Anterior Cruciate Ligament Reconstruction Clinical Trial
Official title:
Blood Flow Restriction Training Versus Standard Physical Therapy in Post-Operative and Post-Traumatic Rehabilitation Patients
Occlusion training, resistance exercise performed with a specialized venous tourniquet, leads to beneficial changes in muscle at low resistance and minimal stress on the nearby joint. This novel resistance training has the potential to greatly improve extremity muscle strength gains for rehabilitation patients who are unable for medical reasons to perform high resistance exercise. Our study will explore this with specific rehabilitation populations: post-operative knee scopes, post-operative anterior cruciate ligament (ACL) reconstruction patients who have acute post-operative changes in thigh muscle function and chronic thigh weakness. The primary outcome is to achieve accelerated functional thigh recovery with outcome measures including thigh strength, validated questionnaires, and validated functional testing. Occlusion training can enhance rehab patients outcomes, reduce the cost of care, and improve the skills and efficiency of care providers.
Occlusion training is the restriction of venous outflow from an extremity with the use of a
tourniquet during weight-training or resistance exercises. The technique is a safe and
effective method of improving strength through muscle hypertrophy in healthy, active
individuals (1-7). The technique has also been shown to be safe and effective in patient
populations with various comorbidities (8).These strength gains can be achieved while
training with loads as low as 20% of an individual's one repetition maximum (1RM). This is
contrary to the American College of Sports Medicine (ACSM) weight-training guidelines that
state muscle hypertrophy can only be achieved when an individual lifts loads close to 80% of
the 1RM (9).
The purpose of this project is to compare occlusion resistance training to traditional
resistance training methods for rehabilitation patients. This will include both an acute
post-operative ACL reconstruction cohort and a chronic thigh weakness cohort. Post-operative
lower extremity weakness as well as chronic muscle weakness after trauma correlate with lower
functional performance.(10,11) We will treat the patients and follow these two cohorts
simultaneously.
Specific Aim 1: To determine if occlusion training will accelerate the recovery of thigh
muscle function and strength in post-operative anterior cruciate ligament (ACL)
reconstruction as compared to a standard post-operative rehabilitation protocol.
Specific Aim 2: To determine if occlusion training will increase quadricep and hamstring
muscle function for battlefield wounded warriors with severe thigh weakness as a result of
trauma or volumetric muscle loss as compared to standard ACSM resistance training guidelines.
Specific Aim 3: To determine if occlusion training will accelerate the recovery of thigh
muscle function and strength in post-operative soft tissue knee arthroscopy as compared to a
standard post-operative rehabilitation protocol.
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