Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine ( 2026 )  25 ,  691  -  700   DOI: https://doi.org/10.52082/jssm.2026.691

Research article
The Acute Effects of Blood Flow Restriction on Ankle Muscle Reaction Time and Proprioception in Healthy Individuals
Melike Tuğran1, , Ufuk Şekir2, Müge Hasanoğlu2, Hakan Gür2, Bedrettin Akova2
Author Information
1 Department of Sports Medicine, Kocaeli Darıca Training and Research Hospital, Kocaeli, Turkey
2 Department of Sports Medicine, Medical Faculty of Uludag University, Bursa, Turkey

Melike Tuğran
✉ Department of Sports Medicine, Kocaeli Darıca Training and Research Hospital, Kocaeli, Turkey
Email: tugranmelike@gmail.com
Publish Date
Received: 09-06-2026
Accepted: 09-07-2026
Published (online): 01-09-2026
Narrated in English
 
 
ABSTRACT

Blood flow restriction (BFR) induces hypoxic and metabolic stress, which may alter afferent feedback and neuromuscular control. However, its acute effects on ankle sensorimotor function remain unclear. The aim of the study was to investigate the acute effects of lower-limb BFR on multidimensional ankle sensorimotor function in healthy adults. Twenty-four participants (12 females, 12 males) completed two conditions in randomized order and a crossover design: BFR at 60% arterial occlusion pressure (AOP) and a control condition (20 mmHg). All measurements were performed during occlusion. Outcomes included joint position sense (active and passive), kinesthesia, static and dynamic balance, lower-limb muscle activation (surface electromyography), and muscle reaction time during sudden ankle inversion. BFR impaired active joint position sense at 20 degrees of inversion (p = 0.011), with no changes at other angles or in kinesthesia. Static balance deteriorated, with increases in sway area (p = 0.017), sway distance (p = 0.029), and sway velocity (p < 0.001), particularly under eyes-closed single-leg stance. Posterolateral reach distance decreased (p = 0.023), accompanied by reduced lower-limb muscle activation. Tibialis anterior muscle reaction time during 30 degrees of inversion in the ankle neutral position was shortened (p < 0.001), whereas peroneus longus muscle responses were unchanged. Acute lower-limb BFR impairs ankle sensorimotor control by reducing proprioceptive accuracy, balance performance, and muscle activation, while shortening reaction time. These findings suggest caution when applying BFR during tasks that require high postural demands or end-range control. Registration number and date: NCT07307339, 12/26/2025

Key words: Blood flow restriction, ankle, electromyography, balance, reaction time


           Key Points
  • BFR at 60% AOP impaired ankle joint position sense and static balance, particularly during eyes-closed single-leg stance.
  • BFR reduced lower-limb muscle activation across all three Y-Balance Test directions and shortened tibialis anterior muscle reaction time without altering peroneus longus responses.
  • Balance-demanding, perturbation-based, and end-range ankle tasks should be performed cautiously while the cuff remains inflated, even in healthy individuals.
 
 
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