Blood flow restriction training as a rehabilitative tool for anterior cruciate ligament reconstruction patients

Abstract

Injuries to the anterior cruciate ligament in athletic populations are frequent, with roughly 150,000 occurring each year. Anterior cruciate ligament reconstruction (ACLR) using an autograph is the most common option to regain function, indicating months of rehabilitation with an early focus on preventing atrophy of the quadriceps muscles and restoring extensor strength in order to regain function and long term functional outcomes. Unfortunately, exercises utilized to increase extensor strength can place significant shear stress on the recovering joint and healing tendon graft. One promising technique to decrease this stress is through low pressure vascular occlusion combined with low load resistance training. Some studies have shown that this style of Blood Flow Restriction (BFR) training can produce similar strength gains to high resistance training alone, indicating its application for post-operative knee conditions, especially ACLR. This type of training is poorly understood but is thought to utilize cell swelling and oxidative stress in which fast twitch muscle fibers are more readily recruited as well as an increased presence of metabolic compounds associated with muscle growth such as cytokine and growth hormone. A literature review was conducted to assess and analyze current data on the subject, finding 4 well designed studies relevant to the topic. Implications for further research and practical application were drawn from these studies.