Blood flow restriction training in the pre- and postoperative phases of joint surgery

Abstract

AbstractOrthopedic patients are frequently affected by temporary phases of immobility during the course of traumatic/degenerative joint diseases and particularly after joint surgery. These phases are usually accompanied by a significant loss of muscle mass and strength. However, since the patients’ load capacity is usually reduced, physicians and physiotherapists are often faced with the dilemma of not being able to offer an adequate therapeutic strategy for muscle preservation or early muscle building, since the high mechanical loads required for this in the training process are usually not feasible or even contraindicated for a certain period of time. In recent years, a training technique originating from sports science, called blood flow restriction (BFR) training, has increasingly been used in preoperative therapy or for rehabilitation. As the BFR method uses special blood pressure cuffs to occlude venous outflow from the exercising limb during exclusively low mechanical load strength training, the significant effects of muscle hypertrophy demonstrated by this method are of greatest interest to rehabilitation research. This article focuses on the training technique, the underlying mechanisms and potential risks, as well as integration of the technique into the clinical rehabilitation process based on existing data. Furthermore, this article provides the basis for a future consensus paper to validate the usability and effectiveness of BFR training in the conservative and rehabilitative therapeutic phases of joint surgery.