Altered Plantar-Receptor Stimulation Impairs Postural Control in Those With Chronic Ankle Instability

in Journal of Sport Rehabilitation
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Context:

Postural control as assessed via time-to-boundary (TTB) measures has been shown to be impaired in those with chronic ankle instability (CAI). Foot orthotics have been shown to improve postural control, although it is not clear if this is via mechanical or sensorimotor mechanisms.

Objective:

To assess the effect of textured shoe inserts that provide no mechanical support on postural control as assessed by TTB measures in subjects with CAI.

Design:

A crossover design to examine the effects of a textured insole on postural control in individuals with unilateral CAI. The independent variables were vision (eyes open, eyes closed) and texture (textured insole, sham insole, control).

Setting:

Laboratory.

Participants:

20 physically active individuals, 12 men, 8 women, age 18–45 y (21.5 ± 5.51) with self-reported CAI.

Intervention:

Each subject balanced in shod single-limb stance with eyes open and eyes closed under 3 conditions (control, sham, and textured insole). The order of testing under the 3 shoe conditions and 2 vision conditions was counterbalanced.

Main Outcome Measures:

The mean of TTB minima and the standard deviation of TTB minima in the mediolateral (ML) and anteroposterior directions.

Results:

There were significant reductions in TTB ML magnitude and variability found in the textured condition compared with the control and sham conditions. In the textured condition, subjects failed significantly more trials than any other condition.

Conclusions:

Stimulating the plantar surface of the foot, via a textured insole, has an effect in the broad spectrum of postural-control maintenance in individuals with CAI.

McKeon is with the Dept of Rehabilitation Sciences, University of Kentucky, Lexington, KY. Stein is with the Dept of Sports Medicine, Monmouth University, West Long Branch, NJ. Ingersoll is with the Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Mount Pleasant, MI. Hertel is with the Dept of Human Services, University of Virginia, Charlottesville, VA.