Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes

Effects of low-load blood flow restriction training in healthy adult tendons: A systematic review and meta-analysis

OBJECTIVE

To systematically review the effects of low-load blood flow restriction training (LL-BFR) on healthy adult tendons.

DESIGN

A systematic review with meta-analysis.

LITERATURE SEARCH

Six electronic databases were searched by two researchers.

STUDY SELECTION CRITERIA

Clinical trials comparing the effects of LL-BFR to high-load resistance training (HL-RT) or low-load resistance training (LL-RT) in healthy adult tendons.

DATA SYNTHESIS

Two reviewers selected the eligible clinical trials, and one reviewer exported the data. Two reviewers evaluated the study quality and risk of bias using the PEDro scale and the ROB2 scale. We performed meta-analysis where appropriate using a random-effects model. We rated the quality of evidence using GRADE.

RESULTS

Six studies were eligible. We analyzed tendon cross-sectional area (CSA) and tendon stiffness as the outcomes. Across all comparisons, there was low-to moderate-quality evidence of a difference between LL-BFR and LL-RT immediately after exercise. There was high-quality evidence of no difference between LL-BFR and HL-RT in the long term.

CONCLUSION

The effects of LL-BFR on the tendons depends on the time and dose of the intervention. LL-BFR could be useful to increase the CSA of the tendons in a similar or superior way to HL-RT after 8 weeks of intervention.

Feasibility of Blood Flow Restriction Exercise in Adults with a Non-surgically Treated Achilles Tendon Rupture; a Case Series

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.

Comparing the effect of intermittent blood flow restriction training and high-load resistance training in patients with patellofemoral pain: study protocol for a randomised trial

BACKGROUND

Patellofemoral pain (PFP) syndrome is a common knee joint functional disorder. Blood flow restriction (BFR) training has shown promise in improving PFP; however, the effectiveness of intermittent BFR (iBFR) training remains uncertain. This study aims to compare the rehabilitative effects of iBFR combined with low-load resistance training and high-load resistance training in PFP patients and to assess the effectiveness of iBFR combined with low-load resistance training for improving PFP.

METHODS AND ANALYSIS

This randomised, patient-assessor blinded, controlled trial will include 42 eligible PFP patients randomly allocated to an intervention group (iBFR combined with low-load resistance training) or a control group (high-load resistance training) in a 1:1 ratio. Participants will receive interventions three times per week for 8 weeks and will be followed up for 24 weeks. The primary outcome measure is pain, and the secondary outcomes include self-reported function, quality of life, muscle strength and muscle thickness. Assessments will be conducted at baseline, 8 weeks and 24 weeks during follow-up. Intention-to-treat analysis will be performed.Collectively, we expect that the findings of this randomised clinical trial will contribute to understanding the potential benefits of iBFR training and provide insightful guidance for developing more effective treatment strategies for patients with PFP.

ETHICS AND DISSEMINATION

This study was approved by the Sports Science Experiment Ethics Committee of Beijing Sport University (2022274H). Written informed consent will be obtained from all participants. Trial results will be disseminated through peer-reviewed publications.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry (ChiCTR2300068281).