The Effect Of Plyometric Training With Blood Flow Restriction After Anterior Cruciate Ligament Reconstruction

Abstract

Quadriceps and hamstring muscles weakness are common after anterior cruciate ligament reconstruction (ACLR). Despite rehabilitation programs, the problem persists and has negative effects on knee function. Plyometric exercises are used during rehabilitation to facilitate muscle strength, function and return to sports. However, the effects of plyometric training with blood flow restriction (BFR) have never been investigated on patients with ACLR. PURPOSE: The aim of this study was to investigate the effects of plyometric training with BFR on muscle strength, muscle thickness and knee function after ACLR. METHODS: Twenty-eight patients who completed a 12-week rehabilitation program after ACLR were included in the study. Patients were randomly allocated into two groups. Group-1 (n=14, age: 19.6±2.1 years) performed plyometric training with BFR 3 days a week for 8 weeks. Group-2 (n=14, age: 20.3±3.3 years) performed the same plyometric training without BFR. Knee muscle strength, muscle thickness and knee function were evaluated before and after the interventions. Concentric knee extension and flexion muscle strength were evaluated with isokinetic dynamometer at 60°/s and 180°/s angular velocities. The thickness of the rectus femoris (RF), vastus medialis obliques and lateralis (VMO-VL) were assessed with ultrasonography. Vertical jump (VJ) and one-leg hop (OLH) tests were used to assess the performance of the patients. The subjective knee function was evaluated with IKDC knee form and ACL-RSI score. In addition one leg hop test and ACL-RSI score were evaluated only after intervention. Mann Whitney-U test was used to analyze the change before and after the intervention between groups. RESULTS: Group-1 had significantly higher quadriceps (p<0.05, p<0.05) hamstring muscle strength (p<0.05, p<0.05) at 60°/s and 180°/s angular velocities respectively and higher muscle thickness of RF (p<0.05), VL (p<0.05) and VMO (p<0.05) compared to group-2. In addition, the VJ test (p<0.05) and ACL-RSI score (p<0.05) were higher in group-1 compared to group-2. CONCLUSIONS: The results of the study indicated that plyometric training with BFR was more effective in improving the muscle thickness, muscle strength and knee function.