Early Postoperative Role of Blood Flow Restriction Therapy to Avoid Muscle Atrophy

Patterson, Stephen D.; Hughes, Luke; Owens, Johnny G.

doi:10.1007/978-3-030-22361-8_12

Cited by 3 publications

(5 citation statements)

References 102 publications

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“…Anterior Cruciate Ligament (ACL) injury is one of the most frequent musculoskeletal conditions worldwide. In the USA, more than 250,000 cases per year are reported [1]. Muscle weakness and atrophy of the quadriceps and hamstrings is a common feature in patients following operations such as ACL reconstruction [2].…”

Section: Introductionmentioning

confidence: 99%

“…Τhe reduced weight bearing and unloading context of ACL rehabilitation during the early postoperative stages predispose to muscle atrophy [3]. In recent decades, postoperative rehabilitation methods have been significantly differentiated from an approach of minimal muscle activity and full immobilization [4][5][6] towards one of increased muscle activation and range of movement (ROM) in the early stages following surgery [4,5]. The American College of Sports Medicine recommends a minimum resistance training load of 60% to 70% of 1 repetition maximum (1 RM) in order to gain strength and 70% to 85% of 1 RM to achieve muscle hypertrophy.…”

Section: Introductionmentioning

confidence: 99%

“…Studies have shown that exercise with Blood Flow Restriction (BFR) is an efficient technique to attenuate muscle atrophy and ameliorate muscle strength and hypertrophy in patients following ACLR surgery [3,[7][8][9]. BFR is an innovative training method that aims to partially restrict arterial inflow and fully restrict venous outflow by placing a pressurized cuff to the proximal thigh during exercise [1]. During low-resistance exercises, reduced oxygen is delivered to muscle cells.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effects of Exercise with Blood Flow Restriction (BFR) in the Post Operative Rehabilitation of Anterior Cruciate Ligament (ACL) Reconstruction Patients: A Case Series

2023

J Orthop Res Ther

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The purpose of this study was to demonstrate whether addition of BFR interventions to a postoperative ACL rehabilitation program can reverse muscle atrophy, improve strength, and restore imbalance between the two limbs following ACL Reconstruction (ACLR). Sixteen patients aged 15 to 40 years, that had been treated with ACLR, were randomly divided into two exercise groups: the experimental group that performed a BFR protocol in addition to the standard physical therapy, and the control group that performed only standard physical therapy. Interventions were performed during weeks 12-18 postoperatively. Measurements at the beginning and after the completion of the intervention program included assessments of a) muscle morphology of the injured limb by measuring the perimeter of the quadriceps at 10cm and 20cm proximal to the superior patellar pole, b) muscle strength deficit at 60°/s as measured using the CYBEX isokinetic evaluation, c) clinical outcome using IKDC, KOOS & VAS Scores. There were statistically significant improvements in thigh circumference of the BFR group compared to the control group at 10cm (1.4 ± 0.9% vs 0.6 ± 0.9%) (p<0.004) and 20cm (2.25 ± 1.6% vs 1.1 ± 1.2%) (p<0.001). Significantly greater attenuation of knee flexors strength deficit at 60°/s was observed in the BFR group (p<0.024). No statistically significant differences were found neither in the strength deficit of the extensor muscles (p>0.226) nor in clinical scores between the two groups. This study suggests that BFR intervention during rehabilitation of patients following ACLR are beneficial in terms of muscle mass and strength.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effects of Exercise with Blood Flow Restriction (BFR) in the Post Operative Rehabilitation of Anterior Cruciate Ligament (ACL) Reconstruction Patients: A Case Series

2023

J Orthop Res Ther

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“…The possibility of gains in strength and MH related to low mechanical stress makes RT with BFR (RT+BFR) a good alternative for older adults [ 7 ] and individuals recovering from orthopedic injuries. [ 8 , 9 ] It becomes valid to add that the adaptations conferred by the application of the BFR are not only imitated to the strength exercises. Previously, it was found that the passive application of BFR (i.e., without exercise) was able to attenuate postoperative atrophy [ 10 ] and walking with BFR was able to promote MH of the quadriceps in young men.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application and side effects of blood flow restriction technique

Queiros

Dantas

Neto³

et al. 2021

Medicine

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The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings. To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique. This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique. Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60–80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively). Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.

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Time to Save Time: Beneficial Effects of Blood Flow Restriction Training and the Need to Quantify the Time Potentially Saved by Its Application During Musculoskeletal Rehabilitation

et al. 2021

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The main goal of musculoskeletal rehabilitation is to achieve the pre-injury and/or pre-surgical physical function level with a low risk of re-injury. Blood flow restriction (BFR) training is a promising alternative to conventional therapy approaches during musculoskeletal rehabilitation because various studies support its beneficial effects on muscle mass, strength, aerobic capacity, and pain perception. In this perspective article, we used an evidence-based progressive model of a rehabilitative program that integrated BFR in four rehabilitation phases: (1) passive BFR, (2) BFR combined with aerobic training, (3) BFR combined with low-load resistance training, and (4) BFR combined with low-load resistance training and traditional high-load resistance training. Considering the current research, we suppose that a BFR-assisted rehabilitation has the potential to shorten the time course of therapy to reach the stage where the patient is able to tolerate resistance training with high loads. The information and arguments presented are intended to stimulate future research, which compares the time to achieve rehabilitative milestones and their physiological bases in each stage of the musculoskeletal rehabilitation process. This requires the quantification of BFR training-induced adaptations (eg, muscle mass, strength, capillary-to-muscle-area ratio, hypoalgesia, molecular changes) and the associated changes in performance with a high measurement frequency (≤1 wk) to test our hypothesis. This information will help to quantify the time saved by BFR-assisted musculoskeletal rehabilitation. This is of particular importance for patients, because the potentially accelerated recovery of physical functioning would allow to return to their work and/or social life earlier. Furthermore, other stakeholders in the healthcare system (eg, physicians, nurses, physiotherapists, insurance companies) might benefit from that with regard to work and financial burden.

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Early Postoperative Role of Blood Flow Restriction Therapy to Avoid Muscle Atrophy

Cited by 3 publications

References 102 publications

The Effects of Exercise with Blood Flow Restriction (BFR) in the Post Operative Rehabilitation of Anterior Cruciate Ligament (ACL) Reconstruction Patients: A Case Series

The Effects of Exercise with Blood Flow Restriction (BFR) in the Post Operative Rehabilitation of Anterior Cruciate Ligament (ACL) Reconstruction Patients: A Case Series

Application and side effects of blood flow restriction technique

Time to Save Time: Beneficial Effects of Blood Flow Restriction Training and the Need to Quantify the Time Potentially Saved by Its Application During Musculoskeletal Rehabilitation

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