Should an ankle prehabilitation/rehabilitation be conducted shod or barefoot?

Abstract

Background: It is known that excessive inversion and plantar flexion are the main cause for lateral ankle sprains; these injuries are the highest occurrences within netball players. Various injury prevention programmes have been conducted in netball, although these have been unsuccessful. Studies have found ankle stability and proprioception to be inhibited following an injury; the rehabilitation process is essential to overcome this. Balance training is an important element to help improve stability, proprioception and neuromuscular control at the ankle. It can be seen that, through rehabilitation, ankle stability can be restored; therefore it could be argued that improving ankle stability earlier, could prevent an injury occurring. Aim: The main focus of this study was to investigate whether ankle stability has a greater improvement by performing prehabilitation barefoot, compared to wearing athletic trainers. Methods: Twenty participants, injury free, from Cardiff Metropolitan University Netball teams volunteered to take part in this study. Ethical approval and informed consent was obtained prior to the study. Initial data collected from the subjects included height, weight, age and limb length. The star excursion balance test was conducted in week one, to gather a baseline measure of ankle stability in all subjects. The participants were then split into two groups; the control group wore trainers, and the experimental group were barefoot. All volunteers took part in the same prehabilitation programme for six weeks; the only difference being the footwear conditions. In week eight, following the six week programme, all participants completed post testing in order to collect comparative data; post testing followed the same procedure as in week one. Data analysis was then conducted to investigate differences between the participants pre and post data, and also to research differences between the control group and experimental group. Results: Firstly, the baseline data for each participant was evaluated to ensure there was no significant differences before training was implemented. Following data analysis, it could be seen that the prehabilitation programme was effective by improving all participants ankle stability. Further investigation then showed that the experimental group (barefoot) had a greater overall percentage improvement than the control group (trainers). Each participants’ results were then calculated relative to leg length; using this data, the same data analysis was conducted. These results mimicked the previous results, where data was not normalised to leg length. Conclusion: The findings of this study indicate that subjects who participated in prehabilitation barefoot, had greater improvements in stability. Overall, highlighting that in order to reduce the risk of ankle injuries, ankle stability and proprioception are best enhanced by barefoot activity. It would now be useful for this #i information to be applied to prehabilitation programmes, aiming to reduce the risk of an injury occurring. !