Demand is coming-Are you ready?
This case study included a 19 year-old female soccer player who presented three days following a hamstring tendon autograft ACL arthroscopic reconstructive surgery. Twenty-three weeks prior to surgery, the athlete sustained an on-field injury, which resulted in a right ACL rupture, a grade 3 MCL sprain, and a large bucket-handle tear of the medial meniscus. The post-operative protocol included joint and soft tissue mobilization, electrotherapies, electrical muscle stimulation, proprioceptive exercises, stretching, and AROM exercises. Blood flow restriction training was implemented throughout the treatment plan, as outlined below. The protocol started with passive BFR and progressed week by week. A constant pressure of 100mmHg was used throughout.
The results showed maintenance of Lower Extremity Functional Scale (LEFS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores, as well as no loss of thigh or leg girth measurements from pre-op to 12 weeks post-op. The authors concluded that, “Low intensity exercise supplemented with vascular restriction may prove to be an efficient and effective means of maintaining post-surgical muscle size and subjective knee function.”
What do you think? Should BFR training be included in ACL rehabilitation across the board or is more research needed at this time?
Lejkowski PM, Pajaczkowski JA. Utilization of Vascular Restriction Training in post-surgical knee rehabilitation: a case report and introduction to an under-reported training technique. J Can Chiropr Assoc. 2011;55(4):280-287.
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****Remember, the use of BFR training should not be based solely on a success story. The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.