Use of Blood Flow Restriction (BFR) Therapy in Post-operative Rehabilitation Following Distal Biceps Tendon Repair

NCT ID: NCT04503421

Last Updated: 2023-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

64 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-15

Study Completion Date

2021-09-15

Brief Summary

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The goal of this investigation is to determine if using BFR during postoperative therapy would lead to increased and expedited strength gains. Additionally, the investigators would like to determine if BFR is beneficial in preventing muscle atrophy and fatty infiltration in the setting of bicep tendon tears, due to the altered tension-length relationship following surgery. The study will also look at patient reported outcomes metrics and pain scores to determine if BFR has a significant impact on the patient experience surrounding distal biceps tear and surgical repair

Detailed Description

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Conditions

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Bicep Tendon Rupture

Keywords

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blood flow restriction Rehabilitation Physical therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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BFR

Patient will use the following rehabilitation protocol while incorporating blood flow restriction therapy:

* Post-op weeks 0-6: Passive shoulder and wrist Range of Motion (ROM) only

* Sling immobilization with active wrist and shoulder ROM
* Active extension of biceps to 30 degrees, No active flexion
* 6-9 weeks full active extension in brace

* Maintain wrist and shoulder flexibility
* Begin rotator cuff/deltoid isometrics, progress active extension in brace
* Weeks 9-12: Gently advance ROM to tolerance

* Discontinue sling
* Begin active flexion and extension against gravity.
* Advance strength to light resistance, maintain flexibility/ROM
* Weeks 12-6 months: Gradual return to full ROM and pain free o Begin gradual flexion strengthening and advance as tolerated

Group Type EXPERIMENTAL

Blood Flow Restriction Therapy

Intervention Type OTHER

Use of a tourniquet set to 50% of limb occlusion pressure while performing post operative physical therapy

Control (no BFR)

patients will use following rehabilitation protocol without the use of blood flow restriction therapy:

* Post-op weeks 0-6: Passive shoulder and wrist Range of Motion (ROM) only

* Sling immobilization with active wrist and shoulder ROM
* Active extension of biceps to 30 degrees, No active flexion
* 6-9 weeks full active extension in brace

* Maintain wrist and shoulder flexibility
* Begin rotator cuff/deltoid isometrics, progress active extension in brace
* Weeks 9-12: Gently advance ROM to tolerance

* Discontinue sling
* Begin active flexion and extension against gravity.
* Advance strength to light resistance, maintain flexibility/ROM
* Weeks 12-6 months: Gradual return to full ROM and pain free o Begin gradual flexion strengthening and advance as tolerated

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Blood Flow Restriction Therapy

Use of a tourniquet set to 50% of limb occlusion pressure while performing post operative physical therapy

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18-80
* Undergoing distal biceps tendon repair

Exclusion Criteria

* Revision Biceps tendon repair,
* Irrepairable tendon injury,
* Biceps repairs with biologic augmentation,
* Patients with concomitant neurovascular injury,
* Inability to tolerate BFR treatment,
* Unable to complete full course of physical therapy,
* Peripheral vascular disease,
* History of Venous thromboembolism (VTE)
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Henry Ford Health System

OTHER

Sponsor Role lead

Responsible Party

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Charles S Day

Orthopedic Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Health Ford Health System

Detroit, Michigan, United States

Site Status

Countries

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United States

References

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Wernbom M, Augustsson J, Raastad T. Ischemic strength training: a low-load alternative to heavy resistance exercise? Scand J Med Sci Sports. 2008 Aug;18(4):401-16. doi: 10.1111/j.1600-0838.2008.00788.x. Epub 2008 May 3.

Reference Type BACKGROUND
PMID: 18466185 (View on PubMed)

Huynh T, Leiter J, MacDonald PB, Dubberley J, Stranges G, Old J, Marsh J. Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique. JB JS Open Access. 2019 Aug 27;4(3):e0013.1-6. doi: 10.2106/JBJS.OA.19.00013. eCollection 2019 Jul-Sep.

Reference Type BACKGROUND
PMID: 31592499 (View on PubMed)

Ohta H, Kurosawa H, Ikeda H, Iwase Y, Satou N, Nakamura S. Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction. Acta Orthop Scand. 2003 Feb;74(1):62-8. doi: 10.1080/00016470310013680.

Reference Type BACKGROUND
PMID: 12635796 (View on PubMed)

Takarada Y, Takazawa H, Ishii N. Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc. 2000 Dec;32(12):2035-9. doi: 10.1097/00005768-200012000-00011.

Reference Type BACKGROUND
PMID: 11128848 (View on PubMed)

Clark BC, Manini TM, Hoffman RL, Williams PS, Guiler MK, Knutson MJ, McGlynn ML, Kushnick MR. Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy adults. Scand J Med Sci Sports. 2011 Oct;21(5):653-62. doi: 10.1111/j.1600-0838.2010.01100.x. Epub 2010 Mar 11.

Reference Type BACKGROUND
PMID: 21917016 (View on PubMed)

Other Identifiers

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Henry - IRB00000253

Identifier Type: -

Identifier Source: org_study_id