Ayak bileği yaralanmalarından sonra sporcularda Aircast ortez ve elastik bandaj kullanımının fiziksel performans üzerine etkisi

Öz

Amaç: Bu çalışma ayak bileği yaralanması olan sporcularda Aircast® ortez ve elastik bandaj uygulamasının fiziksel performans üzerine etkisini değerlendirmek amacıyla yapılmıştır. Çalışma planı: Çalışmaya ayak bileği yaralanması geçirmiş 60 elit erkek futbolcu alındı. Olguların tümünün yaralanmış ayak bileğine sırasıyla herhangi bir ortez uygulamadan, elastik bandaj sarılarak ve Aircast® ortez takılarak, ayak bileğinin sagital ve frontal düzlemdeki hareket genişliği, tibialis anterior, tibialis posterior ve peroneal kaslar için bir maksimum tekrar testi, gastrosoleus için parmak ucunda yükselme testi, tek ve çift ayak dikey sıçrama testleri ve 10 basamak/sn testi uygulandı. Bulgular: Tek ayak dikey sıçrama, 10 basamak/sn testi ve parmak ucunda yükselme testlerinin sonuçları arasında istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Her iki dış destekle yapılan çift ayak dikey sıçrama test sonuçlarının hiçbir şey uygulanmayan ayak bileğine göre daha iyi olduğu saptandı (p<0.05). Dikey sıçrama testlerinde de Aircast® ortez ile alınan sonuçlar elastik bandaj uygulamasına göre anlamlı derecede üstündü (p<0.05). Aircast® ortezin inversiyon ve eversiyon hareketlerini de elastik bandaj uygulamasına oranla daha fazla kısıtladığı belirlendi (p<0.05). Çıkarımlar: Dış destekler ayak-ayak bileği eklem hareket açıklığını belirli oranlarda kısıtlamasına rağmen, bu kısıtlama sporcuların fiziksel formlarını olumsuz yönde etkilememiştir. Sporcuların yaralanma riskinin azaltılmasında, tekrarlı yaralanma oluşmasının önlenmesinde ve spora erken dönüşün sağlanmasında Aircast® ortezin elastik bandaja oranla daha etkili olduğu görüşüne varıldı.

Anahtar Kelimeler

• Aircast® ortez; ayak bileği; bağ yaralanması; elastik bandaj; fiziksel performans.

Effects of Aircast brace and elastic bandage on physical performance of athletes after ankle injuries

Öz

Objective: The aim of this study was to evaluate the effect of using Aircast® orthosis and elastic bandage application on the physical performance of athletes with ankle injuries.
Methods: The study included 60 elite male football players with ankle injuries. Ankle range of motion on the sagittal and frontal plane was measured. One maximum repetition test for the tibialis anterior, tibialis posterior and peroneal muscles; fingertip rise test, single- and double-feet vertical jump tests and 10-step/sec test for the gastrosoleus were performed. All tests were performed three times; without brace application, wrapped in elastic bandage and fitted with the Aircast® orthosis.
Results: There was no statistically significant difference between the test results of single-foot vertical jump, 10-step/sec and fingertip rise tests (p>0.05). Double-feet vertical jump test results with both exterior supports were better than the ankle without any support (p<0.05). Vertical jump test results were significantly higher with the Aircast® orthosis than elastic bandage (p<0.05). Inversion and eversion movements were restricted significantly more in the Aircast® orthosis than in the elastic bandage (p<0.05).
Conclusion: Although external supports restrict the foot-ankle range of motion in specific ratios, these restrictions did not adversely affect the athlete’s physical fitness. The Aircast® orthosis was more effective than the elastic bandage in reducing injury risk, preventing repetitive injuries and providing an early return to sports.

Anahtar Kelimeler

• Aircast brace
• ankle
• elastic bandage
• ligament injury
• physical performance

Kaynakça

1. Slaven EJ, Mathers J. Management of chronic ankle pain using joint mobilization and ASTYM® treatment: a case report. J Man Manip Ther 2011;19:108-12. CrossRef
2. Dubin JC, Comeau D, McClelland RI, Dubin RA, Ferrel E. Lateral and syndesmotic ankle sprain injuries: a narra- tive literature review. J Chiropr Med 2011;10:204-19.
3. Janssen KW, van Mechelen W, Verhagen EA. Ankles back in randomized controlled trial (ABrCt): braces ver- sus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial. BMC Musculoskelet Disord 2011;12:210. CrossRef
4. McGuine TA, Brooks A, Hetzel S. The effect of lace-up ankle braces on injury rates in high school basketball play- ers. Am J Sports Med 2011;39:1840-8. CrossRef
5. Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train 2011;46:133-41. CrossRef
6. Eren OT, Gür B, Öztürk I, Kuzgun Ü. Early mobilization versus cast in the treatment of lateral ankle sprains. [Article in Turkish] Acta Orthop Traumatol Turc 1999;33:197- 200.
7. Aşık M, Şen C, Dikici F, Taşer ÖF. Bröstrom-Gould pro- cedure for the treatment of chronic lateral ankle insta- bility. [Article in Turkish] Acta Orthop Traumatol Turc 2000;34:64-70.
8. Faraji E, Daneshmandi H, Atri AE, Onvani V, Namjoo FR. Effects of prefabricated ankle orthoses on postural stability in basketball players with chronic ankle instabil- ity. Asian J Sports Med 2012;3:274-8.

9. Fong DT, Chan YY, Mok KM, Yung PSh, Chan KM. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol 2009;1:14. CrossRef
10. Woods C1, Hawkins R, Hulse M, Hodson A. The Foot- ball Association Medical Research Programme: an audit of injuries in professional football: an analysis of ankle sprains. Br J Sports Med 2003;37:233-8. CrossRef
11. van Rijn RM, van Os AG, Kleinrensink GJ, Bernsen RM, Verhaar JA, Koes BW, et al. Supervised exercises for adults with acute lateral ankle sprain: a randomised controlled trial. Br J Gen Pract 2007;57:793-800.
12. Otman S, Demirel H, Sade A. Kas kuvveti ve değerlendirme yöntemleri. In: Otman S, Demirel H, Sade A, editors. Tedavi hareketlerinde temel değerlendirme prensipleri. Ankara: 1995. p. 73-143.
13. Otman S, Demirel H, Sade A. Normal eklem hareketle- rinin değerlendirilmesi. In: Otman S, Demirel H, Sade A editors. Tedavi hareketlerinde temel değerlendirme pren- sipleri. Ankara: 1995. p. 58-73.
14. De Carli A, Vadalà A, Ciardini R, Iorio R, Ferretti A. Spontaneous Achilles tendon ruptures treated with a mini-open technique: clinical and functional evaluation. J Sports Med Phys Fitness 2009;49:292-6.
15. Temfemo A, Hugues J, Chardon K, Mandengue SH, Ah- maidi S. Relationship between vertical jumping perfor- mance and anthropometric characteristics during growth in boys and girls. Eur J Pediatr 2009;168:457-64. CrossRef
16. Ergun N, Baltacı G. Sporcunun değerlendirilmesi. In: Er- gun N, Baltacı G, editors. Spor yaralanmalarında fizyoter- api ve rehabilitasyon prensipleri. Ankara: 1997. p. 19-119.
17. Lee WC1, Kobayashi T, Choy BT, Leung AK. Com- parison of custom-moulded ankle orthosis with hinged joints and off-the-shelf ankle braces in preventing ankle sprain in lateral cutting movements. Prosthet Orthot Int 2012;36:190-5. CrossRef
18. Beynnon BD, Renström PA, Alosa DM, Baumhauer JF, Vacek PM. Ankle ligament injury risk factors: a prospective study of college athletes. J Orthop Res 2001;19:213-20.
19. Waterman BR, Owens BD, Davey S, Zacchilli MA, Bel- mont PJ Jr. The epidemiology of ankle sprains in the Unit- ed States. J Bone Joint Surg Am 2010;92:2279-84. CrossRef
20. Kofotolis N, Kellis E. Ankle sprain injuries: a 2-year pro- spective cohort study in female Greek professional basket- ball players. J Athl Train 2007;42:388-94.
21. McGuine TA, Greene JJ, Best T, Leverson G. Balance as a predictor of ankle injuries in high school basketball play- ers. Clin J Sport Med 2000;10:239-44. CrossRef
22. Olmsted LC, Vela LI, Denegar CR, Hertel J. Prophylactic Ankle Taping and Bracing: A Numbers-Needed-to-Treat and Cost-Benefit Analysis. J Athl Train 2004;39:95-100.
23. Beynnon BD, Murphy DF, Alosa DM. Predictive Factors for Lateral Ankle Sprains: A Literature Review. J Athl Train 2002;37:376-80.
24. Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med 2005;39:324-9. CrossRef
25. Krosshaug T, Andersen TE, Olsen OE, Myklebust G, Bahr R. Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities. Br J Sports Med 2005;39:330-9. CrossRef
26. Gravlee JR, Van Durme DJ. Braces and splints for muscu- loskeletal conditions. Am Fam Physician 2007;75:342-8.
27. Ambegaonkar JP, Redmond CJ, Winter C, Cortes N, Am- begaonkar SJ, Thompson B, et al. Ankle stabilizers affect agility but not vertical jump or dynamic balance perfor- mance. Foot Ankle Spec 2011;4:354-60. CrossRef
28. Ozer D, Senbursa G, Baltaci G, Hayran M. The effect on neuromuscular stability, performance, multi-joint coordi- nation and proprioception of barefoot, taping or preventa- tive bracing. Foot (Edinb) 2009;19:205-10. CrossRef
29. Verhagen EA, Bay K. Optimising ankle sprain prevention: a critical review and practical appraisal of the literature. Br J Sports Med 2010;44:1082-8. CrossRef