血流限制作为ACL重建术后中期康复的辅助手段：一项随机假对照研究
简介
该研究为一项随机对照试验，纳入48例18-35岁接受初次单侧ACL重建的患者，在术后13-20周（中期康复阶段）分别进行血流限制（BFR）训练或假BFR训练。两组均采用相同低负荷抗阻训练（30% 1RM），BFR组个体化加压至40%动脉闭塞压，假BFR组仅维持最低袖带压力。术后24周评估显示，BFR组IKDC评分、Tegner活动评分、膝伸屈肌等长力量、Y-…
英文摘要
PURPOSE: To determine whether adjunctive blood flow restriction (BFR) training during postoperative weeks 13-20 is associated with differences in functional, strength, balance, muscle morphology, and neuromuscular outcomes compared with sham BFR following anterior cruciate ligament reconstruction (ACLR). METHODS: In this single-centre randomized controlled trial, 48 patients aged 18-35 years who underwent primary unilateral ACLR were randomly assigned to a BFR group or a Sham-BFR group. From postoperative weeks 13 to 20, both groups performed identical low-load resistance training (30% one-repetition maximum) twice weekly. The BFR group received individualized blood flow restriction at 40% arterial occlusion pressure, whereas the Sham-BFR group underwent the same protocol with minimal cuff pressure. Outcomes assessed at postoperative week 24 included the International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, knee range of motion (ROM), isometric knee extensor and flexor strength, quadriceps muscle thickness, Y-Balance Test performance, and quadriceps surface electromyography (sEMG). RESULTS: Forty-three patients completed the study (BFR, n = 21; Sham-BFR, n = 22). At 24 weeks postoperatively, the BFR group demonstrated statistically significantly higher IKDC score and Tegner Activity Scale than the Sham-BFR group (p < 0.01). Knee extensor and flexor strength, Y-Balance Test composite scores, and quadriceps sEMG amplitudes were also significantly greater in the BFR group (p < 0.05). No significant between-group differences were observed in knee ROM or quadriceps muscle thickness. CONCLUSION: Adjunctive BFR training during mid-stage ACLR rehabilitation was associated with more favourable functional, strength, balance, and neuromuscular outcomes than sham BFR at 24 weeks postoperatively. These findings should be interpreted cautiously because baseline outcome measurements and immediate post-intervention assessments were not available. TRIAL REGISTRATION: (Chinese Clinical Trial Registry (https://www.chictr.org.cn), No. ChiCTR2400087631, 31/07/2024).