title: Acute effects of rearfoot manipulation on dynamic standing balance in healthy individuals.
abstract: Dynamic standing balance is essential to perform functional activities and is included in the treatment of many lower extremity injuries. Physiotherapists utilize many methods to restore standing balance including stability exercises, functional retraining, and manual therapy. The purpose of this study was to investigate the effects of a rearfoot distraction manipulation on dynamic standing balance. Twenty healthy participants (age: 24.4 ± 2.8 years; height: 162.9 ± 37.7 cm; mass: 68.0 ± 4.8 kg; right leg dominant = 20) completed this study. Following familiarization, dynamic standing balance was assessed during: (1) an experimental condition immediately following a rearfoot distraction manipulation, and (2) a control condition. Dominant leg balance was quantified using the Y-balance test which measures lower extremity reach distances. Reach distances were normalized to leg length and measured in the anterior, posteromedial and posterolateral directions. Overall balance was calculated through the summing of all normalized directions. Paired t-tests and Wilcoxon rank tests were used to compare balance scores for parametric and non-parametric data as appropriate. Significance was set at 0.05 a priori. Effect size (ES) was calculated to determine the clinical impact of the manipulation. Increased reach distances (indicating improved balance) were noted following manipulation for overall balance (p = 0.03, ES = 0.26) and in the posteromedial direction (p = 0.01, ES = 0.42). Reach distances did not differ for the anterior (p = 0.11, ES = 0.16) or posterolateral (p = 0.11, ES = 0.25) components. Dynamic standing balance improved after a rearfoot distraction manipulation in healthy participants. It is hypothesized that manual therapy applied to the foot and ankle may be beneficial to augment other therapeutic modalities when working with patients to improve dynamic standing balance.
authors.affiliation: East Tennessee State University, Department of Physical Therapy, Johnson City, TN 37604, United States. Electronic address: wassinger@etsu.edu.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Wassinger
authors.affiliation: East Tennessee State University, Department of Physical Therapy, Johnson City, TN 37604, United States.
authors.forename: Ariel
authors.initials: A
authors.lastname: Rockett
authors.affiliation: East Tennessee State University, Department of Physical Therapy, Johnson City, TN 37604, United States.
authors.forename: Lucas
authors.initials: L
authors.lastname: Pitman
authors.affiliation: East Tennessee State University, Department of Physical Therapy, Johnson City, TN 37604, United States.
authors.forename: Matthew Matt
authors.initials: MM
authors.lastname: Murphy
authors.affiliation: East Tennessee State University, Department of Physical Therapy, Johnson City, TN 37604, United States.
authors.forename: Charles
authors.initials: C
authors.lastname: Peters
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000502:physiology*; D005260:Female; D005528:Foot / Q000502:physiology*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000379:methods*; D004856:Postural Balance / Q000502:physiology*; D011187:Posture / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D012016:Reference Values; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Ankle; Dynamic standing balance; Manipulation