Thesis (Ph.D)-Cairo University, 2024.

Bibliography: pages 109-122.

Background: Ankle sprains are among the most common recurrent injuries
of the lower extremity. If untreated, can lead to recurrent ankle sprains, which may
contribute to the development of chronic ankle instability. Low load blood flow
restriction (LL-BFR) training provides a better outcome than low-load training
alone and a more tolerable approach to heavy-load training. Purpose: The present
study purpose was to study the combined effect of LL-BFR and proprioception
training on muscle strength, proprioceptive accuracy, balance and foot and ankle
functional abilities in recurrent ankle sprain patients. Methods: A total of 68
participants with grade I and II recurrent ankle sprain participated in this study. They
were randomly assigned to four groups. All groups received physical therapy three
times weekly for four consecutive weeks. Group A (control group) received
conventional physical therapy only, Experimental Group B received conventional
physical therapy with LL-BFR, Experimental Group C received conventional
physical therapy with proprioception training and Experimental Group D received
conventional physical therapy, LL-BFR and proprioception training. Outcome
measures were peak torque of dorsiflexors, planter flexors, invertors and evertors
muscles, proprioceptive accuracy of ankle joint in dorsiflexion and planter flexion
directions by isokinetic dynamometer, overall stability index (OSI), anteroposterior
stability index (APSI), mediolateral stability index (MLSI) and limits of stability
(LOS) by BIODEX balance system and foot and ankle functional abilities in
Activities of Daily Living (ADLs) by Foot Ankle Ability Measure (FAAM).
Results: MANOVA of mixed 4 x 2 design was carried out to test the impact of
treatment (between groups) After four weeks of intervention. It was found that
Group D had significantly higher Dorsi-flexors, Planter flexors, Evertors and
Invertors peak torque at 60° and at 180° compared to other groups. Regarding active
proprioceptive accuracy of ankle joint, it was found that Group B performed better
than Group A, Group C performed better than Group A, Group D performed better
than Group A and Group C. For passive proprioceptive accuracy of ankle joint,
Group D performed better than other groups. There was no statistic significant
difference in the mean values of OSI, APSI and MLSI pre-study and post study
among the four groups. Pairwise multiple comparisons for LOS found that Group


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D performed significantly better than other groups. Group B also performed better
than Groups A and C. For FAAM score, it was found that there was significant
difference between Groups A and B in favor to Group B, between Groups A and
D in favor to Group D. Conclusions: Low load blood flow restriction training
combined with proprioception training enhanced muscle strength, proprioceptive
accuracy of ankle joint in dorsiflexion and planter flexion directions, LOS, also
enhanced foot and ankle functional abilities in ADLs with only clinical importance
increasement in OSI, APSI, MLSI post study in recurrent ankle sprain patients.

شارك في هذه الدراسة ما مجموعه 68 مريضًا مصابًا بالتواء الكاحل المتكرر. تم تعيينهم عشوائيًا إلى أربع مجموعات. تلقت جميع المجموعات العلاج التقليدي ثلاث مرات في الأسبوع لمدة أربعة أسابيع متتالية . بالإضافة إلى ذلك، تلقت المجموعة أ (المجموعة الضابطة) العلاج التقليدي فقط، وتلقت المجموعة التجريبية ب تدريب تقييد تدفق الدم عند الأحمال المنخفضة، وتلقت المجموعة التجريبية ج تدريب الإدراك الذاتي، وتلقت المجموعة التجريبية د تدريب تقييد تدفق الدم عند الأحمال المنخفضة بالإضافة إلى تدريب الإدراك الذاتي. تم قياس المتغيرات على النحو التالي: قمة عزم الدوران لعضلات الكاحل باستخدام جهاز الديناموميتر المتساوي السرعة، وحساسية موضع المفصل النشطة والممنوعة باستخدام جهاز الديناموميتر المتساوي السرعة، ومؤشر الاستقرار العام ومؤشر الاستقرار الأمامي - الخلفي ومؤشر الاستقرار الوسطي - الجانبي وحدود الاستقرار باستخدام نظام توازن بيوديكس، وقدرات القدم والكاحل في أنشطة الحياة اليومية باستخدام قياس قدرة القدم والكاحل.

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Text in English and abstract in Arabic & English.