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Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Abstract

This article aims to evaluate the Effectiveness of Blood Flow Restriction Exercise in Improving Quadriceps Strength in Patients with ACL Reconstruction. This project is a literature study in narrative form. The background for conducting this research is the high incidence of ACL tears, ranging from 78 to 81 cases per 100,000 population worldwide in a year. The most common surgical treatment provided is ACL reconstruction. Quadriceps strength reduction after 6 months post-operation reaches 20% compared to pre-operation. From the symptoms and clinical complaints of quadriceps muscle weakness, one of the interventions that can be performed is Blood Flow Restriction Exercise. A search was conducted using various databases, resulting in the discovery of 10 articles, which were then filtered and selected to obtain 7 articles. Rresulting in a final selection of 5 articles. The objective of this study is to determine the effectiveness, dosage, and success factors of BFRE in improving quadriceps muscle strength in patients post-ACL reconstruction using isokinetic and isometric dynamometers. Research results showed an increase in quadriceps muscle strength, even in knee function. The dosage provided varied but still had a positive impact. In conclusion, the administration of BFRE can be an intervention solution to improve quadriceps muscle strength in patients post-ACL reconstruction.

References

Journal article

  1. Jung WS, Kim SH, Nam SS, Kim JW, Moon HW. Effects of Rehabilitation Exercise with Blood Flow Restriction after Anterior Cruciate Ligament Reconstruction. Appl Sci. 2022;12(23).
  2. Li X, Li J, Qing L, Wang H, Ma H, Huang P. Effect of quadriceps training at different levels of blood flow restriction on quadriceps strength and thickness in the mid-term postoperative period after anterior cruciate ligament reconstruction : a randomized controlled external pilot study. 2023;1-14
  3. Tramer JS, Khalil LS, Jildeh TR, Abbas MJ, McGee A, Lau MJ, et al. Blood Flow Restriction Therapy for 2 Weeks Prior to Anterior Cruciate Ligament Reconstruction Did Not Impact Quadriceps Strength Compared to Standard Therapy. Arthrosc - J Arthrosc Relat Surg. 2023;39(2):373–81.
  4. Vieira de Melo RF, Komatsu WR, Freitas MS de, Vieira de Melo ME, Cohen M. Comparison of Quadriceps and Hamstring Muscle Strength after Exercises with and without Blood Flow Restriction following Anterior Cruciate Ligament Surgery: A Randomized Controlled Trial. J Rehabil Med. 2022;54(3):jrm00337.
  5. Hughes L, Rosenblatt B, Haddad F, Gissane C, McCarthy D, Clarke T, et al. Comparing the Effectiveness of Blood Flow Restriction and Traditional Heavy Load Resistance Training in the Post-Surgery Rehabilitation of Anterior Cruciate Ligament Reconstruction Patients: A UK National Health Service Randomised Controlled Trial. Sport Med [Internet]. 2019;49(11):1787–805.

Other Journal

  1. Richmond JC. Anterior Cruciate Ligament Reconstruction. Vol. 26, Sports Medicine and Arthroscopy Review. 2018. 165–167 p.
  2. Wang H, Tao M, Shi Q, He K, Cheng CK. Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis. Bioengineering. 2022;9(10).
  3. Söderman T, Wretling ML, Hänni M, Mikkelsen C, Johnson RJ, Werner S, et al. Higher frequency of osteoarthritis in patients with ACL graft rupture than in those with intact ACL grafts 30 years after reconstruction. Knee Surgery, Sport Traumatol Arthrosc [Internet]. 2020;28(7):2139–46. Available from:https://doi.org/10.1007/s00167-019-05726-6
  4. Zein MI. Cedera Anterior Cruciate Ligament (Acl) Pada Atlet Berusia Muda. Medikora. 2013;XI(2):111–21.
  5. Prodromos C, Joyce B, Shi K. A meta-analysis of stability of autografts compared to allografts after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007 Jul;15(7):851–6.
  6. Frank CB, Jackson DW. The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am. 1997 Oct;79(10):1556–76.
  7. Paschos NK, Howell SM. Anterior cruciate ligament reconstruction: Principles of treatment. EFORT Open Rev. 2016;1(11):398– 408.
  8. Maralisa AD, Lesmana SI, Fisioterapi D, Fisioterapi F, Unggul UE, Graft H, et al. Penatalaksanaan Fisioterapi Rekonstruksi Acl Knee Dextra Hamstring. Indones J Physiother Res Educ. 2020;1(1):4–17.
  9. Indriastuti & Pristianto A. Program Fisioterapi pada Kondisi Pasca Rekonstruksi Anterior Cruciate Ligament ( ACL ) Fase I : A Case Report. Physio J. 2021;1(2):1–9.
  10. Oiestad BE, Holm I, Aune AK, Gunderson R, Myklebust G, Engebretsen L, et al. Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up. Am J Sports Med. 2010 Nov;38(11):2201–10.
  11. Oiestad BE, Holm I, Engebretsen L, Risberg MA. The association between radiographic knee osteoarthritis and knee symptoms, function and quality of life 10-15 years after anterior cruciate ligament reconstruction. Br J Sports Med. 2011 Jun;45(7):583–8.
  12. Paterno M V. Incidence and predictors of second anterior cruciate ligament injury after primary reconstruction and return to sport. J Athl Train. 2015;50(10):1097–9.
  13. Lattermann C, Jacobs CA, Proffitt Bunnell M, Huston LJ, Gammon LG, Johnson DL, et al. A Multicenter Study of Early Anti-inflammatory Treatment in Patients with Acute Anterior Cruciate Ligament Tear. Am J Sports Med. 2017;45(2):325–33.
  14. Palmieri-Smith RM, Thomas AC, Wojtys EM. Maximizing Quadriceps Strength After ACL Reconstruction. Clin Sports Med. 2008;27(3):405–24.
  15. Santoso I, Sari IDK, Noviana M, Pahlawi R. Penatalaksanaan Fisioterapi Pada Post Op Rekonstruksi Anterior Cruciate Ligament Sinistra Grade III Akibat Ruptur Di RSPAD Gatot Soebroto. J Vokasi Indones. 2018;6(1):66–80.
  16. Thomas A, Wojtys E, Brandon C, PalmieriSmith R. Muscle Atrophy Contributes to Quadriceps Weakness after ACL Reconstruction. J Sci Med Sport. 2016;19(1):7– 11.
  17. Thomas A, Wojtys E, Brandon C, PalmieriSmith R. Muscle Atrophy Contributes to Quadriceps Weakness after ACL Reconstruction. J Sci Med Sport. 2015;19.
  18. Thomas AC, Villwock M, Wojtys EM, Palmieri-Smith RM. Lower extremity muscle strength after anterior cruciate ligament injury and reconstruction. J Athl Train. 2013;48(5):610–20.;
  19. Carnac G, Vernus B, Bonnieu A. Myostatin in the pathophysiology of skeletal muscle. Curr Genomics. 2007 Nov;8(7):415–22.
  20. Owens J. Blood Flow Restriction Rehabilitation Accessed. Available from: https://www.owensrecoveryscience.com/?gclid =EAIaIQobChMIoda_9I6q8AIVxgorCh0YFgd2EAAYASAAEgK3APD_BwE

Bahasa Abstract

Artikel ini mengevaluasi tentang Efektivitas Blood Flow Restriction Exercise Dalam Peningkatan Quadriceps Strength Pada Pasien ACL Rekonstruksi. TKA ini merupakan studi literatur dalam bentuk naratif. Latar Belakang dilakukannya penelitian ini adalah kasus robeknya ACL ini memiliki angka yang tinggi, yaitu di rentang 78 sampai 81 kasus dari 100.000 populasi di dunia pada satu tahunnya. Penanganan operasi yang paling sering diberikan adalah rekonstruksi ACL. Pengurangan kekuatan quadriceps setelah 6 bulan pasca operasi menyentuh angka 20% dibandingkan sebelum operasi. Dari gejala dan keluhan klinis kelemahan otot quadriceps, salah satu intervensi yang dapat dilakukan Blood Flow Restriction Exercise. Dari pencarian menggunakan berbagai database, ditemukan 10 artikel yang kemudian disaring dan dipilih 7 artikel. Hasil akhir setelah seleksi adalah 5 artikel. Tujuan dari penelitian ini adalah untuk mengetahui efektivitas, dosis dan factor keberhasilan dari BFRE untuk meningkatkan kekuatan otot quadriceps pasien post rekonstruksi ACL menggunakan isokinetic dynamometer dan isometric dynamometer. Hasil Penelitian Terdapat peningkatan kekuatan otot quadricep bahkan dalam fungsional lutut. Dosis yang diberikan beragam namun tetap berdampak positif. Kesimpulan dari penelitian ini adalah pemberian BFRE dapat menjadi solusi intervensi untuk meningkatkan kekuatan otot quadriceps pada pasien post rekonstruksi ACL.

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