Acute effects of rearfoot manipulation on dynamic standing balance in healthy individuals

Dynamic standing balance is critical in performing functional activities and is included in the treatment of many lower extremity injuries. Physiotherapists employ many methods to restore standing balance including stability exercises, functional retraining, and manual therapy. This study’s purpose 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 after 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 vary for the anterior (p = 0.11, ES = 0.16) or posterolateral (p = 0.11, ES = 0.25) components.

This study found that dynamic standing balance improved after a rearfoot distraction manipulation in healthy participants. It is hypothesized that manual therapy applied to the foot and ankle could be beneficial to supplement other therapeutic modalities when working with patients to improve dynamic standing balance.