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FOTO Rehab Outcomes Blog

Total Knee Arthroplasty and Blood Flow Restriction Training

I know a physical therapist who is highly involved in blood flow restriction training research.  The results of blood flow restriction training are quite impressive for the individuals in which it was intended: for those who have severe exercise restrictions due to procedures the soldiers have underwent.

This study has me pause and wonder. Do you have similar thoughts?
Does the current delivery of services for individuals who have underwent elective surgery for a total knee arthroplasty fail to deliver adequate results? If we look to work that is currently being done by Dutch physiotherapists, are we just not progressive enough in encouraging higher level activities sooner than our comfort level?

I don't tend to believe that blood flow restriction training is the best option for strengthening individuals who have underwent elective total knee arthroplasty.  What may be a better question: who is a candidate for blood flow restriction training? And for those who are candidates, what is the difference in outcomes between blood flow restriction training combined with typical interventions and typical interventions?

Because there is more and more of a push for minimizing costs while maximizing benefits, I'm not sure this particular option will meet the pressures we face to deliver in the most cost effective way.

Below you will find a quick view of the abstract.



                                                                                                            Photo credit: Department of Defense

Occlusion training: pilot study for postoperative lower extremity rehabilitation following primary total knee arthroplasty.



With continued emphasis on the value of healthcare, factors such as quality of life and patient reported outcomes are critical in evaluating high-demand procedures such as knee replacement surgery. Equally important to the surgery itself is maximizing the effectiveness and efficiency of the treatment, both preoperatively and postoperatively, which can have a significant effect the final outcome. Technical outcomes of total knee replacement are generally considered excellent; however, many patients continue to have postoperative pain, functional limitations, and low treatment satisfaction. The recovery process can be difficult and is often prolonged in older patient populations. Blood flow restriction (BFR) training is a resistance exercise performed with a venous tourniquet that stimulates local changes in muscle at low resistance. Herein we report on 3 patients who participated in BFR exercises as an adjunct to their normal physical therapy following total knee arthroplasty.

 2017 Jul-Sep;(2-17):39-43.