The Effects of Blood Flow Restriction Training on Post ACL Reconstruction Patients
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Presenter(s)
Gail Nelson
Abstract
The Effects of Blood Flow Restriction Training on Patients After ACL Reconstruction
Nelson, Gail M.
Kraemer, Nora
Clinical Scenario: ACL tears are most common in basketball, soccer, and volleyball. The recovery process may take up to about 12 months. One key factor of an ACL reconstruction (ACL-R) patient’s recovery is regaining strength while also decreasing pain as much as possible, however regaining strength in early stages of rehabilitation can be difficult due to weight restrictions on the injured leg. This is where blood flow restriction (BFR) training can help the patient along the road of recovery. The purpose of this critical appraisal is to analyze the effectiveness of BFR training compared to heavy load resistance training with knee flexion and extension strength in ACL-R patients aged 18-65.
Focused Clinical Question: In patients between the ages 18 – 65 post ACL-R, what is the effect of low load BFR exercise training compared to traditional heavy load resistance training (control) on knee flexion and extension strength?
Search Strategy: Articles were found by the keywords BFR training and ACL-R. Final article selection was made by the inclusion criteria of ACL-R participants and participant age of at least 18. Exclusion criteria included injuries to the ACL along with other knee structures and ACL injuries that took a conservative approach to rehabilitation. To search for articles, the databases PubMed, CINAHL, and Cochrane library were used. Once these databases were searched with the aforementioned keywords and inclusion criteria was applied, 7 articles were reviewed.
Evidence Quality Assessment: PEDro scores ranged between 7/10 to 10/10. The seventh article was a prospective study. All 7 articles had an Oxford Levels of Evidence score of 2.
Results of Summary and Search: Only two studies found a statistically significant difference, (p=.013 and p=.034), when comparing strength gains between the two interventions. However, knee flexion and extension strength gains were statistically significant within the intervention groups, (p<.05) in six articles. Strengths of the studies included blinding of assessors and consistency in the intervention protocols. Weaknesses were small sample sizes and lack of blinding of the participants.
Clinical Bottom Line: Both BFR training and heavy load resistance training are effective in increasing muscular strength during rehabilitation with post ACL-R patients. However, minimal evidence exists that demonstrates effectiveness of one intervention versus the other. SORT score: B.
Implications: Both interventions increase muscle strength in ACL-R patients. Knowing this, we can apply either intervention with ACL-R patients knowing both interventions are both safe and beneficial for improving knee flexion and extension strength. However, it is difficult to apply the findings to the non-athletic population and when determining what phase of rehabilitation BFR training is most beneficial. It would be beneficial to conduct studies with larger sample sizes, studies specific to collegiate male or female athletes or sport specific, along with evaluating BFR in multiple phases of rehabilitation.
College
College of Nursing & Health Sciences
Department
Health, Exercise & Rehabilitative Sciences
Campus
Winona
First Advisor/Mentor
Nora Kraemer
Presentation Type
Oral Presentation
Format of Presentation or Performance
Pre-Recorded Video
The Effects of Blood Flow Restriction Training on Post ACL Reconstruction Patients
The Effects of Blood Flow Restriction Training on Patients After ACL Reconstruction
Nelson, Gail M.
Kraemer, Nora
Clinical Scenario: ACL tears are most common in basketball, soccer, and volleyball. The recovery process may take up to about 12 months. One key factor of an ACL reconstruction (ACL-R) patient’s recovery is regaining strength while also decreasing pain as much as possible, however regaining strength in early stages of rehabilitation can be difficult due to weight restrictions on the injured leg. This is where blood flow restriction (BFR) training can help the patient along the road of recovery. The purpose of this critical appraisal is to analyze the effectiveness of BFR training compared to heavy load resistance training with knee flexion and extension strength in ACL-R patients aged 18-65.
Focused Clinical Question: In patients between the ages 18 – 65 post ACL-R, what is the effect of low load BFR exercise training compared to traditional heavy load resistance training (control) on knee flexion and extension strength?
Search Strategy: Articles were found by the keywords BFR training and ACL-R. Final article selection was made by the inclusion criteria of ACL-R participants and participant age of at least 18. Exclusion criteria included injuries to the ACL along with other knee structures and ACL injuries that took a conservative approach to rehabilitation. To search for articles, the databases PubMed, CINAHL, and Cochrane library were used. Once these databases were searched with the aforementioned keywords and inclusion criteria was applied, 7 articles were reviewed.
Evidence Quality Assessment: PEDro scores ranged between 7/10 to 10/10. The seventh article was a prospective study. All 7 articles had an Oxford Levels of Evidence score of 2.
Results of Summary and Search: Only two studies found a statistically significant difference, (p=.013 and p=.034), when comparing strength gains between the two interventions. However, knee flexion and extension strength gains were statistically significant within the intervention groups, (p<.05) in six articles. Strengths of the studies included blinding of assessors and consistency in the intervention protocols. Weaknesses were small sample sizes and lack of blinding of the participants.
Clinical Bottom Line: Both BFR training and heavy load resistance training are effective in increasing muscular strength during rehabilitation with post ACL-R patients. However, minimal evidence exists that demonstrates effectiveness of one intervention versus the other. SORT score: B.
Implications: Both interventions increase muscle strength in ACL-R patients. Knowing this, we can apply either intervention with ACL-R patients knowing both interventions are both safe and beneficial for improving knee flexion and extension strength. However, it is difficult to apply the findings to the non-athletic population and when determining what phase of rehabilitation BFR training is most beneficial. It would be beneficial to conduct studies with larger sample sizes, studies specific to collegiate male or female athletes or sport specific, along with evaluating BFR in multiple phases of rehabilitation.
