Mechanistic assessment of blood flow restricted training for an ACL injury

摘要： 前交叉韧带重建手术导致股四头肌长期无力， 生物力学会发生改变，后续受伤的风险也会增加进展甚微 在过去的15-20年里，股四头肌的力量得到了改善。形态学和细胞学的改变 股外侧肌的组成促进前交叉韧带后的肌无力 重建这些功能对传统的物理治疗技术没有反应。一个有前途 一种新兴的治疗方法，血流限制训练（BFRT）已被证明可以解决这些相同的变化 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 表明BFRT可以导致前交叉韧带损伤后肌肉力量的显著增加， 损伤该项目旨在机械地确定BFRT解决潜在肌肉的能力 与常规护理相比，前交叉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， 前交叉韧带重建后的股四头肌强度与常规护理相比。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 经过BFRT的培训。最后，目标3将确定BFRT介导的改善细胞缺陷， 四头肌作为BFRT训练与常规护理的结果。预期的结果将首次显示 BFRT是一种有效的机械治疗，用于使以下个体的股四头肌力量正常化： 前十字韧带重建

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.