Acute BFR Training Effects on Balance and Proprioception
NCT ID: NCT07309068
Last Updated: 2025-12-30
Study Results
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Basic Information
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ACTIVE_NOT_RECRUITING
NA
75 participants
INTERVENTIONAL
2025-11-01
2026-02-01
Brief Summary
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The study is planned to include healthy individuals aged 18-35 years. Participants will be divided into three groups: BFR, sham, and control. Before and after the exercise protocol, all participants' demographic information and physical activity levels will be recorded. In the next phase, participants will undergo assessments of static and dynamic balance, knee and ankle proprioception measurements, and single-leg hop tests. After completing a single-session exercise protocol, all assessment tests will be repeated for each participant. The collected data will be compared across groups.
The expected outcome of the study is that the BFR group, in which arterial occlusion will be applied, will show significant improvements in parameters related to balance and proprioception compared to the other groups.
The novelty of this study lies in examining both the effects of BFR on balance and proprioception and their acute-level manifestations. Currently, studies investigating the effects of BFR on balance and proprioception are limited. Our study aims not only to contribute to the diversity of literature on balance exercise applications but also, if the acute effects of BFR are confirmed, to provide a new perspective on the application of this exercise method in physiotherapy, rehabilitation, and sports sciences.
Detailed Description
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Despite extensive research on BFR's effects on muscle strength and hypertrophy, its influence on balance and proprioception remains relatively unexplored. Proprioception, which enables the perception of body position and movement through interactions between the musculoskeletal and central nervous systems, is essential for postural control, motor coordination, injury prevention, and safe performance of daily and athletic activities. Postural stability depends on the integration of vestibular, visual, and proprioceptive inputs, with muscle stiffness and reflexive responses playing crucial roles. Temporary restriction of blood flow during BFR may modulate sensory feedback from mechanoreceptors, such as muscle spindles and Golgi tendon organs, potentially enhancing proprioceptive acuity and postural control. Activation of group III and IV afferents, which convey mechanical, metabolic, and nociceptive signals to the central nervous system, is considered a key mechanism underlying these effects. Group III afferents are primarily sensitive to mechanical stimuli such as tension and intramuscular pressure, while group IV afferents respond predominantly to metabolic changes. By stimulating these afferent pathways, BFR may facilitate short-term neuromuscular adaptations that improve both balance and proprioception.
Although some studies have reported improvements in postural control and static balance parameters following BFR, the literature remains limited and occasionally inconsistent. There is a particular scarcity of research investigating the acute effects of BFR on proprioception and balance in young sedentary adults, as most prior studies have focused on strength, hypertrophy, or aerobic performance. The present study aims to fill this gap by evaluating the immediate neuromuscular responses to a single session of BFR exercise, with a focus on proprioceptive function and postural stability. Findings from this research are expected to provide novel insights into the application of BFR for rehabilitation, injury prevention, and athletic performance optimization, offering evidence-based guidance for exercise prescription in both clinical and sporting populations.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
OTHER
SINGLE
Study Groups
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Control group
Proprioceptive Exercise Training
All participants will perform the same exercise protocol. The protocol was designed based on studies in the literature examining the effects of proprioception training. The program consists of various balance and proprioceptive exercises performed on a BOSU balance platform. The purpose of the exercises is to improve participants' static and dynamic balance, stimulate the sensorimotor system, and enhance lower extremity stability.
The exercise protocol includes the following sequence: participants will perform squats on the BOSU (10 repetitions), double-leg stance on the BOSU (60 seconds), double-leg ball toss and catch on the BOSU (60 seconds), single-leg stance on the BOSU (60 seconds), and single-leg ball toss and catch on the BOSU (60 seconds). This is followed by double-leg jumps on the BOSU (10 repetitions), single-leg jumps on the BOSU (10 repetitions), and double-leg jumps with 90° trunk rotation on the BOSU (10 repetitions). In the final part, participants will perform double
Sham Group
sham BFR
Participants in the sham BFR group will wear cuffs placed proximally on both thighs. However, no pressure will be applied to restrict blood flow. The cuffs will remain in place throughout the exercise session to simulate the sensation of blood flow restriction without inducing actual occlusion. Participants will perform the same exercise protocol as the BFR group under these conditions.
Proprioceptive Exercise Training
All participants will perform the same exercise protocol. The protocol was designed based on studies in the literature examining the effects of proprioception training. The program consists of various balance and proprioceptive exercises performed on a BOSU balance platform. The purpose of the exercises is to improve participants' static and dynamic balance, stimulate the sensorimotor system, and enhance lower extremity stability.
The exercise protocol includes the following sequence: participants will perform squats on the BOSU (10 repetitions), double-leg stance on the BOSU (60 seconds), double-leg ball toss and catch on the BOSU (60 seconds), single-leg stance on the BOSU (60 seconds), and single-leg ball toss and catch on the BOSU (60 seconds). This is followed by double-leg jumps on the BOSU (10 repetitions), single-leg jumps on the BOSU (10 repetitions), and double-leg jumps with 90° trunk rotation on the BOSU (10 repetitions). In the final part, participants will perform double
BFR Group
BFR
In this group, participants will have cuffs placed proximally on the limb to induce blood flow restriction, and individualized pressure will be applied. Participants will perform the prescribed exercises under blood flow restriction conditions. For the blood flow restriction application, an Occlusion Cuff device will be used. Following the warm-up protocol, cuffs will be placed bilaterally on the most proximal portion of the thigh in both the BFR and sham groups. The cuff tightness will be adjusted to allow the insertion of two fingers between the cuff and the skin at both the upper and lower edges. In the sham group, the cuffs will not be inflated to restrict blood flow, while in the BFR group, the pressure will be set at 80% of the individual's arterial occlusion pressure (AOP). AOP will be determined in the supine position using an Occlusion Cuff Doppler ultrasound device (8 MHz) applied to the posterior tibial artery.
Proprioceptive Exercise Training
All participants will perform the same exercise protocol. The protocol was designed based on studies in the literature examining the effects of proprioception training. The program consists of various balance and proprioceptive exercises performed on a BOSU balance platform. The purpose of the exercises is to improve participants' static and dynamic balance, stimulate the sensorimotor system, and enhance lower extremity stability.
The exercise protocol includes the following sequence: participants will perform squats on the BOSU (10 repetitions), double-leg stance on the BOSU (60 seconds), double-leg ball toss and catch on the BOSU (60 seconds), single-leg stance on the BOSU (60 seconds), and single-leg ball toss and catch on the BOSU (60 seconds). This is followed by double-leg jumps on the BOSU (10 repetitions), single-leg jumps on the BOSU (10 repetitions), and double-leg jumps with 90° trunk rotation on the BOSU (10 repetitions). In the final part, participants will perform double
Interventions
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BFR
In this group, participants will have cuffs placed proximally on the limb to induce blood flow restriction, and individualized pressure will be applied. Participants will perform the prescribed exercises under blood flow restriction conditions. For the blood flow restriction application, an Occlusion Cuff device will be used. Following the warm-up protocol, cuffs will be placed bilaterally on the most proximal portion of the thigh in both the BFR and sham groups. The cuff tightness will be adjusted to allow the insertion of two fingers between the cuff and the skin at both the upper and lower edges. In the sham group, the cuffs will not be inflated to restrict blood flow, while in the BFR group, the pressure will be set at 80% of the individual's arterial occlusion pressure (AOP). AOP will be determined in the supine position using an Occlusion Cuff Doppler ultrasound device (8 MHz) applied to the posterior tibial artery.
sham BFR
Participants in the sham BFR group will wear cuffs placed proximally on both thighs. However, no pressure will be applied to restrict blood flow. The cuffs will remain in place throughout the exercise session to simulate the sensation of blood flow restriction without inducing actual occlusion. Participants will perform the same exercise protocol as the BFR group under these conditions.
Proprioceptive Exercise Training
All participants will perform the same exercise protocol. The protocol was designed based on studies in the literature examining the effects of proprioception training. The program consists of various balance and proprioceptive exercises performed on a BOSU balance platform. The purpose of the exercises is to improve participants' static and dynamic balance, stimulate the sensorimotor system, and enhance lower extremity stability.
The exercise protocol includes the following sequence: participants will perform squats on the BOSU (10 repetitions), double-leg stance on the BOSU (60 seconds), double-leg ball toss and catch on the BOSU (60 seconds), single-leg stance on the BOSU (60 seconds), and single-leg ball toss and catch on the BOSU (60 seconds). This is followed by double-leg jumps on the BOSU (10 repetitions), single-leg jumps on the BOSU (10 repetitions), and double-leg jumps with 90° trunk rotation on the BOSU (10 repetitions). In the final part, participants will perform double
Eligibility Criteria
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Inclusion Criteria
Have normal knee joint range of motion (flexion: 0-135°; hyperextension: 0-10°).
Have normal ankle joint range of motion (dorsiflexion: 0-20°; plantarflexion: 0-45°).
Exclusion Criteria
18 Years
35 Years
ALL
Yes
Sponsors
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Biruni University
OTHER
Responsible Party
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Berivan Beril Kılıç
Asistant professor
Locations
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Biruni University
Istanbul, , Turkey (Türkiye)
Countries
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References
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Wong V, Spitz RW, Song JS, Yamada Y, Kataoka R, Hammert WB, Kang A, Seffrin A, Bell ZW, Loenneke JP. Blood flow restriction augments the cross-education effect of isometric handgrip training. Eur J Appl Physiol. 2024 May;124(5):1575-1585. doi: 10.1007/s00421-023-05386-y. Epub 2024 Jan 2.
Takarada Y, Nakamura Y, Aruga S, Onda T, Miyazaki S, Ishii N. Rapid increase in plasma growth hormone after low-intensity resistance exercise with vascular occlusion. J Appl Physiol (1985). 2000 Jan;88(1):61-5. doi: 10.1152/jappl.2000.88.1.61.
Pope ZK, Willardson JM, Schoenfeld BJ. Exercise and blood flow restriction. J Strength Cond Res. 2013 Oct;27(10):2914-26. doi: 10.1519/JSC.0b013e3182874721.
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Hwang PS, Willoughby DS. Mechanisms Behind Blood Flow-Restricted Training and its Effect Toward Muscle Growth. J Strength Cond Res. 2019 Jul;33 Suppl 1:S167-S179. doi: 10.1519/JSC.0000000000002384.
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Other Identifiers
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6
Identifier Type: -
Identifier Source: org_study_id