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Blood Flow Restriction Training in Women With Posterior Tibial Tendon Dysfunction (BFR-PTTD)

1 sierpnia 2026 zaktualizowane przez: Hajar Mohammed Edris, May University in Cairo

Effects of Blood Flow Restriction Training on Dynamic Postural Stability and Proprioception in Post-Menopausal Women With Posterior Tibial Tendon Dysfunction: A Randomized Controlled Trial

Posterior tibial tendon dysfunction (PTTD) is a common musculoskeletal disorder characterized by pain, impaired foot function, and reduced dynamic stability. As one of the primary causes of adult-acquired flatfoot deformity, it can significantly affect walking ability, balance, and overall performance of daily activities. Although conventional rehabilitation typically emphasizes strengthening the posterior tibial tendon and surrounding muscles, these interventions may not fully address deficits in neuromuscular control and postural stability, highlighting the need for additional therapeutic approaches.

This randomized controlled trial aims to evaluate whether incorporating blood flow restriction (BFR) training into a rehabilitation program provides additional benefits for postmenopausal women with Stage I or flexible Stage II PTTD. A total of 54 eligible participants will be randomly allocated to either a BFR training group or a conventional exercise group. Clinical outcomes will be assessed before and after the intervention, including dynamic postural stability measured with the Biodex Balance System and active and passive ankle joint position sense assessed using the Biodex Isokinetic Dynamometer.

Przegląd badań

Status

Jeszcze nie rekrutacja

Warunki

Interwencja / Leczenie

Szczegółowy opis

Posterior tibial tendon dysfunction (PTTD) is a progressive musculoskeletal disorder that affects the integrity and function of the posterior tibial tendon, leading to pain, impaired foot support, decreased postural stability, and functional limitations. As one of the most common causes of adult-acquired flatfoot deformity, PTTD can substantially interfere with walking, balance, and other daily activities. The condition is particularly prevalent among middle-aged and older women. In postmenopausal women, age-related declines in muscle strength, tendon quality, and neuromuscular function may further compromise lower-limb stability and physical performance.

Blood flow restriction (BFR) training has emerged as a promising rehabilitation technique in which low-load resistance exercise is performed while a pneumatic cuff applies controlled pressure to the proximal portion of the limb. By partially restricting blood flow during exercise, this approach enables individuals to achieve training adaptations that are typically associated with higher exercise intensities while using considerably lower loads. Although BFR has shown encouraging results in the rehabilitation of various musculoskeletal conditions, its effectiveness in individuals with PTTD, particularly postmenopausal women, has not been adequately investigated.

This randomized controlled trial aims to compare the effects of a rehabilitation program incorporating blood flow restriction training with those of a conventional rehabilitation exercise program in postmenopausal women with Stage I or flexible Stage II posterior tibial tendon dysfunction. Eligible participants will be randomly assigned to one of the two intervention groups.

Outcome measures will be assessed at baseline and after completion of 4 weeks. The primary outcome will be dynamic postural stability, measured using the Biodex Balance System. Secondary outcomes will include active and passive ankle joint position sense assessed using the Biodex Isokinetic Dynamometer

The findings of this study are expected to expand the current evidence regarding the use of blood flow restriction training in the rehabilitation of posterior tibial tendon dysfunction. They may also help guide future evidence-based rehabilitation strategies aimed at improving functional outcomes and postural stability in postmenopausal women with this condition.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

54

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

    • Cairo Governorate
      • Cairo, Cairo Governorate, Egipt
        • Faculty of Physical Therapy, May University in Cairo
        • Kontakt:

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  • Female post-menopausal women aged 40-55 years.
  • Clinically diagnosed with Stage I or flexible Stage II posterior tibial tendon dysfunction according to the Johnson and Strom classification modified by Myerson confirmed by an orthopedic physician.
  • Symptoms persisting for ≥ 3 months.
  • Pain intensity of ≥3/10 on the Visual Analogue Scale (VAS) during weight-bearing activities.
  • Medically cleared to participate in blood flow restriction resistance training.
  • Symptoms located at the medial ankle or foot.
  • Pain on palpation of the posterior tibial tendon.
  • A positive double and/or single heel-rise test.
  • Able to walk independently without assistive devices
  • Body Mass Index (BMI) between 18.5 and <24.9 kg/m².
  • Willingness to participate and provide written informed consent.

Exclusion Criteria:

  • Rigidity of the hindfoot.
  • Pain on palpation of the fibular muscles.
  • History of corticosteroid injection in the tendon in a one-month period prior to the study onset.
  • History of surgery to the hindfoot and/or ankle.
  • History of previous surgeries to the musculoskeletal structures (i.e., bones, joint structures, nerves) in either limb of the lower extremities.
  • History of a fracture in either limb of the lower extremities requiring realignment.
  • Acute injury to musculoskeletal structures of other joints of the lower extremity in the previous three months, which impacted joint integrity and function (i.e., sprains, fractures) resulting in interruption of desired physical activity.
  • Hip joint or knee joint replacement.
  • Patients who were possibly at risk of adverse reactions of blood flow restriction (i.e., poor circulatory system, obesity, diabetes, arterial calcification, sickle cell trait, severe hypertension, or renal failure).
  • Any neurological conditions that affect proprioception, such as polyneuropathy, multiple sclerosis, and sensory ataxia.
  • Vestibular deficits and vision problems.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Pojedynczy

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Blood Flow Restriction Group
Participants receive a conventional physical therapy program combined with blood flow restriction. Training
Low-load Resistance exercise performed with a pneumatic cuff applied to the proximal lower extremities
Inne nazwy:
  • BFR
Strengthening Exercises and ankle support
Inne nazwy:
  • CPT
Aktywny komparator: Conventional Physical Therapy Group
Participants receive the same exercise program without blood flow restriction
Strengthening Exercises and ankle support
Inne nazwy:
  • CPT

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Overall Stability Index (OSI)
Ramy czasowe: Baseline and immediately after completion of the 4-week intervention
The Overall Stability Index (OSI) will be measured using the Biodex Balance System. The OSI quantifies the overall variance of platform displacement from level during static balance testing and is expressed in degrees. Lower OSI values indicate better postural stability.
Baseline and immediately after completion of the 4-week intervention
Anteroposterior Stability Index (APSI)
Ramy czasowe: Baseline and immediately after completion of the 4-week intervention
The Anteroposterior Stability Index (APSI) will be measured using the Biodex Balance System. APSI quantifies postural sway in the sagittal (anteroposterior) plane during static balance testing and is expressed in degrees. Lower APSI values indicate better balance control in the anteroposterior direction.
Baseline and immediately after completion of the 4-week intervention
Mediolateral Stability Index (MLSI)
Ramy czasowe: Baseline and immediately after completion of the 4-week intervention
The Mediolateral Stability Index (MLSI) will be measured using the Biodex Balance System. MLSI quantifies postural sway in the frontal (mediolateral) plane during static balance testing and is expressed in degrees. Lower MLSI values indicate better balance control in the mediolateral direction.
Baseline and immediately after completion of the 4-week intervention
Limits of stability (LOS)
Ramy czasowe: Baseline and immediately after completion of the 4-week intervention
Limits of Stability (LOS) will be assessed using the Biodex Balance System SD. LOS evaluates the participant's ability to voluntarily shift the center of gravity toward predefined targets while maintaining postural control. Performance is expressed as an overall percentage score (%), with higher values indicating better dynamic balance and postural control.
Baseline and immediately after completion of the 4-week intervention

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Active Ankle Joint Position Sense
Ramy czasowe: Baseline and immediately after completion of the 4-week intervention
Active ankle joint position sense will be assessed using the Biodex Isokinetic Dynamometer during an active joint reposition test in the sagittal plane. The outcome is expressed as the absolute angular repositioning error in degrees (°). Lower values indicate better proprioceptive accuracy.
Baseline and immediately after completion of the 4-week intervention
Passive Ankle Joint Position Sense
Ramy czasowe: Baseline and immediately after completion of the 4-week intervention
Passive ankle joint position sense will be assessed using the Biodex Isokinetic Dynamometer during a passive joint repositioning test in the sagittal plane. The outcome is expressed as the absolute angular repositioning error in degrees (°). Lower values indicate better proprioceptive accuracy.
Baseline and immediately after completion of the 4-week intervention

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 sierpnia 2026

Zakończenie podstawowe (Szacowany)

1 września 2026

Ukończenie studiów (Szacowany)

1 października 2026

Daty rejestracji na studia

Pierwszy przesłany

28 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

1 sierpnia 2026

Pierwszy wysłany (Rzeczywisty)

6 sierpnia 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

6 sierpnia 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

1 sierpnia 2026

Ostatnia weryfikacja

1 sierpnia 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • MUC

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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