Self Stretching, Plantar Self Massage and Manual Stimulation on Balance and Reaction Time

Study Overview
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Brief Summary
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The aim of this study is to investigate the instantaneous effects of self-stretching, plantar self-massage and manual stimulation on balance and reaction time in healthy individuals. 102 individuals meeting the inclusion criteria will be included in the study. Individuals will be randomly divided into 3 groups: static stretching group (n=34), self-massage group (n=34) and manual stimulation group (n=34). Static stretching will be applied to all individuals (n=102). In addition to static stretching, self-massage will be applied to individuals in the self-massage group (n=34). Individuals in the manual stimulation group (n=34) will receive manual stimulation in addition to static stretching. Individuals will be evaluated in terms of static balance, dynamic balance, reaction time and foot functionality before and immediately after the applications.

Official Title
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Instant Effect of Self Stretching, Plantar Self Massage and Manual Stimulation on Balance and Reaction Time in Healthy Individuals

Conditions
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Healthy, Stretch

Intervention / Treatment
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* Other: static stretching
* Other: self massage
* Other: Manual Stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: being between 18 and 50 years old having Body Mass Index (BMI) limit to be 20-25 having Normal range of motion of the ankle joint having the score of the foot is between 0 and +5 according to the foot posture index, having the score 3+ on ankle muscle strength Exclusion Criteria: being pregnant having undergone surgery on the foot and ankle in the last 6 months history of lower extremity injury with residual symptoms in the past year having diseases that affect the balance such as rheumatic disease, osteoarthritis, multiple sclerosis being professional athlete presence of vestibular disease (Meniere, Vertigo etc.), diabetes, neuropathy Being in being in the menopausal period having hip flexor muscle shortening having basal ganglia disorders such as Parkinson's disease, Huntington's disease having sensory problems on the sole of the foot

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: static stretching group<br>The stretch will be done by placing both feet on a raised platform, lowering the heel off the platform without touching the ground, and held in this position to perform a static stretch. They will perform 5 repetitions, 15 seconds of rest and 1 minute of stretching. | Other: static stretching<br>* The stretch will be done by placing both feet on a raised platform, lowering the heel off the platform without touching the ground, and held in this position to perform a static stretch. They will perform 5 repetitions, 15 seconds of rest and 1 minute of stretching.<br>|
| Experimental: self massage group<br>In addition to the self-stretching application, plantar self-massage will be applied. Plantar self massage will be shown to the participants by the physiotherapist with a 7 cm spiky massage ball. Then, participants will be asked to self-massage the plantar sole of the foot for 5 minutes with a 7 cm spiky massage ball. | Other: static stretching<br>* The stretch will be done by placing both feet on a raised platform, lowering the heel off the platform without touching the ground, and held in this position to perform a static stretch. They will perform 5 repetitions, 15 seconds of rest and 1 minute of stretching.<br>Other: self massage<br>* In addition to the self-stretching application, plantar self-massage will be applied. Plantar self massage will be shown to the participants by the physiotherapist with a 7 cm spiky massage ball. Then, participants will be asked to self-massage the plantar sole of the foot for 5 minutes with a 7 cm spiky massage ball.<br>|
| Experimental: Manual Stimulation Group<br>In addition to the self-stretching application, manual stimulation will be applied. Manual protocol: A) Pressure will be applied in each interdigital space and on the longitudinal arch with shear in the longitudinal direction (5 repetitions of 10 seconds each). B) Pressure with transverse shear on the metatarsal heads (5 repetitions of 5 seconds each) C) Static pressure will be applied to the first and fifth metatarsal head, center of the midfoot, and heel (5 repetitions per 10-second period each). | Other: static stretching<br>* The stretch will be done by placing both feet on a raised platform, lowering the heel off the platform without touching the ground, and held in this position to perform a static stretch. They will perform 5 repetitions, 15 seconds of rest and 1 minute of stretching.<br>Other: Manual Stimulation<br>* In addition to the self-stretching application, manual stimulation will be applied. Manual protocol: A) Pressure will be applied in each interdigital space and on the longitudinal arch with shear in the longitudinal direction (5 repetitions of 10 seconds each). B) Pressure with transverse shear on the metatarsal heads (5 repetitions of 5 seconds each) C) Static pressure will be applied to the first and fifth metatarsal head, center of the midfoot, and heel (5 repetitions per 10-second period each).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| One Leg Standing Test | It will be used to evaluate static balance. If the cut-off value is <10 seconds, there is a balance disorder, if it is <5 seconds, there is a risk of falling. | change in static balance immediately after application | 
| Functional Reach Test | It will be used to evaluate dynamic balance. The distance that the person can reach is measured. Higher scores mean better performance. | change in dynamic balance immediately after application | 
| Y Balance Test | It will be used to evaluate dynamic balance. The distance that the person can reach is measured. Higher scores mean better performance. | change in dynamic balance immediately after application | 
| Nelson's Foot Reaction Time Test | It will be used to evaluate reaction time. The time that the person can react is measured. Higher scores mean worse performance. | change in reaction time immediately after application | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active-passive Limb Matching Test | It will be used to evaluate proprioception. Same position mean better performance. | change in proprioception immediately after application | 
| Goniometer | It will be used to evaluate range of motion of ankle. Dorsiflexion range of motion is 20 degree. Plantar flexion range of motion is 50 degree. Eversion range of motion is 15 degree. Inversion range of motion is 35 degree. Higher score means better performance. | change in range of motion immediately after application | 
| Foot Posture Index | It will be used to evaluate foot posture. Palpation of the talus head in the hindfoot, inclination under and over the lateral malleolus, pronation/supination of the calcaneus, ballooning in the talonavicular joint region in the forefoot, medial longitudinal arch structure, and abduction/adduction of the forefoot relative to the hindfoot are evaluated. Each of these criteria takes values between -2 and +2. 0 means the foot is in neutral position, positive values are interpreted as pronation, and negative values are interpreted as supination. | change in foot posture immediately after application | 
| Thomas test | It will be used to evaluate hip flexor shortness. If the other leg raise, it is positive. | change in hip flexor shortness immediately after application | 
| Pointed-blunt Test | It will be used to evaluate presence of sensory problems. Higher scores mean worse performance. Scoring: Normal <6mm Fair 6-10mm Poor 11-15mm | change in sensory immediately after application | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Self Stretching, Self Massage, Manual Stimulation, Balance, Reaction Time, Healthy