The Effect of Rehabilitation with Blood Flow Restriction on Muscle Function Following Total Knee Replacement

Low-load resistance exercise rehabilitation combined with blood flow restriction (BFR) has been suggested as an effective and safe alternative way to improve muscle strength and size compared to traditional high-load resistance exercise in clinical populations. However, there are few studies conducted to investigate the effect of low-load resistance exercise rehabilitation with BFR following total knee replacement. PURPOSE: To compare the result of rehabilitation with or without BFR on muscle function in the patients who were treated with total knee replacement surgery. METHODS: Twenty-one participants were randomized into two different interventions: low-load resistance exercise rehabilitation with BFR (BFR group, n=11) and without BFR (control group, n=10). Exercise sessions were performed 6 times per week, 30 minutes per session, for 2 weeks in all participants. Over the twelve exercise sessions in BFR group, an elastic cuff was worn on the subject’s proximal thigh in its intensity being progressively increased from 160 mmHg at the first session up to 240 mmHg at the end by adjusting the external compression. For the analysis, muscle strength, rate of torque development (RTD), range of motion (ROM), muscle mass, thigh circumference, the Timed Up and Go test, 10-m walking test and single-limb stance were measured. All outcome measures were assessed before and after the intervention. RESULTS: In knee extensor strength, the degree of change in the BFR group was significantly larger than that in the control group (0.33±0.21 vs. 0.11±0.11 Nm/kg, p<0.05). In knee extensor RTD, although there was no statistical difference between the two groups, it was nearly significant (p=.051). However, we found no significant results between groups in other outcome variables. CONCLUSIONS: Low-load resistance exercise rehabilitation with BFR led to significant increases in knee extensor strength. Rehabilitation combined with BFR may be useful for the patients who are in need of fast recovery in muscle function following a total knee replacement surgery.