Related Experiment Video
Updated: May 16, 2025
Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
Impact of Plantar Massage and Ankle Mobilization on Visual Reliance in Those With Chronic Ankle Instability: A
Erik A Wikstrom1, M Spencer Cain2, Kyeongtak Song3
1Department of Exercise and Sport Science, MOTION Science Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Context:
Those with chronic ankle instability (CAI) rely more on visual information to maintain postural control. Plantar massage and ankle joint mobilization are moderately successful at improving CAI-associated postural control impairments. Manual therapies may have a larger influence on the underlying sensory strategy used to maintain postural control, but their effect on these strategies remains unknown.
Objective:
To evaluate the effects of separate 2-week plantar massage and ankle joint mobilization interventions on estimates of visual reliance during single-limb stance in those with CAI and determine whether changes in visual reliance estimates were driven by concurrent changes in peripheral- or spinal-level sensorimotor function.
Design:
Randomized controlled clinical trial.
Setting:
Research laboratory.
Patients:
Sixty participants with CAI.
Interventions:
Participants were equally randomized into plantar massage, ankle joint mobilization, and control (no intervention) groups. The manual therapy groups received six 5-minute treatments of their respective interventions over a 2-week period.
Main Outcome Measure:
A percentage modulation outcome quantified an individual's reliance on visual information by estimating the weight given to visual information during eyes-open stance based on the magnitude of postural instability that occurs with vision removed. Secondary measures included joint position sense, plantar light-touch thresholds, and the H-reflex. Outcomes were captured before (baseline), immediately after (post), and 1-month (follow-up) after the 2-week intervention.
Results:
Plantar massage resulted in significant percentage modulation changes in sagittal (P ≤ .046) but not frontal plane outcomes (P ≥ .069) relative to the control group. Joint mobilization did not alter percentage modulation changes (P ≥ .413). Significant correlations between percentage modulation changes and peripheral sensorimotor function were noted primarily at the 1-month follow-up.
Conclusions:
A 2-week plantar massage but not an ankle joint mobilization intervention alters sagittal plane percentage modulation values during single-limb stance in those with CAI. These changes may be driven by changes in peripheral sensorimotor function.
