Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes

Abstract

ObjectiveTo identify current evidence on blood flow restriction training (BFRT) in tendon injuries and healthy tendons, evaluating physiological tendon effects, intervention parameters, and outcomes.MethodsThis scoping review was reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Databases searched included MEDLINE, CINAHL, AMED, EMBase, SPORTDiscus, Cochrane library (Controlled trials, Systematic reviews), and five trial registries. Two independent reviewers screened studies at title/abstract and full text. Following screening, data was extracted and charted, and presented as figures and tables alongside a narrative synthesis. Any study design conducted on adults, investigating the effects of BFRT on healthy tendons or tendon pathology were included. Data were extracted on physiological tendon effects, intervention parameters and outcomes with BFRT.ResultsThirteen studies were included, three on tendinopathy, two on tendon ruptures, and eight on healthy Achilles, patellar, and supraspinatus tendons. A variety of outcomes were assessed, including pain, function, strength, and tendon morphological and mechanical properties, particularly changes in tendon thickness. BFRT intervention parameters were heterogeneously prescribed.ConclusionDespite a dearth of studies to date on the effects of BFRT on healthy tendons and in tendon pathologies, preliminary evidence for beneficial effects of BFRT on tendons and clinical outcomes is encouraging. As BFRT is a relatively novel method, definitive conclusions, and recommendations on BFRT in tendon rehabilitation cannot be made at present, which should be addressed in future research, due to the potential therapeutic benefits highlighted in this review.

Surgery or physical therapy, that is the question: the aftermath of an accident boarding a plane

“…After an examination, we could both see the improvements as I had no pain, my knee flexion had increased and my walking was unrestricted. The ultrasound showed healing of the tendon tearing, and I had improved muscle strength 3 4. Eleven weeks after my accident and after 5 weeks of twice-weekly BFR training, my BFR programme progressed from isometric contractions to weight bearing exercises and squats.…”

Konservative Behandlung von chronischen Tendinopathien des Ellenbogens

“…Aufgrund seiner übungsinduzierten Hypoalgesie kann das Blood-Flow-Restriction-Training (Okklusionstraining) am Ellenbogen ( Abb. 6 ) eine sinnvolle Ergänzung zu den bekannten Übungsformen darstellen 3 . Es existieren kaum Studien zur Behandlung einer LE mit einem Okklusionstraining, jedoch gibt es Hinweise auf eine Schmerzreduktion und Verbesserung der Ellenbogenfunktion nach 6–12 Wochen 10 .…”

Comparing the effect of intermittent blood flow restriction training and high-load resistance training in patients with patellofemoral pain: study protocol for a randomised trial

“…21 The low training loads used in BFR training reduce joint loads during training, which is beneficial for increasing patient adherence. 22 Therefore, BFR training is expected to be a more efficient alternative to high-load resistance training in musculoskeletal rehabilitation.…”

“…Its mechanism of action involves occluding venous blood flow while partially blocking arterial blood flow to create a state of limb ischaemia, thereby increasing local and systemic metabolic stress, activating the signalling pathways for muscle hypertrophy20 and enhancing neuromuscular excitability 21. The low training loads used in BFR training reduce joint loads during training, which is beneficial for increasing patient adherence 22. Therefore, BFR training is expected to be a more efficient alternative to high-load resistance training in musculoskeletal rehabilitation.…”