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Background <p>Flexible flatfoot is a common musculoskeletal disorder in middle-aged women, causing collapse of the medial longitudinal arch, biomechanical alterations, impaired sensory organization, and increased postural instability. This randomized controlled trial compared the effects of 6 weeks of short foot exercises (SFE) with and without blood flow restriction (BFR) on Foot Posture Index (FPI-6), sensory organization, and center of pressure (COP) displacement.</p> Methods <p>In this assessor-blinded RCT, 60 middle-aged women (35–55 years) with flexible flatfoot (FPI-6 &gt; 6) were randomly allocated to SFE + BFR (<i>n</i> = 30) or SFE alone (<i>n</i> = 30). Both groups performed identical SFE protocols (3 sessions/week, 45 min/session for 6 weeks). The BFR group used proximal-shank cuff pressure at 40–80% limb occlusion pressure. Outcomes included FPI-6, equilibrium scores, and COP displacement in mediolateral (X) and anteroposterior (Y) axes across six Sensory Organization Test (SOT) conditions, measured via NeuroCom dynamic posturography at baseline and post-intervention. Data were analyzed using mixed 2 × 2 × 6 ANOVA (SPSS v27, <i>α</i> = 0.05).</p> Results <p>All participants completed the study with no adverse events. Both groups showed significant within-group improvements in FPI-6, equilibrium scores (most SOT conditions), and COP stability (particularly Y-axis; all <i>P</i> &lt; 0.05). No significant between-group differences were found for any outcome (all <i>P</i> &gt; 0.05), with large within-group effect sizes (ηp<sup>2</sup> = 0.45–0.78).</p> Conclusion <p>Six weeks of SFE, with or without BFR, significantly improved foot posture, sensory organization, and postural stability in middle-aged women with flexible flatfoot. Under the current protocol and within the limitations of this study, BFR did not confer additional statistically significant benefit. SFE is a safe and effective intervention for this population; its cost‑effectiveness warrants further economic evaluation.</p> Trial registration <p>The trial was prospectively registered at the UMIN Clinical Trials Registry (UMIN000061327; link: <a href="https://center6.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000070174">https://center6.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000070174</a><Emphasis Type="Underline">)</Emphasis>.</p>

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Effects of short foot exercises with and without blood flow restriction on Foot Posture Index, sensory organization, and center of pressure displacement in middle-aged women with flexible flatfoot: a randomized controlled trial

  • 期刊论文

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  • 发表日期：

    2026年7月28日

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  • Qazal Mavrsatinia,
  • Seyed Kazem Mosavi Sadati,
  • Shirin Amini

摘要

Background

Flexible flatfoot is a common musculoskeletal disorder in middle-aged women, causing collapse of the medial longitudinal arch, biomechanical alterations, impaired sensory organization, and increased postural instability. This randomized controlled trial compared the effects of 6 weeks of short foot exercises (SFE) with and without blood flow restriction (BFR) on Foot Posture Index (FPI-6), sensory organization, and center of pressure (COP) displacement.

Methods

In this assessor-blinded RCT, 60 middle-aged women (35–55 years) with flexible flatfoot (FPI-6 > 6) were randomly allocated to SFE + BFR (n = 30) or SFE alone (n = 30). Both groups performed identical SFE protocols (3 sessions/week, 45 min/session for 6 weeks). The BFR group used proximal-shank cuff pressure at 40–80% limb occlusion pressure. Outcomes included FPI-6, equilibrium scores, and COP displacement in mediolateral (X) and anteroposterior (Y) axes across six Sensory Organization Test (SOT) conditions, measured via NeuroCom dynamic posturography at baseline and post-intervention. Data were analyzed using mixed 2 × 2 × 6 ANOVA (SPSS v27, α = 0.05).

Results

All participants completed the study with no adverse events. Both groups showed significant within-group improvements in FPI-6, equilibrium scores (most SOT conditions), and COP stability (particularly Y-axis; all P < 0.05). No significant between-group differences were found for any outcome (all P > 0.05), with large within-group effect sizes (ηp2 = 0.45–0.78).

Conclusion

Six weeks of SFE, with or without BFR, significantly improved foot posture, sensory organization, and postural stability in middle-aged women with flexible flatfoot. Under the current protocol and within the limitations of this study, BFR did not confer additional statistically significant benefit. SFE is a safe and effective intervention for this population; its cost‑effectiveness warrants further economic evaluation.

Trial registration

The trial was prospectively registered at the UMIN Clinical Trials Registry (UMIN000061327; link: https://center6.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000070174).