{
  "abstract": "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 ).",
  "abstract_shown": true,
  "affiliations": [
    "Department of Sports Injuries and Corrective Exercises, Faculty of Humanities, Islamic Azad University, East Tehran Branch",
    "Department of Motor Behavior, SR.C, Islamic Azad University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
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        0
      ],
      "name": "Qazal Mavrsatinia"
    },
    {
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        1
      ],
      "name": "Seyed Kazem Mosavi Sadati"
    },
    {
      "affs": [
        0
      ],
      "name": "Shirin Amini"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a8p1rv6xh9jsc.bib",
  "cited_by": 0,
  "doi": "10.1186/s13063-026-09924-9",
  "fulltext_url": "https://doi.org/10.1186/s13063-026-09924-9",
  "id": "a8p1rv6xh9jsc",
  "issns": [
    "1745-6215"
  ],
  "landing_url": "https://doi.org/10.1186/s13063-026-09924-9",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R5-920"
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    [
      "openalex",
      "2204|Lower Extremity Biomechanics and Pathologies"
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  "openalex": "W7171492366",
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  "pmcid": null,
  "pmid": null,
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/a8p1rv6xh9jsc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:46:25Z",
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      "url": "https://doi.org/10.1186/s13063-026-09924-9"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1745-6215",
      "subfield": "clinical-trials"
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  "title": "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",
  "title_text": "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",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:25Z",
  "url": "https://research.draconitic.com/paper/a8p1rv6xh9jsc",
  "venue": "Trials",
  "versions": []
}