The comparative efficacy of kinesiology tape vs prehabilitation training on dynamic stability

in uninjured participants: A pilot study.

Summary

The epidemiology and aetiology of ankle sprain injuries have received considerable

attention in the literature, but the problem persists. Injury prevention strategies typically

include multi-modal exercise interventions. The development of kinesiology tape offers an

alternate means of improving joint stability, without the movement restriction commonly

associated with traditional taping methods. Our results show that both a 6-week

proprioception training intervention and prolonged kinesiology tape application significantly

improved single leg stance performance relative to a control group (P = 0.02). Despite the

equivalence in the magnitude of change in balance, the mechanism was different with the

kinesiology tape improving balance in the anterio-posterior plane and the training

programme improving medio-lateral stability. Our findings have implications for the

selection of prehabilitation strategies in subjects with no prior history of ankle instability.

Author Information

Claire Farquharson, Matt Greig PhD

Sports Injuries Research Group, Dept of Sport and Physical Activity,

Edge Hill University, St Helens Road, Ormskirk, Lancs, L39 4QP, United Kingdom

Corresponding Author: Dr Matt Greig

Tel: (+44) 01695 584848, Fax: (+44) 01695 584812, Email: matt.greig@edgehill.ac.uk

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The comparative efficacy of kinesiology tape vs prehabilitation training on dynamic stability

in uninjured participants: A pilot study.

Abstract

Background: The epidemiology and aetiology of ankle sprain injuries has been well

documented. Traditionally multi-modal exercise interventions have formed the basis of

prehabilitation, however more contemporary developments in the applications of

kinesiology tape warrant consideration. The aim of the present study was to compare the

efficacy of a proprioception training programme and kinesiology tape application on

measures of ankle joint stability. Methods: 48 recreationally active Sports Therapy

students, with no ankle joint injury history or instability were randomly assigned within

three experimental conditions: a 6 week (12 sessions) training programme comprising

rehabilitative exercises (R), kinesiology tape (KT) application using a joint stabilisation

technique across the talocrural joint, and a control (C) condition. Overall (OSI) and

directional medio-lateral (MLI) and anterio-posterior (API) stability indices were quantified

during an athletic single leg stance (ASLS) on the Biodex Stability System (BSS). Results:

Both the Rehabilitation (R) and Kinesiology Tape (KT) interventions produced a significant (P

= 0.02) improvement in OSI. Whilst the magnitude of improvement was equivalent

between interventions, the mechanism was different. The R group achieved the reduction

in OSI primarily through a reduction in MLI, whereas in the KT group the improvement in OSI

was primarily attributable to a reduction in API. This alteration in balance strategy as a

result of the interventions has implications for injury prevention. Conclusions: Over 6

weeks, both a training program and prolonged kinesiology tape application produced

equivalent improvements in single legged balance performance. The interventions resulted

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in altered balance strategies, with the reduction in inversion-eversion seen in the

Rehabilitation group preferable for the prevention of ankle sprain injury.

Key Words: injury prevention, ankle, proprioception, taping

INTRODUCTION

The epidemiology and aetiology of ankle sprain injuries in sport have been well described,

and the high rate of reoccurrence and potential development of functional ankle instability

has led to several review papers on prevention strategies (1,2). The development of

prehabilitative strategies has typically focused on either strength and balance training (3,4)

or traditional taping (rigid tape) and bracing methods to assist joint stability and

proprioception (5,6). However researchers and clinicians universally agree to the poor

efficacy in application over time, and the potential influence of joint ROM restriction on

athletic performance (7,8). The development of elastic adhesive tape purported to mimic

human skin is more commonly known as kinesiology taping (KT) various benefits and

potential mechanisms are theorised, dependent on application and has provided the basis

for its use as an alternate prevention strategy (9). The mechanistic rationale for enhanced

ankle proprioception to assist joint stability is in the capacity of KT to stimulate joint and

muscle receptors, either directly through joint correction applications to the talocrural joint,

or indirectly through peroneal muscle facilitation (10,11).

The outcome measure in dynamic stability was used to investigate with the suggested

physiological mechanisms associated with KT in comparison to the application of a

proprioceptive, strength and stability training programme (PSSTP). These interventions are

widely used within the clinical setting to assist functional and dynamic stability via enhanced

joint position sense, peroneal reaction strength, reaction time and postural sway (12-14).

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Despite commonality in the positive results of such intervention programmes, there is a lack

of consensus among studies with regards to the content, design and frequency (15-17).

Our aim was to evaluate the difference between kinesiology taping in comparison to a

traditional six week PSSTP on dynamic stability. Interventions are likely to be most

successful where the participant has an inherent need, and as such many ankle intervention

studies have considered participants with ankle instability. Our focus is in the prevention

rather than management of ankle joint sprain injuries, and therefore we applied these

interventions in a population with no history of previous ankle joint injury or instability. We

hypothesised that both kinesiology tape and PSSTP would improve performance on an

athletic single leg stance (ASLS) in comparison to a control condition on a Biodex Stability

System (BSS). With limited previous research we have no rationale to suggest which of the

interventions would be optimal.

MATERIALS AND METHODS

Participants were selected from an undergraduate cohort of Sports Therapy students (n =

180). A total of 48 participants completed the study, randomly sub-divided into three

experimental groups (C, KT, R) of 16 participants (9 male, 7 female). This process is

summarised in Figure 1. The sampling of participants into the conditional groups was based

upon baseline performance of the ASLS, to ensure equivalence between groups pre-

intervention in gender distribution and base-line measures on dynamic stability.

** Insert Figure 1 near here **

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Eligibility criteria was split into initial screening for relevant previous or current injuries and

medical conditions. All subjects were further assessed for eligibility through further health

screening and objective clinical tests or ligament laxity (anterior drawer and talar tilt). Any

current or previous history of lower limb or joint injuries in the last 12 months, neurological

conditions associated with visual or vestibular symptoms, skin allergies, medical conditions

that may alter ligament laxity and objectively any apparent laxity excluded the subject from

the study (18).

The dependent variables measured were overall stability index (OSI), and the component

directional indices in the medial/lateral index (MLI) and anterior/posterior (API) planes

during ASLS. All participants provided written informed consent in accordance with the

departmental ethical procedures, following the principles outlined in the Declaration of

Helsinki, and with research compliance recorded.

Experimental Design

The study employed a pre- and post-test design to quantify the influence of each 6 week

intervention. All subjects completed the ASLS on the BSS (Biodex Inc, Shirley, NY). The BSS

objectively assessed dynamic stability via multiaxial movements on a moveable balance

platform. Subjects were asked to stand on their dominant leg, pre-determined through the

ball kick test, subjects completed three trials of kicking a ball and the leg used to kick the

ball was recorded as the dominant leg. Both arms were folded with the non-weight bearing

limb knee at a comfortable knee flexion position with 0° hip flexion, 30 second interval at

level 2, deemed an appropriate unstable surface for healthy subjects (19-21) . We

quantified each trial for overall stability index (OSI), and the component directional balance

indices in the medial/lateral (MLI) and anterior/posterior (API).

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A minimum of four familiarisation trials were conducted by each participant prior to base

line evaluation to allow an overview of the testing procedure and to reduce the learning

effect. Subsequently, test sessions were completed immediately prior to the intervention

and on completion of the six week intervention protocol. The KT group were also tested

after the initial application of KT to identify immediate response. Before each test all

subjects completed a standardised warm up on the cycle ergometer prior (22).

Intervention

The KT group had a correction technique transversely applied, with a single “I” strip at 120%

of resting length centrally across the talocrural joint from posterior of medial and lateral

malleoli. KT was worn for 3 days after application, followed by 4 days without tape

application to reduce the risk of skin irritation or potential breakdown. This process was in

accordance with KT® application guidelines (9). The area was cleaned and prepared prior

to the application, with tape activation and removal procedures adhering to manufacturers

guidelines (9). This procedure was repeated each week for the duration of the intervention.

The R group attended a 20 minute multi-station PSSTP twice a week for 6 weeks (23). The

aim of the exercise program was to develop proprioception, strength and co-ordination of

the ankle joint complex, with a battery of exercises performed in a circuit. Each exercise

was completed over 60 sec, with a 1:1 work:rest ratio imposed on all exercises. The training

battery consisted of single leg stance on stable and mobile surfaces (to include exercise mat,

air pad, wobble boards, mini trampoline, aerobic step), single leg abduction with theraband,

and walking along a balance beam. Modifications were made every 2 weeks to ensure

progression in the exercise modality through increased duration and reduced work:rest

ratio.

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The same daily activity was performed by the Control group, who did not attend the

proprioception sessions or wear any form of corrective taping for the duration of the

interventions. All procedures were performed by the same therapist and all groups were

advised to continue with daily activity throughout the six week period.

Statistical Analysis

A 3 (condition: KT, R, C) x 2 (time: pre, post) repeated measures ANOVA was conducted for

OSI, API and MLI, with statistical significance set at P ≤ .05. All measures are reported as

mean ± standard deviation. All statistical analysis was completed using PASW Statistics

Editor 18.0 for windows (SPSS Inc., Chicago, USA).

RESULTS

Figure 2 summarises the influence of each intervention over the 6 week period on the task

outcome measure of OSI. With equivalence between groups established at baseline,

ANOVA revealed a significant main effect for time (P = 0.05) and a significant interaction

effect (P = 0.04). Post-Hoc testing revealed that the post-intervention score for OSI was

significantly enhanced in both the KT (Pre: 2.69 ± 0.83, Post: 1.52 ± 0.62; P = 0.02) and R

(Pre: 2.62 ± 0.70, Post: 1.38 ± 0.58; P = 0.02) groups. There was no significant change in OSI

for the C group. Post-intervention, both KT and R significantly out-performed C (P = 0.02),

but the interventions were not significantly different to each other.

** Insert Figure 2 near here **

The same pattern was observed in the medio-lateral stability index (Figure 3), with a

significant main effect for both time and interaction (P = 0.05). As with OSI, the post-

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intervention score for MLI was significantly better in both the KT (Pre: 1.76 ± 0.46, Post: 0.46

± 0.27; P = 0.03) and R (Pre: 1.81 ± 0.52, Post: 0.98 ± 0.28; P = 0.03) groups. No change was

observed in the C group. The post-intervention score in the KT group was significantly

better than the R group, which were themselves significantly better than the C group (P =

0.05).

** Insert Figure 3 near here **

The anterio-posterior stability index displayed the reverse trend (Figure 4), with post-

intervention performance better in the R group than in either KT or C (P = 0.05). Again post-

intervention score improved for both KT (Pre: 1.72 ± 0.42, Post: 1.06 ± 0.37; P = 0.03) and R

(Pre: 1.70 ± 0.54, Post: 0.63 ± 0.26; P = 0.03) groups, with no change observed in the C

group.

** Insert Figure 4 near here **

DISCUSSION

Our aim was to evaluate the efficacy of two prehabilitative intervention strategies on ASLS, a

marker of ankle joint stability within this pilot study. We used healthy subjects with no

history of joint instability, and in this respect our pilot study offers a comparison of

strategies to prevent ankle joint sprain injury, with clinical relevance given the epidemiology

of ankle sprains.

The comparison between kinesiology tape and a PSSTP training programme represents both

the logistical challenges to the recreational athlete, and the increasing popularity of such

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tapes. To demonstrate equivalence, or even to inform decision on the most effective

intervention strategy, has the potential to enhance injury prevention choices for those

athletes without the medical support typically associated with the elite level of

performance. Whilst not an elite population, our findings would also inform practice for the

sports rehabilitator, where the application of kinesiology tape might be considered far less

labour intensive than a prehabilitation programme.

We developed our intervention groups to ensure equivalence between groups at baseline.

Task performance outcome on the ASLS was observed to improve significantly after both

active interventions, with no change in the control group. A six week intervention was

therefore effective in significantly reducing Overall Stability Index, indicative of improved

dynamic stability. There was no difference between the interventions however, with the

kinesiology tape matching the benefits of the PSSTP. Intuitively the training programme

would provide a more global improvement compared with the localised tape application.

Our training program was designed to develop adaptation both locally (through potential

effects in proprioception, strength, joint position sense, postural sway and muscle reaction

time) and centrally (potentially via stimulation of the subcutaneous receptors that influence

the neuromuscular control of the whole kinetic chain through spinal reflex stimulation,

cognitive programming and brainstem activity) (1,14,24,25). In comparison, the kinesiology

tape application was designed to manipulate a mechanistic response in the somatosensory

stimulation, via potential effects in the afferent input of KT to assist joint and ligament

stability (25). A three day application, repeated over six weeks, was designed to achieve

stimulation of the receptors through functional daily activity. The stimulation via constant

tissue shearing, vibrating and buffering is considered to create a tactile and thermal effect to

enhance proprioception of the joint and surrounding muscles (26). In our study both

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interventions produced an equivalent positive enhancement of dynamic balance

performance, with implications for enhanced joint stability on injury risk.

The ASLS we used represents a means of quantifying performance on a multi-axial unstable

platform apparatus similar to wobble-boards that form part of many intervention and

prehabilitation programmes. The unstable system reacts to the movement of the

participant such that multi-axial stress is placed simultaneously on both plantar-dorsi flexion

and inversion-eversion. This multi-directional mechanical demand replicates the

mechanisms of that can induce ankle complex injury, and the balance index is a function of

performance in both planes. In this respect the two interventions differed, with the training

group displaying enhanced task performance primarily through a reduction in the medio-

lateral index, whereas the KT resulted in enhanced anterio-posterior performance. The

stabilometer task provides a measure of the deviation of a surface which is free to pivot

about a central axis. Better performance, and a lower stability index, is indicative of less

platform deviation. The training group therefore enhanced their overall stability index by

reducing platform deviation in the medio-lateral plane, and the KT group by restricting

anterio-posterior movement. This difference in balance strategy has potential implications

for injury prevention, despite the same overall improvement in balance performance. The

mechanism of ankle sprain injury has traditionally been considered to include both plantar

flexion and inversion (27), but more recently inversion has been considered as the primary

risk factor with injuries observed in the absence of plantar flexion (28). In this respect the

rehabilitation program, which resulted in reduced movement in the inversion-eversion

plane must be considered superior for potential injury prevention. The KT created a

reduction in plantar-dorsi flexion during the task, perhaps as a direct result of the taping

method applied across the talocrural joint from posterior of medial and lateral malleoli. The

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tape therefore acts to stimulate the medial and lateral ligamentous structures, to stabilise

the joint. The afferent feedback provided by the tape (7) is therefore in the medio-lateral

plane, and potentially therefore encourages the participant to work with the tape through

additional neuromuscular stimulation, and develop a balance strategy characterised by

movement in that plane. It should be noted that performance did improve, but the balance

strategy employed is likely to have implications for subsequent injury risk (29-31).

Alternatively, developing an ankle strategy in the medio-lateral plane might protect the

participant from injury by a gradual process of strength adaptation in inversion and

eversion. It should also be considered that local modifications made in the postural control

pattern are likely to produce compensatory corrections elsewhere to maintain stability (32-

35).

The process of dynamic balance is complex and multi-factorial, including both static

(ligaments, articular surfaces) and dynamic (neuromuscular system) components (32). The

aetiological risk factors associated with joint sprain injury incidence and severity include

impaired proprioception and postural stability (36). The muscular responses which act to

protect joint stability should be further investigated using electromyography, and the

compensatory contributions of hip and knee strategies should also be considered. The use

of a healthy group in our study has implications for the extrapolation of our results, and it is

possible that those with chronic ankle instability would perform differently in response to

each intervention (37). Our aims were to evaluate, which informed our choice of

proprioceptive program and taping strategy, was in the prevention (rather than

management) of injury.

CONCLUSION

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A six week intervention comprising either kinesiology tape application across the talocrural

joint or a proprioceptive training program both improved performance on a ASLS on the

BSS. Each intervention produced an equivalent improvement in performance relative to a

control group. However the mechanisms of improvement altered between the intervention

modalities, with the training program creating a balance strategy characterised by stability

in inversion-eversion, and the tape more reliant on a plantar-dorsi flexion strategy. In this

respect the training program might have longer term benefits with ankle joint sprain

aetiology highlighting inversion of the ankle as the primary factor. Our study was conducted

on a healthy group with no history of joint instability or injury, and as such the results

should not be generalised toward injury management and may warrant future randomised

controlled trials to evaluate injury prevention with injury incidence outcome measure.

REFERENCES

1. Thacker SB, Stroup DF, Branche CM, Gilchrist J, Goodman RA & Weitmann E. The

prevention of ankle sprains in sports. A systematic review of the literature. Am J

Sports Med. 1999;27(6):753-60.

2. Fong DT, Hong Y, Chan LK, Yung PS, Chan KM. A systematic review on ankle sprains

in sports. Sports Med. 2012;37(1):73-94.

3. Alex JY, Lwei Hsiu L. Twelve week biomechanical ankle platform system training

postural stability and ankle proprioception in subjects with unilateral ankle

instability. Clin Biomech. 2008;23(6):1065-1072.

4. Blackburn JT, Guskiewicz KM, Petschauer M, Prentice W. Balance and joint

stability: the relative contributions of proprioception and muscular strength. J

Sport Rehabil. 2000;9:315-328.

12

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

5. Cloak R, Galloway S & Wyon M. The effect of ankle bracing on peak mediolateral

ground reaction force during cutting maneuvers in collegiate male basketball

players. J Strength Cond Res. 2010;24(9):29-33.

6. Spanos S, Brunswic M, Billis E. The effect of taping on the proprioception of the

ankle in a non weight bearing position, amongst injured athletes. The Foot.

2008;18(2):25-33.

7. Miralles I, Monterde S, Salvador M, Salvat I, Fernandex-Ballart J, Becerio J. Ankle

taping can improve proprioception in healthy volunteers. Foot Ankle Int.

2010;31(12):1099-1106.

8. Raymond J, Nicholson LL, Hiller CE, Refshauge K. The effect of ankle taping or

bracing on proprioception in functional ankle instability; A systematic review and

meta analysis. J Sci Med Sport. 2012;15:386-392.

9. Kase K. Kinesio #1 in Elastic Therapeutic Taping. KT1 Workbook. KinesioTaping

Association International; 2008.

10. Halseth T, McChesney JW, DeBilso M, Vaughn, Lien J. The effects of kinesiotaping

on proprioception at the ankle. J Sports Sci Med. 2004;3:1-7.

11. Briem K, Eythorsdottir H, Magnusdottir RG. Palmarsson R, Runarsdottir T,

Sveinsson T. Effects of kinesiotape compared with non elastic sports tape and the

untapped ankle during a sudden inversion perturbation in male athletes. J Orthop

Sports Phys Ther. 2011; 41(5):328-335.

12. Sodermann K, Werner S, Pietila T, Engstrom B, Alfredson H. Balance board training:

prevention of traumatic injuries of the lower extremities in female soccer players?

A prospective randomised intervention study. Knee Surg Sports Traumatol

Arthrosc. 2010;8:356-363.

13

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

13. Hess D, Joyce C, Arnold B, Gansneder B. Effect of a 4 week agility-training program

on postural sway in functionally unstable ankle. J Sport Rehabil. 2001;10:24-35.

14. McKeon PO, Hertel J. Systematic Review of postural control and lateral ankle

instability, Part II: Is balance training clinically effective? J Athl Train.

2008;43(3):305-315.

15. Wester JU, Jespersen SM, Nielsen KD, Neumann L. Wobble board training after

partial sprains of the lateral ligaments of the ankle: a prospective randomised

study. J Orthop Sports Phys Ther. 1996;23:332-336.

16. Osborne MD, Chou L-shan, Laskowski ER, Smith H, Kaufman KR. The effect of ankle

disk training on muscle reaction time in subjects with a history of ankle sprain. Am

J Sports Med. 2001;29(5):627-632.

17. Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4 week comprehensive

rehabilitation program on postural control and lower extremity function in

individuals with chronic ankle instability. J Orthop Sports Phys Ther.

2007;37(6):303-311.

18. Beynnon BD, Murphy DF, Alosa DM. Predictive factors for lateral ankle sprains: A

literature review. J Athl Train. 2002;37(4):376-390.

19. Rein S, Fabien T, Zwipp H, Rammell S, Weindell S Postural control and functional

ankle stability in professional and amateur dancers. Clinical Neurophysiology.

2011;122(8):1602-1610

20. Akhbari B, Takamjani IE, Salavati M, Ali Sangari M A 4 week biodex stability

exercise program improved ankle musculature onset, peak latency and balance

measures in functionally unstable ankles. Phys Ther in Sport.2007;8(3):117 -129

14

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

21. Testerman RV, Griend C Evaluation of ankle instability using the Biodex Stability

System Foot and Ankle Int. 1999;20(5):317-321

22. Bradley PS, Olsen PD, Portas MD. The effect of static, ballistic and proprioceptive

neuromuscular facilitation on vertical jump performance. J Strength Cond Res.

2007; 7(1):223-226.

23. Eils E, Rosenbaum D. A multi-station proprioceptive exercise program in patients

with ankle instability. Med Sci Sports Exerc. 2001;33(12):1991-1998.

24. Morrissey D. Proprioceptive shoulder taping. J Bodyw Mov Ther. 2000;4:189-194.

25. Lephart SM, Pinicevero DM, Giraido JL, Fu FH. The role of proprioception in the

management and rehabilitation of athletic injuries. Am J Sports Med.

1997;25(1):130-137.

26. Simoneau GG, Degner RM, Kramper CA, Kittleson KH. Changes in ankle joint

proprioception resulting from strips of athletic tape applied over the skin. J Athl

Train. 1997; 32(2):141-147.

27. Greig M, Walker-Johnson C. The influence of soccer-specific fatigue on functional

stability. Phys Ther Sport. 2007;8:185-190.

28. Fong DTP, Ha SCW, Mok KM, Chan CWL, Chan KM. Kinematic analysis of ankle

inversion ligamentous sprain injuries in sports: five cases from televised tennis

competitions. Am J Sports Med. 2012;40:2627-2632.

29. Greig M, McNaughton L Soccer-specific fatigue descreases reactive postural

control with implications for ankle sprain injury. Res Sports Med 2014; 22:4: 368-

379.

30. Nakajima MA, Baldridge, C The effect of kinesio tape on vertical jump and dynamic

postural control. Int J Sports Phys Ther.2013;8(4):393-406

15

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

31. Bicici S, Karatas N, Baltaci G Effect of athletic taping and kinesiotaping on

measurements of functional performance in basketball players with chronic

inversion sprains. IJSPT. 2012;7(2):154-66

32. Adlerton AK, Moritz U, Moe-Nilssen R. Force plate and accelerometer measures

for evaluating the effect of muscle fatigue on postural control during one-legged

stance. Physiother Res Int. 2003;8(4):187-199.

33. Nunes GS, de Noronha M, Cunha, HS, Ruschel C, Borges NG Jr. Effect of kinesio

tape on jumping and balance in athletes: a crossover randomized controlled trial.

Strength Cond Res. 2013;Nov27(11): 3183-9

34. Fayson SD, Needle AR, Kaminski TW. The effects of ankle kinesio taping on ankle

stiffness and dynamic balance. Research in Sports Medicine. 2013;21:204-216

35. Briem K, Eythorsdottir H, Magnusdottir RG, Palmarsson R, Sveinsson T Effects of

kinesio tape compared to non elastic sports tape and the untaped ankle during

sudden inversion pertubation in male athletes. JOSPT. 2011;41(8): 621

36. Barrack RL, Skinner HB, Buckley SL. Proprioception in the anterior cruciate

deficeient knee. Am J Sports Med. 1989;17:1-6.

37. Bernier JN, Perrin DH. Effect of coordination training of proprioception of the

functionally unstable ankle. J Orthop Sports Phys Ther. 1998;27:264-275.

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LIST OF FIGURES

Figure 1. Participant recruitment process.

Figure 2. The influence of a 6 week intervention on overall stability index (OSI). * Denotes

significant difference between pre- and post-intervention measures. ** Denotes

significant difference between intervention modalities.

Figure 3. The influence of a 6 week intervention on the medio-lateral component (MLI).

Figure 4. The influence of a 6 week intervention on the anterio-posterior component (API).

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KT C R0.0

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Pre Post

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** **

KT C R0.0

0.2

0.4

0.6

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19

1

2

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5

KT C R0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

Pre Post

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20

1