T he tendency toward repeated ankle sprains and recurring symptoms (eg, pain, weakness, giving way) has been termed "chronic ankle instability" (CAI) 35 and reported to occur in as high as 40% to 70% of individuals who have sustained a lateral ankle sprain. 7,23,45 Changes in sensorimotor system function are thought to be involved in the decreased postural control and joint position awareness and increased instability found in individuals with CAI. 13,24,46 T T STUDY DESIGN: Prospective cohort study. T T OBJECTIVE:To assess the effect of 6 weeks of balance training on sensorimotor measures previously found to be deficient in participants with chronic ankle instability (CAI). T T BACKGROUND:CAI is the tendency toward repeated ankle sprains and recurring symptoms, occurring in 40% to 70% of individuals who have previously sustained a lateral ankle sprain. Recent studies have found deficits in sensorimotor measures in individuals with CAI. As balance training is a common component of ankle rehabilitation, understanding its effect on the sensorimotor system in individuals with CAI may enable us to optimize protocols to better utilize this rehabilitation method. T T METHODS:Twelve participants with CAI and 9 healthy volunteers participated. Independent variables were group (CAI, control) and time (pretraining, posttraining). Participants with CAI who completed a 6-week balance training program and healthy controls who did not get any training were pretested and posttested at the beginning and at the end of 6 weeks. T T RESULTS:The individuals in the CAI group who performed balance training demonstrated better performance than control participants on baselineadjusted posttraining measures of dynamic balance in the anterior medial (P = .021), medial (P = .048), and posterior medial directions (P = .030); motoneuron pool excitability Hmax/Mmax ratio (P = .044) and single-limb presynaptic inhibition (P = .012); and joint position sense inversion variable error (P = .017). It may be of note that no systematic differences were detected for static balance or plantar flexion joint position sense tasks. T T CONCLUSIONS:After 6 weeks of balance training, individuals with CAI demonstrated enhanced dynamic balance, inversion joint position sense, and changes in motoneuron pool excitability compared to healthy controls who did not train. T T LEVEL OF EVIDENCE:Therapy, level 2b.

These changes in temperature suggest corresponding changes in peripheral blood flow in the treated areas as well as in adjacent not-massaged areas. Moreover, the results suggest dynamic infrared thermography as a useful tool to measure noninvasive, noncontact changes in peripheral blood flow for massage therapy research.

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Objectives The purpose of this study is to determine if an 8-week low-carbohydrate/high-protein (LC/HP) dietary intervention will show improvements in clinically important metrics of metabolic function and body composition in individuals with spinal cord injury (SCI). Methods Twenty-one participants with long-standing SCI (≥3 years post-injury) (age: 45 ± 13 years) were randomly assigned to an 8-week iso-caloric high-protein/low-carbohydrate (HPLC) diet or their habitual control diets. Injury levels ranged between cervical vertebrate 4 to lumbar vertebrate 3. The HPLC diet included ∼30% total energy as protein (40% energy from carbohydrate) and participants were provided with all study meals if they were assigned to the HPLC group. Each participant underwent an oral glucose tolerance test (OGTT) and DXA scanning before and after the intervention after an overnight fast. Blood glucose and insulin during the OGTT were assessed, and their respective incremental areas under the curve were calculated, as well as Matsuda index, an indicator of insulin sensitivity. The blood lipid panel was analyzed using the fasting samples. A two-way repeated-measures ANOVA model was used to evaluate the main effect of diet, time, and their interaction. Results We observed no main effect of time, diet, and their interaction on the fasting concentrations of glucose, insulin, their respective concentrations at 120-minute during the OGTT, and areas under the curve, but a trend for decreased insulin AUC among participants in the HPLC group (P = 0.07). There is a trend for the diet by time interaction effect for the Matsuda index (P = 0.11). The Matsuda index quantitatively increased in the HPLC group while remained in the control group. In contrast, an interaction effect was observed for several outcomes. These outcomes were decreased in the HPLC group, and include total Cholesterol (−23.9mg/dL),  LDL (−15.8 mg/dL),  total body fat mass (−5%), and visceral fat mass (−11%) (P < 0.05 for all). Fat-free mass did not change over time. Conclusions Our results support that our HPLC diet can be safely adopted by individuals with SCI to achieve improvements in glucose metabolism and lipid profile and body composition. Funding Sources The study was funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (#90SI5019).

Background: Falls are the primary cause of accidental death in older persons, producing increased morbidity, decreased independence, and billions in medical costs annually. Massage therapy (MT) may produce adaptations that decrease risk of falling. If MT can improve stability in older persons, it may provide a new intervention for this issue. Purpose: Determine the acute effects of a 60-minute MT treatment on static and functional balance, neurological measures, heart rate, and blood pressure in healthy, older individuals. Setting: Laboratory Research Design: A 2 by 4 (treatment by time) mixed factorial experimental design for the cardiovascular and postural control variables; independent variables were treatment with two levels (control, MT) and time with four levels (pretreatment baseline, immediate post-treatment, 20-minute post-treatment, 60-minute post-treatment). Neurological measures utilized a 2 by 2 mixed design, with testing conducted pre- and 60-minutes post-treatment. Participants: Thirty-five healthy, older volunteers (19 male and 16 female; ages 62.9 ± 4.6). Intervention: A 60-minute full-body therapeutic massage. The control group rested quietly in the treatment room. Main Outcome Measures: Static (double-legged) and functional (single-legged) postural control with eyes-open and eyes-closed; Hoffmann-reflex measures; heart rate, and systolic and diastolic blood pressure. Results: MT significantly decreased rectangular displacement area in both the eyes-open and eyes-closed, double-legged stance conditions ( p < 0.05); displacement velocity in both eyes-open conditions ( p < .05); and systolic and diastolic blood pressure ( p < .05), while increasing heart rate ( p < .05). MT also significantly lowered H max /M max ratios compared to controls ( p = .002). Decreased H max /M max measures were correlated to improved stability. Conclusions: A single, 60-minute, full-body massage therapy treatment was shown to have a stabilizing effect on measures of static and dynamic balance and physiological factors related to stability in older adults. MT should be investigated as a potential intervention to decrease falls in older individuals.