Matthew A Kilgas1, Alicia E DenHerder2, Lydia L M Lytle3, Cameron T Williams4, Steven J Elmer5. 1. Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan; and School of Health and Human Performance, Northern Michigan University, Marquette, Michigan. 2. Department of Kinesiology and Integrative Physiology, Michigan Technological University; and Department of Physical Therapy, Central Michigan University, Mt Pleasant, Michigan. 3. Department of Kinesiology and Integrative Physiology, Michigan Technological University; and Aspirus Keweenaw Outpatient Therapies, Calumet, Michigan. 4. Department of Physical Therapy, Central Michigan University; and Department of Kinesiology and Integrative Physiology, Michigan Technological University. 5. Department of Kinesiology and Integrative Physiology, Michigan Technological University, 1400 Townsend Dr, Houghton, MI 49931 (USA); and Department of Physical Therapy, Central Michigan University.
Abstract
BACKGROUND AND PURPOSE: After total knee arthroplasty (TKA), persistent quadriceps muscle atrophy and weakness impairs physical function. Blood flow restriction (BFR) exercise is emerging as a potential method to improve muscle size and strength in clinical populations with orthopedic limitations. There are no randomized controlled studies documenting BFR exercise after TKA. This case report describes the use of home-based BFR exercise to increase quadriceps size, strength, and physical function after TKA. CASE DESCRIPTION: A 59-year-old man (6 months post-TKA) performed body weight and walking exercises with BFR 5×/wk for 8 weeks. Blood flow in the TKA leg was restricted using a thigh cuff inflated to 50% of limb occlusion pressure. Lean leg mass, vastus lateralis thickness, knee extensor strength, and physical function were measured at baseline (6 months post-TKA), posttraining (8 months post-TKA), and long-term follow-up (14 months post-TKA). OUTCOMES: After training, lean leg mass, vastus lateralis thickness, and knee extensor strength in the TKA leg increased by 4%, 14%, and 55%, respectively. Compared with baseline, posttraining knee extensor strength symmetry (TKA/uninvolved leg) increased from 64% to 98%. The patient's performance improved for the 30-second chair stand, 40-m fast walk, and 6-minute walk tests. Increased quadriceps and physical function were maintained at the long-term follow-up. DISCUSSION: With enhanced quadriceps and physical function, the patient resumed independent physical activity. Muscle and strength gains surpassed those typically reported after TKA. Outcomes suggest that home-based BFR exercise was feasible, safe, and effective. BFR exercise after TKA is promising and warrants further research.
BACKGROUND AND PURPOSE: After total knee arthroplasty (TKA), persistent quadriceps muscle atrophy and weakness impairs physical function. Blood flow restriction (BFR) exercise is emerging as a potential method to improve muscle size and strength in clinical populations with orthopedic limitations. There are no randomized controlled studies documenting BFR exercise after TKA. This case report describes the use of home-based BFR exercise to increase quadriceps size, strength, and physical function after TKA. CASE DESCRIPTION: A 59-year-old man (6 months post-TKA) performed body weight and walking exercises with BFR 5×/wk for 8 weeks. Blood flow in the TKA leg was restricted using a thigh cuff inflated to 50% of limb occlusion pressure. Lean leg mass, vastus lateralis thickness, knee extensor strength, and physical function were measured at baseline (6 months post-TKA), posttraining (8 months post-TKA), and long-term follow-up (14 months post-TKA). OUTCOMES: After training, lean leg mass, vastus lateralis thickness, and knee extensor strength in the TKA leg increased by 4%, 14%, and 55%, respectively. Compared with baseline, posttraining knee extensor strength symmetry (TKA/uninvolved leg) increased from 64% to 98%. The patient's performance improved for the 30-second chair stand, 40-m fast walk, and 6-minute walk tests. Increased quadriceps and physical function were maintained at the long-term follow-up. DISCUSSION: With enhanced quadriceps and physical function, the patient resumed independent physical activity. Muscle and strength gains surpassed those typically reported after TKA. Outcomes suggest that home-based BFR exercise was feasible, safe, and effective. BFR exercise after TKA is promising and warrants further research.
Authors: Isaac B Majors; Simon C Mears; Christopher K Oholendt; Nicholas A Hargett; C Lowry Barnes; Jeffrey B Stambough Journal: J Arthroplasty Date: 2022-02-11 Impact factor: 4.435
Authors: Elisio A Pereira-Neto; Kylie N Johnston; Hayley Lewthwaite; Terry Boyle; Andrew Fon; Marie T Williams Journal: Chron Respir Dis Date: 2021 Jan-Dec Impact factor: 2.444