The effectiveness and safety of blood flow restriction training for the post-operation treatment of distal radius fracture

Abstract

Introduction

Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load training, which is suitable for post-op rehabilitation. We explored the effectiveness and safety of BFR therapy in DRF patients who underwent surgery.

Materials and methods

Thirty-five patients were randomly assigned to either the BFR or the regular training (RT; no BFR therapy) groups. All patients completed the same 4-week postoperative rehabilitation program, including anti-inflammatory treatments, strengthening and range of motion (ROM) training. In the BFR group, the pressure was 120 mmHg in strengthening training course. Pain, circumferences of wrists and forearms, ROM, muscle strength, and D-dimer levels were evaluated at weeks 0, 2, and 4. Radius union scoring system (RUSS) was measured at weeks 4 and 12. Finally, wrist functionality (Cooney modification) was evaluated at week 12.

Results

The BFR group had significantly decreased pain levels compared with the RT group (p < 0.01, effect size= 2.33, −2.44 at weeks 2 and 4). Swelling was effectively relieved in both groups. The wrist swelling was less in the BFR group (p < 0.01, effect size = −2.17 at week 4). The isometric strength of wrist extension (p < 0.01, effect size = 1.5, 3.02 at weeks 2 and 4), flexion (p < 0.01, effect size = 1.33, 2.53 at weeks 2 and 4), and functionality significantly increased in the BFR group (p < 0.01, effect size = 2.80 at week 12). No risk of VT in the BFR group was found. BFR did not threaten bone healing.

Conclusions

In patients with DRF who underwent corrective surgery, BFR therapy effectively relieved pain and swelling, increased muscle strength and wrist function, and had no additional risks for bone healing and VT.

KEY MESSAGES

1. BFR therapy can significantly reduce pain, strengthen muscles, and improve function.

2. BFR therapy did not significantly improve passive ROM, and further research is needed to determine its ability to reduce swelling.

3. BFR therapy is safe and effective for DRF patients after ORIF, but requires individualized protocols and frequent assessments. Further research is needed for other orthopedic surgeries.

Keywords:

• Rehabilitation therapy
• blood flow restriction
• distal radial fracture
• wrist function

Acknowledgments

The authors would like to thank the Orthopedics Department of The First Affiliated Hospital of Chongqing Medical University for supporting participants recruiting.

Authors’ contributions

All authors contributed to the study conception and design. Yi Fan: Study conception and design; drafting the article; data collection; data analysis and interpretation. Dingqun Bai: Study conception and design. Chongyuan Cheng: Data collection. Guihua Tian: Data collection; data analysis and interpretation; revising the article critically for intellectual content and final approval of the version to be published. All authors read, approved the final manuscript and agreed to be accountable for all aspects of the work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, Guihua Tian, upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.