Immediate Effects of Blood Flow Restriction Combined With Whole Body Vibration on Balance, Proprioception, and Function in Non-Professional Male Athletes With Chronic Ankle Instability Publisher



Malmir K ; Bajalan A ; Ghotbi N ; Ashnagar Z
Source: BMC Sports Science, Medicine and Rehabilitation Published:2025

Abstract

Background: Chronic ankle instability (CAI) is associated with impaired balance, proprioception, and limited dorsiflexion range of motion (ROM). Whole-body vibration (WBV) and blood flow restriction (BFR) may address these deficits. This study aimed to determine whether adding BFR to WBV would produce greater immediate improvements in these parameters compared to WBV alone. Methods: In this double-blind, randomized controlled trial, thirty-eight non-professional male athletes with CAI were randomly assigned to WBV (n = 19; age: 23.5 ± 4.7 years) or WBV + BFR group (n = 19; age: 24.1 ± 4.9 years). Both groups received a single session of WBV at 30 Hz and 2 mm amplitude; the WBV + BFR group additionally underwent BFR at 80% arterial occlusion pressure. Balance error scoring system (BESS), modified star excursion balance test (m-SEBT), ankle dorsiflexion proprioception, side hop test, dorsiflexion ROM, and perceived instability were measured before and after the intervention. Results: Statistical tests showed no significant changes in BESS scores (p > 0.05). The WBV + BFR group showed a significant improvement in anterior reach of the m-SEBT (p = 0.04), while the WBV-only group did not (p = 0.69). Statistical analysis indicated a significant reduction in dorsiflexion repositioning error in the WBV group (p = 0.004), with between-group differences favoring WBV. Perceived instability significantly improved in the combined group (p = 0.001). Both groups showed improved dorsiflexion ROM (p < 0.05), with no significant difference between them (p = 0.76). Conclusion: Both WBV and WBV + BFR improved dorsiflexion ROM in athletes with CAI, but neither produced immediate gains in static or dynamic balance, except for anterior reach with the combined intervention. Adding one session of BFR to WBV appeared to impair proprioception and increase perceived instability. These methods may be better used as adjuncts in rehab, not standalone treatments. Clinically, they should be applied cautiously and not immediately before activities demanding high joint stability. Clinical trial registration: Registered at IRCT (IRCT20230203057314N1; June 2, 2023). © 2025 Elsevier B.V., All rights reserved.