Blood Flow Restriction Therapy in Lower Limb Extensor Injuries

Not Applicable

Recruiting

Interventions: Behavioral: Physical Therapy with placebo pressure cuff
Behavioral: Physical Therapy with pressure cuff

Brief Summary: The primary objective of the study is to determine the efficacy of blood flow restriction therapy on patients with lower limb extensor injuries by measuring pre and post blood flow restriction therapy strength and muscle mass.

Detailed Description: The purpose is to restrict venous outflow with an inflatable cuff to create a high intensity environment increases muscle hypertrophy, thus promoting a more efficient form of rehabilitation. Blood flow restriction therapy is a blood pressure cuff placed around the desired limb with a handheld device that controls the pressure exerted by the cuff. The cuff is placed around the desired limb before a specific exercise, the physical therapist determines the appropriate pressure and time, and the patient completes the exercise as they normally would. The monitor determines the limb occlusion pressure and has an automatic timer that will deflate after the specified time has elapsed. There are also audio and visual alarms that alert the user of under or over pressurization. The specific pressure will vary based on patient's tolerance and will stay consistent through each exercise. Thus far blood flow restriction therapy has been tested in patients with several pathologies but there is limited literature on its effect on lower limb extensor injuries.

Recruitment & Eligibility

Inclusion Criteria

Must be at least 18 years of age and younger than 65 years of age
ASA class I-II
Diagnosed with a lower limb extensor injury (quadriceps tendon rupture, patella tendon rupture, patella fracture)
Intention to receive physical therapy as standard of care

Exclusion Criteria

Legally incompetent or mentally impaired (e.g. minors, Alzheimer's subjects, dementia, etc.)
Younger than 18 years of age or older than 65
Any patient considered a vulnerable subject
Patients with impaired circulation, peripheral vascular compromise, previous revascularization of the extremity, or severe hypertension
Concomitant lower extremity traumatic injuries, delaying or precluding the subject's ability to participate in the therapy
Immobile or use of mobile assistive device prior to injury
No prior extensor injuries
Patients with Sickle cell anemia or venous thromboembolism
Patients with cancer or Lymphectomies
Patients with increased intracranial pressure
Patients with intention to receive standard therapy and not the study therapy

Arm && Interventions

Group	Intervention	Description
blood flow restriction therapy (placebo)	Physical Therapy with placebo pressure cuff	Patients with a placebo pressure will have a pressure setting, 50% lower than the effective setting as stated in the experimental arm
blood flow restriction therapy (pressure cuff)	Physical Therapy with pressure cuff	The cuff will be placed around the upper thigh of the injured leg and set at a pressure that will prevent approximately 80% arterial blood flow. The machine will determine what pressure is required to reach that 80%, when placed on the leg and turned on.

Primary Outcome Measures

Name	Time	Method
Change in extensor strength of both legs	Visit 3 week 6	Isokinetic strength testing with a Biodex dynamometer to measure peak torque

Secondary Outcome Measures

Name	Time	Method
Change in Knee function	Visit 3 week 6	The IKDC subjective knee evaluation form is a self-administered questionnaire which contains 18 items divided into 3 subgroups. These subgroups are symptoms, sports and daily activities and the patients current and previous levels of knee function.
Change in recovery, muscle strength	Visit 1 Week 6	Having bilateral thigh circumference measured

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