Trial Outcomes & Findings for Mechanisms of Manual Therapies in CAI Patients (NCT NCT03418051)

NCT ID: NCT03418051

Last Updated: 2021-08-27

Results Overview

% Modulation of ML COP velocity. First, center of pressure (COP) is calculated in the mediolateral (ML) direction \[side to side\] with eyes open and closed. COP velocity represents the average speed at which an individual's COP moves during the 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML COP Velocity that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as ML COP velocity increased when eyes were closed relative to the eyes open condition. A ML COP velocity change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the immediate post-treatment assessment.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

60 participants

Primary outcome timeframe

Baseline and 24-72 hours post intervention

Results posted on

2021-08-27

Participant Flow

Participant milestones

Participant milestones
Measure
Control
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Overall Study
STARTED
20
20
20
Overall Study
COMPLETED
14
18
17
Overall Study
NOT COMPLETED
6
2
3

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Mechanisms of Manual Therapies in CAI Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control
n=20 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Total
n=60 Participants
Total of all reporting groups
Age, Continuous
19.5 years
STANDARD_DEVIATION .8 • n=39 Participants
21.9 years
STANDARD_DEVIATION 3.9 • n=41 Participants
20.9 years
STANDARD_DEVIATION 3.2 • n=35 Participants
20.7 years
STANDARD_DEVIATION 3.1 • n=31 Participants
Sex: Female, Male
Female
5 Participants
n=39 Participants
3 Participants
n=41 Participants
12 Participants
n=35 Participants
20 Participants
n=31 Participants
Sex: Female, Male
Male
15 Participants
n=39 Participants
17 Participants
n=41 Participants
8 Participants
n=35 Participants
40 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=39 Participants
3 Participants
n=41 Participants
2 Participants
n=35 Participants
7 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
18 Participants
n=39 Participants
17 Participants
n=41 Participants
18 Participants
n=35 Participants
53 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
Asian
1 Participants
n=39 Participants
2 Participants
n=41 Participants
3 Participants
n=35 Participants
6 Participants
n=31 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=39 Participants
1 Participants
n=41 Participants
1 Participants
n=35 Participants
5 Participants
n=31 Participants
Race (NIH/OMB)
White
15 Participants
n=39 Participants
17 Participants
n=41 Participants
14 Participants
n=35 Participants
46 Participants
n=31 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=39 Participants
0 Participants
n=41 Participants
2 Participants
n=35 Participants
3 Participants
n=31 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
0 Participants
n=31 Participants
Region of Enrollment
United States
20 Participants
n=39 Participants
20 Participants
n=41 Participants
20 Participants
n=35 Participants
60 Participants
n=31 Participants
Ankle Instability Instrument
7.4 units on a scale
STANDARD_DEVIATION 1.35 • n=39 Participants
7.4 units on a scale
STANDARD_DEVIATION 1.46 • n=41 Participants
7.0 units on a scale
STANDARD_DEVIATION 1.23 • n=35 Participants
7.3 units on a scale
STANDARD_DEVIATION 1.34 • n=31 Participants
Number of ankle sprains
4.5 sprains
STANDARD_DEVIATION 3.5 • n=39 Participants
4.25 sprains
STANDARD_DEVIATION 2.35 • n=41 Participants
5.1 sprains
STANDARD_DEVIATION 3.85 • n=35 Participants
4.6 sprains
STANDARD_DEVIATION 3.27 • n=31 Participants
Number of giving way episodes
7 giving way episodes
STANDARD_DEVIATION 1.56 • n=39 Participants
10.4 giving way episodes
STANDARD_DEVIATION 16.13 • n=41 Participants
9.15 giving way episodes
STANDARD_DEVIATION 8.63 • n=35 Participants
8.85 giving way episodes
STANDARD_DEVIATION 11.2 • n=31 Participants
Outcome Expectations for Exercise Scale
2.8 units on a scale
STANDARD_DEVIATION 0.83 • n=39 Participants
2.8 units on a scale
STANDARD_DEVIATION 0.76 • n=41 Participants
2.9 units on a scale
STANDARD_DEVIATION 0.85 • n=35 Participants
2.83 units on a scale
STANDARD_DEVIATION 0.81 • n=31 Participants

PRIMARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of ML COP velocity. First, center of pressure (COP) is calculated in the mediolateral (ML) direction \[side to side\] with eyes open and closed. COP velocity represents the average speed at which an individual's COP moves during the 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML COP Velocity that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as ML COP velocity increased when eyes were closed relative to the eyes open condition. A ML COP velocity change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
ML COP Velocity From Baseline to Post Intervention
Baseline
119.91 % modulation
Standard Deviation 47.38
118.91 % modulation
Standard Deviation 47.38
121.07 % modulation
Standard Deviation 44.55
ML COP Velocity From Baseline to Post Intervention
Post Intervention
116.99 % modulation
Standard Deviation 36.16
128.23 % modulation
Standard Deviation 40.10
121.20 % modulation
Standard Deviation 42.83

PRIMARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of ML COP velocity. First, center of pressure (COP) is calculated in the mediolateral (ML) direction \[side to side\] with eyes open and closed. COP velocity represents the average speed at which an individual's COP moves during the 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML COP Velocity that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as ML COP velocity increased when eyes were closed relative to the eyes open condition. A ML COP velocity change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the Follow-Up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
ML COP Velocity From Baseline to Follow-Up
Baseline
119.71 % modulation
Standard Deviation 48.70
116.13 % modulation
Standard Deviation 41.37
119.14 % modulation
Standard Deviation 46.66
ML COP Velocity From Baseline to Follow-Up
Follow-Up
118.86 % modulation
Standard Deviation 45.11
110.80 % modulation
Standard Deviation 46.45
111.06 % modulation
Standard Deviation 43.86

PRIMARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of AP COP velocity. First, center of pressure (COP) is calculated in the anterioposterior (AP) direction \[front to back\]. COP velocity represents the average speed at which an individual's COP moves during the 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML COP Velocity that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as ML COP velocity increased when eyes were closed relative to the eyes open condition. A ML COP velocity change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
AP COP Velocity From Baseline to Post Intervention
Baseline
117.40 % modulation
Standard Deviation 31.73
115.84 % modulation
Standard Deviation 47.32
126.50 % modulation
Standard Deviation 37.95
AP COP Velocity From Baseline to Post Intervention
Post Intervention
120.91 % modulation
Standard Deviation 33.69
122.51 % modulation
Standard Deviation 39.05
100.91 % modulation
Standard Deviation 38.53

PRIMARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of AP COP velocity. First, center of pressure (COP) is calculated in the anterioposterior (AP) direction \[front to back\] with eyes open and closed. COP velocity represents the average speed at which an individual's COP moves during the 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML COP Velocity that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as ML COP velocity increased when eyes were closed relative to the eyes open condition. A ML COP velocity change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
AP COP Velocity From Baseline to Follow-up
Baseline
119.48 % modulation
Standard Deviation 33.02
116.69 % modulation
Standard Deviation 48.19
123.93 % modulation
Standard Deviation 39.40
AP COP Velocity From Baseline to Follow-up
Follow-Up
117.67 % modulation
Standard Deviation 40.04
105.10 % modulation
Standard Deviation 48.54
97.96 % modulation
Standard Deviation 35.18

PRIMARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of ML Time-to-Boundary. First, time-to-Boundary (TTB) is calculated in the mediolateral (ML) direction \[side to side\] with eyes open and closed. TTB represents the time (s) it would take for a participant's center of pressure (i.e. vertical projection of the center of mass) to reach their base of support (i.e. boundary) based on the instantaneous position and velocity of the center of pressure. The base of support is represents the length and width of an individual's foot. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML TTB that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes open balance score - eyes closed balance score) / eyes open balance score. Negative scores indicate a greater reliance on visual information as ML TTB decreased with eyes closed.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
ML TTB From Baseline to Post Intervention
Baseline
-50.76 % modulation
Standard Deviation 13.41
-54.97 % modulation
Standard Deviation 8.98
-55.41 % modulation
Standard Deviation 10.81
ML TTB From Baseline to Post Intervention
Post Intervention
-55.99 % modulation
Standard Deviation 7.14
-56.61 % modulation
Standard Deviation 10.43
-52.28 % modulation
Standard Deviation 11.73

PRIMARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data was due to participants lost to follow up.

% Modulation of ML Time-to-Boundary. First, time-to-Boundary (TTB) is calculated in the mediolateral (ML) direction \[side to side\] with eyes open and closed. TTB represents the time (s) it would take for a participant's center of pressure (i.e. vertical projection of the center of mass) to reach their base of support (i.e. boundary) based on the instantaneous position and velocity of the center of pressure. The base of support is represents the length and width of an individual's foot. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in ML TTB that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes open balance score - eyes closed balance score) / eyes open balance score. Negative scores indicate a greater reliance on visual information as ML TTB decreased with eyes closed.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
ML TTB From Baseline to Follow-Up
Baseline
-48.98 % modulation
Standard Deviation 14.31
-54.18 % modulation
Standard Deviation 9.41
-51.12 % modulation
Standard Deviation 13.00
ML TTB From Baseline to Follow-Up
Follow-Up
-51.12 % modulation
Standard Deviation 13.00
-52.18 % modulation
Standard Deviation 12.69
-53.12 % modulation
Standard Deviation 10.91

PRIMARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of AP Time-to-Boundary. First, time-to-Boundary (TTB) is calculated in the anterioposterior (AP) direction \[front to back\] with eyes open and closed. TTB represents the time (s) it would take for a participant's center of pressure (i.e. vertical projection of the center of mass) to reach their base of support (i.e. boundary) based on the instantaneous position and velocity of the center of pressure. The base of support is represents the length and width of an individual's foot. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in AP TTB that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes open balance score - eyes closed balance score) / eyes open balance score. Negative scores indicate a greater reliance on visual information as AP TTB decreased with eyes closed.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
AP TTB From Baseline to Post Intervention
Baseline
-52.54 % modulation
Standard Deviation 9.67
-54.59 % modulation
Standard Deviation 8.81
-57.53 % modulation
Standard Deviation 8.24
AP TTB From Baseline to Post Intervention
Post Intervention
-52.97 % modulation
Standard Deviation 7.31
-54.39 % modulation
Standard Deviation 11.01
-48.81 % modulation
Standard Deviation 8.67

PRIMARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of AP Time-to-Boundary. First, time-to-Boundary is calculated in the anterioposterior (AP) direction \[front to back\] with eyes open and closed. Time-to-boundary represents the time (s) it would take for a participant's center of pressure (i.e. vertical projection of the center of mass) to reach their base of support (i.e. boundary) based on the instantaneous position and velocity of the center of pressure. The base of support is represents the length and width of an individual's foot. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change in AP TTB that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes open balance score - eyes closed balance score) / eyes open balance score. Negative scores indicate a greater reliance on visual information as AP TTB decreased with eyes closed.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
AP TTB From Baseline to Follow-Up
Baseline
-52.95 % modulation
Standard Deviation 10.40
-55.09 % modulation
Standard Deviation 8.36
-53.98 % modulation
Standard Deviation 10.53
AP TTB From Baseline to Follow-Up
Follow-Up
-51.94 % modulation
Standard Deviation 11.40
-47.38 % modulation
Standard Deviation 12.05
-48.81 % modulation
Standard Deviation 9.92

PRIMARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of 95% Confidence Ellipse. First, center of pressure (COP) excursion \[movement\] is calculated and the magnitude of an ellipse that contains 95% of all data points is calculated with eyes open and closed. The resulting outcome is calculated from a 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as the variable increased when eyes were closed relative to the eyes open condition. A change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
95% Confidence Ellipse From Baseline to Post Intervention
Baseline
270.91 % modulation
Standard Deviation 168.28
270.91 % modulation
Standard Deviation 168.28
290.70 % modulation
Standard Deviation 128.07
95% Confidence Ellipse From Baseline to Post Intervention
Post-Intervention
267.85 % modulation
Standard Deviation 127.60
283.26 % modulation
Standard Deviation 111.89
275.92 % modulation
Standard Deviation 142.78

PRIMARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: All missing data was the result of participants being lost to follow-up.

% Modulation of 95% Confidence Ellipse. First, center of pressure (COP) excursion \[movement\] is calculated and the magnitude of an ellipse that contains 95% of all data points is calculated with eyes open and closed. The resulting outcome is calculated from a 10 second single limb stance trial. Next, % modulation is calculated. This estimates the weight given to visual information during eyes open stance based on the magnitude of change that occurs when vision is removed relative to the eyes open condition (control condition). The following formula is used: % Modulation = (eyes closed balance score - eyes open balance score) / eyes open balance score. Positive scores indicate a greater reliance on visual information as the variable increased when eyes were closed relative to the eyes open condition. A change greater than the eyes open value would result in a value \>100%. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
95% Confidence Ellipse From Baseline to Follow-Up
Baseline
286.29 % modulation
Standard Deviation 173.43
272.07 % modulation
Standard Deviation 142.18
282.06 % modulation
Standard Deviation 129.60
95% Confidence Ellipse From Baseline to Follow-Up
Follow-Up
317.46 % modulation
Standard Deviation 146.05
254.06 % modulation
Standard Deviation 165.90
267.92 % modulation
Standard Deviation 134.57

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: All missing data was the result of participants being lost to follow-up.

Amount of error, measured in degrees, from a target angle of plantar flexion. Participants are shown a target ankle and asked to replicate that angle (i.e. joint position) with their eyes closed. The amount of error from the target angle is recorded as the joint position sense. Larger values (i.e. greater error) indicates worse joint position sense. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=19 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Plantar Flexion Joint Position Sense From Baseline to Post Intervention
Baseline
3.00 Degrees
Standard Deviation 1.82
3.25 Degrees
Standard Deviation 1.60
3.73 Degrees
Standard Deviation 2.54
Plantar Flexion Joint Position Sense From Baseline to Post Intervention
Post Intervention
2.22 Degrees
Standard Deviation 1.36
1.97 Degrees
Standard Deviation 1.54
2.42 Degrees
Standard Deviation 1.67

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data was due to participants being lost to follow up.

Amount of error, measured in degrees, from a target angle of plantar flexion. Participants are shown a target ankle and asked to replicate that angle (i.e. joint position) with their eyes closed. The amount of error from the target angle is recorded as the joint position sense. Larger values (i.e. greater error) indicates worse joint position sense. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Plantar Flexion Joint Position Sense From Baseline to Follow-Up
Baseline
3.04 Degrees
Standard Deviation 1.78
3.04 Degrees
Standard Deviation 1.78
3.72 Degrees
Standard Deviation 2.61
Plantar Flexion Joint Position Sense From Baseline to Follow-Up
Follow-Up
2.35 Degrees
Standard Deviation 1.95
1.51 Degrees
Standard Deviation 1.49
2.62 Degrees
Standard Deviation 2.20

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants being lost at follow up.

Minimal amount of pressure that can be detected by an individual at the head of the 1st metatarsal. Semmes-Weinstein monofilaments, of different diameters (mm), are pressed against the skin using an established 4-2-1 stepping algorithm. Higher values (thresholds) indicate worse light touch sensation thresholds. his analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
1st Metatarsal Light-touch Threshold From Baseline to Post Intervention
Baseline
2.83 mm
Standard Deviation 0.62
3.22 mm
Standard Deviation 0.55
3.61 mm
Standard Deviation 0.76
1st Metatarsal Light-touch Threshold From Baseline to Post Intervention
Post intervention
3.41 mm
Standard Deviation 0.57
3.22 mm
Standard Deviation 0.73
2.83 mm
Standard Deviation 0.54

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants being lost at follow up.

Minimal amount of pressure that can be detected by an individual at the head of the 1st metatarsal. Semmes-Weinstein monofilaments, of different diameters (mm), are pressed against the skin using an established 4-2-1 stepping algorithm. Higher values (thresholds) indicate worse light touch sensation thresholds. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
1st Metatarsal Light-touch Threshold From Baseline to Follow-Up
Baseline
2.95 mm
Standard Deviation 0.67
3.22 mm
Standard Deviation 0.57
3.41 mm
Standard Deviation 0.77
1st Metatarsal Light-touch Threshold From Baseline to Follow-Up
Follow-Up
3.22 mm
Standard Deviation 0.67
3.22 mm
Standard Deviation 0.58
2.83 mm
Standard Deviation 0.81

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants being lost at follow up.

Minimal amount of pressure that can be detected by an individual at the base of the 5th metatarsal. Semmes-Weinstein monofilaments, of different diameters (mm), are pressed against the skin using an established 4-2-1 stepping algorithm. Higher values (thresholds) indicate worse light touch sensation thresholds. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
5th Metatarsal Light-touch Threshold From Baseline to Post Intervention
Baseline
3.22 mm
Standard Deviation 0.60
3.22 mm
Standard Deviation 0.59
3.84 mm
Standard Deviation 0.75
5th Metatarsal Light-touch Threshold From Baseline to Post Intervention
Post Intervention
3.61 mm
Standard Deviation 0.69
3.41 mm
Standard Deviation 0.23
3.22 mm
Standard Deviation 0.69

SECONDARY outcome

Timeframe: Baseline and 4-week Follow Up

Population: Missing data due to participants being lost at follow up.

Minimal amount of pressure that can be detected by an individual at the base of the 5th metatarsal. Semmes-Weinstein monofilaments, of different diameters (mm), are pressed against the skin using an established 4-2-1 stepping algorithm. Higher values (thresholds) indicate worse light touch sensation thresholds. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
5th Metatarsal Light-touch Threshold From Baseline to Follow-Up
Baseline
3.22 mm
Standard Deviation 0.62
3.22 mm
Standard Deviation 0.61
3.84 mm
Standard Deviation 0.76
5th Metatarsal Light-touch Threshold From Baseline to Follow-Up
Follow-Up
3.61 mm
Standard Deviation 0.50
3.41 mm
Standard Deviation 0.85
3.61 mm
Standard Deviation 0.91

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants being lost to follow up or technical issues with equipment.

This measure shows the percentage of excited alpha motor neurons (H) within a muscle upon electrical stimulation, relative to the total number of alpha motor neurons in the same muscle (M). Higher scores represent a greater percentage of excitability (i.e. activation) and is thought to represent better function of the spinal motor pathway. This analysis focused on baseline to the immediate post-treatment assessment. The test is performed using an electric stimulator and electromyography (EMG) to record muscle responses. Stimulation intensity is increased on sequential trials to capture both the H-wave and M-wave responses.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=15 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Soleus H:M Ratio From Baseline to Post Intervention
Baseline
0.68 H:M Ratio
Standard Deviation .140
0.65 H:M Ratio
Standard Deviation 0.18
0.63 H:M Ratio
Standard Deviation 0.30
Soleus H:M Ratio From Baseline to Post Intervention
Post-Intervention
0.67 H:M Ratio
Standard Deviation 0.14
0.62 H:M Ratio
Standard Deviation 0.12
0.64 H:M Ratio
Standard Deviation 0.29

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants being lost to follow up or technical issues with equipment.

This measure shows the percentage of excited alpha motor neurons (H) within a muscle upon electrical stimulation, relative to the total number of alpha motor neurons in the same muscle (M). Higher scores represent a greater percentage of excitability (i.e. activation) and is thought to represent better function of the spinal motor pathway. This analysis focused on baseline to the immediate post-treatment assessment. The test is performed using an electric stimulator and electromyography (EMG) to record muscle responses. Stimulation intensity is increased on sequential trials to capture both the H-wave and M-wave responses.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=13 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Soleus H:M Ratio From Baseline to Follow-Up
Baseline
0.67 H:M Ratio
Standard Deviation 0.15
0.63 H:M Ratio
Standard Deviation 0.18
0.65 H:M Ratio
Standard Deviation 0.25
Soleus H:M Ratio From Baseline to Follow-Up
Follow-Up
0.64 H:M Ratio
Standard Deviation 0.13
0.62 H:M Ratio
Standard Deviation 0.16
0.67 H:M Ratio
Standard Deviation 0.15

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants being lost to follow up or technical issues with equipment.

This measure shows the percentage of excited alpha motor neurons (H) within a muscle upon electrical stimulation, relative to the total number of alpha motor neurons in the same muscle (M). Higher scores represent a greater percentage of excitability (i.e. activation) and is thought to represent better function of the spinal motor pathway. This analysis focused on baseline to the immediate post-treatment assessment. The test is performed using an electric stimulator and electromyography (EMG) to record muscle responses. Stimulation intensity is increased on sequential trials to capture both the H-wave and M-wave responses.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=19 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=15 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Fibularis Longus H:M Ratio From Baseline to Post Intervention
Baseline
0.34 H:M Ratio
Standard Deviation 0.13
0.29 H:M Ratio
Standard Deviation 0.20
0.25 H:M Ratio
Standard Deviation 0.20
Fibularis Longus H:M Ratio From Baseline to Post Intervention
Post-Intervention
0.27 H:M Ratio
Standard Deviation 0.08
0.23 H:M Ratio
Standard Deviation 0.12
0.28 H:M Ratio
Standard Deviation 0.17

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants being lost to follow up or technical issues with equipment.

This measure shows the percentage of excited alpha motor neurons (H) within a muscle upon electrical stimulation, relative to the total number of alpha motor neurons in the same muscle (M). Higher scores represent a greater percentage of excitability (i.e. activation) and is thought to represent better function of the spinal motor pathway. This analysis focused on baseline to the immediate post-treatment assessment. The test is performed using an electric stimulator and electromyography (EMG) to record muscle responses. Stimulation intensity is increased on sequential trials to capture both the H-wave and M-wave responses.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=13 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Fibularis Longus H:M Ratio From Baseline to Follow-Up
Baseline
0.30 H:M Ratio
Standard Deviation 0.08
0.28 H:M Ratio
Standard Deviation 0.20
0.28 H:M Ratio
Standard Deviation 0.20
Fibularis Longus H:M Ratio From Baseline to Follow-Up
Follow-Up
0.29 H:M Ratio
Standard Deviation 0.14
0.23 H:M Ratio
Standard Deviation 0.11
0.32 H:M Ratio
Standard Deviation 0.18

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants being lost to follow up or technical issues with equipment.

A measure of cortical excitability using transcranial electromagnetic stimulation. A higher active motor threshold (AMT) indicates decreased excitability, as a greater stimulus intensity is required to elicit a motor evoke potential (MEP). This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=16 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=10 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Fibularis Longus Active Motor Threshold From Baseline to Post Intervention
Post-Intervention
45.12 % maximum intensity
Standard Deviation 8.37
38.27 % maximum intensity
Standard Deviation 6.75
42.2 % maximum intensity
Standard Deviation 8.46
Fibularis Longus Active Motor Threshold From Baseline to Post Intervention
Baseline
44 % maximum intensity
Standard Deviation 9.87
38.38 % maximum intensity
Standard Deviation 8.60
40.8 % maximum intensity
Standard Deviation 42.2

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure of cortical excitability using transcranial electromagnetic stimulation. A higher active motor threshold (AMT) indicates decreased excitability, as a greater stimulus intensity is required to elicit a motor evoke potential (MEP). This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=15 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=9 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Fibularis Longus Active Motor Threshold From Baseline to Follow-Up
Baseline
44 % maximum intensity
Standard Deviation 10.23
39.6 % maximum intensity
Standard Deviation 8.47
41.22 % maximum intensity
Standard Deviation 6.90
Fibularis Longus Active Motor Threshold From Baseline to Follow-Up
Follow-Up
44.75 % maximum intensity
Standard Deviation 9.16
40.26 % maximum intensity
Standard Deviation 9.26
42.55 % maximum intensity
Standard Deviation 43.80

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure of corticospinal inhibition using transcranial electromagnetic stimulation. The cortical silent period (CSP) will be measured as the distance from the end of the motor evoked potential (MEP) to a return of the mean electromyographic (EMG) signal plus two times the standard deviation of the baseline (pre-stimulus) EMG signal. A longer CSP indicates a greater corticospinal inhibition. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=16 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=10 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Cortical Silent Period From Baseline to Post Intervention
Post-Intervention
0.085 ms
Standard Deviation 0.036
0.114 ms
Standard Deviation 0.038
0.091 ms
Standard Deviation 0.024
Cortical Silent Period From Baseline to Post Intervention
Baseline
0.107 ms
Standard Deviation 0.077
0.125 ms
Standard Deviation 0.084
0.122 ms
Standard Deviation 0.027

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure of corticospinal inhibition using transcranial electromagnetic stimulation. The cortical silent period (CSP) will be measured as the distance from the end of the motor evoked potential (MEP) to a return of the mean electromyographic (EMG) signal plus two times the standard deviation of the baseline (pre-stimulus) EMG signal. A longer CSP indicates a greater corticospinal inhibition. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=15 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=9 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Cortical Silent Period From Baseline to Follow-Up
Baseline
0.088 ms
Standard Deviation 0.037
0.121 ms
Standard Deviation 0.087
0.114 ms
Standard Deviation 0.032
Cortical Silent Period From Baseline to Follow-Up
Follow Up
0.088 ms
Standard Deviation 0.024
0.096 ms
Standard Deviation 0.024
0.110 ms
Standard Deviation 0.046

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure representing the size of a muscle's cortical representation using transcranial electromagnetic stimulation. Map area is the number of stimulus positions whose stimulation evoked an average motor evoked potential ≥ the motor evoked potential threshold. An increase would suggest an expansion of the cortical representation of a selected muscle. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=16 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=10 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Corticomotor Map Area From Baseline to Post Intervention
Baseline
13.43 number of positions
Standard Deviation 10.6
19.6 number of positions
Standard Deviation 12.0
21.8 number of positions
Standard Deviation 15.3
Corticomotor Map Area From Baseline to Post Intervention
Post-Intervention
16.68 number of positions
Standard Deviation 11.47
21.55 number of positions
Standard Deviation 11.4
20.2 number of positions
Standard Deviation 12.14

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost at follow-up or technical issues with equipment.

A measure representing the size of a muscle's cortical representation using transcranial electromagnetic stimulation. Map area is the number of stimulus positions whose stimulation evoked an average motor evoked potential ≥ the motor evoked potential threshold. An increase would suggest an expansion of the cortical representation of a selected muscle. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=15 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=9 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Corticomotor Map Area From Baseline to Follow-Up
Baseline
14.3 number of positions
Standard Deviation 11.79
16.73 number of positions
Standard Deviation 10.1
20.0 number of positions
Standard Deviation 12.92
Corticomotor Map Area From Baseline to Follow-Up
Follow Up
9.08 number of positions
Standard Deviation 6.17
16.73 number of positions
Standard Deviation 6.73
20.66 number of positions
Standard Deviation 12.92

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure representing the size of a muscle's cortical representation using transcranial electromagnetic stimulation. Map volume will be calculated as the sum of the mean normalized MEPs recorded with an increase suggesting greater cortical excitability. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=16 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=10 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Corticomotor Map Volume From Baseline to Post Intervention
Baseline
0.89 number of positions
Standard Deviation 0.29
1.2 number of positions
Standard Deviation 0.60
1.07 number of positions
Standard Deviation 0.72
Corticomotor Map Volume From Baseline to Post Intervention
Post-Intervention
0.80 number of positions
Standard Deviation 0.36
0.93 number of positions
Standard Deviation 0.23
1.05 number of positions
Standard Deviation 0.89

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost at follow-up or technical issues with equipment.

measure representing the size of a muscle's cortical representation using transcranial electromagnetic stimulation. Map volume will be calculated as the sum of the mean normalized MEPs recorded with an increase suggesting greater cortical excitability. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=15 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=9 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Corticomotor Map Volume From Baseline to Follow-Up
Baseline
0.91 number of positions
Standard Deviation 0.32
1.12 number of positions
Standard Deviation 0.62
0.99 number of positions
Standard Deviation 0.50
Corticomotor Map Volume From Baseline to Follow-Up
Follow-Up
0.66 number of positions
Standard Deviation 0.39
0.74 number of positions
Standard Deviation 0.16
0.72 number of positions
Standard Deviation 0.35

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure of cortical activation using electroencephalography. Power spectral density (PSD) reflects the distribution of signal power over frequency (micro Volts). Higher PSDs indicate more cortical activity within the alpha bandwidth. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Alpha Power Spectral Density From Baseline to Post Intervention
Baseline
0.739 mV
Standard Deviation 0.479
0.911 mV
Standard Deviation 0.686
0.755 mV
Standard Deviation 0.428
Alpha Power Spectral Density From Baseline to Post Intervention
Post Intervention
0.731 mV
Standard Deviation 0.477
0.990 mV
Standard Deviation 0.887
0.633 mV
Standard Deviation 0.272

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost at follow up or technical issues with equipment.

A measure of cortical activation using electroencephalography. Power spectral density (PSD) reflects the distribution of signal power over frequency (micro Volts). Higher PSDs indicate more cortical activity within the alpha bandwidth. This analysis focused on baseline to the immediate follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=16 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Alpha Power Spectral Density From Baseline to Follow-Up
Baseline
0.669 mV
Standard Deviation 0.373
0.896 mV
Standard Deviation 0.673
0.707 mV
Standard Deviation 0.425
Alpha Power Spectral Density From Baseline to Follow-Up
Follow-Up
0.718 mV
Standard Deviation 0.398
0.805 mV
Standard Deviation 0.471
0.701 mV
Standard Deviation 0.441

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure of cortical activation using electroencephalography. Power spectral density (PSD) reflects the distribution of signal power over frequency (micro Volts). Higher PSDs indicate more cortical activity within the beta bandwidth. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Beta Power Spectral Density From Baseline to Post Intervention
Baseline
0.355 mV
Standard Deviation 0.147
0.480 mV
Standard Deviation 0.285
0.361 mV
Standard Deviation 0.200
Beta Power Spectral Density From Baseline to Post Intervention
Post Intervention
0.336 mV
Standard Deviation 0.125
0.600 mV
Standard Deviation 0.330
0.354 mV
Standard Deviation 0.162

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost at follow up or technical issues with equipment.

A measure of cortical activation using electroencephalography. Power spectral density (PSD) reflects the distribution of signal power over frequency (micro Volts). Higher PSDs indicate more cortical activity within the beta bandwidth. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=16 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Beta Power Spectral Density From Baseline to Follow-Up
Baseline
0.310 mV
Standard Deviation 0.104
0.442 mV
Standard Deviation 0.169
0.338 mV
Standard Deviation 0.206
Beta Power Spectral Density From Baseline to Follow-Up
Follow-Up
0.309 mV
Standard Deviation 0.080
0.429 mV
Standard Deviation 0.169
0.311 mV
Standard Deviation 0.140

SECONDARY outcome

Timeframe: Baseline and 24-72 hours post intervention

Population: Missing data due to participants lost to follow up or technical issues with equipment.

A measure of cortical activation using electroencephalography. Power spectral density (PSD) reflects the distribution of signal power over frequency (micro Volts). Higher PSDs indicate more cortical activity within the gamma bandwidth. This analysis focused on baseline to the immediate post-treatment assessment.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=20 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=18 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Gamma Power Spectral Density From Baseline to Post Intervention
Baseline
0.116 mV
Standard Deviation 0.046
0.155 mV
Standard Deviation 0.063
0.123 mV
Standard Deviation 0.052
Gamma Power Spectral Density From Baseline to Post Intervention
Post Intervention
0.123 mV
Standard Deviation 0.041
0.172 mV
Standard Deviation 0.097
0.125 mV
Standard Deviation 0.047

SECONDARY outcome

Timeframe: Baseline and 4-week Follow-Up

Population: Missing data due to participants lost at follow up or technical issues with equipment.

A measure of cortical activation using electroencephalography. Power spectral density (PSD) reflects the distribution of signal power over frequency (micro Volts). Higher PSDs indicate more cortical activity within the gamma bandwidth. This analysis focused on baseline to the follow-up assessment.

Outcome measures

Outcome measures
Measure
Control
n=14 Participants
Control group that will receive no intervention throughout the duration of the study (2-weeks).
Joint Mobilization
n=16 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of Grade III anterior-to-posterior talocrural joint mobilization with 1-minute between sets. Mobilizations will be large-amplitude, 1-s rhythmic oscillations from the mid- to end range of arthrokinematic motion.
Massage
n=17 Participants
Participants will receive 6, 5-minute treatment sessions over 2-weeks. Each session will consist of 2, 2-minute bouts of plantar massage bouts with 1-minute between sets. The massage will be a combination of petrissage and effleurage to the entire plantar surface.
Gamma Power Spectral Density From Baseline to Follow-Up
Baseline
0.109 mV
Standard Deviation 0.029
0.149 mV
Standard Deviation .062
0.120 mV
Standard Deviation 0.048
Gamma Power Spectral Density From Baseline to Follow-Up
Follow-Up
0.116 mV
Standard Deviation 0.036
0.166 mV
Standard Deviation 0.072
0.123 mV
Standard Deviation 0.041

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline

Dorsiflexion angle of the ankle at initial contact while walking.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 24-72 hours post intervention

Dorsiflexion angle of the ankle at initial contact while walking.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 4-weeks post intervention

Dorsiflexion angle of the ankle at initial contact while walking.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline

Rate of weight acceptance while walking

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 24-72 hours post intervention

Rate of weight acceptance while walking

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 4-weeks post intervention

Rate of weight acceptance while walking

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline

Dorsiflexion angle of the ankle at initial contact while landing from a jump

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 24-72 hours post intervention

Dorsiflexion angle of the ankle at initial contact while landing from a jump

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 4-weeks post intervention

Dorsiflexion angle of the ankle at initial contact while landing from a jump

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline

Rate of weight acceptance while landing from a jump

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 24-72 hours post intervention

Rate of weight acceptance while landing from a jump

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 4-weeks post intervention

Rate of weight acceptance while landing from a jump

Outcome measures

Outcome data not reported

Adverse Events

Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Joint Mobilization

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Massage

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Erik Wikstrom

University of North Carolina at Chapel Hill

Phone: 9199622260

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place