Patients receiving ACL reconstruction, total joint replacement, or other extensive surgical procedures in the lower extremities are known to experience debilitating muscle atrophy. This results in decreased strength and compromised function in the treated extremity. These deleterious effects are a consequence of inactivity and unloading following injury, as well as the continued disuse during the initial post-operative recovery period. By mimicking the metabolic, mechanical, and hemodynamic challenges of intense resisting exercise with minimal risk, we hypothesize that blood flow restriction (BFR) therapy can attenuate muscle mass loss in patients immediately following lower limb surgery during rehabilitation and thus, maintain muscular strength, preserve physical function, reduce risk of re-injury, and reduce the time and cost of rehabilitation.
Current State & Issues
While BFR therapy appears to be promising, functional assessments following chronic BFR training and association between changes in leg muscle mass and performance have yet to be thoroughly evaluated in a rehabilitation setting. Additionally, much about the response of muscle to BFR therapy is still unknown as measurement timelines in previous investigations have been insufficient to evaluate the cumulative impact of BFR on anabolism and cell signaling.
In order to properly determine the extent to which BFR therapy may prevent muscle loss and preserve function, we have put together a series of research projects designed to:
- Determine If Combined BFR & Standard Rehabilitation Therapy Can Prevent Skeletal Muscle Atrophy and Preserve Physical Function Following ACL Reconstruction Surgery. Hypothesis: (1) Combined rehab and BFR will enhance skeletal muscle growth and prevent atrophy to a greater extent than rehab alone. (2) Combined rehab and BFR will enhance skeletal muscle strength and fatigue resistance to a greater extent than rehab alone.
- Determine If Combined BFR Alone Provided for 5 Days Immediately Following Total-Joint Replacement Can Attenuate Decreases in Leg Skeletal Muscle Mass. Hypothesis: (1) Patients who undergo BFR therapy following surgery will experience less leg skeletal muscle mass loss compared to those who undergo the normal standard of care.
- Determine The Effects of BFR Therapy On Skeletal Muscle with Regards to Energy Metabolism, Muscle Protein Synthesis, and Intramuscular Cell Signaling Responsible For Cell Growth and Degradation. Hypothesis: combined BFR and low intensity resistance exercise will mimic high intensity resistance exercise and increase skeletal muscle protein synthesis. If this were found to be the case, BFR therapy may have a significant impact on standard of care policies for recovery and rehabilitation.
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