effects of ankle taping on single and double leg balance

Sport Science Review, Vol. XIX, No. 1-2, 2010

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Effects of Ankle Taping on Single and Double Leg Balance

Adam C. KNIGHT* • Wendi H. WEIMAR**

Ankle sprains are a common injury and athletic tape is often applied to help prevent this injury, however, the effects of ankle taping on balance are relatively unclear. Additionally, the dominant and non-dominant legs often have different demands placed upon them and may yield different balance scores. Twenty five healthy participants (18 female, 7 male; age=20.5+1.19 years; mass=69.24+12.72 kg; height=1.69+.087 m) completed double and single leg balance assessments with the eyes open and eyes closed under three ankle support conditions: no ankle tape, PowerTape™, and Coach™ Tape, on the Neurocom Basic BalanceMaster™. Balance assessments were completed before ankle taping (pre-test), immediately after ankle taping (acute-test), and after 20 minutes of walking (post-test). The sway velocity of the participants’ center of gravity (deg/s) was the dependent variable. A significant three way interaction was found for the single leg, eyes closed assessment (P = .037), with increased sway velocity for the PowerTape™ and Coach™ tape condition. The non-dominant leg had significantly less sway velocity than the dominant leg for the eyes open condition (P < .001). These results indicate differing affects on balance for different types of athletic tape, and balance differences between the dominant and non-dominant leg, with the non-dominant leg presenting lower sway velocities.

Keyword: ankle sprain, injury, athletic tape, balance, sway velocity

Introduction

The ankle sprain is the most frequently occurring injury in athletics, resulting in a high cost of care and more lost time from competition than any other joint related injury (Shima et al., 2005; Fox et al., 2008). Each year in

* Assistant Professor, Department of Kinesiology, Mississippi State University, PO Box 6186, Mississippi State, MS 39762, phone: 662-325-7234, e-mail address: [email protected]** Associate Professor, Department of Kinesiology, Auburn University, Auburn, AL, USA

DOI:10.2478/v10237-011-0001-3

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the United States, over two million people sustain an ankle sprain (Ubell et al., 2003) and it has been reported that ankle sprains account for up to 25%

of all time lost from athletic competition (Ashton-Miller et al., 1996). Once a person sustains an ankle sprain, he or she is at a much greater risk for re-injury or chronic ankle instability (Midgley et al., 2007; DiStefano et al., 2008).

Ankle taping is a common practice that has been used for many years as a way to prevent ankle sprains. Ankle taping restricts excessive range of motion by acting as an external ligament (Wilkerson, 2002). The utility of tape has been well documented however; ankle taping does have limitations, primarily, tape may lose its effectiveness as the length of time of the activity increases, and this decrement in effectiveness may occur in as little as 10 minutes (Ashton-Miller et al, 1996). However, the ability of athletic tape to limit extreme ranges of motion at the ankle is not affected by prolonged athletic activity (Karlssson & Andreasson, 1992; Lohrer et al., 1999).

In addition to remaining uninjured, balance is imperative for athletic performance (Winter et al., 1998). The assessment of balance has frequently been used as a measure of lower body function and is defined as the process of maintaining the center of gravity over the base of support (Cote et al., 2005). While there have been studies investigating the effects of ankle taping on the latency of the ankle musculature (Lohrer et al., 1999; Karlsson & Andreasson, 1992; Midgley et al., 2007; Shima et al., 2005) and the kinetics and kinematics of drop landings (DiStefano et al., 2008; McCaw & Cerullo, 1999; Riemann et al., 2002), only a few studies have examined the effects of ankle taping on balance. Of the studies that have investigated the influence of athletic tape on balance, 2 of those studies have found no influence (Paris, 1992, Abian-Vicen et al., 2008) and 2 found a decrease in postural control with athletic tape (Bennell & Goldie, 1994, Broglio et al., 2008). Specifically, one study reported that external ankle support decreased postural control in single leg balance tests by increasing the number of times the non-support leg touched the ground (Bennell & Goldie, 1994), while another study reported that external ankle support did not cause any significant changes to balance when compared to no ankle support (Paris, 1992). A recent study revealed that ankle taping did not influence balance performance (Abian-Vicen et al., 2008), but another recent study reported that external ankle support in the form of ankle taping and bracing caused an increased number of errors during the balance error scoring system (BESS) when compared to barefoot conditions before and after 20 minutes of treadmill walking (Broglio et al., 2008). In review of these studies it is apparent that the


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influence of athletic tape on balance has provided mixed results. There has also been a call for more research investigating the influence of ankle taping on functional performance (Abian-Vicen et al., 2008).

Functional performances require the participant to be engaged in activities associated with specific sports and it has been found that athletes place different demands on the dominant and non-dominant legs (Carey et al., 1998; Stephens et al., 2007), with most athletes placing greater demands on the dominant leg (Beynnon et al., 2002). Some research has reported that the ankle of the dominant leg is sprained twice as frequently as the ankle of the non-dominant leg (Ekstrand & Gillquist, 1983; Yeung et al., 1994). Furthermore, single leg balance has also been reported to be a predictor of ankle sprains among high school basketball players, with participants with higher baseline postural sway sustaining more ankle sprains (McGuine et al., 2000). Due to the different demands placed on the dominant and non-dominant legs, a potential difference in balance may exist between the two extremities, and a person with a decrement in balance of one extremity when compared to the other may be more likely to sustain an injury.

Therefore, this project endeavored to investigate (1) the influence of ankle taping on balance, (2) the influence of different types of athletic tape on balance and (3) the relationship between balance and leg dominance. The specific purpose of the present study was to determine if there was a difference in single and double leg balance between ankle taping and no ankle taping; and to determine the effects of a traditional athletic tape (Coach™ tape by Johnson and Johnson) and a new type of athletic tape (PowerTape™ by Andover) used for ankle taping on single and double leg balance. A secondary purpose was to determine if there was a difference in balance between the dominant and non-dominant leg. The authors hypothesized that ankle taping would cause a significant increase in the amount of postural sway when compared to no ankle taping because previous work that found a decrement in balance after the application of ankle taping (Bennell & Goldie, 1994, Broglio et al., 2008). The authors’ also hypothesized that balance would be better on the non-dominant leg, which would be evidenced by a decreased amount of postural sway when compared to the dominant leg. The basis of this hypothesis stems from the findings that leg dominance is often defined as the leg the person would use to kick a soccer ball (Ekstrand & Gillquest, 1983; Yeung et al., 1994) and as such would put greater postural control demands upon the non-dominant leg during the kicking motion, resulting in a lesser amount of postural sway than the dominant leg.

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Methods

ParticipantsTwenty five participants (18 female, 7 male, age: 20.50 + 1.19 years)

volunteered to participate in the study. The participants had a mean height of 1.69 + .087 m and a mean mass of 69.24 + 12.72 kg. The participants were free of any lower extremity injury at least 6 months prior to testing. All participants were physically active (minimum of 30 minutes of physical activity, 4 days/week). The participants performed all testing in his or her own athletic shoes that were used for general physical activity.

DesignThe participants completed the balance assessments on three separate

days. The balance assessments were performed one day without ankle taping, and two days with ankle taping. The order of assignment (no ankle tape, Coach™ Tape, or PowerTape™) was random. Before participation, all participants signed an informed consent approved by the authors’ institutional ethics review committee and answered a preliminary medical questionnaire to determine if they had any medical condition that would prevent them from successfully completing the task.

InterventionOn the two days the participants were selected for ankle taping, both

ankles were taped by the same Certified Athletic Trainer (ATC) with a closed basketweave taping procedure, which is designed to prevent lateral ankle sprains. Ankle taping was conducted one day using foam pre-wrap as the underwrap, with 1.5 inch Coach™ Tape by Johnson and Johnson being applied over the pre-wrap in the closed basketweave manner (Figure 1-see next page). The other taping day, PowerFlex™ was applied as the underwrap followed by 1.5 inch PowerTape™ by Andover being applied over the PowerFlex in the same closed basketweave manner (Figure 2 - see next page). Coach™ tape is a traditional cotton adhesive tape that is frequently used for ankle taping, while PowerTape™ is a new type of tape that is a cohesive rather than an adhesive.

The Neurocom™ Basic Balance Master (Neurocom International, Clackamas, OR) was used to collect all balance data. On each testing day, the participants performed the modified clinical test of sensory interaction on balance (mCTSIB) with the eyes open and eyes closed. This test is a measure of the participants balance when standing on both feet. For the mCTSIB test, the participants stood with both feet (shoulder width apart) on the BalanceMaster™, and looked straight ahead with the arms held


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down by the participant’s side for a total of 30 seconds. The participants also performed the unilateral stance test on both the dominant and non-dominant leg with the eyes open and the eyes closed. For the unilateral stance test, the participants stood on the testing leg, with the knee of the non-testing leg in a flexed position, with the hands placed on his or her hips for a total of 30 seconds. The mCTSIB test was performed first with the eyes open and then with the eyes closed, followed by the unilateral stance test on the left leg with the eyes open and eyes closed and the right leg with the eyes open and eyes closed. The order of leg assignment and eyes open/eyes closed was randomized. The Basic Balance Master™ is a split force platform that records the postural sway velocity of the participants’ center of gravity in degrees per second. The dominant leg was determined by asking the participants with which leg he or she would kick a soccer ball (Ekstrand & Gillquist, 1983; Yeung et al., 1994).

TestingEach testing day, the participants were randomly assigned to one of

the three taping conditions: no ankle tape, Coach™ Tape, or PowerTape. The participants performed both the mCTSIB and the unilateral stance test on both legs upon arrival to the laboratory (pre-test). The participants then had both ankles taped (if assigned to one of the ankle taping groups), or sat on the taping table in the same position as he or she would to have his or her ankles taped for five minutes if assigned to the non-taping group. Immediately after ankle taping treatment, the participants performed both the mCTSIB and unilateral stance tests (acute test). After performing the acute tests, the participants performed twenty minutes of walking at a self selected pace, in order to determine if physical activity affected the athletic

Fig. 1. Pre-wrap and Coach™ tape applied in a closed basketweave

manner to the participant’s ankle.

Fig. 2. Powerflex and PowerTape™ applied in a closed basketweave manner to the

participant’s ankle

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tape and balance. The 20 minute walking protocol was similar to a recent study that examined the affects of ankle taping and physical activity on balance (Broglio et al., 2008). After 20 minutes of walking, the participants were tested again on the mCTSIB and unilateral stance balance tests (post test).

Data AnalysisData analysis was conducted using SPSS for Windows (version 16;

SPSS, Chicago, IL) statistical analysis software. The data for the mCTSIB tests were analyzed with a 3 x 3 factorial design analysis of variance. The first independent variable was taping, with three levels (no tape, Coach™ tape, and PowerTape™) and the second independent variable was the test number, with three levels (pre-test, acute test, and post test). The dependent variable was the sway velocity of the center of gravity in degrees per second. Two separate analyses were conducted: mCTSIB eyes open and mCTSIB eyes closed. The data from the unilateral stance tests were analyzed with a 3 x 3 x 2 factorial design analysis of variance. The first independent variable was taping, with three levels (no tape, Coach™ tape, and PowerTape™), the second independent variable was the test number, with three levels (pre-test, acute test, and post test), and the third independent variable was testing leg, with two levels (dominant leg and non-dominant leg). The dependent variable was the sway velocity of the center of gravity in degrees per second. Two separate analyses were conducted: unilateral stance with the eyes open and unilateral stance with the eyes closed. Where significant main effects were present, Tukey’s test of Least Significant Digits was conducted as a post hoc pair wise comparison. Statistical significance was set at the P < .05 level.

Results

The means and standard deviations for each of the four analyses are presented in the tables below. For the analysis of the unilateral stance test with the eyes closed, there was a significant three-way interaction between the taping condition, test number, and leg, F2, 23= 4.88, P = .037, η2= .169 (Table 1). Post hoc analysis revealed significant differences between several of the variables, mainly the no taping condition and the PowerTape™ and Coach™ tape conditions, which can be found in Table 2. For the analysis of the unilateral stance test with the eyes open, a significant main effect was found for the testing leg, F1, 24= 27.46, P < .001, η2= .534, with the non-dominant leg having a significantly lower sway velocity (0.732 deg/s) than the dominant leg (0.792 deg/s, Table 3). No significant interactions or main effects were found for the mCTSIB eyes open test (Table 4). For the mCTSIB eyes closed test, a significant main effect was found for


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test number (F1, 24= 9.31, P = .005, η2= .280). Post hoc analysis found a significant mean difference between the pre test and the post test (mean difference = -.066 deg/s, P < .001) and the acute test and the post test (mean difference = -.061 deg/s, p<.01, Table 5).

Table 1. Means and Standard Deviations of sway velocity (deg/s) for the Unilateral Stance eyes closed balance test

Condition (Ankle support, leg, test

number)Mean + SD


number)Mean + SD

No Tape, Non-Dominant, Pre 1.821 + 0.402 PowerTape,

Dominant, Acute 1.842 + 0.419

No Tape, Dominant, Pre 1.885 + 0.559 PowerTape, Non-

Dominant, Post 1.944 + 0.545

No Tape, Non-Dominant, Acute 1.746 + 0.539 PowerTape,


No Tape, Dominant, Acute 1.976 + 0.939 Coach tape, Non-

Dominant, Pre 2.118 + 0.645

No Tape, Non-Dominant, Post 1.704 + 0.478 Coach tape,

Dominant, Pre 1.873 + 0.359

No Tape, Dominant, Post 1.826 + 0.476 Coach tape, Non-


PowerTape, Non-Dominant, Pre 2.015 + 0.96 Coach tape, Non-


PowerTape, Dominant, Pre 2.038 + 0.911 Coach tape, Non-


PowerTape, Non-Dominant, Acute 2.132 + 0.685 Coach tape,


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Table 2. Post hoc analysis of the significant three way interaction (ankle support by test leg by test number) for the single leg, eyes closed

assessment. Results are presented as mean sway velocity (deg/s)Condition (Ankle support, leg, test

number)

Mean + SD


number)

Mean + SD P Mean

Difference

No Tape, Non-Dominant, Pre

1.821 + 0.402

PowerTape, Non-Dominant, Acute

2.132 + 0.685 .032 -0.312

No Tape, Non-Dominant, Pre

1.821 + 0.402

Coach tape, Non-Dominant, Pre

2.118 + 0.645 .025 -0.297

No Tape, Non-Dominant, Acute

1.746 + 0.542


2.132 + 0.685 .028 -0.387

No Tape, Non-Dominant, Acute

1.746 + 0.542


2.118 + 0.645 .011 -0.372

No Tape, Non-Dominant, Post

1.704 + 0.478


2.132 + 0.685 .009 -0.428


1.704 + 0.478

PowerTape, Dominant, Post

1.943 + 0.449 .025 -.238


1.704 + 0.478


2.118 + 0.645 .005 -.414


1.704 + 0.478

Coach tape, Non-Dominant, Acute

1.922 + 0.368 .013 -.218


1.704 + 0.478

Coach tape, Dominant, Acute

1.944 + 0.424 .021 -.240


1.704 + 0.478

Coach tape, Non-Dominant, Post

1.984 + 0.563 .029 -.279

PowerTape, Dominant, Acute

1.842 + 0.419


2.132 + 0.685 .011 -.291


1.80 + 0.384


2.132 + 0.685 .01 -.333

PowerTape, Dominant, Acute

1.842 + 0.419


2.118 + 0.645 .039 -.276

Coach tape, Dominant, Pre

1.873 + 0.359


2.118 + 0.645 .04 -.245


1.984 + 0.50


2.118 + 0.645 .001 -.318


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Table 3. Means and Standard Deviations of Amount of postural sway (deg/s) for the Unilateral Stance eyes open balance test

* Indicates a statistically significant difference at the p < .001 level

Table 4. Means and Standard Deviations of Amount of postural sway (deg/s) for the mCTSIB eyes open balance test

Table 5. Means and Standard Deviations of Amount of postural sway (deg/s) for the mCTSIB eyes closed balance test

*Indicates a statistically significant difference at the p < .01 level

Taping Condition

Postural Sway

(deg/s)Test

Postural Sway

(deg/s)Leg

Postural Sway

(deg/s)

No tape .774 + .037 Pre .717 + .024 Dominant .792 + .027*

PowerTape™ .705 + .026 Acute .741 + .034 Non-Dominant

.732 + .025*

Coach™ Tape .718 + .028 Post .739 + .024

Taping Condition Postural Sway (deg/s) Test Postural Sway

(deg/s)No tape .423 + .032 Pre .388 + .025

PowerTape™ .395 + .039 Acute .466 + .028Coach™ Tape .451 + .030 Post .436 + .358

Taping Condition Postural Sway (deg/s) Test Postural Sway

(deg/s)No tape .410 + .022 Pre .387 + .018*

PowerTape™ .408 + .032 Acute .393 + .020*Coach™ Tape .415 + .026 Post .454 + .034*

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Discussion

The purpose of this study was to investigate the effects of ankle taping on double and single leg balance, the influence of different types of athletic tape on double and single leg balance, and to examine balance between the dominant and non-dominant leg. Differing results have been reported in previous studies regarding the affects of ankle taping on balance (Abian-Vicen et al., 2008; Bennell & Goldie, 1994; Broglio et al., 2008; Paris, 1992;), however the influence of PowerTape™ on balance has not been investigated. A significant three way interaction was found for the single leg, eyes closed test condition. For the single leg eyes open condition, the non-dominant leg had significantly lower sway velocity than the dominant leg. Also, a significant main effect for test number was found for the mCTSIB eyes closed assessment. The implications of these findings will now be discussed.

For the unilateral stance eyes closed condition, there was a significant three way interaction between the tape, test, and leg condition. Post hoc analysis revealed significant differences between several of the variables, which can be found in Table 2. For the no ankle taping condition, significantly lower sway velocity was found on the non-dominant leg when compared to Coach™ tape and PowerTape™ conditions on the dominant and non-dominant legs. These findings indicate that both types of athletic tape caused an increase in the sway velocity for the eyes closed condition of both the dominant and non-dominant legs when compared to the no ankle taping condition of the non-dominant leg. This is consistent with previous research that found a decrement in single leg balance after the application of athletic tape to the ankle (Bennell & Goldie, 1994; Broglio et al., 2008). With the eyes closed, an increased reliance on the proprioceptors in the lower extremity is required in order to maintain balance. The application of both types athletic tape to the ankle may have caused a disruption in the cutaneous feedback from the ankle during the single leg, eyes closed condition, causing an increase in postural sway.

There was a significant difference in sway velocity between the dominant and non-dominant leg for the unilateral stance, eyes open condition. The dominant leg had a significantly larger sway velocity, indicating that for static balance, the non-dominant leg is more stable during the eyes open condition. It is known that different demands are placed on the dominant leg and the non-dominant leg (Carey et al., 1998), with the dominant leg producing more strength and power than the non-dominant leg (Stephens et al., 2007). Although the dominant leg may


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have more strength than the non-dominant leg, the lower sway velocity of the non-dominant leg may be due to the person requiring the non-dominant leg to support his or her body weight and maintain balance while kicking a ball or stepping up onto a step. This decrement in balance for the dominant leg may help explain why the dominant ankle is sprained twice as frequently as the non-dominant leg (Ashton-Miller et al., 1996). Furthermore, this finding supports the authors’ contention that the differing demands placed upon the dominant and non-dominant legs has led to measurable differences in postural control during single leg stance. Future research should investigate this difference further and determine if it can be used as a predictor of injury and candidate recommendation for preventative treatment and training.

The participants were assessed on all balance measures three times during each testing session: (a) immediately upon arrival to the laboratory, (b) immediately after ankle taping, and (c) immediately after 20 minutes of walking. For the mCTSIB eyes closed condition, the sway velocity of the participants were significantly larger immediately after ankle taping or after sitting for 5 minutes in the ankle taping position (no ankle taping condition) and after 20 minutes of walking when compared to the initial balance assessment. Although this finding was significant, the fact that this increase in sway velocity occurred for both the no ankle support and ankle support conditions and because there were non-significant findings for test number on the other three balance assessments leads the authors to conclude that physical activity did not cause a degradation in the athletic tape (in relation to balance) in this study. While other studies have found degradation in athletic tape over time in relation to its limiting affects on foot/ankle range of motion (Ashton-Miller et al., 1996), this study did not find that physical activity caused ankle taping to increase the sway velocity after physical activity. However, the authors’ acknowledge that the activity task may not have been taxing enough to cause fatigue in either the participant or the tape.

To the authors’ knowledge, this was the first study to compare the affects of two different types of athletic tape used for ankle taping on balance. Coach™ Tape is the more traditional, cotton athletic tape, while PowerTape™ is a new type of athletic tape that is advertised to keep its effectiveness by preventing excessive range of motion longer than traditional tape. This study did not find a difference in sway velocity when the Coach™ tape was compared to the PowerTape™ on any of the balance measures. While there was an increase in sway velocity during the ankle taping conditions for the single leg, eyes closed assessment, there were no

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significant differences between the no ankle taping condition and either taping condition for the single leg, eyes open assessment, the mCTSIB assessment with the eyes open, nor the mCTSIB assessment with the eyes closed. These results are consistent with previous work that did not find a difference in balance scores between ankle taping and no ankle taping (Abian-Vicen et al., 2008; Paris, 1992). The secondary purpose of the study was to determine if there was a difference in balance between the dominant and non-dominant legs. The dominant leg had significantly greater sway velocity than the non-dominant leg for the unilateral stance eyes open test. This finding supports the authors’ contention that the differing demands placed upon the dominant and non-dominant legs has led to measurable differences in postural control during single leg stance. Intuitively, the non-dominant leg is utilized more for single leg stance, and the dominant leg is utilized more for kicking and stepping over/on objects. This would help explain the greater amount of sway velocity of the dominant leg. Additionally, this study sought to determine the effects of physical activity on balance and if physical activity changes the balance scores of the different ankle support conditions. There was not a significant difference in balance scores across the three different test numbers except for the mCTSIB, eyes closed balance assessment where the sway velocity increased across all three tests (balance decreased over time). This finding is curious since the walking task was at a self-selected and presumably low intensity, so fatigue should have not been an issue. However, since the only difference was noted in the eyes closed condition, once again the influence of proprioception in the absence of vision cannot be overlooked.

There were limitations to the present study. Dynamic balance was not assessed. Future research should examine the affects of different types of athletic tape on dynamic balance. Also, the participants only performed 20 minutes of walking as the physical activity. This amount of time and intensity does not represent the current levels athletes are exposed to in a game nor practice. Future research should use more rigorous activities for a longer period of time.

Conclusions

The use of Coach™ Tape and PowerTape™ in the present study did cause an increase in sway velocity for the single leg stance, eyes closed assessment when compared to the no ankle taping condition. However, there was no difference in the ankle support conditions for the other three assessments. These findings indicate that ankle taping with both PowerTape™ and Coach™ tape may have a negative effect on single leg


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balance, but do not influence double leg balance. There is a difference in balance between the dominant and non-dominant leg, with the dominant leg having a significantly greater sway velocity. This may be due to the different demands placed on the different legs, and may help explain the increase of injuries to the dominant extremity. Future research should continue to examine differences between the dominant and non-dominant extremity.

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Ashton-Miller, J.A., Ottaviani, R.A., Hutchinson, C., & Wojtys, E.M. (1996). What best protects the inverted weightbearing ankle against further inversion? Evertor muscle strength compares favorably with shoe height, athletic tape, and three orthoses. American Journal of Sports Medicine, 24, 800-809.

Bennell, K.L., & Goldie, P.A. (1994). The differential effects of external ankle support on postural control. Journal of Orthopaedic and Sports Physical Therapy, 20, 287-295.

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Ekstrand, J., & Gillquist, J. (1983). Soccer injuries and their mechanism: a prospective study. Medicine and Science in Sports and Exercise, 15, 267-270.

Fox, J., Docherty, C.L., Schrader, J., & Applegate, T. (2008). Eccentric plantar-flexor torque deficits in participants with functional ankle instability. Journal of Athletic Training, 43(1), 51-54.

Karlsson, J., & Andreasson, G.O. (1992). The effect of external ankle support in chronic lateral ankle joint instability. American Journal of Sports Medicine, 20, 257-261.

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McGuine, T.A., Greene, J.J., Best, T., & Leverson, G. (2000). Balance as a predictor of ankle injuries in high school basketball players. Clinical Journal of Sports Medicine, 10 (4), 239-244.

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Paris, D.L. (1992). The effects of Swede-O, New Cross, and McDavid ankle braces and adhesive ankle taping on speed, balance, agility, and vertical jump. Journal of Athletic Training, 27, 253-256.

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Stephens, T.M., Lawson, B.R., DeVoe, D.E., & Reiser, R.F. (2007). Gender and bilateral differences in single-leg countermovement jump performance with comparison to a double-leg jump. Journal of Applied Biomechanics, 23, 190-202.

Ubell, M.L., Boylan, J.P., Ashton-Miller, J.A., & Wojtys, E.M. (2003). The effect of ankle braces on the prevention of dynamic forced inversion. American Journal of Sports Medicine, 31(6), 935-940.

Wilkerson, G.B. (2002). Biomechanical and neuromuscular effects of ankle taping and bracing. Journal of Athletic Training, 37 (4), 436-445.

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effects of ankle taping on single and double leg balance

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