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Blood Flow-Restricted Training for Lower Extremity Muscle Weakness due to Knee Pathology: A Systematic Review

机译：由于膝关节病理学，血液流动限制培训对下肢肌肉无力的培训：系统评价

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Context: Blood flow-restricted training (BFRT) has been suggested to treat lower extremity muscle weakness. The efficacy of BFRT for muscle problems related to knee pathology is unclear. Objective: To determine whether BFRT (1) improves muscle strength and cross-sectional area (CSA) for chronic knee-related lower extremity atrophy and (2) prevents muscle atrophy after knee surgery. Data Sources: A systematic review of the literature from 1974 to 2017 was conducted using the PubMed and Cochrane databases. Study Selection: Controlled trials that used BFRT to treat chronic knee-related lower extremity muscle atrophy or to prevent muscle atrophy after knee surgery that measured the effects on quadriceps or hamstrings muscle strength or CSA were included. Study Design: Systematic review. Level of Evidence: Level 2. Data Extraction: Data were extracted as available from 9 studies (8 level 1, 1 level 2). Assessment of study quality was rated using the Physiotherapy Evidence Database or Methodological Index for Non-Randomized Saidies instruments. Results: BFRT was used after anterior cruciate ligament reconstruction and routine knee arthroscopy and in patients with knee osteoarthritis or patellofemoral pain. There were a total of 165 patients and 170 controls. Vascular occlusion and exercise protocols varied; all studies except 1 incorporated exercises during occlusion, most of which focused on the quadriceps. Six of 7 studies that measured quadriceps strength reported statistically significant improvements after training. Few benefits in quadriceps CSA were reported. Hamstrings strength was only measured in 2 studies. There were no complications related to training. Conclusion: Published limited data show BFRT to be safe and potentially effective in improving quadriceps muscle strength in patients with weakness and atrophy related to knee pathology. The use of short-duration vascular occlusion and light-load resistance exercises appears safe after knee surgery or in arthritic knees. This treatment option requires further investigation to refine protocols related to cuff pressure and exercise dosage and duration.
机译：背景：已建议血流限制训练（BFRT）治疗下肢肌肉弱点。 BFRT对膝关节病理学相关肌肉问题的疗效尚不清楚。目的：确定BFRT（1）是否改善了慢性膝关节膝关节的下肢萎缩和（2）的肌肉力量和横截面积（CSA），可防止膝关节手术后的肌肉萎缩。数据来源：使用PubMed和Cochrane数据库进行了1974年至2017年的文献系统审查。学习选择：使用BFRT治疗慢性膝关节膝关节的下肢肌肉萎缩或防止膝关节手术后肌肉萎缩的受控试验，以抑制对Quadriceps或Hamstrings肌肉强度或CSA的影响。研究设计：系统评价。证据水平：级别2.数据提取：提取数据，如9项研究（8级，1级2）。使用非随机型德德仪器的物理疗法证据数据库或方法指数评估研究质量评估。结果：BFRT在前令韧带重建和常规膝关节视镜检查和膝关节骨关节炎或髌椎间膜疼痛患者中使用。共有165名患者和170例对照。血管闭塞和运动方案变化;所有研究除了1份闭塞期间的练习，其中大部分都集中在Quadriceps上。测量Quadriceps强度的六项研究中的六项研究报告了训练后的统计上显着的改进。报告了Quadriceps CSA中的一些益处。腿筋强度仅在2项研究中衡量。没有与培训相关的并发症。结论：已发布的数据显示BFRT是安全且可能有效地改善患者患者患者患者患者膝关节病理学的患者。在膝盖手术或关节炎膝关节后，使用短持续时间血管闭塞和轻载性锻炼。该处理选项需要进一步调查，以改进与袖带压力和运动剂量和持续时间相关的方案。

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