Effects of blood-flow restriction training on dynamic postural control and ankle function in individuals with chronic ankle instability: a systematic review and meta-analysis of randomized controlled trials.
meta_analysis · Level I
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- Also identified by DOI 10.1186/s13018-026-07018-5.
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Abstract
Decreased ankle-muscle strength and activation can lead to postural control disorders in individuals with chronic ankle instability (CAI). Blood-flow restriction training (BFRT) promotes muscle growth and function at low loads, representing a safe and efficient rehabilitation strategy. However, previous small-scale studies have shown inconsistent results. This review conducted a meta-analysis of existing randomized controlled trials (RCTs) to investigate the influence of BFRT on the dynamic postural control and ankle function of CAI individuals. PubMed, Embase, Cochrane Library, Web of Science, and EBSCO were searched until November 16, 2025. The primary outcomes included Y-balance test (YBT) distance, ankle-muscle strength, and ankle-muscle activation, whereas the secondary outcome was Cumberland ankle instability tool (CAIT) score. Methodological quality was assessed using Cochrane Risk-of-Bias tool (version 2) and PEDro scale. We conducted a meta-analysis using a random-effects model via the metafor package in R software. A total of nine RCTs involving 252 participants were included in this work. Results showed that compared with the control group, BFRT may improve the YBT anterior distance (standardized mean difference [SMD] = 0.57, 95% confidence interval [CI] 0.18 to 0.96; low-certainty evidence) and comprehensive score (SMD = 0.31, 95% CI 0.16 to 0.45; very low-certainty evidence), dorsiflexion muscle strength (SMD = 1.12, 95% CI 0.09 to 2.15; very low-certainty evidence), tibialis anterior muscle activation (SMD = 0.92, 95% CI 0.41 to 1.43; very low-certainty evidence), and CAIT score (MD = 2.30, 95% CI 0.89 to 3.71; very low-certainty evidence). BFRT may improve the dynamic postural control, ankle-muscle strength, muscle activation, and function score of CAI individual. However, further high-quality RCTs are warranted to confirm these findings.