COMPARATIVE EFFECTIVENESS OF BLOOD FLOW RESTRICTION TRAINING VERSUS PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION TECHNIQUES IN MUSCLE STRENGTHENING AMONG POST-ACL RECONSTRUCTION PATIENTS

Abstract

Background: Rehabilitation following anterior cruciate ligament (ACL) reconstruction primarily focuses on restoring muscle strength, functionality, and joint stability to support effective recovery. Blood Flow Restriction Training (BFRT) and Proprioceptive Neuromuscular Facilitation (PNF) are widely utilized interventions for muscle strengthening. While both techniques are effective, there is limited comparative evidence regarding their impact on post-ACL reconstruction recovery. Determining their relative effectiveness is critical for optimizing rehabilitation protocols and improving outcomes for patients undergoing ACL reconstruction.

Objective: To compare the effectiveness of blood flow restriction training versus proprioceptive neuromuscular facilitation techniques in enhancing muscle strength among post-ACL reconstruction patients.

Methods: A randomized clinical trial was conducted on 30 male participants aged 25 to 45 years who began ACL rehabilitation two weeks post-surgery. Participants with hip or ankle pathologies, diabetes, or other lower limb orthopedic issues were excluded. The study was conducted at Civil Hospital Faisalabad and Allied Hospital Faisalabad from April to November 2024. Participants were randomly allocated into two groups: Group A underwent BFRT, while Group B participated in PNF. Both groups followed a 10-week rehabilitation protocol. Muscle strength was assessed using Hand-Held Dynamometry (HHD), and knee function was evaluated using the International Knee Documentation Committee (IKDC) form. Data analysis was performed using SPSS 24.0.

Results: Pre-treatment muscle strength, measured by HHD, showed no significant difference between the groups (Group A: 45.3 ± 7.2 Nm, Group B: 44.8 ± 6.9 Nm, P = .823). Post-treatment, Group A demonstrated significantly greater muscle strength (65.8 ± 6.5 Nm) compared to Group B (60.5 ± 5.8 Nm, P = .020). Similarly, IKDC scores improved more significantly in Group A (78.3 ± 5.4%) than in Group B (73.4 ± 5.1%, P = .015).

Conclusion: Both BFRT and PNF effectively improved muscle strength and knee function in post-ACL reconstruction patients. However, BFRT demonstrated superior outcomes, making it a valuable intervention for enhancing muscle strength and accelerating recovery.