Summary
Discuss the difference and benefits of blood flow optimization versus blood flow restriction in rehabilitation and treatment of ACL tears.
Abstract
Blood Flow Restriction (BFR) with constant pressures has grown in acceptance in orthopedics as a means to increase muscle hypertrophy with work at lower weight levels. At the 2018 New Zealand ACL Study Group meeting, we presented effectiveness in increased muscle hypertrophy with BFR usage in post ACL surgery rehabilitation. Blood Flow Optimization (BFO) is a different technique of cycling intermittent pressures with a narrow oval-shaped air bladder that modifies the venous return while not impeding the arterial flow. 30 seconds of compression is repeatedly followed by 5 seconds of decompression while the compression levels incrementally increased for 16 minutes. This is more beneficial for edema control, muscle hypertrophy and/or reduction of muscle atrophy, vascular proliferation, healing, cognition, and patient tolerance and safety, especially for those who are obese, lead sedentary lifestyles, or are physically weak or unmotivated to rehabilitate or exercise. The purpose of this study is to establish the effectiveness of BFO (intermittent and increasing compression) for post ACL surgery rehabilitation when lower work loads are needed. A current review of the different modalities and effectiveness in the BFR field was conducted as well as a summary of the various published studies for BFO. In comparison to BFR results, BFO has shown better tolerance, compliance and increased cognition in early international studies performed under the guidance of International Olympic Committee sports scientists while developing similar lactate build up. 100 patients in a multi-center international study are being enrolled in post op ACL rehab randomized to the same typical physical therapy protocol with and without BFO (intermittent) usage. With greater comfort and tolerance of BFO usage, the hope is to show similar positive effects through increased time under tension. Current technology exists for convenient monitored home use of BFO and this could become a more effective way to perform ACL rehabilitation.