Blood flow restriction exercise to attenuate postoperative loss of function after total knee replacement: a randomized pilot study

  • Rene Przkora | rprzkora@anest.ufl.edu Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, United States.
  • Kimberly Sibille Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, Florida, United States.
  • Sandra Victor Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, United States.
  • Matthew Meroney Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, United States.
  • Christiaan Leeuwenburgh Department of Aging & Geriatric Research, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, Florida, United States.
  • Anna Gardner Department of Applied Physiology and Kinesiology, University of Florida College of Health and Human Performance, Gainesville, Florida, United States.
  • Terrie Vasilopoulos Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, United States.
  • Hari K. Parvataneni Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, United States.

Abstract

Aging well is directly associated with a healthy lifestyle. The focus of this paper is to relate that attenuation of postoperative loss of muscle function after a total knee arthroplasty (TKA) is an important consideration. Because patients usually do not tolerate standard high-resistance exercise in the preoperative or postoperative period, they often experience a decline in strength and function. Therefore, we tested the feasibility and acceptability of an alternative low-resistance exercise protocol with blood flow restriction (BFR) using a tourniquet in the preoperative period for patients awaiting TKA. We recruited patients undergoing a TKA and randomized six to the BFR exercise for 4 weeks prior to surgery and four to standard of care (no exercise). We measured physical function using the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), leg strength (peak torque), and pain (numerical pain score) 4 to 5 weeks preoperatively and 2 weeks postoperatively. The clinical management, e.g., anesthetic management, did not differ between groups. No complications were observed. Our findings demonstrate the feasibility and acceptability of the BFR intervention. Although preliminary and not powered for comparison, the BFR group demonstrated less decline in SPPB following surgery (−2.2, 95%CI:−4.4,0.1) compared to the no exercise group (−4.8, 95%CI:−7.8,−1.7). No differences were noted for the 6MWT, leg strength, and pain measurements. We conclude that preoperative low-resistance exercise using the BFR is feasible and acceptable, and this test warrants investigation as an intervention to potentially attenuate the postoperative loss of physical function after TKA.

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Published
2021-08-26
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Original Articles
Keywords:
Rehabilitation, blood flow restriction exercise, function, short physical performance battery, total knee arthroplasty
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How to Cite
Przkora, R., Sibille, K., Victor, S., Meroney, M., Leeuwenburgh, C., Gardner, A., Vasilopoulos, T., & Parvataneni, H. K. (2021). Blood flow restriction exercise to attenuate postoperative loss of function after total knee replacement: a randomized pilot study. European Journal of Translational Myology. https://doi.org/10.4081/ejtm.2021.9932

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