Effect of Blood Flow Restr/ct/on Comb/ned W/th Res/stance Tra/n/ng on Muscle Strength /n Anter/or Cruc/ate L/gament Reconstruct/on Rehab/l/tat/on: A Meta-Analys/s of Random/zed Controlled Tr/als
20.Uluslararası Katılımlı Türk Spor Hekimliği Kongresi, İzmir, Turkey, 8 - 11 May 2025, vol.1, no.1, pp.103-104, (Summary Text)
- Publication Type: Conference Paper / Summary Text
- Volume: 1
- City: İzmir
- Country: Turkey
- Page Numbers: pp.103-104
- Eskisehir Osmangazi University Affiliated: Yes
Abstract
Abstract: Objective: In the rehabilitation process following anterior cruciate ligament (ACL) surgery, there
is no conclusive evidence regarding the superiority of resistance exercises performed with blood flow
restriction (BFR) over conventional rehabilitation (CR) exercises. This study aims to evaluate the effects of
incorporating BFR exercises into ACL rehabilitation protocols on quadriceps and hamstring muscle
strength.Methods: Based on the eligibility criteria, 6 randomized controlled trials (RCTs) were included in the
meta-analysis. Between-study heterogeneity was assessed using the Cochran’s Q test and the I² statistic.
Cohen’s d was calculated to determine standardized mean differences and estimate the overall effect size.
Muscle strength was defined as the primary outcome measure.Results: Resistance training combined with
BFR was found to result in greater improvements in both extensor [Standardized Mean Difference (SMD)
0.788 (0.109 - 1.467), p=0.023] and flexor [SMD 0.672 (0.251 - 1.094), p=0.002] muscle strength at an angular
velocity of 60°/s, as measured by isokinetic dynamometry, compared to CR exercises. Notably, these strength
gains were even more pronounced at an angular velocity of 180°/s (extensor;[SMD 1.013 (0.556 - 1.471),
p=0.000], flexor [SMD 1.045 (0.667 - 1.423), p=0.000]. Initiating BFR-based resistance training within the
first four weeks following ACL reconstruction yielded significantly greater improvements in extensor muscle
strength at 60°/s [SMD 0.949 (0.164- 1.734), p=0.018]. However, by the 10th week, resistance training with
BFR no longer demonstrated a statistically significant advantage over CR exercises in extensor strength [SMD
0.090 (-0.717- 0.897), p=0.827] at the 60°/s angular velocity.Conclusion: The combination of resistance
exercises with BFR has been shown to produce a statistically significant increase in both extensor and flexor
muscle strength, as measured at low and high angular velocities. BFR applied within the first four weeks
postoperatively contributed significantly to strength gains, whereas initiating BFR at the 10th week did not
yield a similar effect.
Keywords: Blood flow restriction, Anterior cruciate ligament reconstruction rehabilitation, Muscle strength