Comparative effectiveness of plantar-massage techniques on postural control in those with chronic ankle instability

Context: One of the major concerns after an acute lateral ankle sprain is the potential for development of chronic ankle instability (CAI). The existing research has determined that clinician-delivered plantar massage improves postural control in those with CAI. However, the effectiveness of self-administered treatments and the underlying cause of any improvements remain unclear. Objectives: To determine (1) the effectiveness of a selfadministered plantar-massage treatment in those with CAI and (2) whether the postural-control improvements were due to the stimulation of the plantar cutaneous receptors. Design: Crossover study. Setting: University setting. Patients or Other Participants: A total of 20 physically active individuals (6 men and 14 women) with self-reported CAI. Intervention(s): All participants completed 3 test sessions involving 3 treatments: a clinician-delivered manual plantar massage, a patient-delivered self-massage with a ball, and a clinician-delivered sensory brush massage. Main Outcome Measure(s): Postural control was assessed using single-legged balance with eyes open and the Star Excursion Balance Test. Results: Static postural control improved (P ≤ .014) after each of the interventions. However, no changes in dynamic postural control after any of the interventions were observed (P > .05). No differences were observed between a cliniciandelivered manual plantar massage and either a patient-delivered self-massage with a ball or a clinician-delivered sensory brush massage in any postural-control outcome. Conclusions: In those with CAI, single 5-minute sessions of traditional plantar massage, self-administered massage, and sensory brush massage each resulted in comparable static postural-control improvements. The results also provide empirical evidence suggesting that the mechanism for the posturalcontrol improvements is the stimulation of the plantar cutaneous receptors.