The Effect of Blood Flow Restriction Training on the Patients of Distal Radius Fracture
Condition: Distal Radius Fracture
MeSH terms: Fractures, Bone; Radius Fractures; Wrist Fractures
Study type: Interventional

Summary: 
      The aim of this study was to compare the effect of blood flow restriction (BFR) training and
      traditional rehabilitation training on grip strength, pinch strength (tip pinch strength, key
      pinch strength and tripod pinch strength), range of motion (ROM) of wrist, patient-rated
      wrist evaluation (PRWE) score, muscle stiffness and radiographic outcomes in distal radius
      fracture (DRF) patients during a post-treatment rehabilitation program.
    

Detailed description: 
      This study is a randomized controlled study. Patients in the non-BFR group underwent a
      traditional rehabilitation training. Traditional rehabilitation training is designed based on
      post injury rehabilitation guidelines. This guideline recommends that the early
      rehabilitation of DRF should be progressive, with training loads ranging from self-weight to
      full weight bearing depending on the patient's individual situation. During the six weeks, a
      progressive training load has been applied to the patients. First week: no weight bearing.
      Second to sixth week: resistance was increased by 1LB (~0.45 kg) for individual training only
      if a participant could consecutively achieve at least 30/15/15/15 (75 total) repetitions for
      both training sessions within a given training week. The exercises include grip and pinch,
      wrist flexion with forearm pronated, wrist extension with forearm pronated, wrist flexion
      with forearm supinated, wrist extension with forearm supinated, prayer sign (wrist flexion),
      prayer sign (wrist extension), forearm pronation, and forearm supination. Patients
      participated in 2 training sessions per week with at least 48 hours rest in between for
      continuous 6 weeks. BFR training twice a week for at least 6 weeks has been reported to
      increase muscle hypertrophy and strength. The BFR group underwent the same traditional
      rehabilitation training program but combined with BFR implemented by a medical grade
      tourniquet system (ATS 4000 TS，Zimmer Surgical, Inc. Dover). The tourniquet system consists
      of a ATS 4000 tourniquet system, and a tourniquet cuff (10 cm × 46 cm). The ATS 4000
      tourniquet system tailors the individualized tourniquet pressure to each patient following
      determination of the limb occlusion pressure (LOP), and studies have shown that 50% LOP is
      safe and effective in the rehabilitation of DRF. When the tourniquet system was used, LOPs
      were reassessed for every session before training, and pressures were continually monitored.
      Participants were to perform the entirety of each training (including intra-set rest periods)
      under 50% LOP with the tourniquets released during the 2-minute rest periods between sets.
    

Intervention name(s): Traditional rehabilitation training; Blood flow restriction combined with traditional rehabilitation training
Intervention type(s): Other; Other
Intervention description(s): The non-BFR group undertook traditional rehabilitation training only. Patients participated in 2 training sessions per week with at least 48 hours rest in between for continuous 6 weeks. Clinical assessment of grip strength, pinch strength (tip pinch strength, key pinch strength and tripod pinch strength), ROM of wrist, PRWE score, muscle stiffness and radiographic outcomes, was conducted at the 6th and 12th week from the date of initial DRF.; BFR group completed the traditional rehabilitation training with a medical grade tourniquet applied on the upper arm. Patients participated in 2 training sessions per week with at least 48 hours rest in between for continuous 6 weeks. Clinical assessment of grip strength, pinch strength (tip pinch strength, key pinch strength and tripod pinch strength), ROM of wrist, PRWE score, muscle stiffness and radiographic outcomes, was conducted at the 6th and 12th week from the date of initial DRF.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care