Blog Post Author Biography: Dr. Tomas Megalaa is a researcher and clinician, with expertise in sports injury prevention and rehabilitation. He has recently completed his PhD degree at the University of Sydney. Tomas has published multiple peer-reviewed articles and has extensive clinical and academic experience in Allied Health in Australia.

Citation: Megalaa T, Le PL, Fong Yan A, Beckenkamp PR, Hiller CE. Do ankle braces affect functional performance? A randomised double-blinded cross-over trial. JSAMS Plus. 2024;4:100061. DOI: 10.1016/j.jsampl.2024.100061.

Take-to-the-clinic message: Clinicians and sports practitioners can confidently prescribe ankle braces without concern of having a negative impact on functional performance. This study demonstrated that neither the KISS® nor Aircast ankle brace negatively affected objective measures of functional performance or balance in individuals with and without chronic ankle instability (CAI). Further, participants perceived greater stability and reassurance when they were wearing the KISS® ankle brace compared to no brace during the functional tasks.

Background: Ankle braces are effective in managing and preventing lateral ankle sprains. A new ankle brace, the Kinetic Impulse Suppression System® (KISS®), was developed to allow unrestricted ankle and foot movement within normal ranges while preserving subtalar joint motion in the frontal plane (inversion/eversion) and restricting only end-range joint motion. Despite the known protective benefits of ankle braces, concerns persist regarding their potential impact on functional performance.

Purpose: We aimed to compare the effects of two different ankle braces (KISS® and Aircast) with a no-brace condition on functional performance and perceptions of stability, confidence, and reassurance in individuals with and without CAI. The primary hypothesis was that wearing the KISS® brace would not impair functional performance compared to the no brace condition and participants would present a superior performance compared to the Aircast brace.

Methods: A randomised double-blinded cross-over trial was conducted in people (18-65 years) with and without CAI (determined using the International Ankle Consortium criteria). Participants completed an array of functional performance tests under three conditions: wearing the KISS® ankle brace, the Aircast A60 ankle brace, and no brace (control). The order of condition was randomly allocated, a researcher not involved in data collection applied the braces and the ankle was covered with a black sleeve to keep the assessor blinded to condition. Tests included the side hop test, Star Excursion Balance Test (SEBT), triple hop test, modified T-agility test, and vertical jump test. Perceptions of stability, confidence, and reassurance were also recorded on a 10-point numerical rating scale. Statistical analyses included linear mixed models to assess performance and subjective measures across conditions.

Results: A total of 42 participants were included (21 with and 21 without CAI), 24 females and18 males, with mean (SD) age of 25.4 (7.8) years. No significant differences were found between the three conditions for any objective functional performance measure, including the side hop test (p=0.96), SEBT (p>0.92), triple hop test (p=0.97), agility test (p=0.21), or vertical jump tests (p>0.97). However, subjective measures showed that participants felt significantly more stable and reassured while wearing the KISS brace compared to no brace (p=0.03 and p=0.046, respectively) after performing the side hop test.

Rolling the field forward: This study provides strong evidence that ankle braces do not impair functional performance, addressing a common concern among clinicians, trainers, and athletes. Future research should explore the long-term effects on perception of brace use and evaluate whether different brace designs influence injury prevention strategies and athletic performance. Studies involving elite athletes may help determine if subtle biomechanical effects of bracing emerge in high-performance settings.

Question for the researchers: Given the subjective preference for the KISS brace over the no-brace condition, do you anticipate that different brace designs could have a greater perceived impact on confidence and injury prevention? Would further testing in high-performance athletes reveal different functional outcomes?