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Randomized Controlled Trial
. 2022 Nov 1:54:jrm00337.
doi: 10.2340/jrm.v54.2550.

Comparison of Quadriceps and Hamstring Muscle Strength after Exercises with and without Blood Flow Restriction following Anterior Cruciate Ligament Surgery: A Randomized Controlled Trial

Rafael Francisco Vieira de Melo  1 , William Ricardo Komatsu  2 , Mellissa Sales de Freitas  2 , Maria Eduarda Vieira de Melo  3 , Moises Cohen  2
Affiliations
Randomized Controlled Trial

Comparison of Quadriceps and Hamstring Muscle Strength after Exercises with and without Blood Flow Restriction following Anterior Cruciate Ligament Surgery: A Randomized Controlled Trial

Rafael Francisco Vieira de Melo et al. J Rehabil Med. .

Abstract

Background: Muscle mass loss occurs following anterior cruciate ligament reconstruction surgery.

Objective: To compare the gain in muscle strength in the quadriceps and hamstring muscles in patients following anterior cruciate ligament reconstruction surgery, using exercises with and without blood flow restriction.

Methods: This is a randomized controlled trial, in which 50% (n = 14) of the participants were allocated to the intervention group and the remaining 50% (n = 14) to the control group. The study included the participation of postoperative patients, with reconstruction of the anterior cruciate ligament.

Results: After comparing the rehabilitation of the groups, a statistical difference was observed in the quadriceps with an increase in muscle strength (p < 0.01) after 12 weeks and an increase in muscle strength hamstrings (p < 0.01) after 8 and 12 weeks in the injured legs of the intervention group compared to the control. In the analysis of the participants' physical function, there was an significant increase difference in the Lysholm questionnaire (p < 0.01) after 8 and 12 weeks, in the KOOS pain questionnaire (p < 0.01) after 4 weeks a decrease was observed, symptoms and daily activities (p < 0.01) after 8 and 12 weeks, quality of life (p < 0.01) after 12 weeks, and in the IKDC questionnaire (p < 0.01) after 8 and 12 weeks there was an significant increase difference of the intervention group compared to the control.

Conclusion: After anterior cruciate ligament surgery, exercises with blood flow restriction proved more efficient for improving the muscle strength of the quadriceps and hamstrings, and the physical function of the knee than the same exercises without blood flow restriction.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Overview of the experimental study protocol. KOOS: Knee Injury and Osteoarthritis Outcome Score; IKDC: International Knee Documentation Committee.
Fig. 2
Fig. 2
Overview of study flowchart. ACL: anterior cruciate ligament.
Fig. 3
Fig. 3
Representation of the comparison of muscle strength in knee extension (a) and flexion (b) between groups. N = Newton; *p < 0.01. In all groups, an increase in self-reported scores was observed throughout the rehabilitation period, with the intervention group showing better scores from the 1st post-surgical period for Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale (Pain) and, from the 2nd post-surgical period, for all other scales (Table II).
See this image and copyright information in PMC

References

    1. Žargi T, Drobnič M, Stražar K, Kacin A. Short-term preconditioning with blood flow restricted exercise preserves quadriceps muscle endurance in patients after anterior cruciate ligament reconstruction. Front Physiol 2018; 9: 1150.. - PMC - PubMed
    1. Sonnery-Cottet B, Saithna A, Quelard B, Daggett M, Borade A, Ouanezar H, Thaunat M, Blakeney WG. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. Br J Sports Med 2019; 53 (5): 289–298. - PMC - PubMed
    1. Hughes L, Rosenblatt B, Haddad F, Gissane C, McCarthy D, Clarke T, et al. . Comparing the effectiveness of blood flow restriction and traditional heavy load resistance training in the post-surgery rehabilitation of anterior cruciate ligament reconstruction patients: a UK National Health Service randomised controlled trial. Sports Med 2019; 49 (11): 1787–1805. - PubMed
    1. Iversen E, Røstad V, Larmo A. Intermittent blood flow restriction does not reduce atrophy following anterior cruciate ligament reconstruction. J Sport Health Sci 2016; 5 (1): 115–118. - PMC - PubMed
    1. Lipker LA, Persinger CR, Michalko BS, Durall CJ. Blood flow restriction therapy versus standard care for reducing quadriceps atrophy after anterior cruciate ligament reconstruction. J Sport Rehabil 2019; 28 (8): 897–901. - PubMed

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