The Impact of Blood Flow Restriction Training on Tibial Bone Stress Injury Rehabilitation: An Exploratory Case Series.

IF 1.6 Q3 SPORT SCIENCES International Journal of Sports Physical Therapy Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.122641
Andrew P Golden, Kathleen K Hogan, Jamie B Morris, Bryan B Pickens
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Abstract

Background: Lower extremity bone stress injuries (BSI) are common injuries among athletes and military members. Typical management involves a period of restricted weightbearing which can have rapid detrimental effects upon both muscle and bone physiology. Few studies have investigated the effect of blood flow restriction (BFR) training on bone in the rehabilitative setting.

Purpose: The purpose of this study was to investigate the effects of lower extremity exercise with the addition of BFR upon bone mineral density, bone mineral content, and lean body mass in military members with tibial BSIs.

Study design: Case series.

Methods: Twenty military members with MRI-confirmed tibial BSI were recruited to complete lower extremity exercise with the addition of BFR twice per week for four weeks. The BFR cuff was applied proximally to the participant's involved limb while they performed gluteal, thigh, and leg resistance exercises. Outcomes were assessed at baseline and four weeks. The primary outcomes were whole leg bone mineral density (BMD), bone mineral content (BMC), and lean body mass (LM) as measured by dual-energy x-ray absorptiometry. Secondary outcomes included thigh and leg circumference measures and patient-reported outcomes, including the Lower Extremity Functional Scale (LEFS), Patient-Reported Outcomes Measurement Information System 57 (PROMIS-57), and Global Rating of Change (GROC).

Results: No significant differences were found in BMD (p=0.720) or BMC (p=0.749) between limbs or within limbs over time. LM was generally less in the involved limb (p=0.019), however there were no significant differences between or within limbs over time (p=0.404). For thigh circumference, significant main effects were found for time (p=0.012) and limb (p=0.015), however there was no significant interaction effect (p=0.510). No significant differences were found for leg circumference (p=0.738). Participants showed significant mean changes in LEFS (15.15 points), PROMIS physical function (8.98 points), PROMIS social participation (7.60 points), PROMIS anxiety (3.26 points), and PROMIS pain interference (8.39 points) at four weeks.

Conclusion: The utilization of BFR in the early rehabilitative management of tibial BSI may help mitigate decrements in both bone and muscle tissue during periods of decreased physical loading.

Level of evidence: 4.

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血流限制训练对胫骨骨应力损伤康复的影响:探索性病例系列。
背景:下肢骨应力损伤(BSI)是运动员和军人中常见的损伤。典型的处理方法包括在一段时间内限制负重,这可能会对肌肉和骨骼生理产生快速的不利影响。目的:本研究旨在调查在下肢运动中加入血流限制(BFR)训练对胫骨骨损伤军人的骨矿物质密度、骨矿物质含量和瘦体重的影响:研究设计:病例系列:研究设计:病例系列。方法:招募 20 名经核磁共振成像证实患有胫骨 BSI 的军人进行下肢锻炼,每周两次,每次增加 BFR,持续四周。在进行臀部、大腿和腿部阻力练习时,将 BFR 袖带套在受试者受累肢体的近端。结果在基线和四周时进行评估。主要结果是通过双能 X 射线吸收测量法测得的整条腿骨矿物质密度 (BMD)、骨矿物质含量 (BMC) 和瘦体重 (LM)。次要结果包括大腿和小腿周长测量以及患者报告结果,包括下肢功能量表(LEFS)、患者报告结果测量信息系统 57(PROMIS-57)和全球变化评分(GROC):肢体间或肢体内的 BMD(p=0.720)或 BMC(p=0.749)随时间变化无明显差异。受累肢体的 LM 通常较少(p=0.019),但随着时间的推移,肢体之间或肢体内部无明显差异(p=0.404)。在大腿围度方面,时间(p=0.012)和肢体(p=0.015)具有显著的主效应,但没有显著的交互效应(p=0.510)。腿围没有发现明显差异(p=0.738)。四周后,参与者的 LEFS(15.15 分)、PROMIS 身体功能(8.98 分)、PROMIS 社会参与(7.60 分)、PROMIS 焦虑(3.26 分)和 PROMIS 疼痛干扰(8.39 分)的平均值均有明显变化:结论:在胫骨 BSI 的早期康复治疗中使用 BFR 可能有助于在身体负荷减少期间减轻骨骼和肌肉组织的损伤:4.
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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