Effect of Addition of Blood Flow Restriction Training (BFR-T) to Physiotherapy Exercise Regime on Medial Longitudinal Arch Angle (MLAA) and Navicular Drop in an individual with Flexible Flat Foot: A Case Study

Abstract

Background: Flexible flatfoot may be associated with lowering of the medial longitudinal arch, excessive pronation and discomfort during weight-bearing activities. Exercise-based rehabilitation is commonly used, while evidence concerning blood-flow restriction training for this condition remains limited. Objective: To describe changes in medial longitudinal arch angle and navicular drop following a combined blood-flow restriction and physiotherapy exercise programme in an individual with bilateral flexible flatfoot. Case Presentation: A 19-year-old male physiotherapy student presented with bilateral flexible flatfoot and medial arch pain during walking and prolonged standing. Baseline medial longitudinal arch angles were 131° on the left and 127° on the right. Navicular-drop measurements were 9.2 mm and 13.2 mm, respectively. Intervention: The participant completed four weeks of blood-flow restriction training, three times weekly, together with exercises targeting the intrinsic foot muscles, calf flexibility, heel raising, quadriceps activation and hip musculature. Outcomes were assessed after four weeks and again following a four-week follow-up period. Results: At the end of treatment, medial longitudinal arch angles were 133° on the left and 132° on the right, while navicular drop decreased to 4.4 mm and 6.5 mm, respectively. At follow-up, the corresponding arch angles were 132° and 131°, and navicular-drop values were 9.7 mm and 8.8 mm. No comparative or inferential analysis was performed. Conclusion: Temporary changes in static arch measurements were observed after the combined programme. Controlled studies are required to determine whether blood-flow restriction provides benefit beyond exercise alone.