of the ankle, difficult for dorsal flexion

and it will facilitate the ankle joint in the

plantarflexion and inversion position (Wikstrom and

Hubbard, 2010).

Based on the above paragraph explanation, there

needs external support using Kinesio tape (KT) to

improve the position of the fibula and talus bone to

increase the function of mechanoreceptor which

implies the dynamic balance and reduces the risk the

recurrent tear of ligament during practice. According

to Kumbrink (2012), there are four techniques using

Kinesio tape, namely muscle facilitation, ligament

correction, bone position correction, and lymphatics.

In this study, the techniques designate used are

muscle facilitation and bone position correction

applied to the ankle. This technique will enhance the

work of sensory function mechanoreceptor which

increase the joint position and proprioception to

become more stable.

KT gives an effect to correct the muscle tone and

muscle contraction because of the activation

subcutaneous mechanoreceptor that regulates

sensory feedback stimulation of the fascia and

muscle layers. This feedback will respond to the

proprioceptive to transmit information to the central

nervous system (CNS) and return back to the

peripheral motor system to controlled muscle tone

whether it facilitates and inhibits according to

desired needs and stimulation. Furthermore, to some

pathologies caused by autonomic controls, KT

should be able to provide information through the

mechanoreceptors into the hypothalamus thereby

providing stimulation of tone control globally (Seo

et al., 2016, Chang et al., 2015).

2 METHOD

2.1 Subject

One hundred eleven (111) feet of observations were

obtained from students of the Student Sport

Education Center (SSEC) Ragunan Jakarta,

Indonesia divided into three (3) groups, with

inclusive for CAI (group 1 (KT with Bone position

correction technique) and group 2 (KT with Muscle

facilitation technique) male and female aged 15-20

years, have a history of ankle injuries more than

once times (≥1 times) in the presence of

inflammation and physical activity limitation, ever

felt more than 2 times feeling unstable at the ankle

joints, recurrent injuries without any new

inflammation condition, and self-assessment of

ankle injuries with CAIT <24 point. For group 3

with a normal foot, the criteria are male and female

athletes 15-20 years old, had no history of injury

ankle and knee, self-assessment of ankle injury

with Cumberland Ankle Instability Tool (CAIT)

≥24 point. The exclusion criteria of the subject

there were having a history of musculoskeletal

surgery actions including bones, ligaments,

muscles, and nerves around the ankle joint, has a

history of foot fracture, musculoskeletal acute

injuries (sprains, strains, and fractures) within a

period of three months during the examination. The

randomized control trial group with a twenty-one

(21) feet with CAI entered in group KT with bone

position correction technique, twenty-six (26) feet

with CAI entered in group KT with muscle

facilitation technique, and sixty-four legs (64)

healthy or without CAI were not given any

intervention.

2.2 Instrument

Measurements the dynamic balance was using the

Star Excursion Balance Test (SEBT) were

performed before and after 10 minutes given KT in

both intervention groups. Whereas the healthy foot

group can measurements were taken at any time.

2.3 KT Technique

2.3.1 Bone Position Correction Technique

Using four pieces of KT attached to the area of the

fibula bone to maintain the position of the fibula.

2.3.2 Muscle Facilitation Technique

Using three pieces of KT attached to the peroneus

longus and brevis muscles and given resistance to

the anterior ankle (figure 1).

Table 1: ANOVA.

The Effect of Kinesiotape For Dynamic Balance of Chronic Ankle Instability (CAI) in Youth Indonesian Athletes

141

Figure 1: Muscle facilitation technique (Bicici, et al,

2012).

Figure 2: Fibulla correction technique.

3 RESULT

For group 1 the dynamic balance before and after

given KT with bone position correction technique

was tested using paired sample t-test. The results

show that there was a difference in dynamic balance

with p = 0,000 (<0.005). This describes that there

was an effect for KT in increasing of dynamic

balance in athletes with CAI. While in group 2 was

given KT with muscle facilitation technique was

tested using paired sample t-test. The result shows

that there was a difference in dynamic balance with

p = 0,015 (<0,005). This also describes that there

was a difference in dynamic balance in athletes with

CAI (table 2).

Seeing the benefits of these KT techniques will

be compared with normal ankle SEBT values tested

using ANOVA. The result shows that there was no

difference in the dynamic balance between KT

applied and normal feet with p = 0,539 (> 0,005).

This describes that the use of this KT gives the same

dynamic balance effect as a normal ankle (Table 1).

4 DISCUSSION

Based on the results, the effect of dynamic balance

using SEBT concomitant with a research report by

Tamburella et al (2014) which explained the use of

KT for 48 hours in neurological cases can improve

balance in the spinal cord injury, spasticity and road

patterns. According to this KT will enhance sensory

input by providing a reciprocal response to

proprioceptive and controlling muscle tone

(Tamburella et al., 2014). Cortesi, et al (2011) also

reported that in cases of multiple sclerosis, KT

applied at the ankle will improve motion control,

exteroceptive afferent function, and motor

excitability in the soleus muscle when standing one

foot with the eyes closed. The use of KT on the

ankle can also improve posture stability (Cortesi et

al., 2011). Both reports explain that the elastic

adhesive (Kinesio tape) has an effect on the

neurophysiological functions in the target area the

function of stability will be increased. It describes

that the use of KT can help improve the function of

joint structures so that athletes with CAI can feel

more stable in joint awareness. Followed by

Mohamed et al (2016) explaining KT applied to a

first-degree ankle injury will speeds up functional

improvement.

In this study, there was no difference of SEBT

value between group 1 (bone position correction

technique) 98,14 ± 10,556, group 2 p(muscle

Table 2: Before and After Both Group (Paired sample t-test).

ICOH 2019 - 1st International Conference on Health

142

facilitation technique) 96,5 ± 14,049 and group 3

(normal ankle) 95,13 ± 11,31. Both KT techniques

employed provide balance enhancements parallel to

normal ankle balances. Park and Lee (2016) describe

the use of KT in 12 hemiplegic stroke patients with

decreased body coordination and motion can

improve the ability to walk straight. Improved body

and motion coordination after KT may be caused by

afferent stimulation of the mechanoreceptors of the

skin that responds to efferent feedback on the

muscle. So, the work of the cutaneous fusimotor

reflex and gamma motor fibers will increase muscle

fiber and motor muscle tone (Kim et al., 2014, Park

and Lee, 2016). William et al. (2012) in his meta-

analysis report explained that the effect of KT can be

used as prevention tools for ankle recurrent injuries

even though the resulting motor enhancement

increases not satisfied (Wilson and Bialocerkowski,

2015).

The CAI condition had found in this study is

ankle injury will need the basic physiology of the

somatosensory function that was damaged while

injured cannot provide the efferent/motoric feedback

system on ankle stability would be a risk of recurrent

injury (Williams et al., 2012, Mohamed et al., 2016).

Kinesiotape applied to the ankle joint may perform

as an external control to give a perception on the

ankle joint to increase automation of motor control

while neurophysiological excitability in dynamic

balance for the athlete with CAI condition (Lemos et

al., 2017).

5 CONCLUSIONS

CAI is a condition of ankle injuries that often occur

in athletes and high risk for recurrent injuries. The

use of the Cumberland Ankle Instability Tool

(CAIT) can serve as a diagnostic tool for CAI so that

the determination for the therapy program is more

appropriate. The dynamic balance with SEBT can be

used as a standard to see motor control of the lower

limbs to measure the risk of recurrent ankle injuries.

The use of Kinesio tape can be given before the

athlete/sportsman during exercises or competition to

give some perceptions of stability in the ankle joint.

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