Blood Flow Restriction Training in the Adolescent Patient: Effects on Muscle Strength and Overall Function Following Anterior Cruciate Ligament Reconstruction Surgery
Children's Healthcare of Atlanta
Summary
This is an interventional study that will examine effects of blood flow restriction training (BFRT) in adolescents aged 12-18 after anterior cruciate ligament reconstruction surgery (ACLR). The study aims to identify the effect of BFRT on quadriceps muscle strength and the patient's quality of life, and the overall tolerability of BFRT will be examined. Eight physical therapists at four sports medicine physical therapy (PT) sites will oversee all post-operative PT sessions. Subjects allocated to the BFR group will undergo BFRT, while control group will undergo standard-of-care ACLR rehabilitation, 2 days per week for 16 weeks. Measurements of strength, quality of life, and overall function will be completed at regular intervals.
Description
Background: Approximately 100,000 anterior cruciate ligament reconstructions (ACLR) are performed yearly, and rates of these surgeries in patients younger than 15 years increased by 924% between 1990 and 2007.1 Persistent strength deficits in quadriceps musculature following ACLR are common, even several months after surgery and despite targeted physical therapy to address atrophy.2 Quadriceps atrophy and weakness are associated with worse patient-reported outcomes (PROs),3 as well as altered movement strategies and increased risk of reinjury.4,6 Approximately 20% of teenagers returning to sp…
Eligibility
- Age range
- 12–18 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: 1. Adolescent male and female patients, age 12-18 2. Skeletally mature at time of diagnosis, with closed growth plates, as determined via standard clinic x-ray imaging (this specification automatically excludes pre-pubescent children. 3. Underwent transphyseal ACLR with quadriceps tendon autograft with one of three sports orthopedic surgeons at CHOA 4. Completed pre-surgery strength assessment of bilateral quadriceps, hamstrings, hip abductor and hip adductor musculature. 5. English-speaking adolescents and parents of all races and ethnicities (after preliminary data is ac…
Interventions
- DeviceBlood Flow Restriction using Delfi Personalized Tourniquet System
Participants assigned to the test group will undergo blood flow restriction training 2 days per week beginning at week 1-2 post-surgery and continuing through week 16 post-surgery using the FDA-approved Delfi Personalized Tourniquet System (PTS) with personalized pressure of 80% of the limb occlusion pressure (LOP). The LOP is the amount of pressure required to fully occlude arterial and venous blood flow to the limb. Otherwise, both the test group and control group will follow a standard 6-month post-surgery rehabilitation protocol which is standard of care for ACLR recovery.
Location
- Children's Healthcare of Atlanta Physical TherapyAtlanta, Georgia