Mechanistic assessment of blood flow restricted training for an ACL injury

摘要： 前十字韧带重建手术导致股四头肌长期无力 生物力学发生改变，随后受伤的风险增加。在以下方面进展甚微 在过去的15-20年里，提高了股四头肌的力量。形态和细胞的变化 股外侧肌的组成促进前十字韧带后的肌肉无力 重建。这些功能对传统的理疗技术没有反应。一个有希望的人 新出现的治疗方法--血流限制训练(BFRT)已被证明可以解决这些变化 在健康的受试者中；然而，它从未在受伤的人中进行过测试。当前提案中的试点数据 显示BFRT可以显著增加前十字韧带后的肌肉力量 受伤。这个项目试图机械地确定BFRT处理潜在肌肉的能力 与常规护理相比，前十字韧带重建后的细胞缺陷。当前的目标 建议如下：目标1将确定BFRT是否能够显著改善膝关节力学和 股四头肌力量重建后的前十字韧带与通常护理比较。目标2将 使用先进的磁共振成像技术评估股四头肌形态的改善 在BFRT训练后。最后，目标3将确定BFRT介导的细胞缺陷的改善 股四头肌作为BFRT训练的结果，而不是常规护理。预期的结果将第一次显现 BFRT是使以下个体股四头肌力量正常化的有效机械性治疗方法 前交叉韧带重建术。

Abstract: Anterior cruciate ligament reconstruction surgery results in protracted quadriceps weakness that is associated with altered biomechanics and heightened risk of subsequent injuries. Little progress has been made in improving quadriceps strength in the past 15-20 years. Alterations in the morphological and cellular composition of the vastus lateralis muscle promote muscle weakness following an anterior cruciate ligament reconstruction. These features are not responsive to traditional physical therapy techniques. A promising emerging treatment, blood flow restriction training (BFRT) has been shown to address these same alterations in healthy subjects; however, it has never been tested in those with an injury. Pilot data in the current proposal shows that BFRT can lead to a significant increase in muscle strength following an anterior cruciate ligament injury. This project seeks to mechanistically determine the ability of BFRT to address underlying muscle cellular deficits following anterior cruciate ligament reconstruction compared to usual care. Goals in the current proposal are as follows: aim 1 will determine if BFRT is able to significantly improve knee mechanics and quadriceps strength following an anterior cruciate ligament reconstruction compared to usual care. Aim 2 will use advanced magnetic resonance imaging techniques to assess improvements in quadriceps morphology after training with BFRT. Lastly, aim 3 will identify BFRT-mediated improvements in cellular deficits in the quadriceps as the result of BFRT training versus usual care. The expected outcomes will show for the first time that BFRT is an effective mechanistic treatment for normalizing quadriceps strength within individuals following an anterior cruciate ligament reconstruction.