RESUMO
Blood flow restriction exercise (BFRE) appears to provide a unique opportunity to preserve lower limb muscle and function in patients with an Achilles tendon rupture. The purpose of this study was to investigate the feasibility of BFRE in patients with an Achilles tendon rupture. Additionally, to evaluate muscle volume and patient-reported ankle function, symptoms, complications, and physical activity following 12 weeks of BFRE. Feasibility was measured by adherence to training sessions, drop-out rate, intervention acceptability, ankle pain exacerbation (NRS), and adverse events. At baseline and 12-weeks follow-up, patients completed the Achilles Tendon Total Rupture Score questionnaire and had their thigh and calf circumference measured. At follow-up, patients' ability to perform a single-leg heel rise was tested. Sixteen of 18 patients completed the intervention and for those, adherence to training sessions was 88% ±16%. The mean NRS following BFRE sessions was 1.1 (95%CI: 1; 1.2). Three adverse events occurred during the 12 weeks. Two re-ruptures after completion of the BFRE program and one deep venous thrombosis following cast removal. BFRE was found to be feasible in a subset of patients with an Achilles tendon rupture. However, with three adverse events in a population of 18 patients, the effectiveness and safety of BFRE warrants further investigation.
RESUMO
Former athlete, 30 years of age, suffered several months of moderate anterior knee pain during daily life activities where daily life activities such as negotiating stairs and lifting heavy objects were moderately painful. Magnetic resonance imaging showed normal meniscus and cruciate ligaments and no extra joint fluid. The patient was referred to a physiotherapist who introduced a strengthening program. Low-load resistance training with concurrent blood flow restriction can induce significant gains in maximal muscle strength and mass with minimal exacerbation of knee-joint pain. We describe the outcome of 12 weeks low-load resistance training with concurrent blood flow restriction as a rehabilitation method for anterior knee pain. The patient performed low-load resistance training with concurrent blood flow restriction for the lower limbs (goblet squat, single-leg knee extensions and flexions). After the low-load resistance training with concurrent blood flow restriction, the patient increased isometric knee extensor muscle strength (31%), single-leg hop test performance (23%), obtained clinically relevant improvements in patient-reported outcomes and was able to return to his usual high-loading training regime. Low-load resistance training with concurrent blood flow restriction seems promising to transition patients back to a healthy lifestyle of training and being physically active.
RESUMO
To examine the feasibility and safety of blood flow restricted walking (BFR-W) in patients with intermittent claudication (IC). Moreover, to evaluate changes in objective performance-based and self-reported functioning following 12 weeks of BFR-W. Materials and methods: Sixteen patients with IC were recruited from two departments of vascular surgery. The BFR-W programme implied the application of a pneumatic cuff around the proximal part of the affected limb at 60% limb occlusion pressure in five intervals of 2 min, four times per week for 12 weeks. Feasibility was evaluated by adherence and completion rates of the BFR-W programme. Safety was evaluated by adverse events, ankle-brachial index (ABI) at baseline and follow-up, and pain on a numerical rating scale (NRS pain) before and 2 min after training sessions. Furthermore, changes in performance between baseline and follow-up were evaluated with the 30 seconds sit-to-stand test (30STS), the 6-minute walk test (6MWT) and the IC questionnaire (ICQ). Results: Fifteen out of 16 patients completed the 12-week BFR-W programme and adherence was 92.8% (95% CI: 83.4; 100%). One adverse event unrelated to the intervention was reported causing one patient to terminate the programme 2 weeks prematurely. Mean NRS pain 2 min following BFR-W was 1.8 (95% CI [1.7-2]). ABI, 30STS, 6MWT and ICQ score were improved at follow-up. Conclusions: BFR-W is feasible and appears to be safe in terms of completion rate, adherence to the training protocol, and adverse events in patients with IC. Further investigation of the effectiveness and safety of BFR-W compared to regular walking exercise is needed.
