Side Effects and Patient Tolerance with the Use of Blood Flow Restriction Training after ACL Reconstruction in Adolescents: A Pilot Study.
Jennifer Prue, Dylan P Roman, Nicholas G Giampetruzzi and 5 others
PMID 35391873WHAT IT FOUND
Blood flow restriction training was well tolerated by adolescents after ACL reconstruction.
Across 535 sessions, no major adverse events like blood clots or fainting occurred. Minor side effects like itching were rare, suggesting the technique is safe for this age group.
Key findings
01No major adverse events (deep vein thrombosis, subcutaneous hemorrhage, or fainting) were reported across 535 blood flow restriction training sessions.
02Minor side effects were infrequent, with itching occurring in 7.85% of sessions, paresthesia in 2.81%, and dizziness in 0.75%.
03Patients tolerated the exercise well, completing the prescribed session 89.53% of the time, with only 3.55% of sessions requiring a reduction in pressure.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was very small (29 participants), and the study lacked a control group, so it cannot prove BFRT is superior to other rehabilitation methods. Seven of the 29 participants dropped out before completing the 12-week protocol. The definition of 'inability to finish' included voluntary stoppage, which may have overestimated true physical intolerance. The study only monitored immediate side effects, so it missed potential long-term issues like delayed onset muscle soreness. Most participants were older adolescents, so the findings may not apply to younger patients closer to age 12.
Declared interests
One author (JLP) receives consulting fees and grants from Arthrex, JRF Ortho, and the American Orthopedic Society for Sports Medicine. Another author (AC) holds leadership roles in several pediatric and sports medicine organizations. The remaining authors declared no conflicts of interest.
The easy way to misread this
Do not interpret this study as evidence that blood flow restriction training improves strength or functional outcomes compared to standard care. This was a safety and tolerance pilot with no control group; it only reports that the intervention was not harmful in a small sample of adolescents.