Personalized Blood Flow Restriction Rehabilitation (PBFR)

Aug 22, 2018

Gabe Lucas

by Gabe Lucas
PT, CSCS | Gilbert-Mesa Location

What is BFR?
BFR utilizes a tourniquet system similar to a blood pressure cuff to reduce blood flow to a limb while the patient is performing low load strengthening exercises. Typically, to grow muscle and strength, a person needs to work at a load of 70% 1 repetition max weight. However, people recovering from injury or with arthritic joints are not able to perform this load due to pain and safety. Patients using BFR have demonstrated improved muscle strength and hypertrophy with only 20-30% loads of 1 rep max (1RM). This technique allows patients to work muscles without placing an excessive load on the joint and should be performed under the supervision of a licensed physical therapist. The gains are similar to High-Intensity training at heavy weight. Research has demonstrated improved post-exercise muscle protein synthesis, higher growth hormone elevations, and cellular swelling with BFR compared to resistance training at low loads and no BFR and similar to High-Intensity Training.
When is BFR used?
BFR is indicated in patients with muscle atrophy and weakness that are unable to train at high loads.  Post-operative knees benefit greatly from BFR training. One example of this is a post-op ACL reconstruction that is unable to perform high resistance exercise, particularly in the early stages of rehabilitation.  BFR allows rapid improvement in muscle strength and hypertrophy during these early stages.  BFR is also used commonly in the geriatric community who struggle to gain strength, with arthritic joints to decrease stress and improve strength around the joint, in athletes wanting to improve performance, and in recovery from intense exercise.
Is BFR Safe?
Like any other intervention, BFR is not indicated for all patients and should be performed under the supervision of a licensed physical therapist.  Hundreds of studies have been conducted on BFR and there have been minimal issues. It is also important to perform BFR with an FDA approved device that is self-regulating. These devices are manufactured by Delphi Incorporated through Owens Recovery Science. There are very few certified clinicians with FDA accredited units for BFR in Arizona and one can be located at Foothills Sports Medicine Gilbert-Mesa location. Please contact the office for scheduling to help with strength gains, post-surgical progress, and performance.
Summary
In short BFR training allows our patients and athletes to increase strength and improve muscle size and tone under a low load that is safe for patients and their joints. The research in the literature is vast and expansive. The majority of professional sports teams in the United States and Europe are already incorporating it with their athletes. There are large grants with NASA and the military for more research and implementation. The national orthopedic community is already implementing this treatment with their post-operative patients. This is a treatment modality that we feel is such a blessing for our patients and are excited to provide.
If you are interested in learning more about implementing BFR into your physical therapy plan, we currently offer this service at our Arrowhead, North Central Phoenix and Gilbert-Mesa clinics.

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