DOI QR코드

DOI QR Code

Contributory Effect of Additional Blood Flow Restriction in Active Joint Mobilization for Young Adults with Chronic Ankle Instability: A Pilot Randomized Controlled Trial

  • Hyunjoong Kim (Neuromusculoskeletal Science Laboratory) ;
  • Jihye Jung (Institute of SMART Rehabilitation, Sahmyook University) ;
  • Seungwon Lee (Institute of SMART Rehabilitation, Sahmyook University)
  • Received : 2023.12.07
  • Accepted : 2023.12.22
  • Published : 2023.12.31

Abstract

Objective: Active joint mobilization (AJM) is an effective strategy for treating chronic ankle instability. Recent studies have shown that incorporating blood-flow restriction (BFR) training into joint exercise programs can enhance physical function. The aim of this study was to compare the effects of BFR during active joint mobilization in individuals with chronic ankle instability. Design: A pilot randomized controlled trial. Methods: Thirty participants with chronic ankle instability were randomly assigned to either the BFR plus AJM group (n=15) or the AJM group (n=15). The BFR plus AJM group had BFR applied during the AJM, while the AJM group did not. AJM was performed 10 times with voluntary movement, and BFR was performed only during AJM. Static and dynamic balance abilities were assessed using standardized measurements before and after the study. Data were compared using appropriate statistical analysis. Results: The results showed statistically significant improvements in static and dynamic balance abilities after the AJM intervention program in both the BFR and non-BFR groups (p<0.05). However, the BFR group demonstrated greater improvements in dynamic balance abilities compared to the non-BFR group(p<0.05). Applying BFR during AJM in individuals with CAI was found to be an effective strategy for improving static and dynamic balance abilities. Conclusions: These findings suggest that BFR may be beneficial for the treatment of CAI. Further research is needed to evaluate the long-term effects and safety of BFR training in this population.

Keywords

References

  1. Al-Mohrej OA, Al-Kenani NS. Chronic ankle instability: Current perspectives. Avicenna J Med. 2016;6:103-8.
  2. Hertel J. Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. J Athl Train. 2002;37:364-75.
  3. Zech A, Hubscher M, Vogt L, Banzer W, Hansel F, Pfeifer K. Neuromuscular training for rehabilitation of sports injuries: a systematic review. Med Sci Sports Exerc. 2009;41:1831-41.
  4. Konradsen L, Magnusson P. Increased inversion angle replication error in functional ankle instability. Knee Surg Sports Traumatol Arthrosc. 2000;8:246-51.
  5. Martin RL, Davenport TE, Fraser JJ, Sawdon-Bea J, Carcia CR, Carroll LA, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther. 2021;51:Cpg1-cpg80.
  6. Kim H, Song S, Lee S, Lee S. Short-term effects of joint mobilization with versus without voluntary movement in patients with chronic ankle instability: A single-blind randomized controlled trial. Physical Therapy Rehabilitation Science. 2021;10:1-9.
  7. Kim H, Moon S. Effect of Joint Mobilization in Individuals with Chronic Ankle Instability: A Systematic Review and Meta-Analysis. J Funct Morphol Kinesiol. 2022;7.
  8. Kazemi K, Arab AM, Abdollahi I, Lopez-Lopez D, Calvo-Lobo C. Electromiography comparison of distal and proximal lower limb muscle activity patterns during external perturbation in subjects with and without functional ankle instability. Hum Mov Sci. 2017;55:211-20.
  9. Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med. 2017;51:113-25.
  10. Van Cant J, Dawe-Coz A, Aoun E, Esculier JF. Quadriceps strengthening with blood flow restriction for the rehabilitation of patients with knee conditions: A systematic review with meta-analysis. J Back Musculoskelet Rehabil. 2020;33:529-44.
  11. Caetano D, Oliveira C, Correia C, Barbosa P, Montes A, Carvalho P. Rehabilitation outcomes and parameters of blood flow restriction training in ACL injury: A scoping review. Phys Ther Sport. 2021;49:129-37.
  12. Hill EC, Housh TJ, Keller JL, Smith CM, Anders JV, Schmidt RJ, et al. Low-load blood flow restriction elicits greater concentric strength than non-blood flow restriction resistance training but similar isometric strength and muscle size. Eur J Appl Physiol. 2020;120:425-41.
  13. Loenneke JP, Pujol TJ. The use of occlusion training to produce muscle hypertrophy. Strength & Conditioning Journal. 2009;31:77-84.
  14. Cruz-Diaz D, Lomas Vega R, Osuna-Perez MC, Hita-Contreras F, Martinez-Amat A. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disabil Rehabil. 2015;37:601-10.
  15. Wright CJ, Arnold BL, Ross SE, Linens SW. Recalibration and validation of the Cumberland Ankle Instability Tool cutoff score for individuals with chronic ankle instability. Arch Phys Med Rehabil. 2014;95:1853-9.
  16. Vicenzino B, Branjerdporn M, Teys P, Jordan K. Initial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain. J Orthop Sports Phys Ther. 2006;36:464-71.
  17. Hoch MC, McKeon PO. The effectiveness of mobilization with movement at improving dorsiflexion after ankle sprain. J Sport Rehabil. 2010;19:226-32.
  18. Kim Y, Lee G. Immediate Effects of Angular Joint Mobilization (a New Concept of Joint Mobilization) on Pain, Range of Motion, and Disability in a Patient with Shoulder Adhesive Capsulitis: A Case Report. Am J Case Rep. 2017;18:148-56.
  19. Kim K, Huh Y, Shin S. Acute Effects of the Blood Flow Restriction on the Peak Torque and Work Per Repitition during knee Isokinetic Exercise. Korean Journal of Sports Science. 2016;25:1259-65.
  20. Kim KJ, Heo M. Effects of virtual reality programs on balance in functional ankle instability. J Phys Ther Sci. 2015;27:3097-101.
  21. Perron M, Hebert LJ, McFadyen BJ, Belzile S, Regniere M. The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain. Clin Rehabil. 2007;21:73-81.
  22. Arnoldo T, Victor C-V. Effect size, confidence intervals and statistical power in psychological research. Psychology in Russia: State of the art. 2015;8:27-46.
  23. McKeon PO, Hertel J. Systematic review of postural control and lateral ankle instability, part I: can deficits be detected with instrumented testing. J Athl Train. 2008;43:293-304.
  24. Cao S, Wang C, Ma X, Jiang S, Yu Y, Wang X, et al. Stair descent biomechanics reflect perceived instability in people with unilateral ankle sprain history. Clin Biomech (Bristol, Avon). 2020;72:52-7.
  25. Gerstle EE, O'Connor K, Keenan KG, Cobb SC. Foot and Ankle Kinematics During Descent From Varying Step Heights. J Appl Biomech. 2017;33:453-9.
  26. Pearson SJ, Hussain SR. A review on the mechanisms of blood-flow restriction resistance training-induced muscle hypertrophy. Sports Med. 2015;45:187-200.
  27. Ebig M, Lephart SM, Burdett RG, Miller MC, Pincivero DM. The effect of sudden inversion stress on EMG activity of the peroneal and tibialis anterior muscles in the chronically unstable ankle. J Orthop Sports Phys Ther. 1997;26:73-7.
  28. Herda TJ. Resistance exercise training and the motor unit. Eur J Appl Physiol. 2022;122:2019-35.
  29. Skarabot J, Brownstein CG, Casolo A, Del Vecchio A, Ansdell P. The knowns and unknowns of neural adaptations to resistance training. Eur J Appl Physiol. 2021;121:675-85.
  30. Rosen AB, Yentes JM, McGrath ML, Maerlender AC, Myers SA, Mukherjee M. Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control. J Athl Train. 2019;54:718-26.