Butt Jamaal, Ahmed Zubair
Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Department of Neurosurgery, University Hospitals Birmingham NHS Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2GW, UK.
J Clin Med. 2024 Oct 20;13(20):6265. doi: 10.3390/jcm13206265.
: Anterior cruciate ligament (ACL) reconstruction (ACLR) is often followed by significant muscle atrophy and subsequent loss of strength. Blood flow restriction training (BFRT) has recently emerged as a potential mode of rehabilitation to mitigate these effects. The goal of this systematic review was to evaluate the efficacy of BFRT in functional recovery when compared to traditional rehabilitation methods. : A literature review was conducted across July and August 2024 using multiple databases that reported randomised controlled trials comparing BFRT to traditional rehabilitation methods. Primary outcomes were changes to thigh muscle mass and knee extensor/flexor strength with secondary outcomes consisting of patient-reported functional measures (IKDC and Lysholm scores). The RoB-2 tool was used to assess the risk of bias. : Eight studies met the inclusion criteria; however, substantial heterogeneity prevented a meta-analysis being conducted for the primary outcomes. Three out of the five studies measuring muscle mass reported significant ( < 0.05) findings favouring BFRT. There was variation amongst the strength improvements, but BFRT was generally favoured over the control. Meta analysis of the secondary outcomes showed significant improvements ( < 0.05) favouring BFRT despite moderate heterogeneity. : BFRT shows promise for maintaining muscle mass and improving patient reported outcomes following ACL reconstruction. However, the high risk of bias limits the strength of these conclusions. Further high-quality research needs to be conducted to establish optimal BFRT protocols for this cohort and to determine if BFRT has a place in ACL rehabilitation.
前交叉韧带（ACL）重建术后常伴有明显的肌肉萎缩及随后的力量丧失。血流限制训练（BFRT）最近已成为一种减轻这些影响的潜在康复方式。本系统评价的目的是评估与传统康复方法相比，BFRT在功能恢复方面的疗效。
2024年7月至8月，通过多个数据库进行了文献综述，这些数据库报告了比较BFRT与传统康复方法的随机对照试验。主要结局是大腿肌肉量和膝关节伸肌/屈肌力量的变化，次要结局包括患者报告的功能指标（IKDC和Lysholm评分）。使用RoB - 2工具评估偏倚风险。
八项研究符合纳入标准；然而，由于存在大量异质性，无法对主要结局进行荟萃分析。五项测量肌肉量的研究中有三项报告了显著（<0.05）的结果，支持BFRT。力量改善情况存在差异，但总体上BFRT优于对照组。对次要结局的荟萃分析显示，尽管存在中度异质性，但仍有显著改善（<0.05）支持BFRT。
BFRT在ACL重建后维持肌肉量和改善患者报告结局方面显示出前景。然而，高偏倚风险限制了这些结论的力度。需要开展进一步的高质量研究，以建立针对该队列的最佳BFRT方案，并确定BFRT在ACL康复中是否有一席之地。
