Description: Blood Flow Restriction Training – A Promising Option for Patients
By: Cedars-Sinai Kerlan-Jobe Institute.
One of the biggest “hurdles” (pun intended) that is especially unique to Sports Medicine, is getting otherwise very active patients who have been injured or undergone surgery back to sports or activity safely, and as soon as possible. These are people whose lives (or livelihood in some cases), is defined by their athleticism. A recently published study co-authored by our own Dr. Orr Limpisvasti and Karen Mohr, PT, and conducted at the Cedars-Sinai Kerlan-Jobe Institute, highlights a promising option for patients who are recovering from an orthopaedic injury or who have undergone surgery to repair musculoskeletal damage. It is called Blood Flow Restriction (BFR) training.
The study authors designed a randomized controlled trial to gauge the effectiveness of BFR training on the upper and lower extremities. BFR training involves low-weight exercises performed under vascular occlusion by way of an inflatable cuff. Forty-three healthy study subjects were randomized into an upper extremity BFR, lower extremity BFR, or control group. Participants completed all exercises on both limbs, but the BFR group had something called a pneumatic tourniquet applied to one limb. A pneumatic tourniquet consists of a control unit that is pressure-regulated a hose assembly and an inflatable cuff similar to the one you might experience when having your blood pressure checked. Traditionally, pneumatic tourniquets are used during surgery on the extremities to prevent blood from flowing to the limb being operated on.
What they found, through the use of the pneumatic tourniquet and blood flow restriction training, is that BFR demonstrated a significant increase in strength testing and muscle hypertrophy (a growth and expansion in the size of the body’s muscle cells) in both the upper and lower extremities compared to the non-tourniquet extremity and the control group. Furthermore, BFR training had similar strengthening effects on muscle groups both proximal (shoulder, hip) and distal (forearm, calves) to the tourniquet placement and our data also suggest a systemic or “crossover” strengthening effect of BFR therapy on non-tourniquet extremities.
For patients who cannot tolerate high-load exercises, i.e., orthopaedic patients who are recovering from an injury or surgery, BFR training is a technique that shows incredible promise and produces similar physiologic and clinical effects, with the advantage of less tissue and joint stress that higher-impact types of exercise can have. This finding provides encouraging news for patients who are eager to return to sport or activity after an injury or surgery, but whose bodies aren’t quite ready for a high-impact training regimen.
Sports Medicine is an ever-evolving field of medical specialty. The knowledge that physicians can gain from research paves the way for innovation in medical care and often, better treatment options and outcomes for our patients. It is exciting to see where BFR training takes the recovery process for patients in the future.