Melinda Franettovich

Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running

Objectives: To investigate the effect of an augmented LowDye taping technique on the medial longitudinal arch of the foot during dynamic tasks such as walking and jogging, and to elucidate the relation between tape induced changes in static and dynamic foot posture. Methods: Seventeen subjects (mean (SD) age 27 (5.8) years) who were asymptomatic and exhibited a navicular drop greater than 10 mm were studied. Medial longitudinal arch height standardised to foot length during standing and at mid-stance of walking and jogging was measured from digital video images taken before and after the application of an anti-pronation taping technique. A no tape control condition was also included. Results: Compared with the no tape control condition, tape produced a significant mean (SD) increase in the medial longitudinal arch height index of 0.031 (0.015), 0.026 (0.014), and 0.016 (0.017) during standing, walking, and jogging respectively (p<0.05). The relative increase in medial longitudinal arch height represents an anti-pronation effect. The tape induced changes in the medial longitudinal arch height measured during standing correlated strongly with those measured during walking and jogging (Pearson’s r  =  0.7 and 0.76 respectively). Conclusions: The augmented LowDye tape was effective in controlling pronation during both static and dynamic activity. Tape induced changes in static foot posture paralleled those during walking and jogging.

A physiological and psychological basis for anti-pronation taping from a critical review of the literature

Anti-pronation taping is a treatment technique commonly used by clinicians in the management of lower extremity musculoskeletal pain and injury. The clinical efficacy of anti-pronation tape is described anecdotally and has some support through clinical trials for some foot conditions. However, the mechanism(s) underlying its clinical efficacy is unknown, but are broadly categorized under mechanical, neurophysiological and psychological hypotheses. This article explores these hypotheses and contributes to the understanding of the technique.A computer database search was conducted to identify relevant experimental studies using an a priori defined search strategy. Data were extracted from reviewed articles and wherever possible mean differences between baseline and taped condition and the 95% confidence interval, as well as percentage change scores and effect size statistics were calculated. Articles were organized pertaining to the hypothetical mechanism investigated and presented accordingly into biomechanical, neurophysiological or psychological paradigms.Overall, the research to date has focused predominantly on the mechanical paradigm with far fewer papers being found for the neurophysiological and psychological paradigms. The literature provides evidence that anti-pronation tape has a biomechanical effect, which has been demonstrated by increases in navicular height and medial longitudinal arch height, reductions in tibial internal rotation and calcaneal eversion and alteration of plantar pressure patterns, under both static (i.e. standing) and dynamic (i.e. walking, jogging, running) conditions. The reduction in pronation was dependent on the surrogate measure of pronation used, but generally ranged from as little as 5% increase in longitudinal arch height during jogging to as much as a 33% change in calcaneal eversion during walking. Preliminary evidence from few studies suggests that anti-pronation tape has a neurophysiological effect as it has been shown to reduce the activity of several muscles of the leg during dynamic tasks such as walking, hopping, cutting, back pedalling and drop jumps. Data were difficult to extract from these papers, but it would appear from a small study that the reduction is in the order of about 45% for tibialis posterior.To date, there has been limited investigation of the psychological effects of anti-pronation tape. A main issue, as with most placebo or sham interventions for physical therapy research, is that of an appropriate comparator in this regard. Consequently, these effects are currently not well understood.This article reports of evidence in support of anti-pronation tape exerting a biomechanical effect. As its name suggests, it does reduce pronation. There is emerging evidence of a neurophysiological effect, which is generally one of reduction in muscle activity, but caution is urged in over-interpreting a few studies on small sample sizes. Further research is required in this paradigm before sports medicine practitioners can utilize these findings in day-to-day clinical practice. Due to insufficient evidence, this article was unable to draw any conclusions as to the psychological effects of the tape, but the article does prompt the need for further exploration into the possible role of placebo in the clinical effects of antipronation taping.

Tape that increases medial longitudinal arch height also reduces leg muscle activity: a preliminary study.

PURPOSE : To evaluate the initial effects of antipronation taping (APT) on foot posture and electromyographic (EMG) activity of tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) muscles during walking. METHODS : Five asymptomatic individuals who exhibited lower medial longitudinal arch height on a clinical assessment of gait walked on a treadmill for 10 min before and after the application of an APT technique-specifically, the augmented low-Dye. Arch height (AH) in standing as well as peak and average amplitude, duration, time of onset, and time of offset of recorded EMG activity during walking were analyzed for each condition. RESULTS : APT produced a mean (95% confidence interval (CI)) increase in AH of 12.9% (6.5-19.3; P = 0.005). Mean (95% CI) reductions in peak and average EMG activation of TA (peak: -23.9% (-34.0 to -13.9); average: -7.8% (-13.6 to -2.0)) and TP (peak: -45.5% (-77.3 to -13.7); average: -21.1% (-41.6 to -0.6)) were observed when walking with APT (P < 0.05). The APT also produced a small increase in duration of TA EMG activity of 3.7% (0.9-6.5) of the stride cycle duration, largely because of an earlier onset of EMG activity (4.4%; -8.1 to -0.8 of a stride cycle; P < 0.05). CONCLUSION : APT reduces activity of the TA and TP muscles during walking while increasing AH, which provides preliminary evidence of its role in reducing the load of these key extrinsic muscles of the ankle and the foot. Follow-up study is required to evaluate these findings.

The Ability to Predict Dynamic Foot Posture from Static Measurements

BACKGROUND A study was undertaken to investigate the ability to predict dynamic foot posture from static measurements. METHODS Arch height and arch height ratio measurements were obtained from videotape images of the medial aspect of the foot during standing, walking, and jogging in 5 male and 13 female asymptomatic subjects. RESULTS Arch height and arch height ratio measurements taken in standing explained 66% to 83% of the variance associated with these measurements at midstance during walking and running. Arch height and arch height ratio demonstrated high reliability as static and dynamic measures. CONCLUSIONS The results of this study support the use of arch height and arch height ratio measurements taken statically in the clinical assessment of the foot and may assist the clinician in estimating foot posture during dynamic activity in patients with lower-limb injuries.

Change in running kinematics after cycling are related to alterations in running economy in triathletes

Emerging evidence suggests that cycling may influence neuromuscular control during subsequent running but the relationship between altered neuromuscular control and run performance in triathletes is not well understood. The aim of this study was to determine if a 45 min high-intensity cycle influences lower limb movement and muscle recruitment during running and whether changes in limb movement or muscle recruitment are associated with changes in running economy (RE) after cycling. RE, muscle activity (surface electromyography) and limb movement (sagittal plane kinematics) were compared between a control run (no preceding cycle) and a run performed after a 45 min high-intensity cycle in 15 moderately trained triathletes. Muscle recruitment and kinematics during running after cycling were altered in 7 of 15 (46%) triathletes. Changes in kinematics at the knee and ankle were significantly associated with the change in VO(2) after cycling (p<0.05). The change in ankle angle at foot contact alone explained 67.1% of the variance in VO(2). These findings suggest that cycling does influence limb movement and muscle recruitment in some triathletes and that changes in kinematics, especially at the ankle, are closely related to alterations in running economy after cycling.

Continual use of augmented low-Dye taping increases arch height in standing but does not influence neuromotor control of gait

This study investigated the effect of continual use of augmented low-Dye (ALD) taping on neuromotor control of the lower limb during gait, as well as foot posture and mobility. Twenty-eight females were randomly allocated to wear ALD tape continuously or a no-tape control for a mean 12 + or - 2 days. Electromyographic activity from 12 lower limb muscles, three-dimensional motion at the ankle, knee, hip and pelvis (i.e., measures of neuromotor control) and foot posture and mobility was measured before and after the tape or control interventions. For the tape group, arch height ratio (=arch height/distance from heel to first metatarsophalangeal joint line) was greater by 0.006 (95% confidence interval: 0.0002-0.01, p = 0.04) following the intervention period, whereas no change was observed for the control group (-0.003 (-0.01-0.004), p = 0.36). The difference between groups (0.009 (0.0004-0.02), p = 0.04) equated to a 0.16 cm increase in arch height for the tape group following continual use of ALD tape. There was no change in neuromotor control of gait following continual use of ALD taping (p > 0.05). Continual use of ALD tape for approximately 12 days produced a small change in foot posture, but no alteration in neuromotor control. Previous literature suggests that this increase in arch height is likely to be clinically relevant and may be one factor that contributes to the known efficiency of ALD tape in the treatment of lower extremity pain and injury.

Augmented low-Dye tape alters foot mobility and neuromotor control of gait in individuals with and without exercise related leg pain

BackgroundAugmented low-Dye (ALD) tape is frequently used in the management of lower limb musculoskeletal pain and injury, yet our knowledge of its effect is incomplete, especially in regard to its neuromotor effects.MethodsWe measured electromyographic (EMG) activity of twelve lower limb muscles, three-dimensional kinematics of the ankle, knee, hip and pelvis, foot posture and foot mobility to determine the physiological effect of ALD tape. Fourteen females with exercise related leg pain and 14 matched asymptomatic females walked on a treadmill under three conditions: pre-tape, tape and post-tape. A series of repeated measure analysis of variance procedures were performed to investigate differences in EMG, kinematic, foot posture and mobility measurements.ResultsApplication of ALD tape produced reductions in recruitment of tibialis anterior (7.3%) and tibialis posterior (6.9%). Large reductions in midfoot mobility (0.45 to 0.63 cm) and increases in arch height (0.58 cm), as well as moderate changes in ankle motion in the sagittal (2.0 to 5.3°) and transverse planes (4.0 to 4.3°) were observed. Reduced muscle activation (<3.0%) and increased motion (<1.7°) was observed at more proximal segments (knee, hip, pelvis) but were of smaller magnitude than at the foot and ankle. Changes in foot posture, foot mobility, ankle kinematics and leg muscle activity did not persist following the removal of ALD tape, but at more proximal segments small changes (<2.2°, <5.4% maximum) continued to be observed following the removal of tape. There were no differences between groups.ConclusionsThis study provides evidence that ALD tape influences muscle recruitment, movement patterns, foot posture and foot mobility. These effects occur in individuals with and without pain, and are dissipated up the kinetic chain. ALD tape should be considered in the management of individuals where increased arch height, reduced foot mobility, reduced ankle abduction and plantar flexion or reduced activation of leg muscles is desired.

Altered Neuromuscular Control in Individuals with Exercise-related Leg Pain

PURPOSE To compare neuromuscular control ofthe lower limb during gait between individuals with and without a history of exercise-related leg pain (ERLP). METHODS Fourteen females with a history of ERLP and 14 age-, height-, and weight-matched asymptomatic female controls participated in the study.Electromyographic activity, normalized to maximum voluntary contraction (MVC), from 12 lower limb muscles during walking gait was the primary outcome. Secondary outcomes were three-dimensional kinematics of the lower limb during gait, measurements of static foot posture (arch height and midfoot width in weight bearing and non-weight bearing), and foot mobility (difference in arch height and midfoot width from non-weight bearing to weight bearing and foot mobility magnitude). RESULTS Individuals with a history of ERLP demonstrated lower peak activation (13.7% MVC, 95% confidence interval (CI) = 3.2%-24.3% MVC) and lower average activation of gluteus medius (2.3% MVC, 95% CI = 0.3%-4.3% MVC) when compared with controls (P G 0.05). This reduction in gluteus medius activation was moderately determined (57.1%, P = 0.01) by the duration (beta = 0.555) and severity of pain (beta = -0.516). Peak and average activation of lateral gastrocnemius were also lower than controls (20.5% MVC, 95% CI = 0.6%-40.5% MVC and 1.7% MVC, 95% CI = 0.2%-3.1% MVC, respectively) but were not explained by pain duration or severity. No differences in kinematics at the ankle, knee, hip and pelvis, or differences in static foot posture and mobility were observed between groups (P > 0.05). CONCLUSIONS This study provides evidence of altered neuromuscular control of gait in females with a history of ERLP. Further work is required to discern the clinical relevance of this finding.