Foot and Ankle Massage Boosts Balance in Elderly

A single 20-minute massage and mobilization protocol focused on the feet and ankles of elderly adults significantly improved their performance on balance tests immediately following touch therapy, according to recent research.

The study, “Massage and mobilization of the feet and ankles in elderly adults: Effect on clinical balance performance,” involved 27 subjects between the ages of 65 and 95, with a mean age of roughly 79 years. Volunteers for the study were recruited from three nursing homes.
Each of the subjects received a 20-minute massage and mobilization session, focusing on the feet and ankles. They also each received a placebo intervention, which consisted of applying three demagnetized magnets in the region of the fifth metatarsal for 20 minutes. At least one week separated the two sessions, which were performed in random order.

The massage and mobilization protocol, according to the study’s authors, is one that is widely used among physical therapists and is designed to target the somatosensory system of the feet and ankles. Ten minutes of each intervention was devoted to massage and the other 10 minutes to joint mobilization.

“Given that the somatosensory system includes multiple receptors that provide information about pressure distribution (cutaneous), muscle tension (Golgi tendon organs), joint angle changes (joint receptors) and muscle length changes (spindles), the intervention involved manual massage of the feet and mobilization of the feet and ankles,” state the researchers.

The goal of the massage portion was to boost local blood circulation and stimulate cutaneous receptors. The touch techniques were described as an application of friction, static and glide, with pressure focused on

the sole of the foot. According to the study’s authors, “multidirectional, systematic tractions on the sole of the foot were performed particularly in the heel region and over the metatarsal heads.”

Subject balance evaluations were conducted immediately before and after each session, whether it was the massage and mobilization session or the placebo session with the magnets. These outcome measures were a one-leg balance test, a timed up-and-go test and a lateral-reach test. For each, three trials were performed, and a mean time was calculated.

The research results showed a statistically significant improvement in performance for both the one-leg balance test and the timed up-and-go test following the massage and mobilization protocol, but not after the placebo intervention. As for the lateral-reach test, there was no significant improvement after the touch or placebo sessions.

“In the context of a progressively aging population and increasing falls, these results after only a single 20-minute intervention are very promising,” state the study’s authors.

Authors: Jacques Vaillant, Audrey Rouland, Pascale Martigné, Renaud Braujou, Michael J. Nissen, Jean-Louis Caillat-Miousse, Nicolas Vuillerme, Vincent Nougier and Robert Juvin.

Sources: Laboratoire Santé Plasticité Motricité, Université Joseph Fourier-Grenoble, Grenoble, France; Ecole de Kinésthérapie du Centre Hospitalier Universitaire de Grenoble, Grenoble, France; Hôpital de Saint-Laurent-du-Pont, Saint-Laurent-du-Pont, France; Service de Rhumatologie du Centre Hospitalier Universitaire de Genéve, Genéve, Switzerland; Service de Rhumatologie du Centre Hospitalier Universitaire de Grenoble, Grenoble, France. Originally published in Manual Therapy (2009).