دورية أكاديمية
أعرض في EDS

Effects of a Perioperative Blood Flow Restriction Therapy Program on Early Quadriceps Strength and Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction.

التفاصيل البيبلوغرافية
العنوان: Effects of a Perioperative Blood Flow Restriction Therapy Program on Early Quadriceps Strength and Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction.
المؤلفون: Okoroha KR; Department of Orthopedic Surgery, Division of Sports Medicine, Mayo Clinic, Minneapolis, Minnesota, USA., Tramer JS; Department of Orthopedic Surgery, Division of Sports Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Khalil LS; Department of Orthopedic Surgery, McLaren Flint Hospital, Flint, Michigan, USA., Jildeh TR; Department of Orthopedic Surgery, Michigan State University, East Lansing, Michigan, USA., Abbas MJ; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA., Buckley PJ; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA., Lindell C; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA., Moutzouros V; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
المصدر: Orthopaedic journal of sports medicine [Orthop J Sports Med] 2023 Nov 27; Vol. 11 (11), pp. 23259671231209694. Date of Electronic Publication: 2023 Nov 27 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]-
مستخلص: Background: Quadriceps muscle atrophy remains a limiting factor in returning to activity after anterior cruciate ligament reconstruction (ACLR). Blood flow restriction (BFR) therapy may accelerate quadriceps strengthening in the perioperative period.
Purpose: To evaluate postoperative isometric quadriceps strength in patients who underwent ACLR with a perioperative BFR program.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: Patients indicated for ACLR were randomized into 2 groups, BFR and control, at their initial clinic visit. All patients underwent 2 weeks of prehabilitation preoperatively, with the BFR group performing exercises with a pneumatic cuff set to 80% limb occlusion pressure placed over the proximal thigh. All patients also underwent a standardized postoperative 12-week physical therapy protocol, with the BFR group using pneumatic cuffs during exercise. Quadriceps strength was measured as peak and mean torque during seated leg extension and presented as quadriceps index (percentage vs healthy limb). Patient-reported outcomes (PROs), knee range of motion, and quadriceps circumference were also gathered at 6 weeks, 3 months, and 6 months postoperatively, and adverse effects were recorded.
Results: Included were 46 patients, 22 in the BFR group (mean age, 25.4 ± 10.6 years) and 24 in the control group (mean age, 27.5 ± 12.0 years). At 6 weeks postoperatively, the BFR group demonstrated significantly greater strength compared with the controls (quadriceps index: 57% ± 24% vs 40% ± 18%; P = .029), and the BFR group had significantly better Patient-Reported Outcomes Measurement Information System-Physical Function (42.69 ± 5.64 vs 39.20 ± 5.51; P = .001) and International Knee Documentation Committee (58.22 ± 7.64 vs 47.05 ± 13.50; P = .011) scores. At 6 weeks postoperatively, controls demonstrated a significant drop in the peak torque generation of the operative versus nonoperative leg. There were no significant differences in strength or PROs at 3 or 6 months postoperatively. Three patients elected to drop out of the BFR group secondary to cuff intolerance during exercise; otherwise, no other severe adverse events were reported.
Conclusion: Integrating BFR into perioperative physical therapy protocols led to improved strength and increased PROs at 6 weeks after ACLR. No differences in strength or PROs were found at 3 and 6 months between the 2 groups.
Registration: NCT04374968 (ClinicalTrials.gov identifier).
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: K.R.O. has received grant support from Arthrex; education payments from Arthrex, Endo Pharmaceuticals, and Smith & Nephew; nonconsulting fees from Arthrex and Smith & Nephew; consulting fees from Endo Pharmaceuticals and Smith & Nephew; honoraria from Wright Medical; and hospitality payments from Medical Device Business Services, Stryker, and Zimmer Biomet. J.S.T. has received education payments from Pinnacle. L.S.K. has received education payments from Pinnacle and Medwest Associates. T.R.J. has received consulting fees from Biogen; hospitality payments from Exactech and Zimmer Biomet; and education payments from DePuy Synthes, Pinnacle, and Smith & Nephew. V.M. has received consulting fees from Pacira Pharmaceuticals and education payments from Pinnacle. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Henry Ford Hospital (No. 13080).
(© The Author(s) 2023.)
References: Phys Ther Sport. 2019 Sep;39:90-98. (PMID: 31288213)
J Athl Train. 2017 Sep;52(9):809-819. (PMID: 28787180)
Arthroscopy. 2018 Jan;34(1):205-212. (PMID: 29032903)
J Strength Cond Res. 2017 Nov;31(11):3101-3108. (PMID: 28118308)
Phys Ther. 2019 Aug 1;99(8):1010-1019. (PMID: 30951598)
Int J Sports Phys Ther. 2019 Apr;14(2):180-187. (PMID: 30997270)
Am J Sports Med. 2017 Jan;45(1):34-41. (PMID: 27530413)
Sports Med. 2013 Mar;43(3):179-94. (PMID: 23338987)
Arch Phys Med Rehabil. 2008 Aug;89(8):1535-41. (PMID: 18586220)
Am J Sports Med. 2014 Oct;42(10):2363-70. (PMID: 25086064)
Sports Med. 2019 Nov;49(11):1787-1805. (PMID: 31301034)
Acta Orthop Scand. 2003 Feb;74(1):62-8. (PMID: 12635796)
Am J Sports Med. 2020 Mar;48(4):825-837. (PMID: 32167837)
Sports Med. 2015 Feb;45(2):187-200. (PMID: 25249278)
Am J Sports Med. 2021 Jun;49(7):1938-1944. (PMID: 33196300)
J Physiol. 2012 Sep 1;590(17):4351-61. (PMID: 22802591)
Clin Orthop Relat Res. 2020 Mar;478(3):593-606. (PMID: 31860546)
Orthop J Sports Med. 2014 Jan 21;2(1):2325967113518305. (PMID: 26535266)
Interv Med Appl Sci. 2013 Jun;5(2):53-9. (PMID: 24265891)
Knee Surg Sports Traumatol Arthrosc. 2019 Aug;27(8):2494-2501. (PMID: 30377716)
Sports Health. 2015 May;7(3):231-8. (PMID: 26131300)
Orthop J Sports Med. 2020 Mar 25;8(3):2325967120906822. (PMID: 32232065)
J Sci Med Sport. 2016 Aug;19(8):669-75. (PMID: 26463594)
J Sport Health Sci. 2016 Mar;5(1):115-118. (PMID: 30356481)
J Clin Med. 2020 Dec 27;10(1):. (PMID: 33375515)
Physiother Can. 2016;68(1):15-22. (PMID: 27504043)
Int J Sports Phys Ther. 2020 Dec;15(6):995-1005. (PMID: 33344016)
Am J Sports Med. 2016 Jun;44(6):1502-7. (PMID: 26920430)
J Am Acad Orthop Surg Glob Res Rev. 2020 Jan;4(1):e1900105. (PMID: 32672728)
Sports Health. 2019 Jul/Aug;11(4):301-305. (PMID: 31136725)
Int J Sports Phys Ther. 2015 Feb;10(1):62-8. (PMID: 25709864)
Am J Sports Med. 2015 Nov;43(11):2727-37. (PMID: 26359376)
Am J Sports Med. 2015 Jul;43(7):1662-9. (PMID: 25883169)
Sports Med. 2019 Jan;49(1):95-108. (PMID: 30306467)
Am J Sports Med. 2020 Jun;48(7):1773-1785. (PMID: 31710505)
Int J Sports Med. 2019 Sep;40(10):650-656. (PMID: 31342480)
فهرسة مساهمة: Keywords: ACL; BFR; blood flow restriction; rehabilitation
سلسلة جزيئية: ClinicalTrials.gov NCT04374968
تواريخ الأحداث: Date Created: 20231130 Latest Revision: 20231202
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10683393
DOI: 10.1177/23259671231209694
PMID: 38035216
قاعدة البيانات: MEDLINE
الوصف
تدمد:2325-9671
DOI:10.1177/23259671231209694