Balance training versus balance training and foot and ankle mobilization: a pilot randomized trial in community-dwelling older adults

Background: Balance limitations and foot and ankle problems are common in older adults. Objective: To determine the impact of augmented balance training with foot and ankle mobilizations (FAMs) on balance in older adults. Methods: Two-arm pilot randomized trial. Both groups underwent a 4-week conventional balance training. Additionally, the experimental group received four sessions of FAM. Balance measurement, as assessed by the Berg Balance Scale, was the primary outcome. The secondary outcome was the ankle range of movement (ROM). Outcomes were evaluated 1 day before and after intervention, and at 3 months' post-intervention (midterm). Results: Twenty-eight participants completed the study (14 control, 14 experimental). No between-group differences were observed in terms of balance. Similarly, both groups significantly improved the ankle ROM, but the effects persisted at 3 months only in the FAM group. Conclusion: Augmented balance training with FAM does not improve balance of older adults over conventional methods, but may help to correct ankle mobility limitations at midterm. As this was a pilot study, further studies with adequate sample size are warranted to validate our findings, and elucidate the dose-response relationship of FAM with improvement of balance and ROM in older adults.