29 Predicting short-term response to plantar massage in those with chronic ankle instability

Abstract

Background Plantar massage improves balance impairments associated with chronic ankle instability (CAI). However, there is no data to determine which patients with CAI would respond favourably to a plantar massage intervention. Objective To develop a preliminary clinical prediction rule that identifies which patients with CAI would have a favourable postural control response after a 2-week plantar massage intervention. Design Prospective cohort study. Setting Research laboratory. Participants Nineteen participants with self-reported CAI (age = 22.3 ± 2.8 years; height = 1.7 ± 0.8 m; body mass = 75.5 ± 14.2 kg) participated. CAI was defined as at least two episodes of “giving way” within the past 3 months (mean = 5.4 ± 4.8); scoring ≤90% on the Foot and Ankle Ability Measure (FAAM) (mean = 76.8 ± 12.9%, and scoring ≤80% on the FAAM-Sport (mean = 62.7 ± 13.6%). Interventions Patients received 6, 5-minute plantar massage treatments over a 2-week period. Main outcome measurements Single limb balance (SLBT) was assessed via 3, 20-second trials on a firm surface with eyes closed while errors were tracked. SLBT was recorded before, after the first treatment, and after the final treatment. A favourable response was defined as a change in the SLBT score that exceeded the minimum detectable change after the 2-week intervention. Potential predictor variables were entered into a stepwise logistic regression model to determine the most accurate set of variables for predicting treatment success. Results 10 of the 19 participants had a favourable response (52.6%). Baseline FAAM-Sport scores >70.31% and an SLBT change of >1.67 errors after the first treatment predicted a favourable response (combined r2 = 0.545). Both factors resulted in a 100% favourable response rate while one and no factors resulted in an 86% and 0% favourable response rate respectively. Conclusion Preliminary results suggest that a FAAM-Sport baseline score and an immediate change in SLBT can accurately determine which CAI patients will have a favourable postural control outcome following a 2-week plantar massage intervention.