Key result
Blood flow restriction plus standard rehab reduces activity pain and improves PRWE scores versus rehab alone.
Why the study?
Blood flow restriction therapy is an emerging rehabilitative addition that may allow increased strength at lower loads over shorter time periods after distal radius fracture surgery.
Does blood flow restriction therapy improve pain and disability in patients treated with volar plate fixation following a displaced distal radius fracture?
RCT (n=9)
randomized
Does blood flow restriction therapy improve pain and disability in patients treated with volar plate fixation following a displaced distal radius fracture?
Blood flow restriction therapy is safe and may accelerate pain reduction and functional improvement when used early after operative management of distal radius fractures.
BFR speeds pain relief and PRWE gains after volar plating; extends small RCT evidence but requires larger trials before practice change.
Background Blood flow restriction (BFR) therapy is an emerging addition to rehabilitative programs that allows patients to increase strength at lower loads over shorter time periods. Therefore, we conducted a study to evaluate the safety and efficacy of a rehabilitation program using BFR to a traditional rehabilitation protocol following operative fixation of distal radius fractures. Methods A randomized controlled study was conducted comparing a standardized rehabilitation protocol alone to a combined protocol with the use of BFR therapy in patients treated with volar plate fixation following a displaced distal radius fracture. The same exercises done in the control group were performed by the BFR group with a restrictive tourniquet in place. Patients were followed with serial radiographs to ensure fracture stability. Outcome measures included wrist range of motion, grip strength, pinch strength, visual analog scale (VAS) pain scores at rest and during activity, patient rated wrist evaluation scores (PRWE), and disabilities of the arm, shoulder, and hand scores. Results Nine patients were randomized and enrolled within the BFR group (n = 5) and control (n = 4) groups. Patients within the BFR group had a significantly greater reduction in pain with activity over the course of the rehabilitation program. Additionally, the BFR group had a significant improvement in PRWE scores during the 8-week rehabilitation program. There was no difference in radiographic measures after initiation of BFR, and all patients tolerated therapy without noted complications. Conclusion BFR therapy is safe and well tolerated after operatively treated distal radius fractures. The addition of BFR therapy can result in quicker reduction in pain with activity and improvement in patient disability when used early following operative management of a distal radius fracture. Level of Evidence This is a Level 1, prognostic study.
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Sgromolo et al. (2020) conducted an RCT in distal radius fractures (n=9). Blood flow restriction (BFR) therapy vs. Standardized rehabilitation protocol alone was evaluated on Pain with activity and patient rated wrist evaluation (PRWE) scores. Blood flow restriction therapy combined with standard rehabilitation significantly reduced pain with activity and improved PRWE scores compared to standard rehabilitation alone.
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