Early research for the clinical application of blood flow restriction therapy primarily focused on rehabilitation after surgery (e.g., ACL repair, knee replacement surgery) and in the elderly population. As BFRT research has matured, many other clinical applications for BFR have arisen. Since BFRT is performed at low loads and intensities, it can be implemented in patients not only to recover from injury/surgery, but also to prevent injury, recover from high intensity exercise, combat aging, and improve quality of life while in pain and with reduced mobility [1]. The earlier BFR is implemented in clinical populations the better the clinical outcomes and quality of life for the patient.
Continued education is important when implementing BFRT, as research is continually progressing our understanding of BFR, how it works, who can benefit from it, and how and when it should be implemented.
Training and education for health care professionals
Implementation of BFR in clinical applications (physical therapy, athletic training, occupational therapy) should be accompanied by an appropriate level of education regarding current BFR research, the appropriate indications and contraindications for safe BFR use, and familiarization with the BFR equipment prior to use.
While BFRT is part of the professional scope of practice for physical therapists and athletic trainers, it is up to the clinician to determine whether they are competent in implementing BFR safely and effectively, which patients should receive BFRT, and which protocol(s) should be utilized. Owens Recovery Science is the world leader for educational product on Blood Flow Restriction. Their courses can be used to augment and enhance understanding of BFR, and enables access to purchase Delfi’s PTS for BFR system, the gold standard of BFR technology.
Prehabilitation and recovery
To prevent injury and to prolong the need for more invasive procedures, blood flow restriction therapy can and should be implemented as early as possible. For patients with unstable and painful joints/limbs, maintaining muscle mass and strength is critical to preventing further injury.
Early implementation of BFR can be helpful for patient’s who put their bodies through extreme loads/intensities (e.g., athletes), as BFR can aid during recovery/rest days without wearing out already over loaded muscles and joints which can be key in preventing injury [1, 2].
For the elderly population who naturally experience muscle atrophy and reduced mobility with age, early implementation of BFR can improve quality of life by reducing pain, improving strength and mobility and possibly delay the need for future surgery [3].
Patients who are waiting for surgery are typically less mobile and are in more pain than usual. This can lead to decreased activity and muscle atrophy and loss of strength. By not being able to upkeep muscle strength, the recovery process can become longer post surgery as there is additional deficit to recover from. Since BFR is implemented at lower loads and intensities, it is possible for patients waiting for surgery to tolerate BFRT to maintain their muscle mass and strength, improving their quality of life while waiting and accelerating the rehabilitation process post surgery [4].
Rehabilitation therapy
Post injury, illness, or surgical procedure, BFRT protocols can be implemented earlier than traditional rehabilitation protocols as the lower loads can be tolerated much earlier on in the recovery process. Further, the patient does not need to work up to the required high load/high intensity exercise to regain muscle mass and strength, so they will see the outcomes of BFRT much earlier on in the recovery process [2, 5-6].
There is a substantial body of clinical research investigating the applications and patient populations who may be appropriate for BFRT. Protocols continue to be developed for an ever-growing range of clinical applications, and clinicians should keep up-to-date on the published literature for the most current safe and effective practices.