PTCase SeriesInternational journal of sports physical therapy2022

Resident Case Series: Blood Flow Restriction as an Adjunct to Strengthening Exercises in Two Patients with Subacromial Impingement and High Irritability.

Angel Ceballos, Giorgio Zeppieri, Joel Bialosky

PMID 35949378

WHAT IT FOUND

Two patients with shoulder impingement and high pain completed low-load shoulder exercises with a blood flow restriction cuff.

Their pain, function, and some strength measures improved, and they reached their goals.

Key findings

01Both patients had clinically meaningful improvements on patient-reported pain, function, satisfaction, and activity scores, and both achieved their goals.

02Both patients had between-session pressure pain threshold increases beyond the minimal detectable change, averaging 4.06 kgf/cm2 for Patient A and 2.54 kgf/cm2 for Patient B.

03The patients received blood flow restriction with shoulder exercises and a home exercise program, so the paper cannot separate the contribution of any one component.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only two patients were included, so this describes what happened to two people, not a pattern. The care and follow-up were short: Patient A had three visits over three weeks and one phone follow-up, while Patient B had four visits over four weeks. There was no comparison group, and the case series design cannot determine cause and effect. Blood flow restriction was given together with shoulder exercises and a home exercise program, so the contribution of any single component cannot be separated. The findings may not translate to other patients with subacromial impingement. No measurement error thresholds were established for scaption, horizontal abduction, or abduction strength.

Declared interests

The authors have no conflict of interest to disclose.

The easy way to misread this

Do not conclude that blood flow restriction caused the improvements. The patients also performed shoulder exercises during visits and a home exercise program, and the case series design cannot determine cause and effect.

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