The Effect of Blood Flow Restriction Training on Dynamic Balance in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

Clinical Scenario : Chronic ankle instability (CAI) often leads to sensorimotor deficits, impaired dynamic balance, and an increased risk of early joint degeneration if left untreated. Blood flow restriction training (BFRT) can be used to enhance muscle strength and hypertrophy across the ankle joint muscles in those with CAI. Individuals with CAI frequently demonstrate muscle weakness and atrophy around the ankle joint, which further contributes to instability and recurrent sprains. However, its efficacy for improving dynamic balance in CAI remains unknown. Clinical Question : Does adding BFRT to traditional rehabilitation result in greater improvements in dynamic balance in individuals with CAI compared to traditional rehabilitation alone? Summary of Key Findings : Three randomized controlled trials evaluating dynamic balance outcomes following BFRT interventions in individuals with CAI were reviewed. Results showed that BFRT did not lead to additional improvement in dynamic balance outcomes compared with traditional rehabilitation alone, regardless of whether BFRT was applied independently or in combination with rehabilitation. Clinical Bottom Line : Adding BFRT to standard rehabilitation does not provide additional improvements in dynamic balance for individuals with CAI. While BFRT remains beneficial for improving muscle strength and activation, clinicians should continue to prioritize conventional neuromuscular and proprioceptive rehabilitation strategies to address dynamic balance deficits. Strength of Recommendation : Grade B evidence supports BFRT does not improve dynamic balance in those with CAI.