前交叉韧带重建术后患者高血流限制训练康复效果的系统综述

doi:10.3969/j.issn.1006-9771.2024.07.006

Abstract

Abstract:

Objective To systematically review the effect of high blood flow restriction training (BFRT) on patients after anterior cruciate ligament reconstruction (ACLR).
Methods Relevant literature was searched in PubMed, Web of Science, Embase, Cochrane Library, CNKI, CBM, Wanfang data, and VIP databases using subject term search methods from the inception to May 1st, 2024. The methodological quality of the included literatures was assessed using Physiotherapy Evidence Database (PEDro) scale, and relevant data were extracted for systematic review.
Results A total of seven articles were finally included, involving 183 subjects from six countries. The intervention sites were mainly hospital rehabilitation departments and rehabilitation centers. The publication dates ranged from 2016 to 2023. In BFRT group, lower limbs were compressed during conventional rehabilitation training, with intermittent of 0.5 to 2 minutes or without deflation. BFRT would increase muscle strength, muscle hypertrophy, and improved knee joint function. Total duration of intervention and training intensity affected the improvement.
Conclusion High BFRT can improve the condition of the muscles around the knee joint and promote functional recovery after ACLR. To ensure the safety and effectiveness of the training, low-intensity strength training should be employed, with 15 to 30 repetitions per set, four to five sets per session, two to three sessions per week, and a total training duration of at least three weeks.

Key words: anterior cruciate ligament reconstruction, blood flow restriction training, knee joint function, systematic review

CLC Number:

R687.4

TANG Letian, HUANG Zhaoxin, LIU Chao, XIAO Xiaofei. Effect of high blood flow restriction training on patients after anterior cruciate ligament reconstruction: a systematic review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 789-796.

Figures/Tables 4

Table 1

Figure 1

Table 2

Table 3

Basic characteristics of included literatures"

纳入文献	国家/地区	n (C/T)	年龄/岁	移植物类型	干预地点	干预方法		干预方案(BFRT)	加压强度	康复效果
纳入文献	国家/地区	n (C/T)	年龄/岁	移植物类型	干预地点	C	T	干预方案(BFRT)	加压强度	康复效果
Li等^[21] (2023)	中国	23(6/17) T₁：9 T₂：8	18~40	自体肌腱	康复科	等长抗阻训练、抗阻膝关节屈曲和伸展训练训练负荷：低负荷	BFRT+对照组训练训练负荷：低负荷	康复训练每周2次，共8周；训练中加压，休息阶段放气放松30 s，至训练结束	试验组1：40% LOP 试验组2：80% LOP	股直肌和股中间肌的厚度、等速屈伸膝峰力矩测试、YBT测试、IKDC评分均改善；试验组2改善更显著
Okoroha 等^[22](2023)	美国	38(22/16)	14~40	自体骨-髌腱骨移植、半腱肌腱移植或股四头肌腱移植	康复科	常规康复训练训练负荷：低负荷	BFRT+对照组训练训练负荷：低负荷	康复训练每周2~3次，共12周；训练中加压，休息阶段放气放松1 min，至训练结束	80% LOP	屈伸肌力、股四头肌围度、VAS评分、IKDC评分、关节活动范围改善更显著
Vieira de Melo等^[23](2022)	巴西	24(12/12)	18~59	自体腘绳肌腱	康复科	常规康复训练训练负荷：低负荷	BFRT+对照组训练训练负荷：低负荷	康复训练每周2次；共12周训练全程加压，至训练结束	80% LOP	两组膝关节屈伸力量和功能均改善；干预时间越长，BFRT组改善效果更优
Curran等^[24](2020)	美国	34(16/18)	14~30	自体骨-髌腱-骨移植、半腱肌腱移植或股四头肌腱移植	康复科	常规康复训练训练负荷：高负荷	BFRT+对照组训练训练负荷：高负荷	康复训练每周2次；共8周训练中加压，休息阶段放气放松2 min，至训练结束	80% LOP	两组股四头肌肥大、股直肌体积、膝关节屈伸力量和IKDC评分均没有改善
Hughes等^[25](2019)	英国	28(14/14)	29±7	自体腘绳肌腱	康复科	常规康复训练训练负荷：高负荷抗阻训练	BFRT+常规康复训练训练负荷：低负荷	康复训练每周2次，共8周；训练中加压，休息阶段放气放松2 min，重复至训练结束	80% LOP	肌肉厚度、10 RM强度、等速屈伸膝峰力矩、ROM、Lysholm评分、KOOS评分、IKDC评分改善更明显，疼痛减轻更明显
Kacin等^[26](2021)	斯洛文尼亚	12(6/6)	18~45	未提及	康复科	BFRT＋常规康复训练训练负荷：低负荷	BFRT+常规康复训练训练负荷：低负荷	康复训练每周3次，共3周；训练中加压，组间放气放松45 s/90 s/45 s	C: 20 mmHg T: 150 mmHg	膝关节伸肌横截面积、肌力和耐力改善，膝关节屈肌的肌力和耐力改善，但对屈肌肥大无作用
Iversen等^[27](2016)	挪威	24(12/12)	18~40	自体腘绳肌腱	康复科	常规康复训练训练负荷：低负荷	BFRT+常规康复训练训练训练负荷：低负荷	康复训练每天2次，共2周；训练中加压，休息阶段放气放松3 min，至训练结束	130~180 mmHg	两组股四头肌横截面积均无改善

Table 3

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纳入文献	资格标准	随机分配	分配隐藏	基线相似	被试施盲	评估者施盲	被试流失率≤15%	意向性分析	组间统计比较	报告点测量和变异量值	总分
Li等^[21](2023)	√	√	√	√			√	√	√	√	7
Okoroha等^[22](2023)	√	√	√	√			√	√	√	√	7
Vieira de Melo等^[23](2022)	√	√	√	√			√	√	√	√	7
Curran等^[24](2020)	√	√	√	√			√	√	√	√	7
Hughes等^[25](2019)	√	√	√	√		√	√	√	√	√	8
Kacin等^[26](2021)	√	√	√	√	√	√	√	√	√	√	9
Iversen等^[27] (2016)	√	√		√		√	√	√	√	√	7

Effect of high blood flow restriction training on patients after anterior cruciate ligament reconstruction: a systematic review

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