Blood flow restriction training compared with standardized physical therapy after ACL reconstruction may not lead to improved return-to-sport outcomes in elite collegiate athletes, according to data presented recently at the American Orthopaedic Society for Sports Medicine annual meeting.
“[Blood flow restriction training] BFRT does not improve return to sport times in our division 1 athlete cohort. Our data wasn’t necessarily suggestive of particular postoperative timeframe where BFRT is most effective. Ultimately, we think it is a matter of finding a balance between BFRT and traditional rehab exercises,” Sai K. Devana, MD, said at the American Orthopaedic Society for Sports Medicine Annual Meeting.
In a retrospective chart review, Devana and colleagues studied division 1 athletes at University of California, Los Angeles who underwent primary ACL reconstruction. All athletes followed a standardized postoperative rehabilitation protocol based on guidance of the MOON panel. However, one group had the addition of BFRT, which was 80% occlusion pressure. Primary outcome measure was the time to return-to-sport. Secondary outcome measure was postoperative strength of the quadriceps determined by hand-held dynamometry and measured as a percentage compared with the unaffected extremity.
Researchers found the BFRT group of 22 athletes had a mean return-to-sport time of 409 ± 134 days from surgery. For 33 athletes who followed the standardized rehabilitation protocol alone, mean return-to-sport time was 332 ± 100 days. For athletes in the BFRT group, mean quadriceps strength increased 0.67 percentage points for every 1 week of rehabilitation.
Average absolute changes in hand-held dynamometry were calculated in 4-week intervals. Devana said the first significant increase in strength occurred between weeks 13 and 16 at 10%. Athletes had hand-held dynamometry gains relative to baseline over time. However, Devana said, “only 50% of patients got to 90% hand-held dynamometry or higher at the 52-week mark, which is what we typically tell patients in terms of return-to-sport expectations.”