Jakobsen Thomas Linding, Thorborg Kristian, Fisker Jakob, Kallemose Thomas, Bandholm Thomas
Centre of Rehabilitation, City of Copenhagen, Copenhagen, Denmark.
Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Amager and Hvidovre Hospital, Hvidovre, Denmark.
J Exp Orthop. 2022 Oct 4;9(1):101. doi: 10.1186/s40634-022-00533-4.
Blood flow restriction - low load strength training (BFR-LLST) is theoretically superior to traditional heavy strength training when rehabilitating patients who cannot heavily load tissues following surgery. The main purpose of this study was to examine the feasibility of BFR-LLST added to usual care exercise early after cartilage or meniscus repair in the knee joint.
We included 42 patients with cartilage (n = 21) or meniscus repair (n = 21) of the knee joint. They attended 9 weeks of BFR-LLST added to a usual care exercise program at an outpatient rehabilitation center. Outcome measures were assessed at different time points from four (baseline) to 26 weeks postoperatively and included adherence, harms, knee joint and thigh pain, perceived exertion, thigh circumference (muscle size proxy), isometric knee-extension strength, self-reported disability and quality of life.
On average, patients with cartilage or meniscus repair completed > 84% of the total BFR-LLST supervised sessions. Thirty-eight patients reported 146 adverse events of which none were considered serious. No decrease in thigh circumference or exacerbation of knee joint or quadriceps muscle pain of the operated leg was found in either group during the intervention period.
BFR-LLST added to usual care exercise initiated early after cartilage or meniscus repair seems feasible and may prevent disuse thigh muscle atrophy during a period of weight bearing restrictions. Harms were reported, but no serious adverse events were found. Our findings are promising but need replication using a RCT-design.
NCT03371901 , preprint (open access): https://www.medrxiv.org/content/10.1101/2022.03.31.22272398v1.
对于术后无法对组织进行重负荷训练的患者进行康复治疗时，血流限制-低负荷强度训练（BFR-LLST）在理论上优于传统的大强度力量训练。本研究的主要目的是检验在膝关节软骨或半月板修复术后早期，将BFR-LLST添加到常规护理锻炼中的可行性。
我们纳入了42例膝关节软骨（n = 21）或半月板修复（n = 21）的患者。他们在门诊康复中心参加了为期9周的BFR-LLST，并将其添加到常规护理锻炼计划中。在术后4周（基线）至26周的不同时间点评估结果指标，包括依从性、不良事件、膝关节和大腿疼痛、自觉用力程度、大腿围度（肌肉大小指标）、等长膝关节伸展力量、自我报告的残疾情况和生活质量。
平均而言，软骨或半月板修复患者完成了超过84%的BFR-LLST总监督疗程。38例患者报告了146起不良事件，其中无一被认为是严重的。在干预期间，两组中患侧大腿围度均未减小，膝关节或股四头肌疼痛也未加重。
在软骨或半月板修复术后早期开始的常规护理锻炼中添加BFR-LLST似乎是可行的，并且可能在负重限制期间预防废用性大腿肌肉萎缩。有不良事件报告，但未发现严重不良事件。我们的研究结果很有前景，但需要采用随机对照试验设计进行重复验证。
NCT03371901，预印本（开放获取）：https://www.medrxiv.org/content/10.1101/2022.03.31.22272398v1 。
