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Blood Flow Restriction Rehabilitation

Matthew Buckthorpe, Giovanni La Rosa, Francesco Della Villa
One of the main priorities of rehabilitation after anterior cruciate ligament reconstruction (ACLR) surgery is the restoration of knee extensor muscle strength. Residual deficits in knee extensor muscle size and strength after injury are linked to poor biomechanics, reduced knee function, increased knee osteoarthritis risk, as well as heightened risk of re-injury upon return to sport. Most studies indicate that knee extensor muscle strength is typically not resolved prior to return to sport. This clinical commentary discusses strategies to optimize and accelerate the recovery of knee extensor strength post-surgery, with the purpose to support the clinician with evidence-based strategies to implement into clinical practice...
February 2019: International Journal of Sports Physical Therapy
Rodrigo Kohn Cardoso, Aline Machado Araujo, Rafael Bueno Orcy, Maristela Bohlke, Jean Pierre Oses, Fabrício Boscolo Del Vecchio, Franklin Correa Barcellos, Maria Cristina Gonzalez, Airton José Rombaldi
Chronic kidney disease (CKD) is associated with physical weakness and increased oxidative stress and inflammation levels. Rehabilitation programs are associated with an improvement in the functional capacity, inflammatory and oxidative stress profile. Exercise associated with blood flow restriction (BFR) has been demonstrating positive effects in training programs, but there is lack information about exercise with BFR in CKD. Therefore, the aim of the present study is to describe a protocol using continuous moderate exercise with blood flow restriction (BFR) applied during hemodialysis (HD) to measures health indicators and immune system and oxidative stress parameters in CKD patients...
2019: MethodsX
Matt Wentzell
Objective: To describe the successful rehabilitation of a distal biceps brachii tendon reattachment following an acute traumatic tendon rupture. Clinical Features: A 30-year-old weightlifter presented five days post-op after a left distal biceps tendon repair. A three month one pound weight-restriction was recommended by the attending surgeon. Active and passive elbow and wrist range of motion were markedly reduced with profuse post-operative swelling and bruising noted upon initial inspection...
December 2018: Journal of the Canadian Chiropractic Association
V O Belash, D E Mokhov, E S Tregubova
BACKGROUND: The pathological changes in the cervical spine frequently result in the disturbances of the blood supply in the vertebral-basiliar system. The degenerative-dystrophic processes in the cervical spine occupy the leading place in the pathogenesis of the vertebral artery syndrome (VAS) causing disorders of the microcirculation and innervation, as well as the restriction of mobility and the development of somatic dysfunctions. It can be assumed that the manual methods applied to manage this condition can be effective in the removal the functional abnormalities in the blood flow...
2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Matthew B Jessee, Samuel L Buckner, J Grant Mouser, Kevin T Mattocks, Scott J Dankel, Takashi Abe, Zachary W Bell, John P Bentley, Jeremy P Loenneke
An inability to lift loads great enough to disrupt muscular blood flow may impair the ability to fatigue muscles, compromising the hypertrophic response. It is unknown what level of blood flow restriction (BFR) pressure, if any, is necessary to reach failure at very low-loads [i.e., 15% one-repetition maximum (1RM)]. The purpose of this study was to investigate muscular adaptations following resistance training with a very low-load alone (15/0), with moderate BFR (15/40), or with high BFR (15/80), and compare them to traditional high-load (70/0) resistance training...
2018: Frontiers in Physiology
Vasileios Korakakis, Rodney Whiteley, Giannis Giakas
OBJECTIVES: To evaluate if application of blood flow restriction (BFR) combined with low-load resistance training (LLRT) would induce significant anterior knee pain (AKP) reduction compared to LLRT alone. DESIGN: Randomised Controlled Trial. SETTING: Institutional physiotherapy clinic. PARTICIPANTS: Forty males suffering from AKP were randomly allocated in the LLRT-BFR or LLRT group. BFR was applied at 80% of complete vascular occlusion...
November 2018: Physical Therapy in Sport
Peter Ladlow, Russell J Coppack, Shreshth Dharm-Datta, Dean Conway, Edward Sellon, Stephen D Patterson, Alexander N Bennett
Background: There is growing evidence to support the use of low-load blood flow restriction (LL-BFR) exercise in musculoskeletal rehabilitation. Purpose: The purpose of this study was to evaluate the efficacy and feasibility of low-load blood flow restricted (LL-BFR) training versus conventional high mechanical load resistance training (RT) on the clinical outcomes of patient's undergoing inpatient multidisciplinary team (MDT) rehabilitation. Study design: A single-blind randomized controlled study. Methods: Twenty-eight lower-limb injured adults completed a 3-week intensive MDT rehabilitation program...
2018: Frontiers in Physiology
Colin W Bond, Kyle J Hackney, Scott L Brown, Benjamin C Noonan
Synopsis Restoration of skeletal muscle mass and strength is critical to successful outcomes following orthopaedic surgery. Blood flow restriction (BFR) resistance exercise has emerged as a promising means of augmenting traditional low-intensity physical rehabilitation exercise and has yielded successful outcomes in a wide range of applications. Though BFR is well tolerated and safe for most individuals, patients who have undergone orthopaedic surgery may be an exception, due to their heightened risk for venous thromboembolism (VTE)...
January 2019: Journal of Orthopaedic and Sports Physical Therapy
Brian Day
Personalized (based on a percentage of a patient's limb occlusion pressure) blood flow restriction is emerging as a potential advancement in orthopaedic surgery. Safe application of the technology requires the use of medical devices capable of customizing the pressures applied to individual patients. In those circumstances, it is a low risk and noninvasive technique. By limiting muscle atrophy and aiding in the recovery of strength and function, it has the potential to significantly reduce the morbidity from limb trauma and surgery, and aid in achieving a substantially earlier return to full activity...
August 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Nicholas N DePhillipo, Mitchell I Kennedy, Zach S Aman, Andrew S Bernhardson, Luke T O'Brien, Robert F LaPrade
Blood flow restriction (BFR) therapy is becoming increasingly popular in musculoskeletal injury rehabilitation. In particular, this form of therapy is being utilized more often in the postoperative setting following knee surgery, including anterior cruciate ligament reconstruction. BFR therapy provides patients and clinicians an alternative treatment option to standard muscle strengthening and hypertrophy guidelines in the setting of postoperative pain, weakness, and postoperative activity restrictions that contribute to muscle atrophy...
August 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Luke Hughes, Bruce Paton, Fares Haddad, Benjamin Rosenblatt, Conor Gissane, Stephen David Patterson
OBJECTIVES: To compare the acute perceptual and blood pressure responses to: 1) light load blood flow restriction resistance exercise (BFR-RE) in non-injured individuals and anterior cruciate ligament reconstruction (ACLR) patients; and 2) light load BFR-RE and heavy load RE (HL-RE) in ACLR patients. DESIGN: Between-subjects, partially-randomised. METHODS: This study comprised 3 groups: non-injured BFR-RE (NI-BFR); ACLR patients BFR-RE (ACLR-BFR); ACLR patients HL-RE (ACLR-HL)...
September 2018: Physical Therapy in Sport
Joshua Krieger, Donald Sims, Cameron Wolterstorff
Blood flow-restricted resistance (BFRR) training is effective as a means to improve muscle strength and size while enduring less mechanical stress. It is generally safe but can have adverse effects. We present a case of an active duty Soldier who developed rhabdomyolysis as a result of a single course of BFRR training. He was presented to the emergency department with bilateral lower extremity pain, was admitted for electrolyte monitoring and rehydration, and had an uncomplicated hospital course and full recovery...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Jon Stavres, Tyler J Singer, Amber Brochetti, Martin J Kilbane, Steven W Brose, John McDaniel
BACKGROUND: Blood flow restriction (BFR) exercise, which already has shown promise in the able-bodied population, may be a novel method for improving muscle function in the incomplete spinal cord injury (iSCI) population. However, the feasibility and tolerance for BFR exercise in this population is unknown. OBJECTIVE: To determine the feasibility and safety of BFR exercise in the iSCI population, with special attention paid to acute hemodynamic changes and the risk of deep vein thrombosis (DVT)...
May 23, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Kevin T Mattocks, Matthew B Jessee, J Grant Mouser, Scott J Dankel, Samuel L Buckner, Zachary W Bell, Johnny G Owens, Takashi Abe, Jeremy P Loenneke
Blood flow restriction by itself or in combination with exercise has been shown to produce beneficial adaptations to skeletal muscle. These adaptations have been observed across a range of populations, and this technique has become an attractive possibility for use in rehabilitation. Although there are concerns that applying blood flow restriction during exercise makes exercise inherently more dangerous, these concerns appear largely unfounded. Nevertheless, we have advocated that practitioners could minimize many of the risks associated with blood flow-restricted exercise by accounting for methodological factors, such as cuff width, cuff type, and the individual to which blood flow restriction is being applied...
April 2018: Current Sports Medicine Reports
Richard A Ferguson
No abstract text is available yet for this article.
June 2018: Acta Physiologica
Hans Erik Bøtker, Thomas Ravn Lassen, Nichlas Riise Jespersen
Rapid admission and acute interventional treatment combined with modern antithrombotic pharmacologic therapy have improved outcomes in patients with ST elevation myocardial infarction. The next major target to further advance outcomes needs to address ischemia-reperfusion injury, which may contribute significantly to the final infarct size and hence mortality and postinfarction heart failure. Mechanical conditioning strategies including local and remote ischemic pre-, per-, and postconditioning have demonstrated consistent cardioprotective capacities in experimental models of acute ischemia-reperfusion injury...
June 1, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Bobby G Yow, David J Tennent, Thomas C Dowd, Jeremy P Loenneke, Johnny G Owens
Blood flow restriction (BFR) training is a technique shown to be safe and effective at increasing muscular strength and endurance in healthy fitness populations and is under study for its use in postinjury rehabilitation. BFR stimulates muscular strength and hypertrophy gains at much lower loads than traditional methods, allowing patients to begin the rehabilitation process much sooner. We report on 2 patients who incorporated BFR training into their traditional rehabilitation program after Achilles tendon ruptures...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Peter Ladlow, Russell J Coppack, Shreshth Dharm-Datta, Dean Conway, Edward Sellon, Stephen D Patterson, Alexander N Bennett
Background: A challenge for rehabilitation practitioners lies in designing optimal exercise programmes that facilitate musculoskeletal (MSK) adaptations whilst simultaneously accommodating biological healing and the safe loading of an injured limb. A growing body of evidence supports the use of resistance training at a reduced load in combination with blood flow restriction (BFR) to enhance hypertrophic and strength responses in skeletal muscle. In-patient rehabilitation has a long tradition in the UK Military, however, the efficacy of low intensity (LI) BFR training has not been tested in this rehabilitation setting...
2017: Pilot and Feasibility Studies
Juan Martín-Hernández, Alejandro Santos-Lozano, Carl Foster, Alejandro Lucia
The combination of low-load resistance training [or more recently, neuromuscular electrical stimulation (NMES)] with a moderate local blood flow restriction (BFR) is becoming a widespread training and rehabilitation method. Scientific data indicate the overall safety of BFR, at least in healthy young people. However, it has been associated with side effects, usually minor, and further research is warranted regarding the safety and efficacy of this technique, especially in clinical populations. We found 3 syncope/presyncopal episodes among 21 healthy people (9 men), all occurring in men and during familiarization sessions (in which BFR was applied alone) but not thereafter (BFR sessions combined with NMES): 1 subject experienced a brief syncope and 2 other subjects exhibited presyncopal symptoms (sweating, lightheadedness, and pallor)...
November 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
William R Vanwye, Alyssa M Weatherholt, Alan E Mikesky
To improve muscular strength and hypertrophy the American College of Sports Medicine recommends moderate to high load resistance training. However, use of moderate to high loads are often not feasible in clinical populations. Therefore, the emergence of low load (LL) blood flow restriction (BFR) training as a rehabilitation tool for clinical populations is becoming popular. Although the majority of research on LL-BFR training has examined healthy populations, clinical applications are emerging. Overall, it appears BFR training is a safe and effective tool for rehabilitation...
2017: International Journal of Exercise Science
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