Blood Flow Restriction Treatment to Change Physical Therapy

August 07, 2019

By Delain Stafford

An innovative physical therapy technique originally developed to help wounded soldiers can now benefit injured athletes in our area, as well as patients recovering from surgery and other injuries.

Blood Flow Restriction Therapy, or BFR, is a cutting-edge, new physical therapy service for our region, according to Andrea Marchi, a physical therapist and director of rehabilitation services at SoutheastHEALTH.

This technology was researched and used by rehabilitation specialists working with returning soldiers to help them recover from blast traumas they had sustained in the Middle East. Because of their injuries, therapists were often unable to get the injured soldiers strong enough with the traditional strength training methods. Many times the soldiers needed an amputation despite all their rehab efforts, Marchi says.

Due to the striking results of the research and successful use by the military, BFR was picked up by professional sports leagues and larger Division 1 athletic programs, and it has been used by athletes to recover from and prevent injuries.

“It’s one of the most widely researched physical therapy treatment options at this time, and it’s now spilling over to traditional rehabilitation facilities like ours,” Marchi said.

The technique utilizes inflatable cuffs that apply pressure to the injured extremity while the patient performs low-intensity exercises.

The pressure is customized to the patient’s needs and is precision-controlled by a microprocessor.

This technology produces muscle fatigue that mimics higher intensity work outs, allowing a person who can’t tolerate normal strength training following an injury or surgery to get the same strength gains they would if they were training without injury.

“The patient is able to effectively train with lighter weights and lower intensity early in their recovery process. They can gain strength and muscle size without exercising at an intensity level that could hurt them or that they can’t physically perform,” Marchi said.

The BFR technique addresses one of the most difficult obstacles patients must overcome when recovering from an injury or certain types of surgery — the loss of fitness levels, strength and muscle during the sedentary early stages of the recovery process.

Research has shown there is up to a 30% loss of muscle strength following an injury, and BFR, combined with low-intensity exercise, has been proven to combat this problem.

“It used to be a given that a patient would experience atrophy, or muscle loss, in the affected limb following an injury or surgery because they were not able to safely perform exercises at the level needed to maintain or strengthen the muscle at that point in their rehab,” Marchi said. “It took months to recover from that loss. BFR allows physical therapists to begin effective strength training sooner to prevent that atrophy.”

Patients can experience results quicker when using BFR therapy as well, Marchi said. Increases in strength and muscle size can be seen as early as six weeks with BFR, compared to 12 weeks with traditional strength training.

Blood Flow Restriction Therapy also can be used with biking, walking or other aerobic exercise to improve muscle strength, size and cardiovascular fitness. Marchi said the research is building for using BFR with aerobic exercise. A few studies have already shown improvements with both college athletes and older adults alike. In addition, BFR has been shown to decrease pain during use, enabling the patient to perform exercises that pain would typically prevent. Marchi says she’s successfully used the technique with a patient suffering from advanced knee arthritis who was unable to use stairs before BFR treatments.

“Although this technology has been utilized frequently with sports, there is a lot of research being done with older patients and bedridden people who experience problems with loss of muscle mass,” she said. “This is going to change the way we do physical therapy.”