NCT04484961

Brief Summary

The study is a prospective randomized control trial consisting of subjects requiring ACL reconstruction with BTB autograft. Subjects were randomly divided into two groups following their inclusion in the study. One group underwent the normal ACL rehab protocol as determined by the participating surgeons. The study group underwent normal ACL rehab modified by use of a tourniquet for blood flow restriction during selected exercises.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Mar 2016

Longer than P75 for not_applicable

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 18, 2016

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 10, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 10, 2020

Completed
3 days until next milestone

First Submitted

Initial submission to the registry

July 13, 2020

Completed
11 days until next milestone

First Posted

Study publicly available on registry

July 24, 2020

Completed
4.3 years until next milestone

Results Posted

Study results publicly available

November 25, 2024

Completed
Last Updated

November 25, 2024

Status Verified

October 1, 2024

Enrollment Period

4.3 years

First QC Date

July 13, 2020

Results QC Date

January 18, 2022

Last Update Submit

October 10, 2024

Conditions

Outcome Measures

Primary Outcomes (3)

  • Determine if BFR Changes Loss of LE Lean Muscle Mass

    LE lean muscle mass was measured in kilograms using DEXA (iDXA, GE®)

    Pre-surgery, 6 weeks post-surgery and 12 weeks post-surgery

  • Determine if BFR Changes Loss of Bone Mass

    Bone mass was measured in grams using DEXA (iDXA, GE®)

    Pre-surgery, 6 weeks post-surgery and 12 weeks post-surgery

  • Determine if BFR Changes Loss of Bone Mineral Density

    Bone mineral density was measured in grams/cm2 using DEXA (iDXA, GE®)

    Pre-surgery, 6 weeks post-surgery and 12 weeks post-surgery

Secondary Outcomes (7)

  • Does BFR Change the Number of Exercise Repetitions in Functional Physical Therapy Testing

    Week 8 and Week 12 post-surgery

  • Does BFR Change the Number of Exercise Repetitions in Functional Physical Therapy Testing

    8 weeks post surgery, 12 weeks post surgery

  • Does BFR Change the Number of Exercise Repetitions in Functional Physical Therapy Testing

    8 weeks post surgery, 12 weeks post surgery

  • Does BFR Change the Number of Exercise Repetitions in Functional Physical Therapy Testing

    8 weeks post surgery, 12 weeks post surgery

  • Does BFR Change the Number of Exercise Repetitions in Functional Physical Therapy Testing

    8 weeks post surgery, 12 weeks post surgery

  • +2 more secondary outcomes

Study Arms (2)

Control - Routine Rehab

NO INTERVENTION

Participants in this group received standard ACL rehab with no blood flow restriction therapy.

Experimental - BFR

EXPERIMENTAL

Participants in this group received standard ACL rehab with the addition of blood flow restriction therapy.

Device: Blood flow restriction (BFR)

Interventions

The study group underwent normal ACL rehab modified by use of a tourniquet for blood flow restriction during selected exercises.

Experimental - BFR

Eligibility Criteria

Age18 Years - 35 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Ages 18-35
  • Received ACL surgery with a patellar tendon autograft

You may not qualify if:

  • Concomitant meniscal tear or additional ligamentous injury to the knee
  • Obesity (BMI\>30)
  • Diabetes
  • Cardiovascular, renal, liver or pulmonary disease
  • Active infections
  • Cancer (current or treated within the past 2 years) or coagulation disorder
  • Rapid weight change within the past year
  • Physically unable to participate in the intervention
  • Are not currently taking, or recently (w/in 1month of participation) taken prescribed or over the counter ergogenic aids or compounds known to be banned by the NCAA. The NCAA banned substances list can be viewed from: http://www.ncaa.org/health-and-safety/policy/2014-15-ncaa-banned-drugs
  • Unable to complete a minimum of 85% of the assigned rehabilitation sessions.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (30)

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  • Abe T, Yasuda T, Midorikawa T, et al. Skeletal muscle size and circulating IGF-1 are increased after two weeks of twice daily "KAATSU" resistance training. Int J KAATSU Train Res. 2005;1(1):6-12

    BACKGROUND
  • Anderson AW, Smith JJ. Proximal tibial fracture after patellar tendon autograft for ipsilateral ACL reconstruction. J Knee Surg. 2009 Apr;22(2):142-4. doi: 10.1055/s-0030-1247739.

    PMID: 19476179BACKGROUND
  • Anderson MJ, Diko S, Baehr LM, Baar K, Bodine SC, Christiansen BA. Contribution of mechanical unloading to trabecular bone loss following non-invasive knee injury in mice. J Orthop Res. 2016 Oct;34(10):1680-1687. doi: 10.1002/jor.23178. Epub 2016 Feb 10.

    PMID: 26826014BACKGROUND
  • Ardern CL, Webster KE, Taylor NF, Feller JA. Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: two-thirds of patients have not returned by 12 months after surgery. Am J Sports Med. 2011 Mar;39(3):538-43. doi: 10.1177/0363546510384798. Epub 2010 Nov 23.

    PMID: 21098818BACKGROUND
  • Beaudart C, Dawson A, Shaw SC, Harvey NC, Kanis JA, Binkley N, Reginster JY, Chapurlat R, Chan DC, Bruyere O, Rizzoli R, Cooper C, Dennison EM; IOF-ESCEO Sarcopenia Working Group. Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporos Int. 2017 Jun;28(6):1817-1833. doi: 10.1007/s00198-017-3980-9. Epub 2017 Mar 1.

    PMID: 28251287BACKGROUND
  • Bowman EN, El-shaar R, Milligan H, et al. The Proximal and Distal Effects of Blood Flow Restriction Therapy on Upper and Lower Extremity Strengthening: A Randomized Controlled Trial. Orthop J Sports Med. 2019;7(7_suppl5):2325967119S2325900337.

    BACKGROUND
  • Cook SB, Clark BC, Ploutz-Snyder LL. Effects of exercise load and blood-flow restriction on skeletal muscle function. Med Sci Sports Exerc. 2007 Oct;39(10):1708-13. doi: 10.1249/mss.0b013e31812383d6.

    PMID: 17909396BACKGROUND
  • Dankel SJ, Jessee MB, Abe T, Loenneke JP. The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure. Sports Med. 2016 Jan;46(1):23-33. doi: 10.1007/s40279-015-0407-7.

    PMID: 26446893BACKGROUND
  • Elkasrawy M, Immel D, Wen X, Liu X, Liang LF, Hamrick MW. Immunolocalization of myostatin (GDF-8) following musculoskeletal injury and the effects of exogenous myostatin on muscle and bone healing. J Histochem Cytochem. 2012 Jan;60(1):22-30. doi: 10.1369/0022155411425389.

    PMID: 22205678BACKGROUND
  • Fry CS, Glynn EL, Drummond MJ, Timmerman KL, Fujita S, Abe T, Dhanani S, Volpi E, Rasmussen BB. Blood flow restriction exercise stimulates mTORC1 signaling and muscle protein synthesis in older men. J Appl Physiol (1985). 2010 May;108(5):1199-209. doi: 10.1152/japplphysiol.01266.2009. Epub 2010 Feb 11.

    PMID: 20150565BACKGROUND
  • Giles L, Webster KE, McClelland J, Cook JL. Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial. Br J Sports Med. 2017 Dec;51(23):1688-1694. doi: 10.1136/bjsports-2016-096329. Epub 2017 May 12.

    PMID: 28500081BACKGROUND
  • Hamrick MW. A role for myokines in muscle-bone interactions. Exerc Sport Sci Rev. 2011 Jan;39(1):43-7. doi: 10.1097/JES.0b013e318201f601.

    PMID: 21088601BACKGROUND
  • Korakakis V, Whiteley R, Epameinontidis K. Blood Flow Restriction induces hypoalgesia in recreationally active adult male anterior knee pain patients allowing therapeutic exercise loading. Phys Ther Sport. 2018 Jul;32:235-243. doi: 10.1016/j.ptsp.2018.05.021. Epub 2018 May 31.

    PMID: 29879638BACKGROUND
  • Lambert B, Hedt C, Epner E, et al. BFR For Proximal Benefit: Blood Flow Restriction Therapy For The Shoulder? Med Sci Sports Exerc. 2019;51(6):972-973.

    BACKGROUND
  • Lambert B, Hedt CA, Jack RA, et al. Blood flow restriction therapy preserves whole limb bone and muscle following ACL reconstruction. Orthop J Sports Med. 2019;7(3_suppl2):2325967119S2325900196.

    BACKGROUND
  • Lambert BS, Hedt C, Moreno M, Harris JD, McCulloch P. Blood Flow Restriction Therapy for Stimulating Skeletal Muscle Growth: Practical Considerations for Maximizing Recovery in Clinical Rehabilitation Settings. Tech Orthop. 2018;33(2):89-97.

    BACKGROUND
  • Lambert BS, Shimkus KL, Fluckey JD, Riechman SE, Greene NP, Cardin JM, Crouse SF. Anabolic responses to acute and chronic resistance exercise are enhanced when combined with aquatic treadmill exercise. Am J Physiol Endocrinol Metab. 2015 Feb 1;308(3):E192-200. doi: 10.1152/ajpendo.00689.2013. Epub 2014 Nov 25.

    PMID: 25425002BACKGROUND
  • Loenneke JP, Kim D, Fahs CA, Thiebaud RS, Abe T, Larson RD, Bemben DA, Bemben MG. Effects of exercise with and without different degrees of blood flow restriction on torque and muscle activation. Muscle Nerve. 2015 May;51(5):713-21. doi: 10.1002/mus.24448.

    PMID: 25187395BACKGROUND
  • Mundermann A, Payer N, Felmet G, Riehle H. Comparison of volumetric bone mineral density in the operated and contralateral knee after anterior cruciate ligament and reconstruction: A 1-year follow-up study using peripheral quantitative computed tomography. J Orthop Res. 2015 Dec;33(12):1804-10. doi: 10.1002/jor.22962. Epub 2015 Jul 14.

    PMID: 26123943BACKGROUND
  • Patterson SD, Brandner CR. The role of blood flow restriction training for applied practitioners: A questionnaire-based survey. J Sports Sci. 2018 Jan;36(2):123-130. doi: 10.1080/02640414.2017.1284341. Epub 2017 Feb 1.

    PMID: 28143359BACKGROUND
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    BACKGROUND
  • Scott BR, Loenneke JP, Slattery KM, Dascombe BJ. Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development. Sports Med. 2015 Mar;45(3):313-25. doi: 10.1007/s40279-014-0288-1.

    PMID: 25430600BACKGROUND
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    PMID: 19653816BACKGROUND
  • Thangamani VB, Flanigan DC, Merk BR. Intra-articular distal femur fracture extending from an expanded femoral tunnel in an anterior cruciate ligament (ACL) reconstructed knee: a case report. J Trauma. 2009 Dec;67(6):E209-12. doi: 10.1097/TA.0b013e3181469f42.

    PMID: 19065114BACKGROUND
  • Vechin FC, Libardi CA, Conceicao MS, Damas FR, Lixandrao ME, Berton RP, Tricoli VA, Roschel HA, Cavaglieri CR, Chacon-Mikahil MP, Ugrinowitsch C. Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly. J Strength Cond Res. 2015 Apr;29(4):1071-6. doi: 10.1519/JSC.0000000000000703.

    PMID: 25264670BACKGROUND
  • Wright R, Spindler K, Huston L, Amendola A, Andrish J, Brophy R, Carey J, Cox C, Flanigan D, Jones M, Kaeding C, Marx R, Matava M, McCarty E, Parker R, Vidal A, Wolcott M, Wolf B, Dunn W. Revision ACL reconstruction outcomes: MOON cohort. J Knee Surg. 2011 Dec;24(4):289-94. doi: 10.1055/s-0031-1292650.

    PMID: 22303759BACKGROUND
  • Yamanaka T, Farley RS, Caputo JL. Occlusion training increases muscular strength in division IA football players. J Strength Cond Res. 2012 Sep;26(9):2523-9. doi: 10.1519/JSC.0b013e31823f2b0e.

    PMID: 22105051BACKGROUND
  • Zargi T, Drobnic M, Strazar K, Kacin A. Short-Term Preconditioning With Blood Flow Restricted Exercise Preserves Quadriceps Muscle Endurance in Patients After Anterior Cruciate Ligament Reconstruction. Front Physiol. 2018 Aug 24;9:1150. doi: 10.3389/fphys.2018.01150. eCollection 2018.

    PMID: 30197599BACKGROUND

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Interventions

Blood Flow Restriction Therapy

Condition Hierarchy (Ancestors)

Knee InjuriesLeg InjuriesWounds and Injuries

Intervention Hierarchy (Ancestors)

Exercise TherapyRehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsPhysical Therapy Modalities

Results Point of Contact

Title
Bradley Lambert, PhD
Organization
Houston Methodist Hospital

Study Officials

  • Patrick McCulloch, MD

    The Methodist Hospital Research Institute

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants were randomized to either receive standard physical therapy or standard physical therapy with blood flow restriction therapy.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal investigator

Study Record Dates

First Submitted

July 13, 2020

First Posted

July 24, 2020

Study Start

March 18, 2016

Primary Completion

July 10, 2020

Study Completion

July 10, 2020

Last Updated

November 25, 2024

Results First Posted

November 25, 2024

Record last verified: 2024-10

Data Sharing

IPD Sharing
Will not share