Isokinetic Exercise Combined With Blood Flow Restriction: High-Load Vs Low-Load Training

NCT07384780 | Not Yet Recruiting

• 1 other identifier: GulfMU
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to see which type of strengthening exercise with a tight band (blood flow restriction) helps people recover better after ACL reconstruction. The study includes adults after ACL surgery who are doing physiotherapy to rebuild thigh muscle strength and knee function. The main questions are:

• Does heavy strengthening with blood flow restriction improve thigh strength, knee function, and daily activities more than light strengthening with blood flow restriction after ACL surgery?
• Can light strengthening with blood flow restriction give similar benefits to heavy strengthening while putting less strain on the knee? Researchers will compare a heavy-exercise program plus blood flow restriction to a light-exercise program plus blood flow restriction to see which gives better strength and functional improvements. Participants will:
• Come for supervised physiotherapy sessions and do knee exercises on a machine, using either heavy or light loads while a cuff on the thigh gently squeezes to reduce blood flow.
• Have their leg strength, and knee questionnaires checked several times during the study.

Conditions

ACL Repair; ACL Reconstruction

Keywords

blood flow restriction training ACL; Blood flow restriction; ACL Rehab; ACLR; ACL Reconstruction; BFR therapy anterior cruciate ligament reconstruction; BFR therapy ACLR; BFR Therapy; low-load versus high-load BFR knee rehabilitation; isokinetic strength training after ACL surgery; physiotherapy rehabilitation protocol ACL isokinetic BFR; Knee physiotherapy; ACL; ACL Isokinetic; ACLٍ Isokinetic

Outcome Measures

Primary Outcomes (2)

• Muscle Strength

  Muscle strength will be measured using Biodex System 4 Pro for concentric quadriceps and hamstring strength at 60°/s and eccentric quadriceps at 60°/s. Recorded parameters: peak torque(Nm/kg), total work(J), and average power(W).

  Outcome measures will be measured at baseline(week 0), mid-intervention(week 3) and post-intervention(week 6)

• Muscle Girth

  Muscle girth will be measured by measuring the mid-thigh circumference using an inch tape at 15cm above the superior border of the patella. The mean of two readings will be recorded

  Outcome measures will be measured at baseline(week 0), mid-intervention(week 3) and post-intervention(week 6)

Secondary Outcomes (3)

• Pain Reduction

  Outcome measures will be measured at baseline(week 0), mid-intervention(week 3) and post-intervention(week 6)

• Blood Flow

  Outcome measures will be measured at baseline(week 0), mid-intervention(week 3) and post-intervention(week 6)

• Tolerability and Perception of the Intervention(s)

  Outcome measures will be measured at baseline(week 0), mid-intervention(week 3) and post-intervention(week 6)

Study Arms (2)

ACL Reconstruction Population

ACTIVE COMPARATOR

Other: High Load Isokinetic Training with Blood Flow Restriction; Other: Low Load Isokinetic Training with Blood Flow Restriction

Healthy Population

ACTIVE COMPARATOR

Other: High Load Isokinetic Training with Blood Flow Restriction; Other: Low Load Isokinetic Training with Blood Flow Restriction

Interventions

Low Load Isokinetic Training with Blood Flow Restriction OTHER

Low Load strength training that was administered through the use of an isokinetic device, and not conventional strength training equipment, combined with blood flow restriction.

Also known as: Low Load strength training, Low Load Isokinetic training, Blood Flow Restriction, BFR

ACL Reconstruction Population; Healthy Population

High Load Isokinetic Training with Blood Flow Restriction OTHER

High Load strength training that was administered through the use of an isokinetic device, and not conventional strength training equipment, combined with blood flow restriction.

Also known as: High Load strength training, High Load Isokinetic training, Blood Flow Restriction, BFR

ACL Reconstruction Population; Healthy Population

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• For ACLR group:
• Isolated unilateral ACL reconstruction 8-16 weeks post-surgery with medical clearance for moderate to high resistance training.
• For control group(healthy population):
• Healthy adults with no musculoskeletal pathology.

You may not qualify if:

• History of cardiovascular or metabolic diseases
• Deep vein thrombosis
• Coagulopathy
• Hypertension
• Skin lesions or infections at the site of BFR cuff administration
• Neuromuscular disorders
• Non-clearance from the surgeon or physiotherapist or resistance training.

Sponsors & Collaborators

• Gulf Medical University: lead

Related Publications (27)

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  BACKGROUND

• Gopinatth V, Garcia JR, Reid IK, Knapik DM, Verma NN, Chahla J. Blood Flow Restriction Enhances Recovery After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arthroscopy. 2025 Apr;41(4):1048-1060

  BACKGROUND

• Lin Q, Zhang Y, Qin J, Wu F. Effects of Low-Load Blood Flow Restriction Training on Muscle Volume After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2024 Dec 13;12(12):23259671241301731

  BACKGROUND

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  BACKGROUND

• Koc BB, Truyens A, Heymans MJLF, Jansen EJP, Schotanus MGM. Effect of Low-Load Blood Flow Restriction Training After Anterior Cruciate Ligament Reconstruction: A Systematic Review. Int J Sports Phys Ther. 2022 Apr 1;17(3):334-346

  BACKGROUND

• Moletta C, Kuenze CM, Morgan K, Coiner DR, Jacobson TA, Schmitz KH, Zajac NN, Boumerhi JS, Grindstaff TL. Hamstrings volumetric adaptations to a four-week Nordic hamstring exercise protocol in individuals with ACL reconstruction: a preliminary case series. Int J Sports Phys Ther. 2025 Sep 1;20(5):801-814

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• Mengis N, Höher J, Ellermann A, Eberle C, Hartner C, Keller M, Rippke JN, Sprenger N, Stein T, Stoffels T, Egloff C, Niederer D. A Guideline for Validated Return-to-Sport Testing in Everyday Clinical Practice: A Focused Review on the Validity, Reliability, and Feasibility of Tests Estimating the Risk of Reinjury After ACL Reconstruction. Orthop J Sports Med. 2025 May 5;13(5):23259671251317208

  BACKGROUND

• Hiemstra LA, Webber S, MacDonald PB, Kriellaars DJ. Contralateral limb strength deficits after anterior cruciate ligament reconstruction using a hamstring tendon graft. Clin Biomech (Bristol). 2007 Jun;22(5):543-50

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• Kuenze C, Hart JM. Quadriceps strength thresholds and patient-reported function after anterior cruciate ligament reconstruction: a systematic review. J Sport Rehabil. 2023 Jun 1;32(5):458-468. doi: 10.1123/jsr.2022-0362

  BACKGROUND

• Schwery NA, Kiely MT, Larson CM, Wulf CA, Heikes CS, Hess RW, Giveans MR, Solie BS, Doney CP. Quadriceps strength following anterior cruciate ligament reconstruction: normative values based on sex, graft type and meniscal status at 3, 6 & 9 months. Int J Sports Phys Ther. 2022 Apr 1;17(3):434-444

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• Liao LR, Ng GYF, Jones AY, Lee LK, Leung HK, Ng SSM. Predicting maximal strength of quadriceps from submaximal performance in individuals with knee joint osteoarthritis. J Orthop Sports Phys Ther. 2015;45(5):408-414

  BACKGROUND

• Nascimento DCN, Rolnick N, Sousa Neto IV, Severin R, Beal FLR. A useful blood flow restriction training risk stratification for exercise and rehabilitation. Front Physiol. 2022 Mar 11;13:808622

  BACKGROUND

• Welsh JJ, Robinson DM, Dankel SJ. A systematic review examining blood flow restriction in combination with isokinetic resistance exercise. J Trainology. 2024;13(1):3-11

  BACKGROUND

• Hughes L, Patterson SD, Haddad F, Rosenblatt B, Gissane C, McCarthy D, Clarke T, Ferris G, Dawes J, Paton B. Examination of the comfort and pain experienced with blood flow restriction training during post-surgery rehabilitation of anterior cruciate ligament reconstruction patients: A UK National Health Service trial. Phys Ther Sport. 2019 Sep;39:90-98

  BACKGROUND

• Rolnick N, Kimbrell K, Cerqueira MS, Weatherford B, Brandner C. Perceived barriers to blood flow restriction training. Front Rehabil Sci. 2021 Jul 8;2:697082

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• Farooq U, Cheema MY, Imran M, Gulzar M. Acute and chronic blood flow restriction resistance training: mechanisms and applications in sports. J Exerc Sci Fit. 2025;23(2):279-288

  BACKGROUND

• Büyüklüoğlu G, Akinoğlu B, Günaydin H, Küçük İ, Örsçelik A, Kocahan T. Isokinetic exercise combined with blood flow restriction (BFR) may produce a greater change in the angle of peak torque. Med Sport. 2025;78(1):18-22

  BACKGROUND

• Kubosch EJ, Izadi M, Wawrzyniak N, Hedtmann K, Pässler V, Rolvien T, von der Heide D, Lutter C, Fehér D, Engelhardt M. Blood flow restriction training for hamstring muscle strength after anterior cruciate ligament reconstruction: a randomized controlled trial. Knee. 2024 Aug;41:2444-2452

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• Kwon S, Bae KC, Yon CJ, Kim DH. Current narrative review-application of blood flow restriction exercise in clinical knee problems. Medicina (Kaunas). 2025 Jul 30;61(8):1377

  BACKGROUND

• Su C, Zhang Z, Liang B, Zhou S, Long X. Effects of blood flow restriction combined with high-load training on muscle strength and sports performance in athletes: a systematic review and meta-analysis. Front Physiol. 2025;16:1603568

  BACKGROUND

• Piskin NE, Aktug ZB, Kara M, Yavuz G, Ozturk GT, Ibis S, Aka H. The effect of blood flow restriction training on isokinetic strength, muscle thickness and athletic performance. J Musculoskelet Neuronal Interact. 2025;25(2):208-218

  BACKGROUND

• Chang H, Yan J, Lu G, Chen B, Zhang J. Muscle strength adaptation between high-load resistance training versus low-load blood flow restriction training with different cuff pressure characteristics: a systematic review and meta-analysis. Front Physiol. 2023 Aug 25;14:1244292

  BACKGROUND

• Colombo V, Valenčič T, Steiner K, Škarabot J, Folland J, O'Sullivan O, Kluzek S. Comparison of blood flow restriction interventions to standard rehabilitation after an anterior cruciate ligament injury: a systematic review. Am J Sports Med. 2024 Apr 9;52(14):3641-3650

  BACKGROUND

MeSH Terms

Interventions

Blood Flow Restriction Therapy

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities

Central Study Contacts

Osman Z Khan, Bachelors of Physiotherapy

CONTACT

+971563292389; osman.thekhan@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 27, 2026
• First Posted: February 3, 2026
• Study Start: February 1, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 1, 2026
• Last Updated: February 5, 2026

Record last verified: 2026-02