scholarly journals Effect of Blood Flow Restriction Training on Quadriceps Muscle Strength, Morphology, Physiology, and Knee Biomechanics Before and After Anterior Cruciate Ligament Reconstruction: Protocol for a Randomized Clinical Trial

2019 ◽  
Vol 99 (8) ◽  
pp. 1010-1019 ◽  
Author(s):  
Lauren N Erickson ◽  
Kathryn C Hickey Lucas ◽  
Kylie A Davis ◽  
Cale A Jacobs ◽  
Katherine L Thompson ◽  
...  
Keyword(s):  
Blood Flow ◽  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Quadriceps Strength ◽  
Knee Biomechanics ◽  
Flow Restriction ◽  
Anterior Cruciate

Abstract Background Despite best practice, quadriceps strength deficits often persist for years after anterior cruciate ligament reconstruction. Blood flow restriction training (BFRT) is a possible new intervention that applies a pressurized cuff to the proximal thigh that partially occludes blood flow as the patient exercises, which enables patients to train at reduced loads. This training is believed to result in the same benefits as if the patients were training under high loads. Objective The objective is to evaluate the effect of BFRT on quadriceps strength and knee biomechanics and to identify the potential mechanism(s) of action of BFRT at the cellular and morphological levels of the quadriceps. Design This will be a randomized, double-blind, placebo-controlled clinical trial. Setting The study will take place at the University of Kentucky and University of Texas Medical Branch. Participants Sixty participants between the ages of 15 to 40 years with an ACL tear will be included. Intervention Participants will be randomly assigned to (1) physical therapy plus active BFRT (BFRT group) or (2) physical therapy plus placebo BFRT (standard of care group). Presurgical BFRT will involve sessions 3 times per week for 4 weeks, and postsurgical BFRT will involve sessions 3 times per week for 4 to 5 months. Measurements The primary outcome measure was quadriceps strength (peak quadriceps torque, rate of torque development). Secondary outcome measures included knee biomechanics (knee extensor moment, knee flexion excursion, knee flexion angle), quadriceps muscle morphology (physiological cross-sectional area, fibrosis), and quadriceps muscle physiology (muscle fiber type, muscle fiber size, muscle pennation angle, satellite cell proliferation, fibrogenic/adipogenic progenitor cells, extracellular matrix composition). Limitations Therapists will not be blinded. Conclusions The results of this study may contribute to an improved targeted treatment for the protracted quadriceps strength loss associated with anterior cruciate ligament injury and reconstruction.

scholarly journals Blood flow restriction in the postoperative of anterior cruciate ligament reconstruction

2021 ◽  
Author(s):  
Sabrina Queiroz de Oliveira ◽  
Barbarah Hemilly de Souza Valente ◽  
Dayane Azevedo Pereira ◽  
Letícia Pavoni dos Passos ◽  
Paloma Morgade Zaccaro ◽  
...  
Keyword(s):  
Blood Flow ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Blood Flow Restriction ◽  
Cruciate Ligament Reconstruction ◽  
Flow Restriction ◽  
Anterior Cruciate

Blood flow restriction is a physical therapy technique that consists of promoting increased strength and muscle hypertrophy, similar to protocols with high loads. It can be used in the prevention and rehabilitation of injuries, health promotion and improvement in sports performance, as in the postoperative period of anterior cruciate ligament reconstruction, accelerating functional recovery. To identify the effects of blood flow restriction in patients undergoing anterior cruciate ligament reconstruction. Through a systematic review of the literature, randomized clinical trials were selected according to the highest PEDro score. The search involved the PEDro database, PubMed, using the following terms: bloodflow restriction, anterior cruciate ligament, anteriorcruciate ligament injury and BFR exercise, published between 2000 and 2021. Six RCTs were selected: three did not demonstrate benefits in relation to atrophy, strength, volume and activation of the quadriceps muscle during blood flow restriction, when used through isometric, concentric and eccentric exercises, with progressive loads or without loads. In two other RCTs, there were positive results in relation to the aforementioned parameters, where freeexercises were performed, with body resistance and sessions with occlusive stimuli and occlusion release. Finally, one of the RCTs showed equal improvement in both groups in quadriceps hypertrophy and strength; and regarding the use of flow restriction inone of the groups, there was a reduction in joint pain and effusion. Blood flow restriction has shown contradictory results in relation to atrophy, decreased pain, effusion and asymmetry of the quadriceps muscle in patients undergoing anterior cruciate ligament reconstruction.

scholarly journals Gait Biomechanics in Individuals Meeting Sufficient Quadriceps Strength Cutoffs Following Anterior Cruciate Ligament Reconstruction

2021 ◽  
Author(s):  
Brian Pietrosimone ◽  
Hope C. Davis-Wilson ◽  
Matthew K. Seeley ◽  
Christopher Johnston ◽  
Jeffrey T. Spang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Stance Phase ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Quadriceps Strength ◽  
Cruciate Ligament Reconstruction ◽  
Gait Biomechanics ◽  
Anterior Cruciate

Abstract Context: Quadriceps weakness is associated with disability and aberrant gait biomechanics following anterior cruciate ligament reconstruction (ACLR). Strength sufficiency cutoff scores, that normalize quadriceps strength to the mass of an individual, are capable of predicting individuals who will report better function following ACLR. Yet, it remains unknown if gait biomechanics differ between individuals who meet a strength sufficiency cutoff (strong) compared to those who do not (weak). Objective: Determine if vertical ground reaction force (vGRF), knee flexion angle (KFA) and internal knee extension moment (KEM) differ between strong and weak individuals with an ACLR throughout stance phase of walking. Design: Comparison-control. Setting: Laboratory Participants: Individuals who received unilateral ACLR ≥12 months prior to testing were dichotomized into strong (n=31) and weak groups (n=116). Main Outcome Measures: Maximal isometric quadriceps strength was collected at 90° of knee flexion using an isokinetic dynamometer and normalized to body mass. Individuals demonstrating ≥3.0Nm/kg were considered strong. Three-dimensional gait biomechanics were collected at a self-selected walking speed. Biomechanical data were time-normalized to 100% of stance phase. vGRF were normalized to body weight (BW), and KEM was normalized to BW*height. Pairwise comparison functions were calculated for each outcome to identify between-group differences for each percentile of stance. Results: vGRF was significantly greater in weak participants for the first 22% of stance (average difference of 6.2% BW) and lesser in weak participants between 36–43% of stance (1.4% BW). KFA was significantly greater (i.e., more flexion) in strong participants between 6–62% of stance (2.3°) and lesser (i.e., less flexion) between 68-79% of stance (1.0°). KEM was significantly greater in strong participants between 7–62% of stance (0.007 BW*height). Conclusions: ACLR individuals able to generate knee extension torque ≥3.0Nm/kg exhibit different biomechanical gait profiles compared to weak individuals, which may allow for better energy attenuation following ACLR.

Sign in / Sign up

Export Citation Format

Share Document