The Effectiveness of Blood Flow Restriction Training Compared to Standard Rehabilitation in Adult and Adolescent Populations after ACL Reconstruction: A Critically Appraised Topic

Clinical Scenario: Quadriceps atrophy, weakness and lack of range of motion are common after anterior cruciate ligament reconstruction. Blood Flow Restriction Training, alone or in combination with exercise, has shown to be a safe intervention to promote muscular hypertrophy, increasing ROM and improving knee function. The purpose of this critically appraised is to show the current evidence that supports the use of BFR for increasing quadriceps strength and ROM following ACLR in comparison with standard rehabilitation and standard care. Focused Clinical Question: In adults and adolescent populations, is the use of BFRT more effective for increasing quadriceps strength and ROM after ACLR than standard rehabilitation? Clinical Bottom Line: Reviewed data suggested that a short duration (pre-surgery or post-surgery) of moderate pressure BFR combined with low-resistance muscular training does not appear to measurably affect quadriceps crossed-sectional area and increase quadriceps femoris muscle mass or isometric strength. However, a relatively long duration of moderate-pressure BFR combined with low-resistance muscular training may increase quadriceps CSA and hypertrophy to a greater extent than low-resistance muscular training alone. In addition, it is proven to show a greater reduction in knee joint pain and effusion as well an increased in ROM and stability, leading to greater overall improvements in physical function.