Ankle Proprioception, Blood Flow Restriction
Conditions
Keywords
ankle, proprioception, blood flow restriction
Brief summary
his randomized controlled crossover study aims to investigate the acute effects of lower limb blood flow restriction (BFR) on ankle joint proprioception, postural control, and muscle activation in healthy adults. Each participant will complete test sessions under BFR (60% individualized arterial occlusion pressure) and control (20 mmHg sham) conditions. Outcome measures include joint position sense, kinesthesia, static and dynamic balance performance, and electromyographic (EMG) activity and reaction times of selected lower limb tibialis anterior and peroneus longus muscles.
Detailed description
Lateral ankle sprains are among the most common musculoskeletal injuries and may lead to chronic ankle instability (CAI), partly due to impaired proprioception and neuromuscular control. Blood flow restriction (BFR) training is widely used to augment muscular adaptations with low external loads; however, its acute effects on joint proprioception and sensorimotor control, particularly at the ankle joint, remain unclear and may be detrimental under certain conditions. This randomized controlled crossover trial will examine the effects of a single-session lower limb BFR application on ankle joint position sense, kinesthesia, static and dynamic balance, and EMG-based reaction time and activity of lower limb muscles in healthy adults. Participants aged 18-40 years without recent ankle sprain, neuromuscular, cardiovascular, or thromboembolic disease will undergo standardized proprioception tests using an isokinetic dynamometer, static balance tests on a force platform, Y-balance test, and inversion simulation platform assessments under BFR (60% arterial occlusion pressure) and low-pressure control (20 mmHg) conditions. Individual arterial occlusion pressure (AOP) will be determined using Doppler ultrasound, and BFR will be applied with a pneumatic cuff at the most proximal thigh. All measurements will be performed on the dominant lower limb with sessions scheduled at the same time of day to minimize circadian variability. The primary hypothesis is that acute lower limb BFR will worsen ankle joint proprioception and sensorimotor control compared with the control condition, potentially indicating a transient increase in injury risk during BFR-assisted activities.
Interventions
OTHERBlood Flow Restriction
Arm Description: Participants perform balance/proprioception tests under lower limb blood flow restriction at % 60 AOP.
Sham BFR Description: Participants perform the same tests with sham(20 mmHg) blood flow restriction
Sponsors
Uludag University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
NONE
Intervention model description
Arm 1: Experimental - Blood Flow Restriction Participants perform balance and proprioception tests under lower-limb blood flow restriction at 60% arterial occlusion pressure. Arm 2: Sham Comparator - Sham Blood Flow Restriction Participants perform the same balance and proprioception tests with sham blood flow restriction at 20 mmHg. This is a randomized crossover study, and all participants complete both conditions in a randomized order.
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged between 18 and 40 years * No known neuromuscular or cardiovascular disease
Exclusion criteria
* History or presence of cardiac, coronary artery, or peripheral arterial disease * Presence or history of varicose veins, hypertension, diabetes mellitus, or pulmonary disease * History of pulmonary embolism or deep vein thrombosis * Use of medications affecting the central nervous or cardiovascular systems * Use of oral contraceptives or anticoagulants * Pregnancy * Open wounds or significant scar tissue at the cuff application site * History of lower extremity musculoskeletal injury or surgery * Any neurological, vascular, or systemic condition that may interfere with test performance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| static balance performance | day 3 | sway area (mm\^2) in single-leg and tandem stance with eyes open/closed on force platform (HUR SmartBalance). |
| Static Balance Performance | day 3 | Center of pressure path length (mm) in single-leg and tandem stance with eyes open/closed on force platform (HUR SmartBalance). |
| Change in Kinesthesia Threshold (degrees) | day 1 and day 2 | Minimal angular displacement (degrees) at which movement is first perceived in inversion and plantarflexion. |
| Static balance performance | day 3 | sway velocity (mm/s) in single-leg and tandem stance with eyes open/closed on force platform (HUR SmartBalance). |
| Change in Ankle Joint Position Sense Error (degrees) | day 1 and day 2 | Absolute error (degrees) between target and reproduced angles during passive and active joint position sense tests in inversion and plantar flexion, measured with an isokinetic dynamometer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peroneus Longus and Tibialis Anterior Reaction Time (ms) | day 4 | Time from onset of platform-induced inversion to EMG activation exceeding 2× resting activity. |
| Lower Limb EMG Activity (%MVIC) | day 4 | Mean EMG amplitude normalized to maximal voluntary isometric contraction values. |
| Y-Balance Test Reach Distances (cm) | day 4 | Anterior, posteromedial and posterolateral reach distances of the tested limb. |
Countries
Turkey (Türkiye)
Outcome results
None listed