Effects Of Blood Flow Restriction Training On Early Quadriceps Atrophy After Anterior Cruciate Ligament Reconstruction

OBJECTIVE:To observe the clinical effects of blood flow restriction training(BFRT)on early quadriceps atrophy after anterior cruciate ligament reconstruction,and to provide theoretical basis and clinical guidance for blood flow restriction training in functional recovery after anterior cruciate ligament reconstruction.METHODS:A total of 60 patients within 6 weeks after anterior cruciate ligament reconstruction in the orthopedic rehabilitation ward of Honghui Hospital,Xi’an Jiaotong University from September 2019 to February 2020 were randomly divided into experimental group and control group,with 30 people in each group.Both groups received basic rehabilitation treatment of the same plan:(1)The control group adopted routine muscle strength rehabilitation program once a day,5 days a week and for 6 weeks.Including straight leg raising,anti-gravity knee extension,multi-angle resistance isometric contraction and limited range low-load isotonic contraction training.(2)The experimental group received the same muscle strength training program as the control group under the blood flow limitation of 80% limb occlusive pressure(arterial occlusive pressure),once a day,5 days a week,and for 6 weeks.Before and after treatment,the Visual Analogue Scale(VAS),the degree of knee joint swelling,the thigh circumference at the superior pole of patella,the thickness of quadriceps femoris and knee joint Lysholm scale were evaluated before and after treatment.The evaluation data were statistically analyzed and processed by SPSS26.0software.RESULTS:The main results were as follows:(1)The results of quadriceps muscle thickness analysis before and after intervention were as follows: compared with before intervention,the thickness of rectus femoris(RF)and vastus lateralis(VL)in experimental group increased,but the thickness of vastus medialis(VM)remained unchanged,but the thickness of vastus intermedialis(VI)and vastus medialis oblique(VMO)decreased significantly(P <0.001).The thickness of RF、VL、VM、VI and VMO in control group decreased significantly after 6 weeks of intervention(P < 0.001).After 6 weeks of intervention,there were significant differences in the thickness of RF and VL between the experimental group and the control group,but there was no significant difference in the thickness of VI、VM and VMO between the two groups.(2)The results of thigh circumference analysis before and after intervention were as follows: After 6 weeks of intervention,the thigh circumference of both groups decreased,but continued to decrease compared with the control group,the experimental group showed an increasing trend on the basis of 2 weeks of intervention.finally,the thigh circumference of the experimental group and the control group decreased by 0.6% and 6.3% respectively after 6 weeks of intervention,and there was a significant difference in thigh circumference between the two groups after 6 weeks of intervention(P < 0.05).(3)After intervention,the pain and swelling of knee joint in both groups were significantly improved as compared with those before intervention(P < 0.001),but there was no significant difference between the two groups(P > 0.05).(4)The Lysholm score of knee joint after intervention was significantly better than that before intervention(P < 0.001),except the swelling item score was not significantly improved in both groups(P > 0.05),and the other scores,including the total score,were significantly improved in both groups(P < 0.001).After 6 weeks of intervention,the scores of instability,upstairs,pain and squatting in the experimental group were remarkably better than those in the control group(P < 0.05),but there was no significant difference in claudication,support,strangulation and swelling between the two groups(P > 0.05).After 6 weeks of intervention,the total score of knee joint Lysholm scale was improved more significantly in the experimental group(P <0.001).CONCLUSION:(1)Six-week blood flow restriction combined with conventional muscle strength rehabilitation program has a significant effect on maintaining the thigh circumference of the affected limb in the early stage after anterior cruciate ligament reconstruction;(2)Six-week blood flow restriction combined with routine muscle strength rehabilitation program can effectively reduce the early atrophy of rectus femoris and vastus lateralis after anterior cruciate ligament reconstruction.(3)Blood flow restriction combined with routine muscle strength rehabilitation training can significantly improve the subjective function scores of knee joint in the early stage after anterior cruciate ligament reconstruction,such as stability,upstairs,squatting and pain.it is of great significance to improve the function of knee joint.