Editorial Commentary: Blood Flow Restriction Therapy Continues to Prove Effective

Abstract

Blood flow restriction (BFR) training continues to look promising to try and maintain muscle mass or to rebuild muscle mass and strength after injury or surgery. Because additional potential benefits include pain control, increased gene expression (leading to atrophy reduction), and muscle excitation, our use of the modality favors earlier over middleor late-phase postoperative use. We initiate BFR therapy 2-14 days postoperatively, often with reduced cuff pressure in the first several sessions before increasing to the recommended therapeutic occlusion level. We have observed the greatest benefit for individuals who are noneweight-bearing for 6 to 8 weeks and who may have more postoperative restrictions due to the nature of the surgery. Compared with the opposite thigh, we have seen instances in which quadriceps girth has been preserved, although not increased, following the noneweight-bearing period. Ideally, we use 1 to 3 low-load resistance training exercises per session at least 2 times per week for 6 weeks. We also employ BFR following osteotomy or any procedure where bone drilling is used, as researchers have observed improved bone health. Additional benefits relevant to the early postoperative phase, such as effusion and pain reduction, have not been clearly established. Anecdotally, we have seen effusion levels temporarily increase during treatment but then resolve to baseline within 30 to 60 minutes of tourniquet deflation. Further high-level research is necessary to objectively validate BFR use and which patients may best benefit from it.

Blood Flow Restriction Therapy for Use After Extremity Fracture: A Critically Appraised Topic

“…Despite an ever-increasing breadth of evidence to support the efficacy of blood flow restriction (BFR) in rehabilitation for a vast array of muscular injuries, [1][2][3] far less data exist to elucidate the role of BFR in treatment of osseous injuries, which remain an equally common pathology in active populations. 4,5 Ineffective or inadequate rehabilitation can lead to detrimental loss of strength and atrophy of supporting muscles, increased pain, and prolonged return to preinjury function.…”