EFFECT OF ANKLE AND FOOT MOBILIZATION ON STATIC BALANCE IN OLDER ADULTS
Description
This thesis, titled "Effect of Maitland Grade III–IV Ankle and Foot Joint Mobilization on Static Balance in Older Adults," is a randomized controlled trial (n = 92) investigating whether manual joint mobilization can improve postural stability in the elderly. The study is grounded in the understanding that static balance depends on integrated input from the visual, vestibular, and somatosensory systems, with the ankle-foot complex serving as the primary somatosensory contact point with the ground. With aging, periarticular mechanoreceptors in the ankle and foot lose density and sensitivity, degrading proprioceptive feedback and increasing fall risk. The central hypothesis is that Maitland Grade III (large-amplitude, end-range) and Grade IV (small-amplitude, end-range) oscillatory mobilizations mechanically stimulate these mechanoreceptors—particularly at the talocrural and subtalar joints—improving joint afferent signaling and, consequently, static balance control. The literature review situates this work against a body of manual therapy and balance research frequently limited by underpowered samples, absent power calculations, inconsistent outcome measures, and overstated causal claims from cross-sectional or short-duration designs. Every citation in this review underwent verification against original, retrievable sources, eliminating any fabricated or misattributed references. This critical appraisal directly shaped the thesis's methodological choices, particularly its emphasis on adequately justified sample size and dual outcome measurement. Methodologically, participants were randomized into an intervention group receiving structured Grade III–IV mobilization and a comparison group, with balance assessed using two complementary tools: the Balance Error Scoring System (BESS), which quantifies errors across multiple stance and surface conditions, and the Four Stage Balance Test, a progressively challenging functional measure widely used in geriatric fall-risk screening. Using both a granular, error-based measure and a functional, stage-based measure was a deliberate choice to strengthen inferential validity and address the single-outcome-measure limitation common in prior studies.
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Institutions
- Maharishi Markandeshwar University, MullanaHaryana, Ambāla