Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2025; 16(6): 106804
Published online Jun 18, 2025. doi: 10.5312/wjo.v16.i6.106804
Effect of blood flow restriction on muscle strength and stability following foot and ankle injury: A systematic review
Julia M Balboni, Karthik Madhira, Victor Martinez, Wei-Shao Tung, John G Kennedy, Arianna L Gianakos
Julia M Balboni, Department of Orthopaedic Surgery, University of New England College of Osteopathic Medicine, Biddeford, ME 04005, United States
Karthik Madhira, Department of Orthopaedics, New York Institute of Technology College of Osteopathic Medicine, Glen Head, NY 11545, United States
Victor Martinez, Department of Orthopedic Surgery, University of Texas Health San Antonio, San Antonio, TX 78229, United States
Wei-Shao Tung, Department of Orthopaedics, Massachusetts General Hospital, Boston, MA 02114, United States
John G Kennedy, Department of Orthopedic Surgery, NYU Langone Health, New York, NY 10002, United States
Arianna L Gianakos, Department of Orthopaedic Surgery, Yale University School of Medicine, New Haven, CT 06510, United States
Author contributions: Balboni JM and Gianakos AL designed the research study; Balboni JM, Madhira K, and Martinez V performed the research; Tung WS contributed analytic tools; Balboni JM, Madhira K, Martinez V, and Tung WS analyzed the data; Balboni JM wrote the manuscript with support from Gianakos AL and Kennedy JG; Gianakos AL and Kennedy JG critically reviewed the manuscript for important intellectual content. All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Julia M Balboni, Department of Orthopaedic Surgery, University of New England College of Osteopathic Medicine, 11 Hills Beach Road, Biddeford, ME 04005, United States. jbalboni@une.edu
Received: March 7, 2025
Revised: April 1, 2025
Accepted: May 7, 2025
Published online: June 18, 2025
Processing time: 103 Days and 14 Hours
Core Tip

Core Tip: Blood flow restriction (BFR) involves limiting blood flow to an actively exercising muscle with the goal of inducing an acute hypoxic state. When used in combination with traditional rehabilitation exercises, BFR can improve strength and stability in patients with a history of foot or ankle injury. Our meta-analysis investigated whether rehabilitation involving BFR is more effective than traditional rehabilitation in improving muscle strength, size, and stability after foot and ankle injury.