EFFECTS OF EXTERNAL ANKLE SUPPORTS ON FUNCTIONAL
PERFORMANCE IN DIVISION II FEMALE SOCCER ATHLETES

A THESIS
Submitted to the Faculty of the School of Graduate Studies
and Research
of
California University of Pennsylvania in partial
fulfillment of the requirements for the degree of
Master of Science

by
Lysha Draskovic

Research Advisor, Dr. Edwin Zuchelkowski
California, Pennsylvania
2012

iii

ACKNOWLEDGEMENTS
“Success is not final, failure is not fatal, it is the
courage to continue that counts.”
Due to the many obstacles thrown my way I felt this
quote summed up the past year for me and my experiences
here at California University of Pennsylvania. First I
would like to take the time to thank my research advisor
Dr. Zuchelkowski. I could not have completed this without
your help and guidance. I would also like to thank Dr. Tom
West for all his help as well; you have been a constant
support for my work. I would also like to thank the rest of
my thesis committee, Dr. DiCesaro and Dr. Hess, for their
continued support and statistical guidance throughout this
process. I could not have done this without you.
I would like to thank my parents for their support
from a distance and giving me the emotional support I
needed throughout this year. I could not have done this
without you both.
I would like to thank the Cal U women’s soccer team
and the 16 girls that helped me finish my thesis. You were
all very helpful with your time and willingness to help and
for that I am very grateful.

iv
TABLE OF CONTENTS
Page
SIGNATURE PAGE

. . . . . . . . . . . . . . . ii

AKNOWLEDGEMENTS . . . . . . . . . . . . . . . iii
TABLE OF CONTENTS
LIST OF TABLES
INTRODUCTION
METHODS

. . . . . . . . . . . . . . iv

. . . . . . . . . . . . . . . vii

. . . . . . . . . . . . . . . . 1

. . . . . . . . . . . . . . . . . . 5

Research Design
Subjects

. . . . . . . . . . . . . . 5

. . . . . . . . . . . . . . . . . 6

Instruments . . . . . . . . . . . . . . . 7
Support Conditions

. . . . . . . . . . . . 7

Data Collection Sheet . . . . . . . . . . . 7
Testing Instruments . . . . . . . . . . . . 7
Procedures

. . . . . . . . . . . . . . . . 8

Hypothesis

. . . . . . . . . . . . . . . . 11

Data Analysis
RESULTS

. . . . . . . . . . . . . . . 12

. . . . . . . . . . . . . . . . . . 13

Demographic Information
Hypothesis Testing

. . . . . . . . . . . 13

. . . . . . . . . . . . . 14

Additional Findings . . . . . . . . . . . . . 16
DISCUSSION . . . . . . . . . . . . . . . . . 18
Discussion of Results . . . . . . . . . . . . 18
Conclusions . . . . . . . . . . . . . . . . 22

v
Recommendations. . . . . . . . . . . . . . . 23
REFERENCES . . . . . . . . . . . . . . . . . 25
APPENDICES . . . . . . . . . . . . . . . . . 29
APPENDIX A: Review of Literature

. . . . . . . . 30

Introduction . . . . . . . . . . . . . . . . 31
Prophylactic Devices

. . . .

. . . . . . . . 33

Taping . . . . . . . . . . . . . . . . . 33
Bracing

. . . . . . . . . . . . . . . . 35

DonJoy Ankle Ligament Protector

. . . . 35

AirCast Sport Stirrup . . . . . . . . . 35
Active Ankle . . . .
Swede-O

. . . . . . . . . 36

. . . . . . . . . . . . . . . 36

Malleoloc
ASO Lace-up

. . . . . . . . . . . . . . 37
. . . . . . . . . . . . . 38

Ankle Injury Rate and Mechanisms

. . . . . . 39

Prevention of Ankle Injuries . . . . . . 40
Effects of External Ankle Supports on
Performance
Agility

. . . . . . . . . . . . 41

. . . . . . . . . . . . . . . . 42

Sprint Speed . . . . . . . . . . . . . . 42
Vertical Jump Height

. . . . . . . . . . 43

Vertical Ground Reaction Force . . . . . . 43
Range of Motion . . . . . . . . . . . . . 44
Kicking Biomechanics . . . . . . . . . . . . 46

vi
Summary

. . . . . . . . . . . . . . . . . . 47

APPENDIX B: The Problem . . . . . . . . . . . . 48
Statement of the Problem . . . . . . . . . . . 49
Definition of Terms . . . . . . . . . . . . . 49
Basic Assumptions . . . . . . . . . . . . . . 50
Limitations of the Study . . . . . . . . . . . 51
Significance of the Study

. . . . . . . . . . 51

APPENDIX C: Additional Methods .

. . . . . . . . 52

Demographic Information Form (C1)

. . . . . . . 53

Informed Consent Form (C2) . . . . . . . . . . 55
IRB: Institutional Review Board (C3) . . . . . . 60
Individual Data Collection Sheet (C4) . . . . 74
Figures for Target (C5)

. . . . . . . . . . . 76

REFERENCES . . . . . . . . . . . . . . . . . 80
ABSTRACT

. . . . . . . . . . . . . . . . . 84

vii

LIST OF TABLES

Table

Title

Page

Demographic Information

Mean Scores for Distance and Accuracy . . . . 15

. . . . . . . . . 14

INTRODUCTION

Ankle injuries are among the most common injury in
sports today, comprising forty-five percent of all sports
injuries.1 Many choices are available to athletes when
dealing with ankle injuries, such as taping and bracing.
The literature clearly supports that external ankle
supports mechanically limit range of motion (ROM). Most
braces limit motion of the subtalar joint, limiting
inversion and eversion but allowing for full talocrural
joint motion. Whether these external ankle supports affect
performance is still in question because of conflicting
research.
Inconsistent data exists as to whether external ankle
supports inhibit functional performance. From an injury
standpoint, external ankle supports decrease ROM and
therefore decrease the risk of injury. However, if external
ankle supports decrease athletic performance, as some
studies suggest2-6, does this risk outweigh the benefits of
injury prevention? A variety of ankle supports exist.

This

study will observe the use of tape versus a specific laceup brace. While the literature regarding functional
performance in athletes can be used across the board for

2
all different types of athletes, there is minimal
literature that can be used for any specific sport.
A number of researchers have examined the effects of
different types of tape when taping an ankle3,7-9, taping
techniques2,7-14 and different braces2,7,11,12,15-23 on various
measures of performance. While most researchers have looked
at explosive performance such as ground reaction forces,16,17
vertical jump height,24-28 sprint speed,25-28 and agility,23,2527

kicking for distance or accuracy in soccer has yet to be

studied. MacKean et al5 looked at the effects of tape,
Swede-O, Active Ankle, and Aircast Sport Stirrup on skills
specific to basketball. The subjects were tested on
vertical jump height, jump shot, sprint drill, and
submaximal treadmill run. Vertical jump height, the sprint
drill, and the submaximal run could potentially be
comparable to soccer athletes. Wiley et al29 looked at the
effects of a Malleoloc ankle brace on a figure-eight course
and concluded that this brace did not affect performance.
However, the researcher did not specify the criteria for
subject selection in this study, therefore decreasing the
ability to compare results specifically to soccer athletes.
Researchers have also looked at the effects external
ankle supports have on range of motion,11-14,22,29,30-32
strength,24,31,33 ankle stiffness,19 and balance.18 It is

3
apparent that bracing and taping the ankle decrease range
of motion. Paris et al22 looked at the effects of taping and
bracing on ROM initially after application and after
activity. The brace conditions showed a longer effect of
decreasing ankle ROM than tape. Martin et al11 also looked
at the effectiveness of brace conditions versus tape
conditions before and after exercise and supported the same
conclusion. The difference between these two studies is
Paris et al22 used the Swede-O lace-up and Subtalar Support
ankle braces and Martin et al11 used the Swede-O lace-up and
Aircast Sport Stirrup. The direct effect of ankle supports
on soccer performance is still not understood.
Enough evidence exists to support a potential for
taping and bracing to both positively and negatively affect
performance. How support conditions affect specific skills
in soccer is unknown. Being able to kick accurately and for
distance are important to soccer athletes. The results of
this study will help determine and clarify whether ankle
supports affect kicking performance. This is useful
information for clinicians and other health care
professionals, specifically certified athletic trainers,
and the evidence will determine if they should encourage
the use of external ankle supports for athletes.
Additionally the results will identify if one support type

4
should be preferred over another. It is important to have
this information because previous research has shown much
controversy about the potential effects of taping and
bracing on performance. Also, the research has not examined
soccer skills specifically, which may show differing
results from other measures of performance. The purpose of
this study is to examine the effects of external ankle
supports on the distance and accuracy a soccer ball is
kicked in Division II soccer athletes.

METHODS

The primary purpose of this study was to examine the
effect of an Ankle Stabilizing Orthosis (ASO®) lace-up ankle
brace versus taping on distance and accuracy a soccer ball
is kicked in collegiate soccer athletes. This section
includes the following subsections:

Research Design,

Subjects, Instruments, Procedures, Hypotheses, and Data
Analysis.

Research Design

This research is a quasi-experimental, within
subjects, repeated measures design (on condition). The
independent variable in this study was support condition.
This condition had three levels: taping, ASO® lace-up ankle
brace, and control (no support). The dependent variables
were (1) the distance a soccer ball is kicked as measured
by a measuring wheel on a turf soccer field, and (2) the
accuracy as measured by the distance from a bulls-eye a
soccer ball is kicked from a distance of 18.29 meters (20
yards). A strength of this study is the use of a within-

6
subjects design so that the subjects act as their own
control. To increase reliability, the researcher was the
only one to fit the ankle braces and tape the subjects, and
subjects wore the same cleats for each testing day. A
sample of convenience of NCAA Division II female soccer
athletes was used, limiting the generalization of this
study.

Subjects

The subjects that were used for this study were
sixteen volunteer female student-athletes from California
University of Pennsylvania women’s varsity soccer team who
were actively participating with the team. Subjects filled
out a Demographic Information Form (Appendix C1) concerning
basic demographic information. Subjects were excluded if
they were currently unable to participate on the team.
Each subject was required to meet with the researcher
on two different days. The first day was used to fill out
an Informed Consent Form (Appendix C2) and Demographic
Information Form (Appendix C1) prior to participation in
the study. The second day was used in order to collect
data. The study was approved by the Institutional Review
Board (Appendix C3) at California University of

7
Pennsylvania. Each participant’s identity remained
confidential and was not included in the study.

Instruments

Support Conditions
White, Johnson and JohnsonTM athletic tape was used to
tape the subjects’ ankles and an Ankle Stabilizing Orthosis®
(ASO®) lace up ankle brace was also used.

Data Collection Sheet
The individual data collection sheet (Appendix C4)
included each subject’s number to maintain confidentiality.
It also included the three support conditions for both
accuracy and distance testing with five trials for each.

Testing Instruments
In measuring distance, a 300-foot tape measure was
used. In measuring accuracy34, a target was constructed
using a plywood sheet measuring 243.5cm wide x 243.5cm (8ft
x 8ft) high. It was held in an upright position by a
posteriorly positioned frame of 5 x 10.2cm wood planks
(Figure 2). A screw was placed in the middle of the target
but was not fully inserted into the plywood, so that a hook

8
at the end of a tape measure could fit over the head of the
screw. A tape measure attached to the screw was used to
determine the distance from the center of the target to the
center of the mark left where the ball struck the target.
Sheets of white paper were placed over the board, which
were covered by sheets of carbon paper with the carbon side
in contact with the white paper (Figure 1, Appendix C5).
The sheets were secured in place using a staple gun. When
the soccer ball struck the carbon paper, it left a mark on
the underlying white paper. To allow for subsequent
measurements, a sheet of white paper containing a ball mark
was replaced with a new sheet of white paper and covered by
carbon paper. A data score sheet was used to record data
for each subject (Appendix C3).

Procedures

The subjects performed a warm up. A specific warm up
for this study was a dynamic warm up consisting of two laps
around a soccer field, side shuffle, carioca, hip cradle,
knee grabs, high knees, leg kicks, butt kicks, lateral
lunges, forward lunges, backward lunges, inch worm, A-skip,
and power skip.

9
Following the warm up, subjects were taped, fitted for
a brace or had no support on both ankles depending on what
support condition they were testing at that time. In
between each support condition, five minutes were allotted
for application, which also helped control for fatigue. The
order of the support conditions was counterbalanced among
the subjects. Support condition order was determined
randomly to control for the possible effects of fatigue.
When taping an ankle, the same taping procedure, which
was a standard taping procedure, was used for all subjects.
First, the ankle was sprayed with Tuf-Skin, an adhesive to
help the pre-wrap adhere better, and then heel and lace
pads, which are made from a type of foam and used to
prevent blisters, were placed on the skin over the Achilles
tendon and talar window. Then pre-wrap was applied to help
minimize irritation from the tape.

Next, three anchors

were placed just inferior to the distal end of the
gastrocnemius muscle. After that three stirrups were placed
medial to lateral alternating with three horseshoes.
Subsequently, two figure eights were added. One began over
the medial malleolus and the other began over the lateral
malleolus. Then two heel locks on each side were added
going behind the ankle. Anchors were placed to close up the
tape once all that was applied.

10
In order to test for kicking distance, the ball was
placed at the end line of a regulation, turf soccer field
and the subject kicked the ball as far as she could.
Subjects were allowed to approach the ball however they
felt comfortable in order to make the most natural kick
possible. Where the ball first hit, a marker was placed by
the researcher at the spot it landed. From that mark, a
measurement using a 300-foot tape measure was taken back to
where the ball was initially placed. This was repeated five
times and an average distance was calculated.
In order to test for accuracy, a target was
constructed using two plywood sheets measuring 243.5cm wide
x 243.5cm high (Figure 1). It was held in an upright
position by a posteriorly positioned frame of 5 x 10.2cm
wood planks (Figures 2 and 3). A screw was placed in the
middle of the board but was not fully inserted into the
plywood, so that a hook at the end of a tape measure could
fit over the head of the screw. A tape measure attached to
the screw was used to determine the distance from the
center of the target to the center of the mark left where
the ball struck the target. Sheets of white paper were
placed over the board, which were covered by sheets of
carbon paper with the carbon side in contact with the white
paper. The sheets were secured in place using a staple gun.

11
When the soccer ball struck the carbon paper, it left a
mark on the underlying white paper. To allow for subsequent
measurements, a sheet of white paper containing a ball mark
was replaced with a new sheet of white paper and covered by
carbon paper.34 The ball was placed 18.28 meters (20 yards)
from the center of the target on the soccer field. The
subjects were instructed to aim for the center of the
target that was placed in the middle of the goal. They were
allowed two practice kicks at the beginning of the entire
testing session and then instructed to kick five times
making a total of 15 kicks for accuracy testing. The
approach and the type of kick were left to the discretion
of the athlete in order to make the kick the most natural.
The cool down was done on the subjects own; they were
allowed to take as long as they needed.

Hypotheses

The following hypotheses were based on previous
research and the researcher’s intuition based on a review
of the literature.
1. Taping will have no effect on the distance and
accuracy a soccer ball is kicked.

12
2. Bracing will have no effect on the distance or
accuracy a soccer ball is kicked.

Data Analysis

All data was analyzed by a repeated measures ANOVA
computed with SPSS version 18.0 for Windows at an alpha
level < 0.05 where support conditions (brace and tape) will
be compared for kicking distance and accuracy.

13
RESULTS

The purpose of this study was to examine the effects
of external ankle supports on the distance and accuracy a
soccer ball is kicked in NCAA Division II female soccer
athletes. The following section contains the data collected
through the study and is divided into three subsections:
Demographic Information, Hypotheses Testing, and Additional
Findings.

Demographic Information

The subjects that participated in this study were
sixteen NCAA Division II female soccer athletes from
California University of Pennsylvania. First the researcher
approached the head soccer coach to ask permission to use
his athletes. Then the researcher approached the team
separate from the coach to ask for volunteers to
participate in the study. The demographic information sheet
(Appendix C5) was collected to give the researcher a
background of the subjects participating in the study. They
ranged from freshman to seniors in college and 18 to 22
years of age with the average age being 19.7 + 1.35 years
old. The years of soccer played ranged from 12 years to 17

14
years with an average of years played being 13.9 + 1.73
years (Table 1).
Table 1: Demographic Information

Age
Years played

Minimum
18
12

Maximum
22
17

Average
19.7
13.9

Standard
Deviation
1.35
1.73

Subjects’ reported positions were goalie, defense,
midfield and forward with the most common position being
midfield. The researcher looked at if they had worn ankle
braces or any kind of lower extremity braces before and if
so what kind. Of the sixteen subjects, one wears a knee
brace on a consistent basis, two wear ankle braces on a
consistent basis, thirteen have had their ankles taped
before, four use prophylactic taping on a consistent basis,
and three have never had their ankles taped before.

Hypothesis Testing

The following hypotheses were tested in this study.
All hypotheses were tested with a level of significance set
at ≤ 0.05.

A repeated measures ANOVA was calculated for

the effect of external ankle supports on functional
performance.

15
Hypothesis 1: Support conditions will have no effect
on distance a soccer ball is kicked.
Conclusion: A within subjects repeated measures ANOVA
on condition was calculated comparing the three levels of
support conditions (tape, brace and no support). A
significant effect was found (F(2,30) = 11.382 p < 0.001).
Mean scores for distance can be found in Table 2.
Table 2: Mean scores for distance and accuracy
No Support
Distance(m) 32.26 + 4.045
Accuracy(m)
0.88 + 0.207

Tape
32.49 + 4.289
0.98 + 0.218

Brace
29.77 + 4.935
0.96 + 0.205

Hypothesis 2: Support conditions will have no effect
on accuracy a soccer ball is kicked.
Conclusion: A within subjects repeated measures ANOVA
on condition was calculated comparing the three levels of
support conditions (tape, brace and no support). No
significant effect was found (F(2,30) = 1.302 p > 0.05).
Mean scores for accuracy can be found in Table 2. Post hoc
analysis determined there to be a significant difference
between no support/taping and bracing (t(15) = 3.536 p <
0.05).

16
Additional Findings

Following the testing of the hypotheses, further
testing was conducted to determine if there was any
relationship between position and support condition on
functional performance and then grade level and support
condition on functional performance. A within subjects
factorial ANOVA was calculated comparing position and
support condition as independent variables and accuracy as
the dependent variable. The main effect of support on
accuracy was not significant (F(2,26) = 1.199 p > 0.05).
The main effect of position was not significant (F(2,26) =
1.641 p > 0.05). The interaction was also not significant
(F(4,26) = 1.090 p > 0.05).
A within subjects factorial ANOVA was calculated
comparing grade level and support condition as independent
variables and accuracy as the dependent variable. The main
effect of support was not significant (F(2,24) = 0.834 p >
0.05). The main effect of year was not significant (F(2,24)
= 1.288 p > 0.05). The interaction was also not significant
(F(6,24) = 0.913 p > 0.05).
A within subjects factorial ANOVA was calculated
comparing grade level and support condition as independent
variables and distance as the dependent variable. The main

17
effect of support was significant (F(2,24) = 7.536 p =
0.003). The main effect of grade level was not significant
(F(2,24) = 0.370 p > 0.05). The interaction was also not
significant (F(6,24) = 0.307 p > 0.05).
A within subjects factorial ANOVA was calculated
comparing position and support condition as independent
variables and distance as the dependent variable. The main
effect of support was significant (F(2,26) = 12.864 p <
0.001).

The main effect of position was not significant

(F(4,26) = 1.427 p > 0.05). The interaction was also not
significant (F(6,24) = 1.397 p > 0.05).

18
DISCUSSION

The purpose of this study was to examine the effects
of external ankle supports on the distance and accuracy a
soccer ball is kicked in NCAA Division II female soccer
athletes. The following section is divided into three
subsections: Discussion of Results, Conclusions, and
Recommendations.

Discussion of Results

The researcher wanted to investigate this topic for
multiple reasons. One reason being there is a lot of
controversy about whether external ankle supports affect
functional performance. The second reason is because there
is little to no research on how external ankle supports
affect functional performance specific to soccer athletes.
Through the researcher’s professional and personal
experience, ankle injuries in soccer are common injuries.
The researcher hypothesized that neither tape nor brace
would have a negative effect on functional performance.
This study determined tape had no effect on kicking
distance or accuracy; brace had no effect on kicking
accuracy but did have an effect on kicking distance.

19
Minimal to no research exists discussing the effects
of external ankle supports on functional performance
specific to soccer. However, much research does exist about
other measures of functional performance such as vertical
jump height, sprint speed, and agility being the most
common. While these variables can be related to soccer
athletes, another part of soccer has yet to be evaluated
and that is looking at how external ankle supports effect
kicking a soccer ball.
Hume et al12 looked at multiple studies that all
discussed the effects of external ankle supports on ground
reaction forces, proprioception, balance, range of motion,
sprint speed, vertical jump height, agility and strength
using a wide variety of external ankle supports. Ten
studies say there is no significant effect on performance
and eight say there is a significant effect on performance.
Another conclusion made in this article is nine studies
claimed bracing has a significant effect on limiting ankle
range of motion. Strength was also affected from bracing
use, which may be an indication as to why distance kicked
decreased in this study.
It is possible distance was affected in the bracing
condition because the foot angle plays a role in kicking.
The brace constricts the ankle-foot complex from going into

20
eversion and plantarflexion, which is typically the range
of motion the ankle needs to be in to hit the ball
properly. By not being able to put the foot in this
specific position, kicking form changes and a negative
effect on the distance occurs. A possible reason why
accuracy was not affected during the brace condition is
because the margin of error was smaller.
The researcher believes the distance of 18.29 meters
(20 yards) for testing accuracy might be too far. With the
target being a third the size of the goal, the area to hit
was too small compared to what soccer athletes are used to
aiming for during soccer.
The tape possibly did not have an effect on kicking
distance or accuracy because it is known that tape loosens
up after 20 minutes of activity whereas a brace is used to
have restrictions on range of motion throughout activity.
The researcher investigated two additional findings 1)
if grade level in college and 2) if position had any
significant effect on kicking. A possible explanation for
why there was no significance found when looking at grade
level and position on accuracy kicking is because of the
years of experience for each athlete as well as the small
margin of error as previously discussed. A freshman and
senior could potentially have played the same number of

21
years even though they are three grades apart. A possible
explanation for why there was a significant difference when
looking at grade level and position on distance is most
likely due to the ankle-foot complex range of motion
restrictions from the brace. In the demographic information
form, one question was how many years have the subjects
played soccer.
When testing for accuracy, the researcher did not
anticipate the number of misses that would occur. Some
subjects ranged from missing once for a particular support
condition to as many as 17 times for another support
condition. The reason this happened could be due to the
wind on some days, which was a variable that was out of the
researcher’s control. Another reason is the distance from
the target the subjects were kicking. Twenty yards may not
seem far, but usually soccer players have a target that is
three times the size of the constructed target when
shooting from 20 yards away. Due to the number of misses
that did occur, fatigue might have been a factor after a
certain amount of misses, which could have also affected
the proceeding trials.
The researcher used Finnoff et al33 recommendations to
construct the target. Plywood was supported by posteriorly
positioned frame made of wood planks. A textured paint was

22
painted onto the plywood. White paper was placed over the
paint and in contact with carbon paper in order to make a
mark on the white paper when the soccer ball made contact
with the board. No explanation was given in the literature
as to the purpose of the textured paint. By having the
textured paint, an imprint potentially could have been seen
better and cause less variation in measurements.

Conclusions

This study revealed taping did not have any
significant effect on kicking distance or kicking accuracy
in soccer athletes. This study also revealed bracing did
not have a significant effect on kicking accuracy but did
on distance a soccer ball is kicked. In this case, the
certified athletic trainers can inform the athletes that
taping will not have any effect on kicking accuracy or
distance and that bracing will not have any effect on
kicking accuracy but might have a significant effect on
kicking distance. However, it should be stressed that the
minimal distance reported lost when wearing an ankle brace
may outweigh the risks of potentially sustaining an ankle
injury and missing part of a season. Kicking for distance
is a small part of soccer that may or may not have an

23
effect in the game whereas accuracy is much more important.
A soccer player needs to be able to be accurate when
shooting on goal and passing the ball to a teammate. When
looking at the two dependent variables, accuracy seems to
be the more important variable in relation to the game.

Recommendations

The first recommendation would be to have the data
collection sessions at an indoor turf soccer facility. It
would reduce any climate variables that may have caused
issues. There were many days the wind might have been a
factor to the number of misses that occurred. The second
recommendation would be to expand the subject population to
males because they might be affected differently than
females but also make the findings more useful as well. The
third recommendation would be to test athletes that wear
external ankle supports, mainly braces, on a consistent
basis because of the potential effects that it had on the
dependent variables. Many of the subjects who did not wear
a brace on a consistent basis complained about the size of
the brace. Masse et al25 stated, “a majority of the subjects
in this study stated that they felt they were working
harder when wearing a prophylactic device than when they

24
were not wearing one.” The fourth recommendation is to
shorten the distance for accuracy. As previously mentioned,
since the target was a third the size of a regulation
soccer goal, it made hitting the target more difficult. A
recommendation would be to have a protocol concerning the
number of misses. If future studies keep the same distance,
allowing only a certain number of total kicks and recording
the misses regardless might help the possible effects of
fatigue. The fifth recommendation would be to paint the
board with a textured paint. The textured paint would allow
for the ball marks to be seen more clearly and have more
accurate measurements.

25
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Sawkins K, Refshauge K, Kilbreath S, Raymond J. The
Placebo effect of ankle taping in ankle instability.
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Cordova ML, Takahashi Y, Kress GM, Brucker JB, Finch
AE. Influence of external ankle supports on lower
extremity joint mechanics during drop landings. J
Sport Rehabilit. 2010;12:136-148.

Metcalfe RC, Schlabach GA, Looney MA, Renehan EJ. A
comparison of moleskin tape, linen tape, and lace-up
brace on joint restriction and movement performance. J
Athl Train. 1997;32(2):136-140.

Paris DL. The effects of the Swede-O, New Cross, and
McDavid ankle braces and adhesive ankle taping on
speed, balance, agility, and vertical jump. J Athl
Train. 1992;27(3):253-256.

MacKean LC, Bell G, Burnham RS. Prophylactic ankle
bracing vs. taping: effects of functional performance
in female basketball players. J Ortho Sport Phys Ther.
1995;22(2):77-81.

Wikstrom E, Arrigenna M, Tillman M, Borsa P. Dynamic
Postural Stability in Subjects with Braced, Functional
Unstable Ankles. J Athl Train. 2006;41:245-250.

Cordova ML, Ingersoll CD, Palmieri RM. Efficacy of
prophylactic ankle support: an experimental
perspective. J Athl Train. 2002;37(4):446-457.

Passerallo AJ, Calabrese GJ. Improving traditional
ankle taping techniques with rigid strapping tape. J
Athl Train. 1994;29(1):76-77.

Thornton JL, Webster JA. The “tape cast” functional
taping for the injured athlete. J Athl Train.
1996;21(2):179-181.

10.

Paris Dl, Vardaxis V, Kokkaliaris J. Ankle ranges of
motion during extended activity periods while taped
and braced. J Athl Train. 1995;30(3):223-228.

26
11.

Martin N, Harter RA. Comparison of inversion restraint
provided by ankle prophylactic devices before and
after exercise. J Athl Train. 1993;28(4):324-329.

12.

Lindley TR, Kernozek TW. Taping and semirigid bracing
may not affect ankle function range of motion. J Athl
Train. 1995;30(2):109-112.

13.

Pederson TS, Ricard MD, Merril G, Schulthies SS,
Allsen PE. The effects of spatting and ankle taping on
inversion before and after exercise. J Athl Train.
1997;32(1):29-33.

14.

Ricard MD, Sherwood SM, Schulthies SS, Knight KL.
Effects of tape and exercise on dynamic ankle
inversion. J Athl Train. 2000;35(1):31-37.

15.

Omori G, Kawakami K, Sakamoto M, Hara t, Koga Y. The
effect of an ankle brace on the 3-dimensional
kinematics and tibio-talar contact condition for
lateral ankle sprains. Knee Surg Sports Traumatol
Arthrosc. 2004;12:457-462.

16.

Hodgson B, Tis L, Cobb S, Higbie E. The effect of
external ankle support on vertical ground-reaction
force and lower body kinematics. J Sport Rehabilit.
2005;14:301-312.

17.

DiStefano LJ, Padua DA, Brown CN, Guskiewicz KM. Lower
extremity kinematics and ground reaction forces after
prophylactic lace-up ankle bracing. J Athl Train.
2008;43(3):234-241.

18.

Hardy L, Huxel K, Brucker J, Nesser T. Prophylactic
ankle braces and star excursion balance measures in
healthy volunteers. J Athl Train. 2008;43(3):347-351.

19.

Zinder SM, Granata KP, Shultz SJ, Gansneder BM. Ankle
bracing and the neuromuscular factors influencing
joint stiffness. J Athl Train. 2009;44(4):363-369.

20.

Metcalfe RC, Schlabach GA, Looney MA, Renehan EJ. A
comparison of moleskin tape, linen tape, and lace-up
brace on joint restriction and movement performance. J
Athl Train. 1997;32(2):136-140.

27
21.

Sharpe SR, Knapick J, Jones B. Ankle braces
effectively reduce recurrence of ankle sprains in
female soccer players. J Athl Train. 1997;32(1):21-24.

22.

Paris Dl, Vardaxis V, Kokkaliaris J. Ankle ranges of
motion during extended activity periods while taped
and braced. J Athl Train. 1995;30(3):223-228.

23.

Beriau MR, Cox WB, Manning J. Effects of ankle braces
upon agility course performance in high school
athletes. J Athl Train. 1994;29(3):224-230.

24.

Sanioglu A, Ergun S, Erkmen N, Taskin H, Goktepe AS,
Kaplan T. The effect of ankle taping on isokinetic
strength and vertical jumping performance in elite
taekwondo athletes. Isokinet Exerc Sci. 2009;17:7378.

25.

Masse SJ. The effects of two ankle braces on sprint
speed, agility, and vertical jump height in healthy
female collegiate athletes. [master’s thesis].
California, PA: California University of Pennsylvania;
2006.

26.

Paris DL. The effects of the Swede-O, New Cross, and
McDavid ankle braces and adhesive ankle taping on
speed, balance, agility, and vertical jump. J Athl
Train. 1992;27(3):253-256.

27.

Cordova M, Scott B, Ingersoll C, LeBlanc M. Effects of
ankle support on lower-extremity functional
performance: a meta-analysis. Med Sci Sports Exerc.
2005;37:635-641.

28.

Coffman JL, Mize NL. A comparison of ankle taping and
the aircast sport stirrup on athletic performance. J
Athl Train. 1989;24(2):123-124.

29.

Wiley JP, Nigg BM. The effect of ankle orthosis on
ankle range of motion and performance. J Orthop Sport
Phys Ther. 1996;23(6):362-369.

30.

Fong CM, Blackburn JT, Norcross MF, McGrath M, Padua
DA. Ankle-dorsiflexion range of motion and landing
biomechanics. J Athl Train. 2011;46(1):5-10.

28
31.

Gehlsen GM, Pearson D, Bahamonde R. Ankle joint
strength, total work, and ROM: comparison between
prophylactic devices. J Athl Train. 1991;26:62-65.

32.

Gross MT, Ballard CL, Mears HG, Watkins EJ. Comparison
of DonJoy Ankle Ligament Protector and Aircast SportStirrup orthoses in restricting foot and ankle motion
before and after exercise. J Orthop Sport Phys Ther.
1992;16(2):60-67.

33.

Bernier JN, Perrin DH, Rijke A. Effect of unilateral
functional instability of the ankle on postural sway
and inversion and eversion strength. J Athl Train.
1997;32(3):226-232.

34.

Finnoff JT, Newcomer K, Laskowski ER. A valid and
reliable method for measuring the kicking accuracy of
soccer players. J Sci Med in Sport. 2002;5(4):348-353.

APPENDICES

APPENDIX A
Review of Literature

REVIEW OF LITERATURE

It is a widely accepted practice in the athletic
training profession to provide prophylactic ankle support
to individuals.1 External ankle supports such as tape and
various ankle braces are common in athletic use today to
support, stabilize, and prevent injury. The main goal of
prophylactic ankle support is to restrict excessive
inversion of the ankle-foot complex while allowing normal
ankle dorsiflexion and plantar flexion.2 The most important
reason for prophylactic device use is to prevent injury
without inhibiting functional performance.3 They are also
used by athletes who have a past medical history of ankle
injuries to prevent future injuries. Taping and bracing
have been shown to decrease ankle range of motion and
provide subtalar (inversion and eversion) joint support
without suffering a loss of talocrural (dorsiflexion and
plantar flexion) joint ROM.1,4-10 The talocrural, or ankle
joint, is a uniaxial, modified-hinge joint formed by the
talus, the medial malleolus of the tibia, and the lateral
malleolus of the fibula.11 Dorsiflexion and plantarflexion
movements occur at this joint. The subtalar joint is a

32
gliding joint that lies beneath the talus, where the
posterior calcaneal facet on the talus articulates with the
posterior facet on the superior aspect of the calcaneus.
Inversion and eversion movements occur at this joint. Since
these prophylactic devices can potentially limit motion in
the talocrural joint, there is the potential for external
supports to alter or decrease physical performance.
Numerous studies examining the difference between
taping and different types of braces on performance
measures such as vertical jump height, agility, and sprint
speed have been conducted.

However, the results as to

whether external ankle supports negatively affect
performance are still in question due to inconsistent
findings. For example, in a review article by Hume et al,12
the author cites nine articles all claiming external ankle
supports do not have a significant effect on performance
while eight claim to have a significant effect on
performance.
The purpose of this Review of Literature is to
enlighten the reader on previous work examining the effects
of various external ankle supports on different measures of
performance. This literature review will examine different
types of ankle braces, ankle injury rates and mechanics,
prevention of ankle injuries, effects of external ankle

33
supports on performance, and will end with a summary of the
research performed to date.

Prophylactic Devices

The general purpose of various ankle braces and taping
techniques is to limit excessive range of motion and
provide support in the ankle joint in order to prevent
ankle injuries. Since the majority of ankle injuries result
from excessive inversion and eversion, prophylaxis has
focused on limiting motion in the frontal plane. Athletic
trainers have choices when it comes to taping or bracing
with a variety of taping techniques available and many
different types of ankle braces on the market. Some of the
major ankle braces used in athletics today are: DonJoy
Ankle Ligament Protector, Aircast Sports Stirrup, Active
Ankle, Swede-O, Malleoloc, McDavid lace-up and Ankle
Stabilizing Orthosis (ASO). Taping techniques will also be
discussed in this section.

Taping
Most ankle tape techniques consist of the same basic
components; however, many variations exist in the
application of these components between health care

34
professionals. A typical ankle taping begins just inferior
to the gastrocnemius and soleus. It begins with a heel and
lace pad over the talar window and over the Achilles
tendon. Pre-wrap is used to minimize irritation from the
adhesive tape. Ankle taping should be composed of three
stirrups starting medially and moving laterally. Horseshoes
are another component to ankle taping in order to keep the
stirrups in place. Heel locks, generally two on each side,
are used to keep the ankle in a neutral position. Usually
two figure eights are used in taping an ankle. Once all
these components are completed, the health care
professional will “close off” the tape with anchors. What
is important to remember is, each health care professional
will have all of these components but each may have a
different order or added components to the ankle tape.
A variety of tape is available to tape an ankle. Some
common tapes other than standard white tape that is used
are Moleskin and Elastikon. Moleskin13 is a non-stretch,
zinc oxide adhesive, which helps prevent irritation. It is
typically used for stirrups when taping an ankle or used
for areas where white tape is not strong enough. It can
also be used for treatment and prevention of blisters,
corns, calluses and chafing. It has a napped cotton backing
that wicks away moisture. Elastikon14 is a thick, porous

35
cotton elastic material with rubber-based adhesive. It is
typically used for areas that need more support because of
its strength and it is also used for hard-to-tape areas
because of its flexibility. These two types of tape are
more expensive per roll than white tape therefore choosing
to use only white tape is more practical. Some schools do
not have the funds to use the more expensive tape and white
tape is the only option. This study can reach a larger
audience by only using white tape as well.

Bracing
DonJoy Ankle Ligament Protector®
This brace has a unique design that allows for full
plantar flexion and dorsiflexion but limits inversion and
eversion. It has an opening over the Achilles tendon to
prevent friction.15

Aircast Sport Stirrup®
An Aircast Sport Stirrup is designed to fit both feet
and only comes in one size. It has a solid, plastic outer
layer to limit inversion and eversion. It has a preinflated inside making it easy to apply because there is
little to do once the brace is on.16

36
Active Ankle™
There are three types of rigid Active Ankle braces:
T1, T2, and Volt. Both T1 and T2 are a solid U-shape
design, which is intended to relieve pressure from the
ankle joint and provides superior protection. They have
bilateral hinges to allow for full talocrural joint range
of motion. There is vinyl padding on the inside to allow
for custom molding to take place for better comfort and
fit. The Volt is made of a carbon fiber shell for support,
has bilateral hinges for full sagittal range of motion, and
a soft padding on the inside for comfort. The purpose of
Active Ankle braces is to limit subtalar range of motion in
order to prevent ankle injuries but allow for sagittal
range so it does not prevent athletic performance.17

Swede-O®
Multiple types of Swede-O ankle braces exist and there
is little clarification as to which one was used in
previous research. The types that will be discussed are
Ankle Lok®, Inner Lok 8®, Strap Lok®, Multi-sport®, and
Tarsal Lok®. The Ankle Lok® is made of three layers of
vinyl laminate to ensure durability. It is a lace-up design
with sidebar stabilizer inserts to allow for a greater
restriction of transverse motion. The back is elastic so it

37
does not interfere with the Achilles tendon. It has an
internal U-shaped spiral that provides added support. The
Inner Lok 8® is similar to an ASO® brace in that there is a
lace-up and figure eight portion. The Strap-Lok® is made of
ballistic nylon for a lightweight and thin feel but still
durable. It is comprised of a lace-up and figure eight
portion with an elastic back over the Achilles tendon. The
Multi-sport is similar to the Strap-Lok® in the sense it is
made of the same material and is comprised of the same
parts. The Tarsal Lok® combines a lace up brace with a
rigid brace. It uses body heat to mold to the contours of
the ankle.18

Malleoloc®
The Malleoloc® is made of a thermoplastic material
that can be heated and molded. It has figure eight Velcro
straps to hold the brace in place as well as provide added
support to the ankle complex. The goal of the Malleoloc®
brace is to increase ankle stability without restricting
mobility. It fits anterior of the lateral malleolus and
posterior to the medial malleolus in order to prevent
eversion ankle sprains. It allows for full talocrural range
of motion.19

38
Ankle Stabilizing Orthosis® (ASO)
This brace consists of a lace-up portion as well as
two figure eight straps for customized fit. It also has a
strap across the top to ensure the straps remain in place.
It is made of nylon, which allows for the ankle to breathe
while in the brace as well as provide durability throughout
activity. It is intended to keep the ankle in a neutral
position preventing inversion ankle sprains. It comes in
different sizes, sized by shoe, in order to create the most
comfortable and appropriate fit possible.
Choosing to use the ASO® lace-up brace is a personal
decision due to the researcher’s individual experience with
this brace as well as using this brace for teams. Almost
all the braces discussed have lace-up and figure eight
components, which makes up the ASO® lace-up brace. Based on
the researcher’s personal experience, Active Ankle braces
are characteristically used in volleyball athletes and are
not seen much outside that specific sport. The DonJoy Ankle
Ligament Protector is an uncommon ankle brace and has
minimal research associated with its use. The Aircast Sport
Stirrup is typically used for treatment of acute ankle
injuries rather than as a prophylactic device. The Swede-O
brace could have been used but due to the lack of
familiarity with this brace, the researcher decided against

39
it. The Malleoloc® brace seems to be out dated and has had
minimal advancements over the years.20

Ankle Injury Rates and Mechanisms

Ankle injuries are among the most common injury in
athletics. Many types of ankle injuries can occur with a
variety of mechanisms and levels of severity. Ankle sprains
tend to occur at foot strike during running or landing from
a jump when the ankle joint complex is plantarflexed and
supinated.12 Seventy-three percent of the athletic
population has sprained at least one of their ankles one or
more times.21 Eighty-five percent of ankle injuries are
acute sprains, and an equally high proportion of these
injuries involve the lateral ligamentous structures of the
ankle.10 Hume et al12 claims that rugby union had the largest
number (22.2%) of ankle injury claims. There is a
mechanical and anatomical explanation for this. The lateral
ankle static stabilizers are made up of three small
ligaments: anterior talofibular ligament (ATF), posterior
talofibular ligament (PTF), and calcaneofibular ligament
(CFL).

The lateral ligaments are much weaker than their

counterparts, the medial ligaments, which combine to form
the deltoid ligament. The deltoid ligament is comprised of

40
four separate ligaments named: tibionavicular ligament,
calcaneotibial ligament, anterior talotibial ligament, and
the posterior talotibial ligament. The spring ligament also
provides structural support to the medial ankle therefore
making the medial ankle more stable. Another anatomical
structure that predisposes ankles to injury is the medial
malleolus, which is anatomically superior to the lateral
malleolus allowing for an increase in inversion. It is
these anatomical structures that create an increase in
inversion range of motion (ROM) in comparison to eversion.

Prevention of Ankle Injuries
The lateral ligament complex of the ankle is the most
common site of injury in sports participants.22 Preventing
ankle injuries is a difficult task to accomplish but one
that is necessary due to the frequency of ankle injuries
that occurs in athletics. The athletic trainer has many
tools at his/her disposal in regards to preventing injury
including strength and conditioning workouts but the focus
of this research is on external ankle supports. It is
common to see a line of athletes waiting to get his or her
ankle taped before practices or games. Many certified
athletic trainers are switching over to ankle braces not
only to reduce cost but also to help prevent ankle injuries

41
over longer periods of activity than tape would. Research
has shown that tape weakens after exercise, whereas braces
limit motion much longer. Paris et al23 states, “although
several studies have shown that tape offered significant
support 10 to 30 minutes into activity, others have
reported significant taped support reduction of 40% to 50%
within 5 to 20 minutes of activity.” Effectiveness of tape
seems to depend on how the tape is applied and factors
other than the mechanical support of taping may explain the
effectiveness of ankle taping preventing ankle sprains.12

Effects of External Ankle Supports on Performance
Much research has been performed examining the effects
of external ankle supports on ROM, vertical jump height,
sprint speed, and agility. However, the data is
inconclusive with some research stating that ankle supports
have no effect on these measures of functional performance
while others suggest the ankle supports provide rigidity to
the ankle, which in turn affects performance in these
categories.

42
Agility
When determining an agility protocol, some
requirements must be considered. Quick change in direction,
moments of acceleration and deceleration, and sprinting are
all recommended.24 Many variations of agility tests were
considered when doing various studies. Some of the most
common agility tests are T-test, Southeast Missouri (SEMO),
shuttle run, figure eight, and four-point run. Agility
times were statistically significant but clinically, they
were not.25 Metcalfe et al1 stated moleskin, linen tape, and
lace-up brace all significantly limited performance in the
SEMO agility test. Cordova et al24 states external ankle
support has virtually no effect on agility. Once again,
even with quality research, the debate is still open.

Sprint Speed
As previously stated, the purpose of an ankle support
is to limit range of motion in the subtalar joint, not the
talocrural joint; therefore, running should not be
affected. In a review article by Cordova et al24, he found
seven articles claiming sprint speed was not affected but
one article claiming sprint speed was affected. The
protocols and procedures were not clearly outlined,
therefore leaving this debate unsolved once again. Coffman

43
et al21 concluded that for both ankle taping and Aircast
Sport Stirrup, speed was significantly different than the
no support condition.

Vertical Jump Height
Metcalfe et al1 stated moleskin tape, linen tape, and
lace-up brace all significantly limited performance in
vertical jump height. Metcalfe quoted Mayhew and Paris both
stating vertical jump height was significantly affected by
prophylactic taping and bracing applications. Coffman et
al21 concluded ankle taping significantly affects vertical
jump height but not for the Aircast Sport Stirrup. Hume et
al12 cites multiple authors who all claim vertical jump
height was negatively affected due to external ankle
supports. Some of these external ankle supports included
Swede-O, DonJoy Ankle Ligament Protector, McDavid, Active
Ankle, Aircast Sports Stirrup, New Cross, Mikros, and
various taping techniques.

Vertical Ground Reaction Force
Landing from a jump is a common task in many sports
that serves as the primary mechanism of many lower
extremity injuries.2 Hodgson et al26 looked at the
relationship between jump height with vertical ground-

44
reaction forces. Volleyball players were used in this study
due to the repetitive jumping involved but this could
pertain to soccer as well because there are times when a
player needs to jump to head the ball or the goalie needs
to jump to catch a ball. Hodgson states, “When landing and
recovering from a jump, the vertical component of the
ground-reaction force ranges from 2.3 to 7.1 times body
weight. Studies that have examined the effect of landing
type on vertical ground-reaction force have reported that
an increase in landing stiffness will result in an increase
in peak vertical ground-reaction force.” Cordova et al2
stated, “ankle taping and bracing may influence impact
absorption during drop landings, which may lead to an
increase in energy absorption at the knee and hip joints.
With this being said, the constant increase in physical
demand could lead to injury. With active ankle braces being
so popular in volleyball today, this is a legitimate
concern as to whether the immediate benefit of decreased
ankle injuries is worth the possibility of chronic injuries
in the future.

Range of Motion
Omori et al4 looked at the effects of the Air-Stirrup
on severed ATF ligaments on cadavers and determined that

45
Air-Stirrup decreased excessive inversion. Hume et al12
cites twenty-six articles, which all claim that external
ankle supports restrict range of motion. Specifically,
Gehlsen27 found that plantar flexion total work is affected
by some support devices indicating a decrease in ROM.
Cordova et al2 states, “For ankle-joint displacement, both
the tape and semirigid-ankle-brace conditions showed
significantly less ankle-joint ROM than no support
condition, whereas no differences were observed between the
tape and semirigid-brace conditions.” Rarick et al28
concluded that the basket weave, stirrups, and heel-lock
conditions provided the most restriction in ROM. Metcalfe
et al1 concluded that a specific taping technique consisting
of tape with moleskin application significantly restricted
range of motion in plantar flexion, dorsiflexion,
inversion, and eversion. Tape alone restricted
dorsiflexion, inversion, and eversion and the braced
condition restricted plantar flexion, dorsiflexion, and
inversion. Gross et al28 looked at the effects of the DonJoy
Ankle Ligament Protector and Aircast Sport Stirrup on ROM
and concluded that both supports significantly reduce
inversion and eversion after application and maintained
their ability to reduce inversion and eversion after
exercise.

46
Kicking Biomechanics

Kicking is a natural fluid motion and a fundamental
skill in soccer.31 Kicking biomechanics is something that is
widely studied by physicists and biomechanics. Mechanics
change between each person depending on what is comfortable
and what type of kick. A different approach is warranted
for distance versus accuracy when kicking a ball. Players
prefer to use an approach angle between 43° and 45° to
generate maximum ball speed.32 It has also been supported
that the last step before kicking is the determining factor
in distance the ball is kicked. When kicking for distance,
it has been shown the longer the last stride length is, the
further the ball will travel. The longer stride length
allows for greater pelvic retraction, which in turn allows
for greater pelvic protraction.32 Clagg et al31 also
concluded that when participants kicked with their dominant
kicking limb they produced a larger pulling force,
indicated by an increase in hip, knee, and ankle flexion,
internal rotation, and adduction torque of the dominant
plant leg. Having the ankle in a plantarflexed, internally
rotated, and adducted position can be greatly limited by
many support conditions. Most of the literature looking at
kicking biomechanics deals with the plant leg, hip on the

47
kicking leg, knee range of motion of the kicking leg, but
not specifically the ankle-foot complex. The upper body has
also been studied for kicking mechanics.

Summary

In summary, the literature provides sufficient
research on support conditions including taping and various
types of braces and how they affect functional performance
such as sprint speed, agility, vertical jump height,
vertical ground reaction force, range of motion, and
kicking. However, no current research reports on how
external ankle supports affect skills necessary to play and
succeed in soccer. It is clear that all external ankle
supports provide some type of stability to the ankle-foot
complex that mainly decreases range of motion. The ideal
support would limit only inversion movement and not plantar
flexion or dorsiflexion. Most claim this is the case, which
is where the controversy remains. The purpose of this
current study is to determine the effects of the ASO laceup brace and a specific taping technique on distance and
accuracy a soccer ball is kicked.

APPENDIX B
The Problem

49
STATEMENT OF THE PROBLEM

Conflicting data exists as to whether external ankle
supports inhibit functional performance. From an injury
standpoint, external ankle supports decrease ROM and
therefore decrease the risk of injury. However, if external
ankle supports decrease athletic performance, as some
studies suggest, does this risk outweigh the benefits of
injury prevention? A variety of ankle supports exist. The
purpose of this study was to examine the effect of external
ankle supports (taping versus a lace-up brace) on the
accuracy and distance with which a soccer ball was kicked.

Definition of Terms
The following terms are defined for this study:
1)

External Ankle Supports – tape or brace support that
is designed to decrease excessive range of motion of
the subtalar joint.

Functional Performance - accuracy and distance a
soccer ball is kicked.

Agility – incorporating sprinting, acceleration,
deceleration, forward and backwards running, and
directional changes.

Vertical Jump Height – Difference between standing

50
reach and the height reached at the end of the
vertical jump.
5)

Ground reaction force – measured using a force plate
while walking.

Sprint speed – 40-yard dash and 50-yard dash.

Range of Motion – using a specific measuring device
called a goniometer to measure ankle range of motion
including inversion and eversion.

Basic Assumptions
The following were basic assumptions of this study:
1)

The ankle taping will be applied equally during each
application.

The subjects will be consistent and perform to the
best of their ability during testing sessions.

The ankle braces will be fitted correctly, high
quality and consistently applied.

Built in rest periods will adequately control for
fatigue.

Instruments and testing procedures are reliable and
valid.

51
Limitations of the Study
The following are possible limitations of the study:
1)

Support conditions may feel uncomfortable due to lack
of previous use.

Only NCAA Division II female soccer players were used
in this study decreasing the ability to extrapolate
the results to the general population.

Only one particular brace was used in this study.

Only white tape was used in this study.

Significance of the Study
The results of this study will help determine and
clarify whether ankle supports affect kicking performance.
This is useful information for clinicians and other health
care professionals, specifically certified athletic
trainers, and the evidence will determine if they should
encourage the use of external ankle supports for athletes.
Additionally the results will identify if one support type
should be preferred over another. It is important to have
this information because previous research has shown much
controversy about the potential effects of taping and
bracing on performance.

Also, the research has not

examined soccer skills specifically, which may show
differing results from other measures of performance.

APPENDIX C
Additional Methods

APPENDIX C1
Demographic Information Form

Demographic Information
Age: ______
Year in school: _________________
Years of soccer played: ______
Kicking foot:

No Preference

Do you wear a brace on a consistent basis?
No

Yes:

Ankle

Knee

Have you had your ankle taped before?
No

Yes

Do you get your ankle taped on a consistent basis?
No

Yes: every day

games only

practices only

APPENDIX C2
Informed Consent Form

Informed Consent Form
1. Lysha Draskovic, who is a Graduate Athletic Training
Student at California University of Pennsylvania, has
requested my participation in a research study at
California University of Pennsylvania. The title of the
research is The Effect of External Ankle Supports on
Functional Performance in Division II Female Soccer
Athletes.
2. I have been informed that the purpose of this study is
to determine if external ankle supports, specifically ankle
taping and braces, affect distance and accuracy when
kicking a soccer ball. I understand that I must be 18 years
of age or older to participate. I understand that I have
been asked to participate along with approximately 19 other
individuals because I am a soccer athlete at California
University of Pennsylvania with no current injury or injury
that affects my participation in this study.
3. I have been invited to participate in this research
project. My participation is voluntary and I can choose to
discontinue my participation at any time without penalty or
loss of benefits. My participation will consist of two
separate days. The first day is solely for filling out a
demographic questionnaire, reviewing and signing this
informed consent form. The second day will involve going
through a dynamic warm-up, kicking a soccer ball at a
target to measure for accuracy and kicking a soccer ball
for distance. All this will be done while wearing an ankle
brace, getting my ankle taped and not having any support
condition. Five kicks will be done for accuracy and five
kicks for distance for each support condition making a
total of thirty kicks that will be scored. This testing
will last for about sixty minutes in total.
When being tested for accuracy, I will be kicking from one
spot on the field 20 yards away from the goal at a target
that is placed in the center of the goal. I am aiming for
the center of the target. I will be allowed two practice
kicks and the next five kicks will be scored and averaged.

When being tested for kicking distance, I will be kicking
from the end line of the soccer field. I will kick the ball
as far as I can. I will have two practice kicks and the
next five kicks will be scored and averaged.
4. I understand there are foreseeable risks or discomforts
to me if I agree to participate in the study. With
participation in a research program such as this there is
always the potential for unforeseeable risks as well.
I will be asked to perform soccer kicks, something I do on
a frequent basis. I understand that I could potentially
strain a muscle or tendon in my leg when kicking for
distance. I will be allowed to discontinue participation if
I am in pain or feel I can no longer continue. I could slip
or fall during testing but this also occurs during normal
participation in soccer. I will be excluded from
participating in the study if I currently have an injury
that prevents my participation from kicking a soccer ball,
if I am currently pregnant or may believe I am pregnant. I
also understand I may be asked to discontinue my
participation if I cannot comply with the testing protocol
established by the researcher. No tests are physically
invasive. If an injury was to occur, the researcher is a
Certified Athletic Trainer and will be able to provide
immediate care and treatment in the athletic training room.
The Athletic Training Room in Hamer Hall at California
University of Pennsylvania is also available to me. The
campus health center is also available on the bottom floor
in Carter Hall. The health center staff can also be reached
by calling 724-938-4232.
5. I understand that, in case of injury, I can expect to
receive treatment or care in Hamer Hall’s Athletic Training
Facility. This treatment will be provided by the
researcher, Lysha Draskovic, under the supervision of the
CalU athletic training faculty, all of which can administer
emergency care. Additional services needed for prolonged
care will be referred to the attending staff at the Downey
Garofola Health Services located on campus.
6. There are no feasible alternative procedures available
for this study.
7. I understand that the possible benefits of my
participation in the research are to help determine the

58
effects of ankle taping and bracing on kicking. This study
can help athletic trainers and other health care
professionals decide whether to encourage the use of
external ankle supports such as taping and this specific
ankle brace in order to prevent ankle injuries without
decreasing functional performance.
8. I understand that the results of the research study may
be published but my name or identity will not be revealed.
Only aggregate data will be reported. In order to maintain
confidentially of my records, Lysha Draskovic will maintain
all documents in a secure location on campus and password
protect all electronic files so that only the student
researcher and research advisor can access the data. Each
subject will be given a specific subject number to
represent his or her name so as to protect the anonymity of
each subject.
9. I have been informed that I will not be compensated for
my participation.
10. I have been informed that any questions I have
concerning the research study or my participation in it,
before or after my consent, will be answered by:
Lysha Draskovic ATC
STUDENT/PRIMARY RESEARCHER
Dra9026@calu.edu
(203) 556-9244
Dr. Edwin Zuchelkowski PhD
RESEARCH ADVISOR
Zuchelkowski@calu.edu
(724) 938-4202
11. I understand that written responses may be used in
quotations for publication but my identity will remain
anonymous.
12. I have read the above information and am electing to
participate in this study. The nature, demands, risks, and
benefits of the project have been explained to me. I
knowingly assume the risks involved, and understand that I
may withdraw my consent and discontinue participation at
any time without penalty or loss of benefit to myself. In
signing this consent form, I am not waiving any legal

59
claims, rights, or remedies. A copy of this consent form
will be given to me upon request.
13. This study has been approved by the California
University of Pennsylvania Institutional Review Board.
14. The IRB approval dates for this project are from:
02/13/12 to 02/12/13.
Subject's signature:___________________________________
Date:____________________
Witness signature:___________________________________
Date:____________________

APPENDIX C3
Institutional Review Board –
California University of Pennsylvania

61
Proposal Number
Date Received

PROTOCOL for Research
Involving Human Subjects

Institutional Review Board (IRB) approval is required before
beginning any research and/or data collection involving human subjects

(Reference IRB Policies and Procedures for clarification)

Project Title The Effects of External Ankle Supports on Functional Performance in Division II Female Soccer
Athletes
Researcher/Project Director

Lysha Draskovic

Phone # (203) 556-9244

E-mail Address dra9026@calu.edu

Faculty Sponsor (if required) Dr. Edwin Zuchelkowski
Department Health Science
Project Dates January 1, 2012 to December 31, 2012
Sponsoring Agent (if applicable) NA
Project to be Conducted at California University of Pennsylvania
Project Purpose:

Thesis

Research

Class Project

Keep a copy of this form for your records.

Other

62
Please attach a typed, detailed summary of your project AND complete items 2
through 6.
1. Provide an overview of your project-proposal describing what you plan to do and how you
will go about doing it. Include any hypothesis(ses)or research questions that might be
involved and explain how the information you gather will be analyzed. For a complete list of
what should be included in your summary, please refer to Appendix B of the IRB Policies and
Procedures Manual.
The purpose of this study is to examine the relationship between prophylactic ankle supports
and two measures of soccer skills, the abilities to kick the ball for distance and accuracy.
Following IRB approval, subjects will be recruited from California University of
Pennsylvania women's soccer team and complete informed consent forms. They will
complete a standard warmup for the women's soccer team they use before each practice and
game. This warm up will consist of jogging two laps around a soccer field, side shuffle,
carioca, hip cradle, knee grabs, high knees, leg kicks, butt kickers, lateral squat, forward
lunges, backward lunges, inch worm, A-skip, and power skip.
After the warmup, the subjects will have one of the three support conditions (tape, brace or
no support) applied to both ankles. Five minutes will be allotted for application, which will
also help control for fatigue. Following completion of the testing for a particular subject, the
same protocol will be applied with the remaining support conditions. The order of the support
condition will be counterbalanced among the subjects. Support condition order will be
determined randomly to control for the possible effects of fatigue.
When taping an ankle, a standard taping procedure will be used. First, the ankle will be
sprayed with Tuf-Skin and then heel and lace pads will be placed on the skin over the talar
window and Achilles tendon. Then pre-wrap will be applied to help minimize irritation from
the tape. Next, three anchors will be placed just inferior to the distal end of the
gastrocnemius muscle. Then three stirrups will be placed medial to lateral alternating with
three horseshoes. Then two figure eights will be added one beginning over the medial
malleolus and the other beginning over the lateral malleolus. Then two heel locks on each
side will be added going behind the ankle. Anchors will be placed to close up the tape once
all that is applied. Braces utilized will be standard ankle braces fitted to manufacturer's
instructions.
In order to test for kicking distance, the ball will be placed at the end line of a regulation, turf
soccer field and the subject will kick the ball as far as they can. They will be allowed to
approach the ball however they feel comfortable in order to make the most natural kick. A
marker will be placed where the ball first hits allowing for a distance measurement. From that
mark, a measurement will be taken back to where the ball was initially placed using a tape
measure. This will be repeated five times and an average distance will be calculated.
In order to test for accuracy, a target will constructed according to Finnoff et al (2002), using
a plywood sheet measuring 243.84cm wide x 243.84cm high. It will be held in an upright
position by a posteriorly positioned frame of 5 x 10.2cm wood planks. A black mark
measuring 5 x 5cm will be placed at the center of the board. This will be referred to as the
bull's-eye. A screw will be placed in the middle of the bull's-eye but will not be fully inserted
into the plywood, so that a hook at the end of a tape measure could fit over the head of the
screw. A tape measure attached to the screw will be used to determine the distance from the
bull's-eye to the center of the mark left where the ball will strike the target. Sheets of white
paper will be placed over the board; these will be covered by sheets of carbon paper with the
carbon side in contact with the white paper. The sheets will be held in place using a staple

63
gun. When the soccer ball strikes the carbon paper, it will leave a mark on the white paper
underneath. To allow for additional measurements, a sheet of white paper containing a ball
mark will be replaced with a new sheet of white paper and covered by carbon paper. The
target will be placed in the middle of a regulation soccer goal that measures 243.84x
731.52cm. The ball will be placed at one spot on the soccer field and the subjects will be
instructed to aim for the center of the target. The spot on the field will be at a distance of 20
yards from the center of the target. They will be allowed two practice kicks before any
support condition will be applied and then instructed to kick five times making a total of
fifteen kicks. They will be scored based on the distance measured from the bull's-eye to the
center of the mark.
The cool down will be done on the subjects own and will be allowed to take as long as they
need.
My hypothesis is support conditions will have no effect on distance and accuracy a soccer
ball is kicked.
Finoff JT, Newcomer K, Laskowski ER. A valid and reliable method for measuring the
kicking accuracy of soccer players. J Sci and Med Sports. 2002;5(4):348-353.
2. Section 46.11 of the Federal Regulations state that research proposals involving human
subjects must satisfy certain requirements before the IRB can grant approval. You should
describe in detail how the following requirements will be satisfied. Be sure to address each
area separately.
a. How will you insure that any risks to subjects are minimized? If there are potential
risks, describe what will be done to minimize these risks. If there are risks, describe
why the risks to participants are reasonable in relation to the anticipated benefits.
The possible risks and/or discomforts are minimal to the subjects. Female division II
soccer athletes will be used for this study. What is being asked of the subjects is
specific to soccer, therefore it is something that is done on a daily basis and is not a
difficult task for the subjects to complete. A subject could potentially strain a muscle
or tendon in her leg when kicking for distance. Subjects will be allowed to
discontinue participation if they are in pain or feel they can no longer continue. The
subjects could slip or fall during testing but this also occurs during normal
participation in soccer. Subjects will be excluded from participating in the study if
they currently have an injury that prevents their participation in soccer practices or
games. No tests are physically invasive. If an injury was to occur, the researcher is a
Certified Athletic Trainer and will be able to provide immediate care and treatment in
the soccer stadium athletic training room. The Athletic Training Room in Hamer Hall
at California University of Pennsylvania is also available to the subjects. The campus
health center is also available on the bottom floor in Carter Hall. The health center
staff can also be reached by calling 724-938-4232.
b. How will you insure that the selection of subjects is equitable? Take into account
your purpose(s). Be sure you address research problems involving vulnerable
populations such as children, prisoners, pregnant women, mentally disabled persons,
and economically or educationally disadvantaged persons. If this is an in-class
project describe how you will minimize the possibility that students will feel coerced.

64
All subjects will be volunteers who are eighteen years of age or older and are NCAA
division II collegiate athletes at California University of Pennyslvania. Prior to this
study, an informational meeting will be held with the potential subjects to explain the
concept of the study in the absence of the coaches. Any athlete will be excluded from
this study if they are currently not participating in practice or competitions due to an
injury.
c. How will you obtain informed consent from each participant or the subject’s legally
authorized representative and ensure that all consent forms are appropriately
documented? Be sure to attach a copy of your consent form to the project summary.
Subjects will complete an informed consent form (attached) at the initial meeting
prior to any participation in this study or any data collection. All subjects will be 18
years of age or older therefore they are able to legally provide their own consent.
Each signed form will be kept by the researcher.
d. Show that the research plan makes provisions to monitor the data collected to insure
the safety of all subjects. This includes the privacy of subjects’ responses and
provisions for maintaining the security and confidentiality of the data.
All data collected will be documented on an individual data collection sheet
(attached). Data will be collected during the spring semester. All subjects are
supposed to come in two different days, one for paperwork and the other for data
collection. The second day will consist of testing under three ankle support
conditions (no support, tape, brace). All collected data, which will be identified by
subject number only, will be maintained by the researcher in a secure location in the
Graduate Program Director's office on campus. Only the researcher and the research
advisor will have access to these records.
3. Check the appropriate box(es) that describe the subjects you plan to use.

Adult volunteers

Mentally Disabled People

CAL University Students

Economically Disadvantaged People

Other Students

Educationally Disadvantaged People

Prisoners

Fetuses or fetal material

Pregnant Women

Children Under 18

Physically Handicapped People

Neonates

4. Is remuneration involved in your project?
5. Is this project part of a grant?
Title of the Grant Proposal
Name of the Funding Agency

Yes or

Yes or
No

No. If yes, Explain here.

If yes, provide the following information:

65
Dates of the Project Period
6.

Does your project involve the debriefing of those who participated?

Yes or

If Yes, explain the debriefing process here.
7. If your project involves a questionnaire interview, ensure that it meets the requirements of
Appendix
in the Policies and Procedures Manual.

66
California University of Pennsylvania Institutional Review Board
Survey/Interview/Questionnaire Consent Checklist (v021209)
This form MUST accompany all IRB review requests
Does your research involve ONLY a survey, interview or questionnaire?
YES—Complete this form
NO—You MUST complete the “Informed Consent Checklist”—skip the remainder
of this form
Does your survey/interview/questionnaire cover letter or explanatory statement include:
(1) Statement about the general nature of the survey and how the data will be
used?
(2) Statement as to who the primary researcher is, including name, phone, and
email address?
(3) FOR ALL STUDENTS: Is the faculty advisor’s name and contact information
provided?
(4) Statement that participation is voluntary?
(5) Statement that participation may be discontinued at any time without penalty
and all data discarded?
(6) Statement that the results are confidential?
(7) Statement that results are anonymous?
(8) Statement as to level of risk anticipated or that minimal risk is anticipated?
(NOTE: If more than minimal risk is anticipated, a full consent form is required—and
the Informed Consent Checklist must be completed)
(9) Statement that returning the survey is an indication of consent to use the data?
(10) Who to contact regarding the project and how to contact this person?
(11) Statement as to where the results will be housed and how maintained? (unless
otherwise approved by the IRB, must be a secure location on University premises)
(12) Is there text equivalent to: “Approved by the California University of
Pennsylvania Institutional Review Board. This approval is effective nn/nn/nn and
expires mm/mm/mm”? (the actual dates will be specified in the approval notice from
the IRB)?

67
(13) FOR ELECTRONIC/WEBSITE SURVEYS: Does the text of the cover letter
or
explanatory statement appear before any data is requested from the participant?
(14) FOR ELECTONIC/WEBSITE SURVEYS: Can the participant discontinue
participation at any point in the process and all data is immediately discarded?
California University of Pennsylvania Institutional Review Board
Informed Consent Checklist (v021209)
This form MUST accompany all IRB review requests
Does your research involve ONLY a survey, interview, or questionnaire?
YES—DO NOT complete this form. You MUST complete the
“Survey/Interview/Questionnaire Consent Checklist” instead.
NO—Complete the remainder of this form.
1. Introduction (check each)
(1.1) Is there a statement that the study involves research?
(1.2) Is there an explanation of the purpose of the research?
2. Is the participant. (check each)
(2.1) Given an invitation to participate?
(2.2) Told why he/she was selected.
(2.3) Told the expected duration of the participation.
(2.4) Informed that participation is voluntary?
(2.5) Informed that all records are confidential?
(2.6) Told that he/she may withdraw from the research at any time without
penalty or loss of benefits?
(2.7) 18 years of age or older? (if not, see Section #9, Special Considerations
below)
3. Procedures (check each).
(3.1) Are the procedures identified and explained?
(3.2) Are the procedures that are being investigated clearly identified?
(3.3) Are treatment conditions identified?
4. Risks and discomforts. (check each)
(4.1) Are foreseeable risks or discomforts identified?
(4.2) Is the likelihood of any risks or discomforts identified?
(4.3) Is there a description of the steps that will be taken to minimize any risks or
discomforts?
(4.4) Is there an acknowledgement of potentially unforeseeable risks?
(4.5) Is the participant informed about what treatment or follow up courses of
action are available should there be some physical, emotional, or psychological harm?

68
(4.6) Is there a description of the benefits, if any, to the participant or to others
that may be reasonably expected from the research and an estimate of the likelihood
of these benefits?
(4.7) Is there a disclosure of any appropriate alternative procedures or courses of
treatment that might be advantageous to the participant?
5. Records and documentation. (check each)
(5.1) Is there a statement describing how records will be kept confidential?
(5.2) Is there a statement as to where the records will be kept and that this is a
secure location?
(5.3) Is there a statement as to who will have access to the records?
6. For research involving more than minimal risk (check each),
(6.1) Is there an explanation and description of any compensation and other
medical or counseling treatments that are available if the participants are injured
through participation?
(6.2) Is there a statement where further information can be obtained regarding the
treatments?
(6.3) Is there information regarding who to contact in the event of researchrelated injury?
7. Contacts.(check each)
(7.1) Is the participant given a list of contacts for answers to questions about the
research and the participant’s rights?
(7.2) Is the principal researcher identified with name and phone number and
email address?
(7.3) FOR ALL STUDENTS: Is the faculty advisor’s name and contact
information provided?
8. General Considerations (check each)
(8.1) Is there a statement indicating that the participant is making a decision
whether or not to participate, and that his/her signature indicates that he/she has
decided to participate having read and discussed the information in the informed
consent?
(8.2) Are all technical terms fully explained to the participant?
(8.3) Is the informed consent written at a level that the participant can understand?
(8.4) Is there text equivalent to: “Approved by the California University of
Pennsylvania Institutional Review Board. This approval is effective nn/nn/nn and
expires mm/mm/mm”? (the actual dates will be specified in the approval notice from
the IRB)
9. Specific Considerations (check as appropriate)
(9.1) If the participant is or may become pregnant is there a statement that the
particular treatment or procedure may involve risks, foreseeable or currently
unforeseeable, to the participant or to the embryo or fetus?

69
(9.2) Is there a statement specifying the circumstances in which the participation
may be terminated by the investigator without the participant’s consent?
(9.3) Are any costs to the participant clearly spelled out?
(9.4) If the participant desires to withdraw from the research, are procedures for
orderly termination spelled out?
(9.5) Is there a statement that the Principal Investigator will inform the participant
or any significant new findings developed during the research that may affect them
and influence their willingness to continue participation?
(9.6) Is the participant is less than 18 years of age? If so, a parent or guardian must
sign the consent form and assent must be obtained from the child
Is the consent form written in such a manner that it is clear that the
parent/guardian is giving permission for their child to participate?
Is a child assent form being used?
Does the assent form (if used) clearly indicate that the child can freely refuse
to participate or discontinue participation at any time without penalty or coercion?
(9.7) Are all consent and assent forms written at a level that the intended
participant can understand? (generally, 8th grade level for adults, age-appropriate for
children)
California University of Pennsylvania Institutional Review Board
Review Request Checklist (v021209)
This form MUST accompany all IRB review requests.
Unless otherwise specified, ALL items must be present in your review request.
Have you:
(1.0) FOR ALL STUDIES: Completed ALL items on the Review Request Form?
Pay particular attention to:
(1.1) Names and email addresses of all investigators
(1.1.1) FOR ALL STUDENTS: use only your CalU email
address)
(1.1.2) FOR ALL STUDENTS: Name and email address of your
faculty research advisor
(1.2) Project dates (must be in the future—no studies will be approved
which have already begun or scheduled to begin before final IRB approval—
NO EXCEPTIONS)
(1.3) Answered completely and in detail, the questions in items 2a through
2d?
2a: NOTE: No studies can have zero risk, the lowest risk is
“minimal risk”. If more than minimal risk is involved you MUST:
i. Delineate all anticipated risks in detail;
ii. Explain in detail how these risks will be minimized;
iii. Detail the procedures for dealing with adverse outcomes
due to these risks.
iv. Cite peer reviewed references in support of your
explanation.

70
2b. Complete all items.
2c. Describe informed consent procedures in detail.
2d. NOTE: to maintain security and confidentiality of data, all
study records must be housed in a secure (locked) location ON
UNIVERSITY PREMISES. The actual location (department, office,
etc.) must be specified in your explanation and be listed on any
consent forms or cover letters.
(1.4) Checked all appropriate boxes in Section 3? If participants under the
age of 18 years are to be included (regardless of what the study involves) you
MUST:
(1.4.1) Obtain informed consent from the parent or guardian—
consent forms must be written so that it is clear that the
parent/guardian is giving permission for their child to participate.
(1.4.2) Document how you will obtain assent from the child—
This must be done in an age-appropriate manner. Regardless of
whether the parent/guardian has given permission, a child is
completely free to refuse to participate, so the investigator must
document how the child indicated agreement to participate
(“assent”).
(1.5) Included all grant information in section 5?
(1.6) Included ALL signatures?
(2.0) FOR STUDIES INVOLVING MORE THAN JUST SURVEYS,
INTERVIEWS, OR QUESTIONNAIRES:
(2.1) Attached a copy of all consent form(s)?
(2.2) FOR STUDIES INVOLVING INDIVIDUALS LESS THAN 18
YEARS OF AGE: attached a copy of all assent forms (if such a form is used)?
(2.3) Completed and attached a copy of the Consent Form Checklist? (as
appropriate—see that checklist for instructions)
(3.0) FOR STUDIES INVOLVING ONLY SURVEYS, INTERVIEWS, OR
QUESTIONNAIRES:
(3.1) Attached a copy of the cover letter/information sheet?
(3.2) Completed and attached a copy of the
Survey/Interview/Questionnaire Consent Checklist? (see that checklist for
instructions)
(3.3) Attached a copy of the actual survey, interview, or questionnaire
questions in their final form?
(4.0) FOR ALL STUDENTS: Has your faculty research advisor:
(4.1) Thoroughly reviewed and approved your study?
(4.2) Thoroughly reviewed and approved your IRB paperwork? including:
(4.2.1) Review request form,
(4.2.2) All consent forms, (if used)
(4.2.3) All assent forms (if used)
(4.2.4) All Survey/Interview/Questionnaire cover letters (if used)
(4.2.5) All checklists

71
(4.3) IMPORTANT NOTE: Your advisor’s signature on the review request
form indicates that they have thoroughly reviewed your proposal and verified
that it meets all IRB and University requirements.
(5.0) Have you retained a copy of all submitted documentation for your records?

73
Dear Lysha Draskovic:
Please consider this email as official notification
that your proposal titled "The Effects of External Ankle
Supports on Functional Performance in Division II Female
Soccer Athletes” (Proposal #11-044) has been approved by
the California University of Pennsylvania Institutional
Review Board as submitted.
The effective date of the approval is 2-13-2012 and the
expiration date is 2-12-2013. These dates must appear on
the consent form.
Please note that Federal Policy requires that you notify
the IRB promptly regarding any of the following:
(1) Any additions or changes in procedures you might wish
for your study (additions or changes must be approved by
the IRB before they are implemented)
(2) Any events that affect the safety or well-being of
subjects
(3) Any modifications of your study or other responses that
are necessitated by any events reported in (2).
(4) To continue your research beyond the approval
expiration date of 2-12-2013 you must file additional
information to be considered for continuing review. Please
contact instreviewboard@calu.edu
Please notify the Board when data collection is complete.
Regards,
Robert Skwarecki, Ph.D., CCC-SLP
Chair, Institutional Review Board

Appendix C4
Individual Data Collection Sheet

Data Collection
Sheet
Subject #
Accuracy (m)
Condition

No Support

Tape

Brace

No Support

Tape

Brace

Trial
1
2
3
4
5
Average
Distance (m)
Condition
Trial
1
2
3
4
5
Average

Appendix C5
Figures for Target

Figure 1: Front view of target

Figure 2: Side view of target

Figure 3: Posterior view of target

80
REFERENCES
1.

Metcalfe RC, Schlabach GA, Looney MA, Renehan EJ. A
comparison of moleskin tape, linen tape, and lace-up
brace on joint restriction and movement performance. J
Athl Train. 1997;32(2):136-140.

Cordova ML, Takahashi Y, Kress GM, Brucker JB, Finch
AE. Influence of external ankle supports on lower
extremity joint mechanics during drop landings. J
Sport Rehabilit. 2010;12:136-148.

Cordova M, Scott B, Ingersoll C, LeBlanc M. Effects of
ankle support on lower-extremity functional
performance: a meta-analysis. Med Sci Sports Exerc.
2005;37:635-641.

DiStefano LJ, Padua DA, Brown CN, Guskiewicz KM. Lower
extremity kinematics and ground reaction forces after
prophylactic lace-up ankle bracing. J Athl Train.
2008;43(3):234-241.

Zinder SM, Granata KP, Shultz SJ, Gansneder BM. Ankle
bracing and the neuromuscular factors influencing
joint stiffness. J Athl Train. 2009;44(4):363-369.

Paris Dl, Vardaxis V, Kokkaliaris J. Ankle ranges of
motion during extended activity periods while taped
and braced. J Athl Train. 1995;30(3):223-228.

Martin N, Harter RA. Comparison of inversion restraint
provided by ankle prophylactic devices before and
after exercise. J Athl Train. 1993;28(4):324-329.

81
10.

Pederson TS, Ricard MD, Merril G, Schulthies SS,
Allsen PE. The effects of spatting and ankle taping on
inversion before and after exercise. J Athl Train.
1997;32(1):29-33.

11.

Norkus SA, Floyd RT. The anatomy and mechanisms of
syndesmotic ankle sprains. J Athl Train.
2001;36(1):68-73.

12.

Hume PA, Gerrard DF. Effectiveness of external ankle
support bracing and taping in rugby union. J Sports
Med. 1998;25(5):285-312.

13.

Andover Medical Supplies.
http://www.andovercoated.com/healthcare/moleskin.html
Online [Available] November 15, 2011.

14.

Elite Home Medical Supplies.
http://www.elitemedical.com/elasticon.html Online
[Available] November 15, 2011.

15.

http://www.orthoticsandbeyond.com/p-20-aircast-sportstirrup.aspx Online [Available] October 18, 2011.

16.

Active Ankle.
http://www.activeankle.com/products/rigids Online
[Available] October 18, 2011.

17.

Cascade http://www.cascade-usa.com/products/ Online
[Available] October 18, 2011.

18.

Swede-O Incorporated. http://www.swedeo.com/ Online
[Available] October 18, 2011.

19.

Bauerfeind Braces and Support.
http://activesupports.com/product/malleoloc-ankle.htm
Online [Available] October 18, 2011.

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ABSTRACT
Title:

The Effects of External Ankle Supports on
Functional Performance in Division II Female
Soccer Athletes

Researcher:

Lysha R. Draskovic, ATC

Advisor:

Edwin Zuchelkowski, PhD

Research Type: Master’s Thesis
Context:

Ankle injuries are among the most common
injury in athletics. It is a widely accepted
practice in the athletic training profession
to provide prophylactic ankle support to
individuals. There it little to no
information about the effects of external
ankle supports on functional performance
specific to soccer.

Objective:

The purpose of this study was to determine
the effects of external ankle supports (tape
and brace) on kicking accuracy and distance.

Design:

Quasi-experimental, within subjects,
repeated measure ANOVA design (on
condition).

Setting:

Data was collected outdoors, on an
artificial turf surface.

Participants:

16 female, 19.6 + 1.35 years of age with 12
to 17 years of experience, Division II
soccer athletes were used as subjects in
this study. This was a convenience sample.

Interventions: The independent variable, support condition
had three levels ASO® EVO® Ankle Stabilizer,
closed basket weave taping, and no support.
Main Outcome
Measures:

The dependent variables were distance (how
far a subject could kick a soccer ball with
maximal effort) and accuracy (how close to
the center of the target they could kick the
ball). Distance measurements were made using

85
a 300-foot tape measure. An 8’x8’ board was
used as a target. Subjects were provided 5
trials for each measure for each support
condition.
Results:

A repeated measures ANOVA was calculated
comparing the effect of support condition on
kicking distance and accuracy. A
significant effect was found for support
conditions having an effect on kicking
distance (F(2,30) = 11.382 p < 0.001). Post
hoc analysis determined there to be a
significant difference between no
support/taping and bracing (t(15) = 3.536 p
< 0.05). The average distance kicked was
29.77 + 4.936 meters. No significant effect
was found for support conditions having an
effect on accuracy (F(2,30) = 1.302 p >
0.05). The average distance kicked was 0.96
+ 0.207 meters. No significant effect was
found for tape having an effect of kicking
distance. The average kicking distance is
32.49 + 4.045 meters. No significant effect
was found for tape having an effect on
kicking accuracy. The average distance
kicked was 0.98 + 0.218 meters.

Conclusions:

Bracing decreased kicking distance. Taping
did not affect either accuracy or distance.
Athletes that wear a brace or get taped on a
consistent basis may have different results
than those that never had his or her ankles
taped or braced before. Taping has been
shown to decrease ankle injuries so if an
athlete has never been taped or braced, tape
is easier to adjust to than braces.