Comparison of blood flow restriction training rehabilitation and general rehabilitation exercise after anterior cruciate ligament reconstruction: A meta-analysis of randomized controlled trials.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-10-30 DOI:10.1002/ksa.12527

Luozhifei Zhou, Benjamin Rothrauff, Lili Chen, Shirong Jin, Sixian He, Jinshen He

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引用次数: 0

Abstract

Purpose: Blood flow restriction training (BFRT) has been found to reduce quadriceps atrophy and weakness after anterior cruciate ligament (ACL) surgery. However, the clinical benefit of BFRT as compared to general rehabilitation exercise (GRE) alone remains uncertain. This study aimed to compare the effects of BFRT and GRE on ACL reconstruction rehabilitation through a meta-analysis of randomized controlled trials.

Methods: PubMed, Web of Science, EMBASE, Elsevier and Biosis were searched for randomized controlled trials comparing BFRT and GRE following ACL reconstruction. Primary outcomes included muscle strength (extensor and flexor muscle general strength), Lysholm score, the International Knee Documentation Committee (IKDC) score, extensor muscle torque (peak torque and average torque) and muscle cross-sectional area (CSA). The secondary outcomes included a range of motion (ROM), pain, Y-balance and the Patient-Reported Outcomes Measurement Information System (PROMIS).

Results: Thirteen randomized controlled trials involving 376 participants were included. The change in muscle strength (Mean difference, MD: 12.96, 95% confidence interval, [95% CI]: 7.02-18.91, heterogeneity, I² = 39%), Lysholm score (MD: 9.41, 95% CI: 8.93-9.88, I² = 40%) and IKDC score (MD: 9.88, 95% CI: 0.57-19.19, I² = 87%) of the BFRT group were superior to that of the GRE group at the time of last follow-up. However, no significant difference was found between the BFRT and the GRE groups regarding the change in muscle CSA, ROM, extensor muscle torque, pain score, Y-balance and PROMIS.

Conclusion: BFRT seems to perform better than GRE in terms of functional improvement and muscle strength following ACL reconstruction, but there seems to be no significant difference between them in terms of joint mobility, pain relief, stability improvement and patient's perception of their disease and treatment.

Level of evidence: Level II.

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前十字韧带重建术后血流限制训练康复与一般康复运动的比较：随机对照试验荟萃分析。

目的：研究发现，血流限制训练（BFRT）可减轻前交叉韧带（ACL）手术后股四头肌萎缩和无力。然而，与单纯的一般康复锻炼（GRE）相比，血流限制训练的临床益处仍不确定。本研究旨在通过对随机对照试验进行荟萃分析，比较BFRT和GRE对前交叉韧带重建康复的效果：方法：在 PubMed、Web of Science、EMBASE、Elsevier 和 Biosis 上搜索了前交叉韧带重建后比较 BFRT 和 GRE 的随机对照试验。主要结果包括肌力（伸肌和屈肌的一般力量）、Lysholm评分、国际膝关节文献委员会（IKDC）评分、伸肌扭矩（峰值扭矩和平均扭矩）和肌肉横截面积（CSA）。次要结果包括活动范围（ROM）、疼痛、Y-平衡和患者报告结果测量信息系统（PROMIS）：结果：纳入了 13 项随机对照试验，共有 376 人参与。在最后一次随访时，BFRT 组的肌力变化（平均差，MD：12.96，95% 置信区间[95% CI]：7.02-18.91，异质性，I2 = 39%）、Lysholm 评分（MD：9.41，95% CI：8.93-9.88，I2 = 40%）和 IKDC 评分（MD：9.88，95% CI：0.57-19.19，I2 = 87%）均优于 GRE 组。然而，在肌肉CSA、ROM、伸肌扭矩、疼痛评分、Y-平衡和PROMIS的变化方面，BFRT组与GRE组之间没有发现明显差异：结论：就前交叉韧带重建后的功能改善和肌肉力量而言，BFRT似乎优于GRE，但就关节活动度、疼痛缓解、稳定性改善以及患者对疾病和治疗的感知而言，两者之间似乎没有显著差异：证据等级：二级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).