Role of interventions targeting plantar cutaneous receptors in improving postural control in chronic ankle...

Chronic ankle instability (CAI) is a disorder that occurs after one or more acute ankle sprains and is characterised by persistent symptoms which include episodes of ''giving way'' a sensation of instability, recurrent ankle sprains, and functional deficits. Despite of effective treatment strategies a comprehensive approach is needed that can break this continuum of disability and improve the postural control. A systematic review with meta-analysis assessing the effectiveness of interventions targeting plantar cutaneous receptors for improving postural control in individuals with chronic ankle instability.

The systematic review with meta-analysis was performed following PRISMA guidelines. Outcome measure used to evaluate the improvement in which static postural control was assessed on SLBT (Single limb balance test) and COP (Centre of pressure) whereas dynamic postural control was assessed on SEBT (star excursion balance test) and scores expressed as mean ± SD and random-effects model were performed, and heterogeneity between the studies was calculated using the I² statistic.

A total of 168 CAI populations were included among the 8 selected studies in the meta-analysis. In which,5 studies using Plantar massage and 3 studies using foot insole were assessed, with moderate to high quality on the Pedro scale (range 4-7). For single and six-sessions of plantar massage showed insignificant effect on SLBT COP and for the single session of custom moulded FO showed insignificant effect on SEBT.

The meta-analysis showed non-significant pooled results for plantar massage and foot orthotics on static and dynamic postural control when assessed on postural outcome measures. Further high-quality evidence-based trials would be required to highlight the importance of sensory targeted approaches to treat the postural instability in CAI patients.