Bfr training before and after11/30/2023 11,14,15 Local physiologic adaptations from BFR training primarily occur in muscles distal to tourniquet placement. 11–14 Blood flow restriction training is safe and well-tolerated in the acute phase of tissue healing. 10 Blood flow restriction (BFR) training uses a tourniquet to impede arterial inflow while occluding venous return, stimulating anaerobic metabolism without heavy resistance. 9 Since the rotator cuff stabilizes the humeral head within the glenoid, incomplete recovery of rotational strength may contribute to recurrent instability and failure to return to sport following shoulder stabilization surgery.Įxercising with loads at 70-85% of one-repetition maximum improves muscle strength but is challenging, symptom-producing, or sometimes even contraindicated following surgery. 7 However, athletes often lack rotational strength and upper extremity performance, 8 with only 80% of athletes and 68% of overhead throwing athletes reaching their pre-injury play level. 5,6 Return to sport typically occurs six months postoperatively, with time from surgery used as the primary measure of readiness. 3,4 Surgical stabilization reduces recurrence and improves self-reported function compared to conservative management for active young adults. 1 Incidence rates range from 23.9 per 100,000 person-years in the general population 2 to 435 per 100,000 person-years in military cadets. Traumatic shoulder instability is a common upper extremity injury. While the degree of improvement attributable to the addition of BFR is unknown, the clinically meaningful improvements in shoulder strength, self-reported function, and upper extremity performance warrant further exploration of BFR during upper extremity rehabilitation. Additionally, over 70 percent of participants met reference values on two to three performance tests at 6-months. Statistically significant and clinically meaningful improvements were reported on the Single Assessment Numeric Evaluation ( p < 0.001 mean difference, 17.7 CI: 9.4, 25.9) and Shoulder Pain and Disability Index ( p < 0.001 mean difference, -31.1 CI: -44.2, -18.0) from six to 12 weeks postoperatively. 093) occurred from six to 12 weeks postoperatively. 108), and internal rotation strength ( p < 0.001 mean difference. 077), abduction strength ( p < 0.001 mean difference. Statistically significant and clinically meaningful increases in surgical extremity external rotation strength ( p < 0.001 mean difference. Twenty cadets performed an average 10.9 BFR training sessions over six weeks. Secondary outcomes included shoulder ROM assessed at each timepoint and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), the Upper Extremity Y-Balance Test (UQYBT), and the Unilateral Seated Shotput Test (USPT) assessed at the six-month follow-up. Primary outcomes were shoulder isometric strength and patient-reported function assessed at 6-weeks, 12-weeks, and 6-months postoperatively. Military cadets who underwent shoulder stabilization surgery completed six weeks of upper extremity BFR training, beginning post-op week six. To observe changes in shoulder strength, self-reported function, upper extremity performance, and range of motion (ROM) in military cadets recovering from shoulder stabilization surgery who completed a standard rehabilitation program with six weeks of BFR training. Blood flow restriction (BFR) may stimulate muscle growth without the need for heavy resistance training post-surgically. Surgical stabilization reduces recurrence, but athletes often return to sport before recovering upper extremity rotational strength and sport-specific abilities. Traumatic shoulder instability is a common injury in athletes and military personnel.
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