Balboni Julia M, Madhira Karthik, Martinez Victor, Tung Wei-Shao, Kennedy John G, Gianakos Arianna L
Department of Orthopaedic Surgery, University of New England College of Osteopathic Medicine, Biddeford, ME 04005, United States.
Department of Orthopaedics, New York Institute of Technology College of Osteopathic Medicine, Glen Head, NY 11545, United States.
World J Orthop. 2025 Jun 18;16(6):106804. doi: 10.5312/wjo.v16.i6.106804.
Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness. Preliminary evidence has shown that blood flow restriction (BFR) rehabilitation can increase muscle strength and stability, helping to restore physical function and prevent repeated injury.
To determine whether BFR is more effective than traditional rehabilitation in improving muscle strength, size, and stability after foot and ankle injury.
A systematic review and meta-analysis were performed. Articles were retrieved from MEDLINE, EMBASE, and CENTRAL databases. Included studies compared the effectiveness of BFR rehabilitation to traditional foot and ankle rehabilitation exercises. Eligible patients were those with a history of foot or ankle injury. Muscle strength, size, and dynamic balance were assessed by comparing improvements in peak torque, cross-sectional area, and percent muscle activation. Methodological quality assessments were performed using the PEDro scale and Methodological Index for Non-Randomized Studies (MINORS).
Ten studies met the inclusion criteria. Five studies were of good to excellent quality according to the PEDro scale, and 5 studies were of moderate quality as per the MINORS criteria. Two studies compared the effect of BFR and non-BFR rehabilitation on muscle strength; the overall mean difference between the BRF and non-BFR groups was 0.09 [95%CI: (0.05, 0.12), < 0.0001]. Two studies analyzed muscle activation following BFR and non-BFR rehabilitation; the overall mean difference between the BRF and non-BFR groups was 0.09 [95%CI: (0.05, 0.12), < 0.0001]. Data on dynamic balance was synthesized from two studies; the mean difference between the BFR and control groups was 1.23 [95%CI: (-1.55, 4.01); = 0.39].
BFR rehabilitation is more effective than non-BFR rehabilitation at improving muscle strength and activation following foot and ankle injury. Additional studies are needed to develop a standardized BFR training protocol.
足踝损伤后肌肉骨骼恢复不佳可导致慢性不稳定和持续性肌肉无力。初步证据表明，血流限制（BFR）康复可增强肌肉力量和稳定性，有助于恢复身体功能并预防反复受伤。
确定BFR在改善足踝损伤后的肌肉力量、大小和稳定性方面是否比传统康复更有效。
进行了系统评价和荟萃分析。从MEDLINE、EMBASE和CENTRAL数据库中检索文章。纳入的研究比较了BFR康复与传统足踝康复锻炼的效果。符合条件的患者为有足踝损伤史者。通过比较峰值扭矩、横截面积和肌肉激活百分比的改善情况来评估肌肉力量、大小和动态平衡。使用PEDro量表和非随机研究方法学指数（MINORS）进行方法学质量评估。
十项研究符合纳入标准。根据PEDro量表，五项研究质量为良好至优秀，根据MINORS标准，五项研究质量为中等。两项研究比较了BFR和非BFR康复对肌肉力量的影响；BFR组和非BFR组之间的总体平均差异为0.09 [95%CI：（0.05，0.12），<0.0001]。两项研究分析了BFR和非BFR康复后的肌肉激活情况；BFR组和非BFR组之间的总体平均差异为0.09 [95%CI：（0.05，0.12），<0.0001]。动态平衡数据来自两项研究的综合分析；BFR组和对照组之间的平均差异为1.23 [95%CI：（-1.55，4.01）；P = 0.39]。
在改善足踝损伤后的肌肉力量和激活方面，BFR康复比非BFR康复更有效。需要进一步研究以制定标准化的BFR训练方案。
