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Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction: a randomized controlled external pilot study
More than 2 million anterior cruciate ligament (ACL) injuries occur worldwide each year. Most surgeons suggest that athletes and active persons with significant knee functional demands, including cutting motions, require and should be offered ligament reconstruction surgery. Despite concentrated reh...
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| Published in: | BMC musculoskeletal disorders 2023-05, Vol.24 (1), p.360-360, Article 360 |
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| description | More than 2 million anterior cruciate ligament (ACL) injuries occur worldwide each year. Most surgeons suggest that athletes and active persons with significant knee functional demands, including cutting motions, require and should be offered ligament reconstruction surgery. Despite concentrated rehabilitation efforts, deficits in quadriceps size and strength can persist for years after surgery. Blood flow restriction (BFR) training can help overcome disuse muscular atrophy in the mid-term postoperative period after anterior cruciate ligament reconstruction (ACLR) surgery. The purpose of this study was to evaluate the effects of quadriceps training with different levels of blood flow restriction on quadriceps strength and thickness of participants after ACLR.
In this study, 30 post-ACL reconstruction participants were randomly divided into three groups (control, 40% Arterial Occlusion Pressure [AOP] and 80% AOP groups). All patients were subjected to different levels of BFR, combined with conventional quadriceps rehabilitation, for 8 weeks. Assessments included scaled maximal isokinetic knee extension strength at 60°/s and 180°/s, the sum of the thickness of the affected femoris rectus and vastus intermedius, Y-balance test performance, and International Knee Documentation Committee questionnaire responses before and after the intervention.
In total, 23 participants completed the entire study. The 80% AOP compression group showed an increase in quadriceps femoris muscle strength and muscle thickness (p |
| doi_str_mv | 10.1186/s12891-023-06483-x |
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In this study, 30 post-ACL reconstruction participants were randomly divided into three groups (control, 40% Arterial Occlusion Pressure [AOP] and 80% AOP groups). All patients were subjected to different levels of BFR, combined with conventional quadriceps rehabilitation, for 8 weeks. Assessments included scaled maximal isokinetic knee extension strength at 60°/s and 180°/s, the sum of the thickness of the affected femoris rectus and vastus intermedius, Y-balance test performance, and International Knee Documentation Committee questionnaire responses before and after the intervention.
In total, 23 participants completed the entire study. The 80% AOP compression group showed an increase in quadriceps femoris muscle strength and muscle thickness (p < 0.01). As compared with the control group, outcome indicators in the 40% AOP and 80% AOP group were improved (p < 0.05). After 8 weeks of experimental BFR intervention, the results were better for the 80% AOP compression group than for the 40% AOP compression group in quadriceps peak torque to body weight at 60°/s and 180°/s angular velocity, as well as the sum of the thickness of the rectus femoris and vastus intermedius.
The combination of BFR and low-intensity quadriceps femoris training can effectively improve the muscle strength and thickness of knee extensors in participants with ACLR and help reduce the difference between the healthy and surgical sides of the knee joint while improving knee-joint function. Choosing quadriceps training with 80% AOP compression intensity could provide the most benefits. Meanwhile, BFR can accelerate the rehabilitation process of patients and allow early entry into the next rehabilitation cycle.
Trial registration Chinese Clinical Trial Registry, registration number ChiCTR2100050011, date of registration: 15/08/2021.</description><identifier>ISSN: 1471-2474</identifier><identifier>EISSN: 1471-2474</identifier><identifier>DOI: 10.1186/s12891-023-06483-x</identifier><identifier>PMID: 37158913</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Accelerated rehabilitation ; Analysis ; Anterior cruciate ligament ; Anterior Cruciate Ligament Injuries - surgery ; Anterior Cruciate Ligament Reconstruction ; Atrophy ; Blood flow ; Blood flow restriction training ; Blood pressure ; Body weight ; Cellular telephones ; Compression ; Different level of restriction ; Exercise ; Experiments ; Health aspects ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Muscle strength ; Musculoskeletal diseases ; Patients ; Physical fitness ; Physical therapy ; Pilot Projects ; Postoperative period ; Quadriceps muscle ; Quadriceps Muscle - diagnostic imaging ; Questionnaires ; Reconstructive surgery ; Rehabilitation ; Research Design ; Rest ; Sports medicine ; Sports training ; Strength training ; The thickness of the rectus femoris and vastus intermedius ; Therapeutics, Physiological ; Training ; Weightlifting</subject><ispartof>BMC musculoskeletal disorders, 2023-05, Vol.24 (1), p.360-360, Article 360</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><rights>2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564t-352ba931562896bdb898bb2f2f8918d770c45552596809bbabeabc876b45417c3</citedby><cites>FETCH-LOGICAL-c564t-352ba931562896bdb898bb2f2f8918d770c45552596809bbabeabc876b45417c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165811/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2815619896?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37158913$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xuefeng</creatorcontrib><creatorcontrib>Li, Jinyu</creatorcontrib><creatorcontrib>Qing, Liang</creatorcontrib><creatorcontrib>Wang, Haonan</creatorcontrib><creatorcontrib>Ma, Huijun</creatorcontrib><creatorcontrib>Huang, Peng</creatorcontrib><title>Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction: a randomized controlled external pilot study</title><title>BMC musculoskeletal disorders</title><addtitle>BMC Musculoskelet Disord</addtitle><description>More than 2 million anterior cruciate ligament (ACL) injuries occur worldwide each year. Most surgeons suggest that athletes and active persons with significant knee functional demands, including cutting motions, require and should be offered ligament reconstruction surgery. Despite concentrated rehabilitation efforts, deficits in quadriceps size and strength can persist for years after surgery. Blood flow restriction (BFR) training can help overcome disuse muscular atrophy in the mid-term postoperative period after anterior cruciate ligament reconstruction (ACLR) surgery. The purpose of this study was to evaluate the effects of quadriceps training with different levels of blood flow restriction on quadriceps strength and thickness of participants after ACLR.
In this study, 30 post-ACL reconstruction participants were randomly divided into three groups (control, 40% Arterial Occlusion Pressure [AOP] and 80% AOP groups). All patients were subjected to different levels of BFR, combined with conventional quadriceps rehabilitation, for 8 weeks. Assessments included scaled maximal isokinetic knee extension strength at 60°/s and 180°/s, the sum of the thickness of the affected femoris rectus and vastus intermedius, Y-balance test performance, and International Knee Documentation Committee questionnaire responses before and after the intervention.
In total, 23 participants completed the entire study. The 80% AOP compression group showed an increase in quadriceps femoris muscle strength and muscle thickness (p < 0.01). As compared with the control group, outcome indicators in the 40% AOP and 80% AOP group were improved (p < 0.05). After 8 weeks of experimental BFR intervention, the results were better for the 80% AOP compression group than for the 40% AOP compression group in quadriceps peak torque to body weight at 60°/s and 180°/s angular velocity, as well as the sum of the thickness of the rectus femoris and vastus intermedius.
The combination of BFR and low-intensity quadriceps femoris training can effectively improve the muscle strength and thickness of knee extensors in participants with ACLR and help reduce the difference between the healthy and surgical sides of the knee joint while improving knee-joint function. Choosing quadriceps training with 80% AOP compression intensity could provide the most benefits. Meanwhile, BFR can accelerate the rehabilitation process of patients and allow early entry into the next rehabilitation cycle.
Trial registration Chinese Clinical Trial Registry, registration number ChiCTR2100050011, date of registration: 15/08/2021.</description><subject>Accelerated rehabilitation</subject><subject>Analysis</subject><subject>Anterior cruciate ligament</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Anterior Cruciate Ligament Reconstruction</subject><subject>Atrophy</subject><subject>Blood flow</subject><subject>Blood flow restriction training</subject><subject>Blood pressure</subject><subject>Body weight</subject><subject>Cellular telephones</subject><subject>Compression</subject><subject>Different level of restriction</subject><subject>Exercise</subject><subject>Experiments</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint</subject><subject>Ligaments</subject><subject>Methods</subject><subject>Muscle strength</subject><subject>Musculoskeletal diseases</subject><subject>Patients</subject><subject>Physical fitness</subject><subject>Physical therapy</subject><subject>Pilot Projects</subject><subject>Postoperative period</subject><subject>Quadriceps muscle</subject><subject>Quadriceps Muscle - diagnostic imaging</subject><subject>Questionnaires</subject><subject>Reconstructive surgery</subject><subject>Rehabilitation</subject><subject>Research Design</subject><subject>Rest</subject><subject>Sports medicine</subject><subject>Sports training</subject><subject>Strength training</subject><subject>The thickness of the rectus femoris and vastus intermedius</subject><subject>Therapeutics, Physiological</subject><subject>Training</subject><subject>Weightlifting</subject><issn>1471-2474</issn><issn>1471-2474</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v1DAQjRCIlsIf4IAsceGSEidxnHBBVVWgUiUucLZsZ7zr4thb2-kHf5s_wGS3lC5CsZTxzHtv7Ocpite0Oqa0794nWvcDLau6Kauu7Zvy9klxSFtOy7rl7dNH8UHxIqXLqqK8b4bnxUHDKUNqc1j8OjMGdCbBkKtZjtFq2CSSo7Te-hWRmYwWERF8Jg6uwaUFqlwIIzEu3JAIKSMr2-AJrkcimAe_ymsi_Ujy2uofHlIi1uMGyGTHMkOcyCakHDYQZbbXQDCwKC0N1pCYl20kOs7aygzE2ZWclrNE0MFjh3nb-QORJGKbMNmfMBIs5RicwxBuUcJLRzbWhYxnmse7l8UzI12CV_f_o-L7p7Nvp1_Ki6-fz09PLkrNujaXDauVHBrKOrS5U6Pqh16p2tQGretHzivdMsZqNnR9NSglFUile96plrWU6-aoON_pjkFeik20k4x3IkgrtokQV0LGbLUDoZoBjOYo0NF24FzWUpqGSc14rU09otbHndZmVhOMGj2I0u2J7le8XYtVuBa0oh3rKUWFd_cKMVzN-GpiskmDc9JDmJOoEcQ61nKG0Lf_QC_DvLi4RbGODmjIX9RK4g2sNwEb60VUnPC2Zz0b2gV1_B8UfiNMFh8KjMX8HqHeEXQMKUUwD5eklVjmXuzmXuDci-3ci1skvXlszwPlz6A3vwGVXQY7</recordid><startdate>20230508</startdate><enddate>20230508</enddate><creator>Li, Xuefeng</creator><creator>Li, Jinyu</creator><creator>Qing, Liang</creator><creator>Wang, Haonan</creator><creator>Ma, Huijun</creator><creator>Huang, Peng</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20230508</creationdate><title>Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction: a randomized controlled external pilot study</title><author>Li, Xuefeng ; Li, Jinyu ; Qing, Liang ; Wang, Haonan ; Ma, Huijun ; Huang, Peng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-352ba931562896bdb898bb2f2f8918d770c45552596809bbabeabc876b45417c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accelerated rehabilitation</topic><topic>Analysis</topic><topic>Anterior cruciate ligament</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Anterior Cruciate Ligament Reconstruction</topic><topic>Atrophy</topic><topic>Blood flow</topic><topic>Blood flow restriction training</topic><topic>Blood pressure</topic><topic>Body weight</topic><topic>Cellular telephones</topic><topic>Compression</topic><topic>Different level of restriction</topic><topic>Exercise</topic><topic>Experiments</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint</topic><topic>Ligaments</topic><topic>Methods</topic><topic>Muscle strength</topic><topic>Musculoskeletal diseases</topic><topic>Patients</topic><topic>Physical fitness</topic><topic>Physical therapy</topic><topic>Pilot Projects</topic><topic>Postoperative period</topic><topic>Quadriceps muscle</topic><topic>Quadriceps Muscle - diagnostic imaging</topic><topic>Questionnaires</topic><topic>Reconstructive surgery</topic><topic>Rehabilitation</topic><topic>Research Design</topic><topic>Rest</topic><topic>Sports medicine</topic><topic>Sports training</topic><topic>Strength training</topic><topic>The thickness of the rectus femoris and vastus intermedius</topic><topic>Therapeutics, Physiological</topic><topic>Training</topic><topic>Weightlifting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Xuefeng</creatorcontrib><creatorcontrib>Li, Jinyu</creatorcontrib><creatorcontrib>Qing, Liang</creatorcontrib><creatorcontrib>Wang, Haonan</creatorcontrib><creatorcontrib>Ma, Huijun</creatorcontrib><creatorcontrib>Huang, Peng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC musculoskeletal disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xuefeng</au><au>Li, Jinyu</au><au>Qing, Liang</au><au>Wang, Haonan</au><au>Ma, Huijun</au><au>Huang, Peng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction: a randomized controlled external pilot study</atitle><jtitle>BMC musculoskeletal disorders</jtitle><addtitle>BMC Musculoskelet Disord</addtitle><date>2023-05-08</date><risdate>2023</risdate><volume>24</volume><issue>1</issue><spage>360</spage><epage>360</epage><pages>360-360</pages><artnum>360</artnum><issn>1471-2474</issn><eissn>1471-2474</eissn><abstract>More than 2 million anterior cruciate ligament (ACL) injuries occur worldwide each year. Most surgeons suggest that athletes and active persons with significant knee functional demands, including cutting motions, require and should be offered ligament reconstruction surgery. Despite concentrated rehabilitation efforts, deficits in quadriceps size and strength can persist for years after surgery. Blood flow restriction (BFR) training can help overcome disuse muscular atrophy in the mid-term postoperative period after anterior cruciate ligament reconstruction (ACLR) surgery. The purpose of this study was to evaluate the effects of quadriceps training with different levels of blood flow restriction on quadriceps strength and thickness of participants after ACLR.
In this study, 30 post-ACL reconstruction participants were randomly divided into three groups (control, 40% Arterial Occlusion Pressure [AOP] and 80% AOP groups). All patients were subjected to different levels of BFR, combined with conventional quadriceps rehabilitation, for 8 weeks. Assessments included scaled maximal isokinetic knee extension strength at 60°/s and 180°/s, the sum of the thickness of the affected femoris rectus and vastus intermedius, Y-balance test performance, and International Knee Documentation Committee questionnaire responses before and after the intervention.
In total, 23 participants completed the entire study. The 80% AOP compression group showed an increase in quadriceps femoris muscle strength and muscle thickness (p < 0.01). As compared with the control group, outcome indicators in the 40% AOP and 80% AOP group were improved (p < 0.05). After 8 weeks of experimental BFR intervention, the results were better for the 80% AOP compression group than for the 40% AOP compression group in quadriceps peak torque to body weight at 60°/s and 180°/s angular velocity, as well as the sum of the thickness of the rectus femoris and vastus intermedius.
The combination of BFR and low-intensity quadriceps femoris training can effectively improve the muscle strength and thickness of knee extensors in participants with ACLR and help reduce the difference between the healthy and surgical sides of the knee joint while improving knee-joint function. Choosing quadriceps training with 80% AOP compression intensity could provide the most benefits. Meanwhile, BFR can accelerate the rehabilitation process of patients and allow early entry into the next rehabilitation cycle.
Trial registration Chinese Clinical Trial Registry, registration number ChiCTR2100050011, date of registration: 15/08/2021.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>37158913</pmid><doi>10.1186/s12891-023-06483-x</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC musculoskeletal disorders, 2023-05, Vol.24 (1), p.360-360, Article 360 |
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| language | eng |
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| source | PubMed (Medline); Publicly Available Content (ProQuest) |
| subjects | Accelerated rehabilitation Analysis Anterior cruciate ligament Anterior Cruciate Ligament Injuries - surgery Anterior Cruciate Ligament Reconstruction Atrophy Blood flow Blood flow restriction training Blood pressure Body weight Cellular telephones Compression Different level of restriction Exercise Experiments Health aspects Humans Knee Knee Joint Ligaments Methods Muscle strength Musculoskeletal diseases Patients Physical fitness Physical therapy Pilot Projects Postoperative period Quadriceps muscle Quadriceps Muscle - diagnostic imaging Questionnaires Reconstructive surgery Rehabilitation Research Design Rest Sports medicine Sports training Strength training The thickness of the rectus femoris and vastus intermedius Therapeutics, Physiological Training Weightlifting |
| title | Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction: a randomized controlled external pilot study |
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