Recently, BFR has been utilized as a substitute for traditional postoperative therapy in patients recovering from a range of musculoskeletal injuries. These early investigations tried to distinguish BFR therapy as a tool for mitigating muscular atrophy in individuals with weight-bearing limitations. In the early 2000’s, with the help of third generation tourniquets allowing BFR to be performed safely and accurately, blood flow restriction therapy was further investigated in patients who had restrictions with the amount of resistance they could withstand while exercising, specifically those who were elderly ( 4). The first study on BFR was published in 1998 with the development and utilization of electric tourniquets ( 3). Kaatsu, while unsophisticated, paved the way for the development of electric tourniquets as well as modern blood flow restriction therapy. Soto’s discovery dubbed Kaatsu utilized bands and ropes to create a tourniquet in order to restrict muscular venous blood flow. The first documented concept and practice of vascular occlusion moderation therapy occurred in the 1970s in Japan by Dr. This article will seek to examine and reassert the value and validity of BFR therapy in patients recovering from ACL reconstructions. However, due to the limited evidence available, as well as a lack of established protocols, BFR has not been widely adapted. The cuff is then set to a certain pressure to provide venous occlusion to the targeted muscle groups allowing for reduction of muscle atrophy ( 2). ![]() BFR utilizes the application of a pneumatic cuff which is placed at the most proximal location of the involved limb ( 2). Because of this, BFR has become an increasingly attractive option. BFR therapy allows for clinicians and patients to work in a low-load bearing environment while still being able to achieve the necessary musculoskeletal strengthening, avoiding the traditional muscle atrophy often prevalent following reconstructive knee surgeries. However, load bearing is limited in post-operative knee reconstruction patients leading to muscular atrophy, a post-operative condition connected with pain and muscle weakness. The American College of Sports Medicine recommends that, in order to maintain and increase optimal muscle strength, the muscle must be stressed with between 60 and 100 percent of the one repetition maximum ( 1). ![]() Notably, this therapeutic method is growing more prolific particularly following anterior cruciate ligament (ACL) reconstruction. Moreover, positive results from BFR case series also lend credence to its value as a substitute for traditional therapy in patients who have weight-bearing limitations, specifically those who are recovering from anterior cruciate ligament reconstructions.īlood flow restriction therapy (BFR) has become an increasingly popular method of post-operative rehabilitation. Based on the literature, BFR therapy mitigates atrophy through type II muscle recruitment while also stimulating hypertrophy in patients, supporting its use post-operatively. Furthermore, analysis of other BFR literature will be utilized to lend further credence to the obtained conclusions. This article will seek to confirm the value and validity of the utilization of BFR therapy. In order to validate the utilization of BFR, an evaluation of the science underlying BFR will be discussed as well as the technique and exercises preformed during therapy. Because this is a relatively new form of therapy, there is a lack of established literature and protocol that is preventing widespread use of the therapy. BFR therapy utilizes a pneumatic cuff to simulate strenuous exercise in an effort to stimulate muscle recruitment, mitigate atrophy, and promote hypertrophy in patients with load-bearing limitations. ![]() An increasingly popular method for post-operative rehabilitation of an ACL reconstruction, as a substitute for traditional therapy, is blood flow restriction therapy (BFR).
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