Blood flow restriction training with cross education for quadriceps muscle recovery after anterior cruciate ligament reconstruction: A prospective, randomized, controlled, single-blind clinical trial.

IF 3.3 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-12-17 DOI:10.1002/ksa.12553

Ceyda Sevinc, Volkan Gürler, Gulcan Harput, Ali Ocguder, F Bilge Ergen, Volga Bayrakcı Tunay

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Abstract

Purpose: Recently, blood flow restriction (BFR) and cross education (CE) trainings are the options for quadriceps strength recovery after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to investigate the effects of CE combined with BFR on quadriceps strength and thickness after ACLR.

Methods: Twenty-four male patients [(Age: 24.9 ± 6.3 years, body mass index: 24 ± 2.3 kg/m²) who had undergone ACLR with hamstring autograft were included. At 4 weeks after surgery, the patients were randomly divided into two groups (Group-1: CE + BFR, n = 13, Group-2: CE, n = 11). All patients had standardized rehabilitation for their reconstructed limb until 12 weeks postsurgery, and they all received CE training for uninjured limb at isokinetic system (quadriceps eccentric contraction, 60°/s 3-set 12-rep, 2-days in a week) during 8 weeks. Group 2 performed the same CE procedure with BFR. Quadriceps isometric strength was measured using an isokinetic dynamometer, while the thickness of quadriceps (rectus femoris, vastus lateralis, vastus medialis obliquus) and cross-sectional area of rectus femoris were evaluated using ultrasound pretraining (4th-week postsurgery) and posttraining (12th-week postsurgery). Analysis of variance was used for statistical analysis.

Results: Group-by-time interaction and the group main effect were not significant for any measured variables in both limbs (p > 0.05). There was a significant main effect of time observed for quadriceps strength and thickness in involved and uninvolved limbs (p < 0.001, p < 0.05, respectively). In Group 1, the limb symmetry index for quadriceps strength increased from 49.3% to 71.7%, while in Group 2, it increased from 50.9% to 75.2%.

Conclusion: BFR training, adapted to CE eccentric strengthening, may not be effective for quadriceps muscle strength recovery after ACLR. Further investigations with varied training protocols are needed to research the impact of BFR on CE.

Level of evidence: Level II randomized controlled trial.

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前交叉韧带重建后限制血流训练与交叉训练对股四头肌恢复的影响：一项前瞻性、随机、对照、单盲临床试验。

目的：最近，血流限制（BFR）和交叉训练（CE）训练是前交叉韧带重建（ACLR）后股四头肌力量恢复的选择。本研究的目的是探讨CE联合BFR对ACLR术后股四头肌力量和厚度的影响。方法：选取24例行ACLR合并自体腘绳肌移植的男性患者（年龄：24.9±6.3岁，体重指数：24±2.3 kg/m2）。术后4周，将患者随机分为两组（组1:CE + BFR， n = 13，组2:CE， n = 11）。所有患者术后12周均进行重建肢体标准化康复，8周内均接受未损伤肢体等速系统CE训练（股四头肌偏心收缩，60°/s 3组12次，每周2天）。第二组采用与BFR相同的CE手术。采用等速测力仪测量股四头肌的等距力量，同时在训练前（术后第4周）和训练后（术后第12周）采用超声评估股四头肌（股直肌、股外侧肌、股内侧肌斜肌）的厚度和股直肌的横截面积。采用方差分析进行统计分析。结果：两肢各测量变量分组时间交互作用及组主效应均无统计学意义（p < 0.05）。观察到时间对受累肢和未受累肢的股四头肌力量和厚度有显著的主要影响(p)结论：适应CE偏心强化的BFR训练可能对ACLR后股四头肌力量恢复无效。需要采用不同的训练方案进行进一步的调查，以研究BFR对CE的影响。证据水平：二级随机对照试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).