Przkora Rene, Sibille Kimberly, Victor Sandra, Meroney Matthew, Leeuwenburgh Christiaan, Gardner Anna, Vasilopoulos Terrie, Parvataneni Hari K
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, Florida.
Eur J Transl Myol. 2021 Aug 26;31(3):9932. doi: 10.4081/ejtm.2021.9932.
Aging well is directly associated with a healthy lifestyle. The focus of this paper is to relate that attenuation of postoperative loss of muscle function after a total knee arthroplasty (TKA) is an important consideration. Because patients usually do not tolerate standard high-resistance exercise in the preoperative or postoperative period, they often experience a decline in strength and function. Therefore, we tested the feasibility and acceptability of an alternative low-resistance exercise protocol with blood flow restriction (BFR) using a tourniquet in the preoperative period for patients awaiting TKA. We recruited patients undergoing a TKA and randomized six to the BFR exercise for 4 weeks prior to surgery and four to standard of care (no exercise). We measured physical function using the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), leg strength (peak torque), and pain (numerical pain score) 4 to 5 weeks preoperatively and 2 weeks postoperatively. The clinical management, e.g., anesthetic management, did not differ between groups. No complications were observed. Our findings demonstrate the feasibility and acceptability of the BFR intervention. Although preliminary and not powered for comparison, the BFR group demonstrated less decline in SPPB following surgery (-2.2, 95%CI:-4.4,0.1) compared to the no exercise group (-4.8, 95%CI:-7.8,-1.7). No differences were noted for the 6MWT, leg strength, and pain measurements. We conclude that preoperative low-resistance exercise using the BFR is feasible and acceptable, and this test warrants investigation as an intervention to potentially attenuate the postoperative loss of physical function after TKA.
健康衰老与健康的生活方式直接相关。本文的重点是指出，全膝关节置换术（TKA）后减轻肌肉功能丧失是一个重要的考虑因素。由于患者在术前或术后通常无法耐受标准的高阻力运动，他们的力量和功能往往会下降。因此，我们测试了一种替代的低阻力运动方案的可行性和可接受性，该方案在术前使用止血带进行血流限制（BFR），用于等待TKA的患者。我们招募了接受TKA的患者，将其中6人随机分配到术前进行4周的BFR运动组，4人分配到标准护理组（不运动）。我们在术前4至5周和术后2周使用简短体能状况量表（SPPB）、6分钟步行试验（6MWT）、腿部力量（峰值扭矩）和疼痛（数字疼痛评分）来测量身体功能。两组之间的临床管理，如麻醉管理，没有差异。未观察到并发症。我们的研究结果证明了BFR干预的可行性和可接受性。尽管是初步研究且没有足够的能力进行比较，但与不运动组相比，BFR组术后SPPB的下降幅度较小（-2.2，95%CI：-4.4，0.1），不运动组为（-4.8，95%CI：-7.8，-1.7）。6MWT、腿部力量和疼痛测量方面没有差异。我们得出结论，术前使用BFR进行低阻力运动是可行和可接受的，这项测试作为一种可能减轻TKA术后身体功能丧失的干预措施值得研究。
