EFFECT OF BRACING VERSUS TAPING ON POST VERTICAL JUMP
BALANCE

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
Nicole Marie Jussaume

Research Advisor, Dr. Shelly DiCesaro
California, Pennsylvania
2010

ii

iii

Dedicated to Paula Jussaume Quinn

"I don't need very much now," said the boy, "just
a quiet place to sit and rest. I am very tired."
"Well," said the tree, straightening herself up
as much as she could, "well, an old stump is good
for sitting and resting. Come, Boy, sit down. Sit
down and rest." And the boy did. And the tree was
happy.
Shel Silverstein “The Giving Tree”

iv

ACKNOWLEDGEMENTS
I first and foremost would like to thank my thesis
committee chair and members; Shelly DiCesaro, Tom West, and
Michael Meyer. My thesis would not have come to fruition
without your dedication and collaboration.
I would also like to thank all of my friends and
family members, immediate and extended, who have imparted
messages and letters of confidence and encouragement. I am
thrilled to come back to New England to see all of you
again.
To my parents; your unfailing love, support, and grace
have given me the strength to persevere throughout this
process. I cannot thank you enough for everything you have
provided me throughout my childhood, adolescence, and early
adulthood. This opportunity would not have been possible
without knowing I always had a comforting ear on the other
end of the receiver patiently listening and offering
advice.

v
TABLE OF CONTENTS
SIGNATURE PAGE

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

DEDICATION PAGE . . . . . . . . . . . . . . . . iii
AKNOWLEDGEMENTS . . . . . . . . . . . . . . . . iv
TABLE OF CONTENTS
LIST OF TABLES
INTRODUCTION
METHODS

. . . . . . . . . . . . . . . v

. . . . . . . . . . . . . . . . viii

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

. . . . . . . . . . . . . . . . . . . 4

RESEARCH DESIGN. . . . . . . . . . . . . . . . 4
SUBJECTS

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

PRELIMINARY RESEARCH. . . . . . . . . . . . . . 6
INSTRUMENTS . . . . . . . . . . . . . . . . . 6
SUPPORT CONDITIONS . . . . . . . . . . . . . . 7
TESTING INSTRUMENTATION . . . . . . . . . . . . 7
PROCEDURES. . . . . . . . . . . . . . . . . . 8
HYPOTHESES. . . . . . . . . . . . . . . . . . 10
DATA ANALYSIS
RESULTS

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

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

DEMOGRAPHIC DATA . . . . . . . . . . . . . . . 12
HYPOTHESIS TESTING
DISCUSSION .

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

. . . . . . . . . . . . . . . . . 16

DISCUSSION OF RESULTS . . . . . . . . . . . . . 16
CONCLUSIONS . . . . . . . . . . . . . . . . . 19

vi
RECOMMENDATIONS. . . . . . . . . . . . . . . . 20
REFERENCES . . . . . . . . . . . . . . . . . . 23
APPENDICES . . . . . . . . . . . . . . . . . . 27
APPENDIX A: Review of Literature

. . . . . . . . . 28

Introduction . . . . . . . . . . . . . . . . . 29
Ankle Anatomy and Physiology

. . . . . . . . . . 30

Mechanisms of Injury. . . . . . . . . . . . . 32
The Injured Ankle . . . . . . . . . . . . . 33
Mechanically and Functionally Unstable Ankles 34
Prophylactic Ankle Devices . . . . . . . . . . 35
Purpose of Pro phylactics . . . . . . . . . . 35
Ankle Taping . . . . . . . . . . . . . . . 36
Ankle Bracing . . . . . . . . . . . . . . . 37
Effects of Prophylactic Ankle Devices on
Performance

. . . . . . . . . . . . . . . 38

Vertical Jump Testing . . . . . . . . . . . 39
Speed and Agility Testing

. . . . . . . . . 40

Balance Testing . . . . . . . . . . . . . . 41
Summary . . . . . . . . . . . . . . . . . . . 43
APPENDIX B: The Problem . . . . . . . . . . . . . 45
Definition of Terms . . . . . . . . . . . . . . 46
Basic Assumptions . . . . . . . . . . . . . . . 47
Limitations of the Study . . . . . . . . . . . . 48
Significance of the Study. . . . . . . . . . . . 48

vii
APPENDIX C: Additional Methods .

. . . . . . . . . 50

Informed Consent Form (C1) . . . . . . . . . . . 51
IRB: California University of Pennsylvania (C2) . . . 55
Demographic Information Sheet (C3) . . . . . . . . 67
Individual Data Collection Sheet (C4) . . . . . . . 69
Subject Order of Support Condition Spreadsheet (C5) . 71
Ankle Support Conditions (C6) . . . . . . . . . . 73
AMTI OR6-7 Force Plate (C7) . . . . . . . . . . . 77
REFERENCES . . . . . . . . . . . . . . . . . . 79
ABSTRACT

. . . . . . . . . . . . . . . . . . 85

viii
LIST OF TABLES
Table

Title

Page

1

Subject Demographic Information

2

Mean Standard Deviation of Anterior/Posterior,
Medial/Lateral Center of Pressure and Mean
Overall Length Scores by Support Condition. .14

3

Mean Overall Length Scores by Support
Condition. . . . . . . . . .

.

.

.

.

.

.

.13

.14

1

INTRODUCTION

Ankle injuries are one of the most common injuries in
athletics.1-4 Prevention and treatment of ankle injuries
commonly includes the application of prophylactic devices
with several types of braces and various ankle-taping
methods available. These prophylactics are used to support,
protect, and potentially prevent further injury to the
affected area. There has been extensive research to
determine the effects of prophylactics on performance and
although there have been some mixed reviews, the majority
of studies have discovered little to no negative effect on
performance.5-12
Although potential impact on performance plays a large
role in the use of prophylactic devices, balance is another
factor associated with performance that warrants
experimental evaluation since balance may be affected by an
acute ankle sprain. Balance is stability produced by the
even distribution of weight along an axis; without the
ability to control this distribution, recurrent ankle
sprains occur and chronic ankle instability is common.13
Several tests measure balance including the Rhomberg Test,

2
Functional Reach Test and Star-Excursion Balance Test.14-18
The drawback to these balance tests is that they are not
functional measures, are performed with controlled
movement, and do not combine balance testing with athletic
performance.
Balance can also be measured digitally using force
platforms. These devices are typically used for their
accuracy, the output of an objective measure and the
various balance measures they can calculate.

Center of

pressure (COP) is one measure of balance that can be
calculated utilizing a force platform. The force platform
measures anteroposterior, mediolateral, and vertical forces
in the x, y and z axes. The information gathered from these
three planes allows for a measurement of the displacement
of center of foot pressure movements and postural sway.16
The deficits that can be measured by a force plate can
extend far past a single leg static test and has been used
during a vertical jump test to determine time to
stabilization after landing.17
The vertical jump is a functional movement required in
most sports and may potentially provide accurate functional
balance measurements when performed on the force platform.
Few studies have used a force platform to measure the
effects of prophylactics on COP during functional

3
testing.14,18 The effects of prophylactics on COP after a
vertical jump is important because it may be related to the
number of injuries that occur in sports requiring vertical
jumping as well as sprinting and agility. Determining the
best prophylactic device to minimize instability will help
decrease future injuries.
The purpose of this study was to examine the effect of
bracing and taping on post-vertical jump balance. The
following question will be addressed. Will there be a
difference in anterior/posterior standard deviation of
center of pressure (SDCOP), medial/lateral SDCOP, and
overall length COP depending on support condition?

4

METHODS
The purpose of this study was to determine the effects
of taping and bracing on post vertical jump balance. This
section includes the following subsections: Research
Design, Subjects, Preliminary Research, Instruments,
Procedures, Hypothesis, and Data Analysis.

Research Design

A quasi-experimental within subject research design
was used for this study. The independent variable was the
type of support condition. The three levels of support
included the Gibney ankle tape method (Appendix C6), ASO
EVO ankle brace (Appendix C6), and an un-taped control
condition. The other independent variable was a measurement
of balance in the anterior/posterior, medial/lateral
directions, and overall COP. The instrument used to
determine center of pressure was an AMTI OR 6-7 force plate
(Serial # 5386.1 Watertown, MA) with Net Force software
version 2.2.
Each subject was tested under all three levels of
prophylactic support during one testing session. To ensure

5
inter-tester reliability, the researcher was the only
person to fit the ankle brace and tape the ankle. The
subjects wore their personal athletic footwear for this
study. A convenient sample of NCAA Division II California
University of Pennsylvania athletes was used, limiting the
generalization of results. The subjects served as their own
control group through performance without the use of
bracing or taping.

Subjects

Subjects (N=15) in this research study were male and
female collegiate NCAA Division II athletes from California
University of Pennsylvania. The subjects were a sample of
convenience and included athletes with and without previous
history of ankle injury.
Each subject completed a Demographic Information Sheet
(Appendix C3) that included information about the subject’s
age, height, weight, previous and current injury to the
ankle, use of prophylactic ankle braces or taping, and
current visual, vestibular, and/or balance issues. Subjects
were restricted from further participation in the study if
they had any lower leg injury requiring medical attention
within 30 days leading up to the study, if the subjects had

6
any current lower leg injury that impeded their athletic
performance, or if they reported any visual, vestibular
and/or balance issues.

Preliminary Research

Pilot testing was conducted to determine how long
bracing, taping, and the vertical jump balance test would
take and to familiarize the researcher with the
instrumentation. Three college-aged students were used as
subjects for the pilot study. Each subject was fitted with
1 of the 3 support conditions and asked to perform a warm
up before the balance test was conducted. The warm up
consisted of a treadmill warm up and dynamic stretching
that is further discussed in the methods section.

Instrumentation

The following instruments were used in this study. A
Demographic Information Sheet created by the researcher
(Appendix C3), Individual Data Collection Sheet (Appendix
C4), and an Order of Support Condition Spreadsheet
(Appendix C5). The subjects’ names were not recorded during

7
this study; instead, each subject was assigned a subject
number based on the Order of Support Condition Spreadsheet.

Support
The support conditions were placed on the subjects’
dominant ankle; this was determined by their response to
Question 7, “what is your dominant leg (the leg you would
use to kick a ball)?”, on the Demographic Information
Sheet. The prophylactic ankle brace used in this study was
an ASO EVO ankle brace featuring; stirrup strap,
stabilizing strap, dynamic cuff with lace up closure,
bilateral capability and ballistic nylon base (Appendix
C6). The Gibney Ankle Taping Method was used for the taped
prophylactic support condition (Appendix C6).

AMTI Force Plate
An AMTI OR 6-7 force plate (Serial # 5386.1 Watertown,
MA) with Net Force software version 2.2 was used to collect
kinetic data (Appendix C7).

8
Procedures

Prior to testing, IRB approval was obtained from the
California University of Pennsylvania Institutional Review
Board for the Protection of Human Subjects (IRB) (Appendix
C2). Subjects were recruited from various men and women’s
California University of Pennsylvania Division II
intercollegiate teams.

The researcher explained the

purpose of the research to each subject when volunteers
were asked to participate.
During their pre-determined testing date, each subject
read and signed an Informed Consent Form (Appendix C1)
approved by the IRB. The researcher answered any questions
the subjects may have had. After signing the consent form
the subjects filled out the Demographic Information Sheet
(Appendix C3).
In order to determine the order of the support
conditions, each condition was assigned a number: 1) No
support 2) Braced 3) Taped. These 3 numbers were randomized
on an excel spreadsheet that acted as a counterbalance to
fatigue and learning over time. The first number on the
spreadsheet was the first support condition used during the
study, the second number was the second support condition
and the last number was the third support condition.

9
A warm-up was completed before performing each
vertical jump balance test, after the selected prophylactic
support condition had been applied. Each subject began with
a five minute light jog at a comfortable pace for the
athlete on a treadmill followed by a dynamic warm-up within
the testing facility. The dynamic warm-up consisted of high
knees, butt kicks, straight leg kicks, and side shuffles.
All components were completed twice in a 10 meter straight
line on the testing facility’s linoleum floor.
Subjects were individually introduced to the vertical
jump test on the force platform. The researcher
demonstrated to the subject how to perform the vertical
jump test and allowed the subject a test trial. A maximum
of 3 test trials were allowed for each subject to become
comfortable with the procedure. The subject was asked to
perform the vertical jump as if they were trying to grab a
basketball rebound. The subject began each vertical jump on
a level surface 30 centimeters away from the force platform
and then used both legs to vertically jump onto the area of
the force platform, landing only on the dominant leg (the
ankle with the support condition applied) and held the
landing for 5 seconds. The force platform measured the
subject’s anterior/posterior SDCOP, medial/lateral SDCOP,
and overall length COP upon landing.

10
Each subject performed 3 trials with a 30 second rest
between trials. The results were recorded on the Individual
Data Collection Sheet (Appendix C4). Up to 5 trials were
performed; a successful trial entailed remaining on the
force platform for a full 5 seconds, not falling off of the
force platform and not touching the non-dominant foot onto
the force platform. If 3 successful jumps were not
completed within those trials, the subject’s data were not
used. The mean overall length COP, anterior/posterior
SDCOP, and medial/lateral SDCOP scores were used for data
analysis and the protocol was the same for all three
support conditions.

Hypothesis

The following hypothesis was tested during this study:
The anterior/posterior SDCOP, medial/lateral SDCOP,
and overall length COP (ability to keep force evenly
distributed) will decrease under the braced condition
compared to tape and no support conditions, indicating an
increase in balance.

11
Data Analysis

A 3 x 3 factorial repeated measures analysis of
variance (ANOVA) was used to analyze the hypothesis
involving the support condition (brace, tape, control) and
balance measures in the anterior/posterior, medial/lateral,
and overall COP directions. The mean standard deviations of
length traveled (cm) in the X axis and Y axis were used for
the anterior/posterior and medial/lateral COP measurements
and the total length traveled (cm) was used for the overall
COP measurement. The level of significance for this study
was set at p ≤ 0.05 for the hypothesis. SPSS version 17.0
for Windows was used for the statistical analysis.

12

RESULTS
The purpose of this study was to examine if there would
be a significant difference between prophylactic bracing
and taping on post vertical jump balance. The independent
variables were support condition with three levels of
support (brace, tape, control) and balance measure with
three levels, the anterior/posterior SDCOP, medial/lateral
SDCOP, and overall length COP. The following section
contains the data divided into three subsections:
Demographic Information, Hypothesis Testing, and Additional
Findings.

Demographic Information

Fifteen (n=15) California University of Pennsylvania NCAA
Division II athletes from basketball (n=4), volleyball
(n=3) and track and field (n=8) participated in the study.
Subject demographics are displayed in the following table.

13
Table 1. Subject Demographic Information
Sport

N

Age(yrs)

Height(cm)

Basketball

4

Volleyball

3

Track and
Field
Total

8

21.00 ±
0.82
19.67 ±
0.58
19.38 ±
0.92
19.87 ±
1.06

194.31 ±
8.43
173.56 ±
3.89
169.88 ±
8.94
177.11 ±
13.21

15

Weight(kg)

93.29 ±
4.43
68.94 ±
4.41
61.14 ±
6.34
71.27 ±
15.02

Number of
Ankle
Sprains
1.25 ±
1.50
0.00 ±
0.00
1.00 ±
1.20
0.87 ±
1.19

Six subjects had sustained an ankle sprain to their
dominant leg and of those 6, 5 had sustained multiple ankle
sprains. Subjects were recruited by a sample of
convenience.

Hypothesis Testing

Hypothesis testing was performed utilizing the data
collected from the 15 subjects who met the specified
criteria described in the methods section. The hypothesis
was tested with a level of significance set at p ≤ 0.05.
Hypothesis 1: The anterior/posterior SDCOP,
medial/lateral SDCOP, and overall length COP (ability to
keep force evenly distributed) will decrease under the
braced condition compared to tape and no support
conditions, indicating an increase in balance.

14
A 3 x 3 factorial repeated measure ANOVA was
calculated comparing the anterior/posterior,
medial/lateral, and overall COP measures under three
different support conditions: control, brace, and tape.
Mean standard deviation scores of anterior/posterior and
medial/lateral COP are found in Table 2. Mean overall
length by support condition is found in Table 3.
Table 2. Mean Standard Deviation of Anterior/Posterior,
Medial/Lateral Center of Pressure and Mean Overall Length
Scores by Support Condition

Direction of
Measurement(cm)
Anterior/Posterior
Medial/Lateral

Control
2.57 ±
1.02
1.35 ±
0.49

Support Condition
Brace

Tape

2.26 ±
0.62
1.34 ±
0.40

2.91 ±
1.62
1.76 ±
1.39

Table 3. Mean Overall Length Scores by Support Condition
Direction of
Measurement(cm)
Overall Length

Control
124.83 ±
61.46

Support Condition
Brace
121.39 ±
58.54

Tape
177.89 ±
156.63

No significant main effect was found for support
condition (F(2,28) = 1.454, p > 0.05). This indicates there
is no difference in performance based upon support
conditions. The support x measure (F(4,56) = 1.441, p >
0.05) was also not significant. This indicates bracing and

15
taping did not affect measure differently. A significant
main effect on COP measure was found (F(2,28) = 81.388, p <
0.001). This indicates that varying scores were found for
the anterior/posterior, medial/lateral, and overall COP
measures.
Due to the significant difference found in the main
effect of COP measure, Post Hoc testing was performed.
Since the overall COP calculated total length traveled
while the medial/lateral and anterior/posterior
calculations were standard deviations of length traveled,
only the medial/lateral and anterior/posterior measures
were compared. Differences between anterior/posterior and
medial/lateral length traveled were examined utilizing a
paired samples t-test. The mean score for the
anterior/posterior measure was 2.57 cm ± 1.166 and the mean
score for the medial/lateral measure was 1.486 cm ± .884.
Subjects had significantly greater variability of COP in
the anterior/posterior direction than the medial/lateral
direction (t(44) = 12.628, p < 0.001).

16

DISCUSSION
The following section is divided into three
subsections: Discussion of Results, Conclusions, and
Recommendations.

Discussion of Results

Ankle injuries are widespread throughout athletics and
researchers have sought to decrease the incidence of ankle
injury without affecting athletic performance. While
several studies have been conducted to examine the effect
of prophylactic bracing and taping on performance, there is
limited research about the effect prophylactic bracing and
taping has on balance. Most studies have examined balance
via the Functional Reach Test, Star-Excursion Balance Test,
time to stabilization measures, and postural sway.18-21
Although this knowledge is useful, in order to fully
understand the effects of prophylactic bracing and taping
on balance, subjects should be instructed to perform
functional sport specific activities that are relative to
the athletes sport.

17
The purpose of this study was to examine the effect of
prophylactic bracing and taping on post vertical jump
balance in healthy male and female NCAA Division II
California University of Pennsylvania athletes. It was
hypothesized that the anterior/posterior, medial/lateral,
and overall center of pressure (ability to keep force
evenly distributed) would decrease under the braced
condition compared to tape and no support conditions,
indicating an increase in balance. Measurements in this
study were collected on a force platform and the data were
analyzed using the associated Net Force software.
Statistical analysis revealed no significant difference in
main effect support condition and main interaction support
x measure.
Although a significant difference was noted for main
effect on measure, this was to be expected due to the
variability of measures between the mean standard deviation
lengths of anterior/posterior and medial/lateral COP while
mean overall length was calculated using total length
traveled. A Post Hoc analysis noted subjects had
significantly greater variability of COP in the
anterior/posterior direction than the medial/lateral
direction. This anterior/posterior length increase is most

18
likely due to the forward motion in the X axis experienced
jumping on to the force platform.
The goal of using a prophylactic device such as an
ankle brace or taping is to prevent lateral ankle sprains
by restricting inversion. By applying external support to
the ankle, ligamentous structures are reinforced and ankle
stability is increased. Ankle bracing and taping have also
been demonstrated to enhance proprioception.22,23
Baier and Hopf24 conducted a single-limb standing
balance test in athletes with functional ankle instability
and found rigid and flexible ankle prophylaxis’s reduced
sway velocity, most likely due to increased ankle
proprioception. Prophylactic ankle taping was also
discovered to not impair performance of physically active
young individuals during counter movement jump tests,
static balance tests, and dynamic posturography tests.18
Prophylactic bracing conditions were determined to have no
effect on the Star Excursion Balance Test measures when
physically active volunteers were tested.25
One study that did functionally test prophylactic
ankle taping and bracing found no significant differences
between devices. Dynamic stability was measured with time
to stabilization on a force plate. The study consisted of
each subject performing a single leg jump-landing with

19
ankle tape, brace, both tape and braces application, and a
control condition without either tape or brace.26 The
methods and results are very similar to this current study.
In both cases, no difference between the control condition
and bracing, control condition and taping, and bracing and
taping conditions were found.
Results may not have been statistically significant
because 60% of the subjects had never sustained a dominant
leg ankle injury. Bracing has been shown to provide greater
benefit to subjects with a prior history of ankle sprains
compared to those who have no prior history.27 Future
studies should test for differences between healthy and
previously injured ankles.

Conclusions

This study revealed that there is no significant
effect on anterior/posterior SDCOP, medial/lateral SDCOP,
and overall length COP when tested under various
prophylactic support conditions; brace, tape, control. The
subjects in this study performed three jumps onto the force
platform each time a new support condition was applied and
the mean of each set of jumps was averaged for data
analysis. With this knowledge, athletic trainers can

20
continue to brace or tape athletes with confidence that
balance will not be affected by either support condition.

Recommendations

It is important for athletic trainers to understand
the biomechanical effects of ankle braces and taping. While
there are several studies examining the effects of
prophylactic bracing and taping on performance, and several
more that examine effects of prophylactic bracing and
taping on static balance, more research needs to be
conducted examining the effects of bracing and taping on
functional balance.
One recommendation for future research would be to
examine the effects of bracing and taping after a full
practice or game so that both the support condition and the
athlete’s are fatigued. While each subject was required to
complete a treadmill and dynamic warm-up with the support
condition applied, this was a brief bout of exercise
compared to a 2 hour practice or game. Balance could be
affected due to loosening of the support condition over
time as well as neuromuscular deficits due to muscle
fatigue.

21
Future studies can also analyze data using different
measures. While this study examined mean standard deviation
and overall length traveled on a force platform, the
computer software can examine several different
measurements like area of ellipse, minimum and maximum COP
in several directions, etc.
Another recommendation would be to perform the same
experiment with a cross section of gym flooring, turf, or
track composite material mounted on top of the force
platform to mimic actual playing surfaces. The force
platform is a stationary instrument with a metal landing
surface; most jumping activities occur on wood flooring,
turf, or grass fields. Applying a similar surface to the
force platform would also allow the athlete the chance to
wear sport specific footwear such as cleats or running
spikes. If the results were found to be the same as this
study, it would support the usage of taping and bracing
across several different types of sports.
One last recommendation would be to perform the
experiment with a larger number of support conditions and
subjects. There are several kinds of prophylactic braces on
the market today and studying their effects on balance
could provide a better option for increasing an athlete’s
balance. The results of this study can be generalized to

22
collegiate athletes, however future research should include
larger samples of varying types of athletes for further
generalization. Also, there will most likely be a greater
distribution of athletes with and without previous ankle
injury; data can be analyzed to examine the effects of
bracing and taping on these two groups. A larger subject
number can also decrease the amount of variability within
the study.

23

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24
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perspective. J Athl Train. 2002;37:446-457.

15.

Paris L. 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;27:253-256.

16.

Hodgson B, Laurie T, Cobb S, Higbie E. The effect of
external ankle support on vertical ground-reaction
force and lower body kinematics. J Sport Rehab.
2006;14:301-312.

17.

Ross S, Guskiewicz K, Yu B. Balance measures for
discriminating between functionally unstable and
stable ankles. Med Sci Sports Exerc. 2009;41(2):399407.

25

18.

Abian-Vicen J, Alegre L, Fernandez-Rodriguez J, Lara
A, Aguado X. Ankle taping does not impair
performance in jump or balance tests. Med Sci Sports
Exerc. 2008;7(3):350-357.

19.

Akbari M, Karimi H, Farahini H, Faghihzadeh S.
Balance problems after unilateral ankle sprains.
Journal of Rehabilitation Research & Development.
2006;43(7):819-823.

20.

Fu A, Hui-Chan C. Ankle joint proprioception and
postural control in basketball players with
bilateral ankle sprains. Am J of Sports Medicine.
2005;33(8):1174-1182.

21.

McGuine T, Greene J, Best T, Leverson G. Balance as
a predictor of ankle injuries in high school
basketball players. Clin J Sports Med.
2000;10(4):239-244.

22.

Cordova M, Ingersoll C, LeBlanc M. Influence of
ankle support on joint range of motion before and
after exercise: a meta-analysis. J Ortho Sports Phys
Ther. 2000;30(4):170-182.

23.

Hume P, Gerrard D. Effectiveness of external ankle
support. Sports Med. 1998;25(5):285-312.

24.

Baier M, Hopf T. Ankle Orthoses Effect on singlelimb standing balance in athletes with functional
ankle instability. Archives of Physical Medicine and
Rehabilitation. 1998;78(8):939-944.

25.

Hardy L, Huxel K, Brucker J, Nesser T. Prophylactic
ankle braces and star excursion balance measures in
healthy volunteers. J Athl Train. 2008;43(4):347351.

26.

Martin, R. Effects of ankle support on time to
stabilization of subjects with stable ankles.
http://hdl.handle.net/10156/1729. 2008.

26
27.

Olmsted L, Vela L, Denegar C, Hertel J. Prophylactic
ankle taping and bracing: a numbers-needed-to-treat
and cost-benefit analysis. J Athl Train. 2004;39:95100.

27

APPENDICES

28

APPENDIX A
Review of Literature

29

REVIEW OF LITERATURE
Ankle injuries are one of the most predominant
injuries in athletics today.1-4 Prophylactic taping and
bracing devices allow athletes to return to play with
support to the injured ankle. While there are several
different ways to tape and brace the injured ankle, there
is inconclusive evidence in the current research to support
the use of one of the methods as the most beneficial or
preferred.

Most evidence supports the use of prophylactic

devices in athletics because there are minimal negative
effects on an athlete’s performance.5-13
The purpose of this review of literature is to present
the reader with previous work examining the differences
between taping and bracing. This will be accomplished
through an examination of: Ankle Anatomy and Physiology,
Prophylactic Ankle Devices, and end with a Summary of the
research provided.

30
Ankle Anatomy & Physiology

The ankle is composed of 3 main joints; the talocrural
joint, the subtalar joint, and the tibiofibular syndesmosis
which allow the rear foot to move in all planar directions.
In order for the ankle to maintain stability, the joint
surfaces must articulate properly and the muscles and
ligaments surrounding the joint must provide stabilization
and limit range of motion.
The talocrural joint is formed from 3 separate bones
that form a hinge joint primarily responsible for
plantarflexion and dorsiflexion as well as the transfer of
torque forces between the lower leg and the foot. The dome
of the talus articulates with the medial and lateral
malleoli of the tibia and fibula respectively and during
full weight bearing, the articulating surfaces against the
talus aid in stabilization. There is a joint capsule and
several ligaments that support this joint including the
anterior and posterior talofibular ligaments and
calcaneofibular ligament laterally while the deltoid
ligament supports this joint medially.
The talus and calcaneus form the subtalar joint where
pronation and supination occur; this joint also aids in the
transfer of torque forces between the lower leg and foot.

31
The talus articulates posterior with the calcaneus and
anterior with the navicular tarsal bone. There are two
separate capsules within the cavity along with 3 intrinsic
subtalar ligaments and peripheral ligaments that include
the calcaneofibular, lateral talocalcaneal and
fibulotalocalcaneal ligaments. Although the calcaneofibular
ligament does not directly connect to the talus, its
relation to the talus helps prevent excessive inversion.
The distal tibiofibular joint is a syndesmosis between the
tibia and fibula. It is unlike the other 2 joints since
there is very little movement between these two bones;
however, the joint is vital to normal ankle biomechanics
and forms the superior border of the talocrural joint.
The muscles and tendons that cross the ankle complex
also contribute to function and stability at the ankle.
There are several muscles that cross the ankle at varying
locations to aid in the four main directions of movement.
These muscles include the anterior tibialis, extensor
digitorum longus and brevis, as well as the peroneous
longus, brevis and tertius. When these muscles
concentrically contract the force generates movement;
however, during eccentric contraction, the muscles act as
dynamic stabilizers.14

32
Ankle joint stabilization is derived from the
somatosensory system, also known as proprioception. The
function of this system is to detect sensory stimuli such
as touch, pain, pressure, and joint movements from
peripheral articular and musculotendinous receptors
concerning muscle length and tension changes as well as
joint position and motion. While there are cutaneous nerves
that aid in joint proprioception, mechanoreceptors found in
the joint capsule, bone and ligaments serve as range limit
detectors, joint compression sensors and signal the
presence of noxious stimuli.15 Ankle proprioception is an
important factor that affects susceptibility to ankle
sprains and in order to protect the mechanoreceptors
located within the skin, musculotendinous unit and within
the bone, joint ligaments and joint capsule, external ankle
prophylactic devices may be applied. The application of a
prophylactic device may actually increase proprioceptive
ability, therefore, decreasing the potential for injury.16

Mechanisms of Injury
Due to a stronger medial joint capsule and ligaments,
inversion sprains involving the lateral structures are more
common and are found to be the most common ankle injury in
recreational and competitive athletes.17 More than 50% of

33
the major injuries sustained in basketball are due to ankle
sprains while ankle sprains constitute 25% of all soccer
and volleyball injuries. Lateral ankle sprains occur during
activities like running, jumping, rapid change in
directions, or participating on an uneven surface when
excessive inversion and plantarflexion occurs.18
Following a lateral ankle sprain, functional
instability is hypothesized to predispose individuals to
re-injury because structural damage occurs to the
ligamentous tissue as well as nervous and musculotendinous
tissue around the ankle. These deficits may impair balance,
reduce range of motion, and impair proprioception.19

The Injured Ankle
The ankle is an intricate compilation of articulations
and musculotendinous connections that can be easily
disturbed. If excessive force is applied to the ankle,
damage to these structures can occur and predispose an
athlete to future injuries including a chronic functionally
and/or mechanically unstable ankle.19 Bracing and taping are
two prophylactic measures often used to protect ankles from
a sprain during athletic participation.17 The application of
an external ankle support can reduce ankle inversion in
turn reducing the risk of a lateral ankle sprain therefore

34
external ankle support should be encouraged when there is a
clear history of recurrent ankle sprains.16

Mechanically and Functionally Unstable Ankles
Two factors have been targeted as precursors to
chronic ankle impairments, mechanical and functional
instability. Mechanical instability occurs due to anatomic
changes that may occur due to an initial ankle sprain.
Changes occur in the synovial lining, as well as
degenerative changes, chronic laxity, and impaired
arthrokinematics. Functional instability is caused by
neuromuscular impairments related to proprioception,
strength, neuromuscular control, and postural control. The
combination of any of these mechanical and functional
impairments is believed to lead to recurrent ankle
sprains.14
If an athlete is predisposed to ankle injuries due to
mechanical and functional instability, preventive measures
should be taken to reduce the recurrence of injury. These
measures include proprioceptive exercises, muscle
strengthening, and the use of prophylactic devices.20

35
Prophylactic Ankle Devices

Prophylactic ankle devices are used to provide
external support to the ankle. There are different methods
of application with traditional athletic tape and several
types of braces on the market. A multitude of studies
examined the effectiveness of bracing and taping against
stability and performance.5-8,10-13,21

Purpose of Prophylactics
The goal of using a prophylactic device is to prevent
lateral ankle sprains by restricting inversion; athletes
with a previous history of inversion ankle sprains are the
most susceptible to reinjury.22 By applying external support
to the ankle, ligamentous structures are reinforced and
ankle stability is increased. Additionally, taping and
bracing have been shown to enhance proprioception.9,16
Several studies have demonstrated that both taping and
bracing protect against injury to the ankle thus reducing
the incidence of a secondary ankle sprain.23

36
Ankle Taping
Athletic tape is commonly used to support the ankle
joint to prevent ankle sprains and recover from previous
injuries.24,25 Although few studies have been conducted to
determine the best method for taping the ankle, the
research available has determined taping can prevent
lateral ankle injuries, especially among previously injured
ankles.26
While there are several styles of ankle taping, Gibney
ankle taping procedure is one of the most common taping
techniques used today. The Louisiana heel lock and figureof-eight wrapping patterns are also used in combination
with the basket weave in contemporary tape techniques.27
Literature has shown a basket weave with stirrups and heel
locks provides the best mechanical resistance against
inversion; excessive inversion is the most common mechanism
of lateral ankle sprains.28 Tape application can be
advantageous to braces because it can conform to the
athlete’s anatomy more precisely and address more
individualized biomechanical problems.
According to Garrick and Requa’s29 study there was a
significant decrease in ankle sprain rates among intramural
basketball players when their ankles were taped. Taping has
been shown to also prevent ankle sprains in soccer players

37
due to the increase mechanical and functional stability.24
Wilkerson27 noted that taping may facilitate the use of
dynamic neuromuscular protective mechanisms and provides a
means to address biomechanical factors responsible for
instability of the talocural joint. Although ankle taping
is a standard practice for athletic trainers, more research
is needed to determine the effectiveness of ankle taping.

Ankle Bracing
Ankle braces are also frequently used after acute
ankle sprains as well as for chronic ankle instability and
offer an alternative to ankle taping.30 This type of support
structure is usually composed of a thermoplastic material
and molded to conform to the user’s foot and ankle in a
stirrup fashion as well as lace up canvas construction.31
Ankle bracing can offer advantages during the acute
management phase of ankle sprains due to its ease of
application and removal, adjustability of tension and in
some cases, edema reduction.27 A cost-benefit analysis
revealed that in a given athletic season, bracing is three
times more cost effective than taping.22
Cordova et al.’s32 analysis regarding the influence of
ankle prophylactics on joint range of motion demonstrated
that a semi-rigid support condition offered restriction of

38
motion in the medial/lateral plane. Semi-rigid ankle
stabilizers have been established to reduce injury to the
ankle ligaments in basketball players.33 When female
subjects used a semi-rigid orthotic during a 3 hour
volleyball practice, the orthotic was effective in
providing initial ankle protection and in guarding against
ligamentous injury.34 Pedowitz et al.35 also found
prophylactic bracing significantly reduced the ankle injury
rate associated with loss of play among Division I female
college volleyball players.

Effects of Ankle Prophylactics on Performance
While the purpose of prophylactic ankle devices is
prevention of primary injury and reduce recurrence of reinjury, competitive athletes are concerned with the devices
effect on performance. If athletes feel they are at risk of
affecting optimal performance they tend to opt out of using
prophylactic devices. The needs of athletic performance
must be weighed against the need for the prevention of
injury to the athlete’s ankle. The athlete’s ankle should
have adequate proprioceptive support and stability without
a significant compromise in performance. Three common
measures of performance are vertical jump, speed and
agility testing.5-8,10-13,21,29

39
Vertical Jump Testing
Jumping is commonplace in several athletic arenas
including basketball, volleyball, and track events. A
multitude of sports also incorporates jumping maneuvers
during competition such as football, volleyball, and
soccer. Since vertical jump testing is a good measure of
power, testing various ankle prophylactic devices during a
vertical jump determines if there is positive, negative, or
neutral effect on power.
Several methods of vertical jump testing have been
used throughout the studies reviewed. Procedures ranged
from putting chalk on the subject’s fingers and performing
a vertical jump next to a wall to using electronic systems
like the VertexTM or Just Jump SystemTM.

6-8,10,12,13,21,36

Vertical jump performance has been tested using taping
methods as well as a variety of bracing methods. Semi-rigid
and soft-shell prophylactic ankle braces were used to
determine their effect on vertical jump height among high
school football players. Both braced conditions had no
significant effect on vertical jump performance.6 A similar
vertical jump study used high school basketball players and
noted no significant differences among the two semi-rigid
prophylactic bracing devices.7 MacKean et al.21 compared the
effectiveness of ankle taping and semi-rigid orthotic

40
discovered that vertical jump height decreased with the use
of the semi-rigid orthotic and was even less with ankle
tape as compared with no tape while Verbrugge’s13 study
noted no impediment on vertical jump height with both a
semi-rigid brace and conventional tape.
Most studies used in this review that compared ankle
bracing to taping concluded that there was very little to
no detrimental effect on vertical jump performance.37
Athletes and athletic trainers should consider the minimal
negative effects on performance is warranted.21

Speed and Agility Testing
Speed and agility is a component of nearly every
athletic competition. As explained above, athletes will
most often refuse to wear any type of prophylactic device
if they feel their speed and agility may be compromised.
There are several tests that can be performed to measure
speed and agility, including sprinting speed, timed shuttle
runs, four point run performance tests, and T-tests.
Several studies have been conducted to determine if certain
ankle braces and tape applications affect these two
factors.5-8,10-13,37,21
Verbrugge’s13 study comparing the effects of bracing
versus taping on motor performance concluded that while the

41
male athletes tested found using a brace to be more
comfortable, both taping and bracing have no substantial
effect on agility and sprinting speed. Several studies
utilized similar performance testing among high school
football and basketball players and noted bracing had no
significant effect on speed and agility.6,7
Among 30 college athletes tested under braced and
taped conditions, there was a significant decrease in
sprinting and agility performance while taped and a minor
decrease while braced.11 Paris37 conducted a study using 18
elite soccer players and found no significant differences
in speed and agility under braced and taped support
conditions. Although some studies have indicated a decrease
in speed and agility performance, literature supporting the
use of external ankle prophylactics for the prevention of
injury outweighs the possibility of performance impairment.

Balance Testing
Although balance is not perceived as a measure of
performance, athletes may notice performance deficits if
their balance is compromised. After an acute lateral ankle
sprain occurs, balance problems may develop because of
damage to musculotendinous and ligamentous tissues that
proprioceptive feedback.38 Balance deficits can been tested

42
through varying functional tests including the Functional
Reach Test, Star-Excursion Balance Test, time to
stabilization measures, and postural sway.38-41 During a
study examining stabilization times with functionally
unstable ankles, Ross et al.42 discovered time to
stabilization was longer for participants with functional
ankle instability than those with stable ankles. Fu and
Hui-Chan39 found basketball players with multiple ankle
sprains had increased errors in repositioning and postural
sway. In a similar study, McGuine et al.41 assessed
susceptibility to ankle injury in high school basketball
players and found athletes who demonstrated high postural
sway scores had nearly 7 times as many ankle sprains as
compared to athletes with low postural sway scores.
Similar balance tests have been conducted using
different prophylactic devices. Baier and Hopf43 conducted a
single-limb standing balance test in athletes with
functional ankle instability and found rigid and flexible
ankle prophylaxis’s reduced sway velocity, most likely due
to increased ankle proprioception. Ankle taping was also
discovered to not impair performance of physically active
young individuals during counter movement jump tests,
static balance tests, and dynamic posturography tests.40
Prophylactic bracing conditions were determined to have no

43
effect on the Star Excursion Balance Test measures when
physically active volunteers were tested.44
One study that did functionally test prophylactic
ankle taping and bracing found no significant differences
between devices. Dynamic stability was measured with time
to stabilization on a force plate. The study consisted of
each subject performing a single leg jump-landing with
ankle tape, brace, both tape and braces application, and a
control condition without either tape or brace.45
Most of the tests found in this literature review were
static or did not require functional athletic movements. In
order to fully understand the effects of prophylactic
bracing and taping on balance, subjects should be
instructed to perform functional sport specific activities
that are relative to the athletes sport. Also, some tests
relied on the investigator to keep balance scores instead
of using a measurement device to accurately collect data.

Summary

Prophylactic ankle devices and their effects on
performance have been thoroughly studied. In most cases
ankle bracing and taping have not shown to negatively
affect performance.5-13 Balance has also been studied in

44
conjunction with prophylactic ankle devices; however, there
is minimal research about the functional effects of
prophylactic ankle devices and balance. Athletes typically
do not stand still during athletic events; therefore, a
stationary test does not offer enough data to support or
negate the effects of prophylactics on balance.
Performing a vertical jump with varying ankle support
conditions to examine balance may be more of a functional
movement rather than statically standing on a force
platform. If the athletic trainer is aware of the
difference in balance when applying varying support
conditions he can more accurately assess the best
prophylactic device needed to increase their athlete’s
balance.

45

APPENDIX B
The Problem

46

THE PROBLEM
The purpose of this study was to determine if bracing
and taping have an effect on post-vertical jump balance.
Subjects performed a vertical jump onto a force platform
and land on the dominant leg with the applied prophylactic
condition.
Studying the effects of prophylactic ankle devices on
balance is important due to the effect an ankle injury has
on balance. Understanding the effects of prophylactic
devices on balance may help sports medicine professionals
determine the type of device that would benefit their
athletes the most.

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

Balance- the ability to maintain a position of
equilibrium; may be measured by postural sway.

2)

Postural Sway- the deviation from the mean center of
pressure of the foot for a given trial.14

47
3)

Center of Pressure- the central point of pressure that
is applied to the foot during standing on the ground.

4)

Prophylactic Ankle Device- a device applied to the
ankle to provide stability, support, and help prevent
injuries to the ankle.

5)

Proprioception- the afferent information derived from
muscles, tendons, joint capsules, and ligaments.46

6)

Chronic Ankle Instability- a combination of mechanical
and functional instability that leads to recurrent
ankle sprains.19

Basic Assumptions
The basic assumptions for this study are as follows:
1)

All subjects will be honest in reporting no previous
lower extremity injury within the past six months.

2)

All subjects will be honest in reporting no current
visual, vestibular or balance issues.

3)

The equipment will be calibrated and work properly
during the study.

4)

All subjects will give their best effort during the
vertical jump balance testing.

5)

All subjects will participate in this study without
any form of coercion.

48
Limitations of the Study
The limitations for this study are as follows:
1)

Testing will be done with a force platform, which
means the athletes will not be landing on a surface
used in their sport.

2)

Athletes will be required to wear their own athletic
footwear during testing. This footwear may not be the
same footwear used in their sport and some athletes
may wear more supportive shoes than others.

3)

Only the ASO EVO ankle brace will be used so the
results will only be generalized for post vertical
jumps with this brace.

Significance of the Study
The significance of this study is to expand the
understanding of ankle bracing and taping and their effects
on post vertical jump balance. During exercise of athletic
performance, a person’s balance is constantly changing due
to forces on the body. The ability to maintain one’s
balance can be measured through the use of center of
pressure measurements. When a force is applied to the body
and a person is unable to maintain a reasonable center of
pressure, injury may occur.

49
Many authors have examined the mechanisms of ankle
injury and prophylactic devices used for prevention and
support.9,16,20,24,26,27,29,31,33,34,35,47,48 Several others have
examined the relationship between prophylactic devices and
performance.5-13 However, there are a limited number of
studies examining these devices effect on balance during
functional activities.
The vertical jump is a functional movement that is
used in a variety of sports and contains two specific
motions (ankle plantarflexion and inversion) that most
commonly result in ankle injury. The findings of this study
may demonstrate that post vertical jump center of pressure
is significantly different between ankle bracing and ankle
taping. If this difference is demonstrated, athletic
trainers may reconsider the use of ankle bracing and taping
for the support and prevention of ankle injuries.

50

APPENDIX C
Additional Methods

51

APPENDIX C1
Informed Consent Form

52

Informed Consent Form
1. Nicole Jussaume, 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 Bracing versus Taping on Post
Vertical Jump Balance.
2. I have been informed that the purpose of this study is
to examine the effects of bracing and taping on post
vertical jump balance. 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 30 other individuals
because I have no current lower extremity injury impeding
my athletic performance nor have I suffered a lower
extremity injury requiring medical attention within the
last 30 days, I am not suffering from any visual,
vestibular or balance issues, and I am a NCAA Division II
California University of Pennsylvania collegiate athlete.
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 involve two
different external ankle support conditions, athletic tape
and bracing, and then partaking in an 8-10 minute dynamic
warm-up that includes a 5 minute light jog on a treadmill
as well as dynamic stretching exercises. The test I will be
performing immediately after the dynamic warm-up is a
vertical jump test using a force platform. My participation
in this study will consist of a brief orientation session
that is included in three testing days.
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. The
possible risks and/or discomforts include possible lower
extremity injury due to falling from loss of balance and
minor fatigue due to the dynamic warm-up. To minimize these
risks the researcher will be asking me questions about
prior injury to my lower extremity. The researcher will
also stand by closely during the vertical jump testing in
case I need help or begin to fall.

53
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, Nicole Jussaume, under the supervision of the
Cal U athletic training faculty, all of which can
administer emergency care. Additional services needed for
prolonged care will be referred to the attending staff at
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
effects of bracing and taping on post vertical jump
balance. This study can help athletic trainers decide a
preferred method of providing external ankle support to
their athletes.
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, Nicole Jussaume 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:
Nicole Jussaume, ATC
STUDENT/PRIMARY RESEARCHER
jus0205@calu.edu
603-508-1542
Shelly Fetchen DiCesaro, PhD, ATC, CSCS
RESEARCH ADVISOR
dicesaro@calu.edu
724-938-4562

54
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
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:
3/18/10 to 3/18/11.
Subject's Signature:__________________Date:________________
Witness Signature:____________________Date:________________

Approved by the California University of Pennsylvania IRB.

55

APPENDIX C2
Institutional Review Board –
California University of Pennsylvania

56
Institutional Review Board
California University of Pennsylvania
Psychology Department LRC, Room 310
250 University Avenue
California, PA 15419
instreviewboard@cup.edu
instreviewboard@calu.edu
Robert Skwarecki, Ph.D., CCC-SLP,Chair

Nicole Jussaume,
Please consider this email as official notification that your proposal titled “Effect of
Bracing Versus Taping on Post Vertical Jump Balance” (Proposal #09-057)
has been approved by the California University of Pennsylvania Institutional
Review Board as amended.
The effective date of the approval is 3-18-2010 and the expiration date is 3-18-2011.
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 3-182011 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

57
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 EFFECT OF BRACING VERSUS TAPING ON POST VERTICAL JUMP BALANCE
Researcher/Project Director Nicole Jussaume
Phone # 603-508-1542

E-mail Address jus0205@cup.edu

Faculty Sponsor (if required) Shelly Fetchen DiCesaro, PhD, ATC,CSCS
Department Health Science
Project Dates March 18, 2010 to March 18, 2011
Sponsoring Agent (if applicable)
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

58
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 will be to examine the relationship between ankle bracing and taping on
post vertical jump balance. Healthy National Collegiate Athletic Association (NCAA) Division II
collegiate athletes from the California University of Pennsylvania age 18 or older are expected to
participate in this study (N=20). All subjects have undergone a pre-season physical prior to their
sport season. Subjects who suffer from any visual, vestibular, balance disorder, serious lower
extremity injury within 30 days prior to the test and/or currently suffering from lower extremity
injury will be excluded from this study.
Each subject who signed the informed consent (attached) and is not suffering from any of the
aforementioned conditions will have one measure of balance performed under three support
conditions (no support, ASO ankle brace, Gibney ankle tape method) during one testing session.
A warm-up will be completed before performing each vertical jump balance test and after the
application of the support condition. Each subject will begin with a five minute light jog at a
comfortable pace on a treadmill followed by a dynamic warm-up within the testing facility. The
warm-up will consist of high knees, butt kicks, straight leg kicks and side shuffles. All
components will be completed twice in a 10 meter straight line. This dynamic warm-up will be
completed after each support condition is applied. The total time for warm-up will take 10
minutes.
Subjects will be individually introduced to the vertical jump test on the force platform. The
researcher will demonstrate to the subject how to perform the vertical jump test and allow the
subject a test trial. One to 3 test trials will be allowed for each subject to become comfortable with
the procedure. The subject will perform the vertical jump as if the subject were trying to grab a
basketball rebound. The subject will begin each vertical jump on a level surface 30 centimeters
away from the force platform and then vertically jump onto the force platform landing only on the
dominant ankle (the ankle with the support condition applied). The force platform will measure
the subject’s anterior/posterior, medial/lateral, and overall COP post vertical jump.
Each subject will perform 3 trials with a 30 second rest between trials. The results will be
recorded on an Individual Data Collection Sheet. Up to 5 trials may be performed; a successful
trial entails remaining on the force platform for a full 5 seconds, not falling off of the force
platform and not touching the non-dominant foot onto the force platform. If 3 successful jumps
are not completed within those trials, the subject’s data will not be used. The mean overall,
anterior/posterior, and medial/lateral COP scores will be used for data analysis and the protocol
will be the same for all three support conditions. Subjects may withdraw from the research at any
time without penalty. Subjects who do not successfully complete the study will be eliminated
from the study without penalty.
The following are the hypotheses for this study: 1) The overall COP (ability to keep force
evenly distributed) will decrease under the braced condition compared to taped and no support
conditions, indicating an increase in balance. 2) The anterior/posterior COP (ability to keep force
evenly distributed) will decrease under the braced condition compared to taped and no support
conditions, indicating an increase in balance. 3) The medial/lateral COP (ability to keep force
evenly distributed) will decrease under the braced condition compared to taped and no support
conditions, indicating an increase in balance.

59
A multivariate analysis of variance (MANOVA) will be used to analyze the hypotheses
involving the support condition (braced, taped, no support) and the dependent variable (COP).
The level of significance for this study will be set at ≤ 0.05 for the hypotheses. SPSS version 17.0
for Windows will be used for the statistical analysis.

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 very minimal and include falling down
during vertical jump balance testing and minor fatigue due to warm-up protocol. The
researcher will minimize the risk of falling by acting as a spotter. If an injury occurs, the
researcher, who is a certified athletic trainer and is certified in CPR, will provide care to
the subject in the Hamer Hall Athletic Training Room.
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.
All subjects will be volunteers who are eighteen years or older and are NCAA
Division II collegiate athletes at the California University of Pennsylvania. Prior to the
study, an informational e-mail will be sent out to the potential subjects to explain the
concept of the study with exclusion criteria. Subjects who suffer from any visual,
vestibular, balance disorder, serious lower extremity injury within 30 days prior to the
test and/or currently suffering from lower extremity injury will be excluded from this
study.
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.
An informed consent form (attached) will be completed and signed by all subjects
before participating in this study on the first day of testing. Each signed form will be kept
by the researcher in a secure location in which only the researcher and research advisor
can access to ensure subject confidentiality.

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.
Data will be collected during the spring semester. All subjects will come once to
measure post vertical jump balance based on three different support conditions (no
support, ASO ankle brace, Gibney ankle tape method). All collected data which will be
identified by subject number will be maintained by the researcher in a secure location in
which only the researcher and research advisor can access to ensure subject
confidentiality.

60

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?

Yes or

Yes or
No

No. If yes, Explain here.

If yes, provide the following information:

Title of the Grant Proposal
Name of the Funding Agency
Dates of the Project Period
6. Does your project involve the debriefing of those who participated?

Yes or

No

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.

61
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)?
(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?

62
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?
(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?

63
(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 research-related 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?
(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)

64
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.
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?

65
(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
(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?

66
Project Director’s Certification
Program Involving HUMAN SUBJECTS
The proposed investigation involves the use of human subjects and I am submitting the complete
application form and project description to the Institutional Review Board for Research Involving
Human Subjects.
I understand that Institutional Review Board (IRB) approval is required before beginning any research
and/or data collection involving human subjects. If the Board grants approval of this application, I
agree to:
1. Abide by any conditions or changes in the project required by the Board.
2. Report to the Board any change in the research plan that affects the method of using human
subjects before such change is instituted.
3. Report to the Board any problems that arise in connection with the use of human subjects.
4. Seek advice of the Board whenever I believe such advice is necessary or would be helpful.
5. Secure the informed, written consent of all human subjects participating in the project.
6. Cooperate with the Board in its effort to provide a continuing review after investigations have
been initiated.
I have reviewed the Federal and State regulations concerning the use of human subjects in research
and training programs and the guidelines. I agree to abide by the regulations and guidelines
aforementioned and will adhere to policies and procedures described in my application. I understand
that changes to the research must be approved by the IRB before they are implemented.
Professional Research
Project Director’s Signature

Department Chairperson’s Signature

Student or Class Research
Student Researcher’s Signature
Supervising Faculty Member’s Signature if
required

Department Chairperson’s Signature

ACTION OF REVIEW BOARD (IRB use only)
The Institutional Review Board for Research Involving Human Subjects has reviewed this application
to ascertain whether or not the proposed project:
1. provides adequate safeguards of the rights and welfare of human subjects involved in the
investigations;
2. uses appropriate methods to obtain informed, written consent;
3. indicates that the potential benefits of the investigation substantially outweigh the risk
involved.
4. provides adequate debriefing of human participants.
5. provides adequate follow-up services to participants who may have incurred physical, mental,
or emotional harm.
Approved[_________________________________]
Disapproved
________________________________________
Chairperson, Institutional Review Board

_______________________
Date

67

APPENDIX C3
Demographic Information Sheet

68

DEMOGRAPHIC INFORMATION SHEET
Subject #: ________
1. Sport: _____________________

4. Age:_________________

2. Position: __________________

5. Height: _____________

3. Gender:_____________________

6. Weight: _____________

Please Circle the Appropriate Answer
7. What is your dominant leg (the leg you would use to kick
a ball)?

RIGHT

LEFT

8. Have you ever sustained an ankle sprain to your dominant
ankle?
If YES, how many?

YES

NO

1 2 3 4 or >4

9. Do you have any current lower extremity injuries or any
lower extremity injuries that have required medical
attention in the last 30 days?

YES

NO

10. Are you experiencing any lower extremity issues that
currently affect your athletic performance?

YES

NO

11. Have you ever worn any type of ankle brace or tape
application in high school or college?

YES

NO

12. Are you currently suffering from any visual, vestibular
or balance disorders?

YES

NO

69

APPENDIX C4
Individual Data Collection Sheet

70

INDIVIDUAL DATA COLLECTION SHEET
Subject #: _____________________
Weight (Newtons): ____________________
CONTROL
Peak Impulse (Newtons): ________________
Average COP (cm): 1_____2_____3_____Mean_______
Average COP along X (cm): 1_____2_____3_____Mean_____
Average COP along Y (cm): 1_____2_____3_____Mean_____
ASO ANKLE BRACE
Peak Impulse (Newtons): ________________
Average COP (cm): 1_____2_____3_____Mean_______
Average COP along X (cm): 1_____2_____3_____Mean_____
Average COP along Y (cm): 1_____2_____3_____Mean_____
GIBNEY ANKLE TAPE METHOD
Peak Impulse (Newtons): ________________
Average COP (cm): 1_____2_____3_____Mean_______
Average COP along X (cm): 1_____2_____3_____Mean_____
Average COP along Y (cm): 1_____2_____3_____Mean_____

71

APPENDIX C5
Subject Order of Support Condition Spreadsheet

72

SUBJECT #

Order of Support Condition

1

1

2

3

2

2

1

3

3

3

1

2

4

1

3

2

5

2

3

1

6

3

2

1

7

1

2

3

8

2

1

3

9

3

1

2

10

1

3

2

11

2

3

1

12

3

2

1

13

1

2

3

14

2

1

3

15

3

1

2

16

1

3

2

17

2

3

1

18

3

2

1

19

1

2

3

20

2

1

3

21

3

1

2

22

1

3

2

23

2

3

1

24

3

2

1

25

1

2

3

26

2

1

3

27

3

1

2

28

1

3

2

29

2

3

1

30

3

2

1

73

APPENDIX C6
Ankle Support Conditions

74

The ASO EVO Ankle Stabilizing Orthosis® Ankle Brace
http://www.asoankle.com

75

Gibney Ankle Tape Method49
1. The athlete’s foot should be maintained in full
dorsiflexion. Spray the front and back of the ankle with
tuff-skin. Place a lubricated heel and lace pad on the
anterior and posterior surface of the ankle. Apply under
wrap to the skin around the mid-forefoot spiraling upward
to just below the belly of the gastrocnemius muscle.
2. Using 1½” white adhesive tape, apply one anchor to the midarch. Apply three overlapping anchors to the lower leg
directly below the gastrocnemius muscle.
3. Apply one stirrup starting on the medial upper anchor and
finishing on the lateral upper anchor. Apply one “U” strip
starting on the medial mid-arch anchor and finishing on the
lateral mid-arch anchor. Repeat this step two more times.
Alternate the stirrups (moving forward) with the “U” strips
(moving upward), in each case overlapping by half the width
of the tape.
4. Start the figure-of-8 support strip on the medial side of
the ankle, just above the malleolus. Travel posterior
around the ankle, across the anterior ankle and continue
down the medial side of the ankle, underneath the foot.
Continue by pulling up on the lateral side, across the
anterior and pulling around to the posterior ankle to
finish this figure-of-8 on the anterior of the ankle.

76
5. The first heel lock starts on the medial side of the ankle
just above the malleolus. Continue around the posterior
ankle, across the anterior, down the medial side, under the
foot and pulls up on the lateral side of the heel. The
second heel lock continues from the posterior, travels
across the anterior, down the lateral side, under the foot
and pulls up on the medial side of the heel.
6. Repeat steps 4 and 5.
7. Begin closure of the lower leg starting just above the
malleolus and working upwards. Overlap each strip be half
the width of the tape and follow the leg contours. Apply a
finishing forefoot closure to seal the ends of all the “U”
strips.

77

APPENDIX C7
AMTI OR 6-7 Force Plate

78

AMTI OR6-7 Force Plate
http://amti.biz/

79

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Miller E, Hergenroeder A. Ankle bracing. Ped Clin
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Hertel J. Functional Anatomy, pathomechanics, and
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ABSTRACT
Title:

THE EFFECT OF BRACING VERSUS TAPING ON POST
VERTICAL JUMP BALANCE

Researcher:

Nicole M. Jussaume

Advisor:

Dr. Shelly DiCesaro

Date:

4/29/2010

Research Type: Master’s Thesis
Context:

There is little research studying the
effects of ankle prophylactics on balance
during functional movement. Understanding
the effects of prophylactic devices on
balance may help sports medicine
professionals determine the type of device
that would most benefit their athletes.

Objective:

The purpose of this study was to determine
the effect of prophylactic bracing versus
taping on single leg post vertical jump
balance.

Design:

Quasi-experimental, within subjects,
repeated measure design.

Setting:

Controlled laboratory setting.

Participants:

15 California University of Pennsylvania
NCAA Division II collegiate athletes with no
lower extremity injury within 30 days of the
study and no visual, vestibular or balance
issues.

Interventions: Subjects were tested during a single
session. All subjects performed a 5 minute
treadmill jog at a comfortable pace set by
the subject followed by a dynamic warm-up.
Subjects performed 3 jumps after each
randomly selected support condition was

86
applied and their data were averaged for the
three jump trials.
Main Outcome
Measures:

Anterior/posterior mean standard deviation
of center of pressure (SDCOP),
medial/lateral SDCOP, and overall length
traveled.

Results:

No significant main effect was found for
support condition (F(2,28) = 1.454, p >
0.05) or for the support x instructor
interaction (F(4,56) = 1.441, p > 0.05). A
significant main effect on COP measure was
found (F(2,28) = 81.388, p < 0.001).

Conclusion:

This study revealed that there is no
significant effect on anterior/posterior
SDCOP, medial/lateral SDCOP, and overall
length traveled when tested under various
support conditions; brace, tape, control.
With this knowledge, athletic trainers can
continue to brace or tape athletes with
confidence that balance will not be affected
by either support condition.

Word Count:

294