The effectiveness and safety of blood flow restriction training for the post-operation treatment of distal radius fracture

Abstract

Introduction: Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load training, which is suitable for post-op rehabilitation. We explored the effectiveness and safety of BFR therapy in DRF patients who underwent surgery.

Materials and methods: Thirty-five patients were randomly assigned to either the BFR or the regular training (RT; no BFR therapy) groups. All patients completed the same 4-week postoperative rehabilitation program, including anti-inflammatory treatments, strengthening and range of motion (ROM) training. In the BFR group, the pressure was 120 mmHg in strengthening training course. Pain, circumferences of wrists and forearms, ROM, muscle strength, and D-dimer levels were evaluated at weeks 0, 2, and 4. Radius union scoring system (RUSS) was measured at weeks 4 and 12. Finally, wrist functionality (Cooney modification) was evaluated at week 12.

Results: The BFR group had significantly decreased pain levels compared with the RT group (p < 0.01, effect size= 2.33, -2.44 at weeks 2 and 4). Swelling was effectively relieved in both groups. The wrist swelling was less in the BFR group (p < 0.01, effect size = -2.17 at week 4). The isometric strength of wrist extension (p < 0.01, effect size = 1.5, 3.02 at weeks 2 and 4), flexion (p < 0.01, effect size = 1.33, 2.53 at weeks 2 and 4), and functionality significantly increased in the BFR group (p < 0.01, effect size = 2.80 at week 12). No risk of VT in the BFR group was found. BFR did not threaten bone healing.

Conclusions: In patients with DRF who underwent corrective surgery, BFR therapy effectively relieved pain and swelling, increased muscle strength and wrist function, and had no additional risks for bone healing and VT.

Keywords: Rehabilitation therapy; blood flow restriction; distal radial fracture; wrist function.

Figure 1.

CONSORT patient flow chart.

Figure 2.

Passive range of motion of wrists.

Figure 3.

Wrist extension in an anti-gravity direction.

Figure 4.

Wrist extension in an anti-gravity direction.

Figure 5.

Pressure setting in the blood flow restriction group. The pressure was set at 120 mmHg.

Figure 6.

The device for measuring pinching strength.

Figure 7.

The joint protractor for measuring joint range of motion.

Figure 8.

The device for measuring gripping strength.

Figure 9.

The device for measuring strength of wrist flexion and extension.