Evidence-based Sports Medicine

Evidence-based Sports MedicinePeroneal reaction timeThe most commonly investigated muscle group is the peronei dueto their role in preventing ankle inversion, a position that causes themajority of lateral ligament ankle sprains. Studies performed onnormal, healthy subjects act as a precursor to those on taping. Twostudies in particular indicate the importance of peronei function andits role in preventing lateral ankle sprain. 62,63 Konradsen andHojsgaard 62 used electromyographic (EMG) assessment of peroneuslongus and brevis on nine patients running on a treadmill. Theirinvestigations concluded that the foot ankle complex requires aninversion (supinated) position at the preheel strike phase of therunning cycle to stimulate the peronei to correct for inversion strain.A further study 63 simulated an ankle sprain by local anaestheticregional block. It established that whereas passive joint anglereproduction was “virtually impossible” after the anaesthesia, activeangle reproduction and peroneal reaction time were far less affected.It was concluded that a mechanically unstable ankle can be helped bythe peronei and other muscle activity. Later work by Feuerbachet al 64 made similar observations about active angle reproduction ofthe ankle joint after anaesthetising two components of the lateralligament complex.When investigating the role of the peronei, experimental work onpatients with mechanically unstable ankles has revealed differences inperoneal function when compared to control subjects. Trends, but nostatistically significant differences, have been found between theperoneal response times of patients with ankle instability and controlgroups. 65,66 Comparisons between injured and good sides of patientswith chronic instability revealed reaction times of 68 ms versus84 ms 38 and 49 ms versus 65 ms, 67 with the injured side having alonger reaction time. The differences between the figures in the twostudies were probably due to dissimilar recording methods. Recentinvestigations 56 discovered that peroneal reaction time rather thanperoneal strength was a discriminating factor following ankle sprain.Other studies have given further insight into the complexity offunctional instability of the ankle and the effect of tape. Glick et al, 56using EMG analysis in running, found that ankle taping allowed theperonei group to contract for a longer period of time at the preheelstrike stage in four mechanically unstable ankles.Karlsson and Andreasson 38 used a trapdoor mechanism on 20subjects with chronic ankle instability and found that the Gibneybasketweave technique significantly shortened the reaction time of theperonei group, thus bringing it closer to times on the normal side.They also noted that the more unstable the ankle, the greater theimprovement.460