- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05754632
The Impact of Blood Flow Restriction Training in Adolescents After ACL Reconstruction: A Randomized Controlled Trial
While there are a number studies that have reported on the use of blood flow restriction training (BFRT) in the adult population, there is limited information about the use of BFRT in the adolescent population. This study aims to evaluate the use of BFRT in conjunction with traditional anterior ligament reconstruction (ACLR) rehabilitation in adolescents.
The purpose of this study is to compare the addition of a BFRT based exercise protocol to a standard ACL rehabilitation protocol in adolescents. Does the addition of BFRT-based exercise improve strength, hypertrophy, and patient reported outcomes after ACLR in the adolescent population?
Study Overview
Status
Intervention / Treatment
Detailed Description
A single randomized control trial will compare the use of exercises augmented with BFRT with quantitative measurements of strength and patient-reported outcomes. A total of 40 youth and adolescent patients undergoing a surgical procedure for ACLR and subsequent physical therapy at our institution will be recruited for this study. Patients will be randomized into one of two groups using computer randomization for allocation: the intervention group receiving BFRT as part of physical therapy, and the control group will follow the institution's standard ACLR rehabilitation protocol. Both groups will follow a time- and criterion-based standardized rehabilitation protocol. The primary outcomes will be isometric and isokinetic knee peak torque and limb symmetry indices. Secondary outcomes will be quadriceps hypertrophy via mid-thigh circumference and patient-reported outcomes.
Target Population Adolescent patients between the ages of 12 and 18 will be recruited at the time of surgery, specifically, those that participate in sports who are undergoing primary ACLR reconstruction at Connecticut Children's
Study Group and Control Group Inclusion Criteria
· Prior to surgery participated in > 50 hours/year of level I or II sports as defined by Noyes et al and planned to return to prior level.
Level I Sports (4-7 days/week) Jumping, hard pivoting, cutting (basketball, volleyball, football, soccer, gymnastics, skiing. wrestling) Running, twisting, turning (racquet sports, baseball, hockey) Level II sports (1-3 days/week) Jumping, hard pivoting, cutting (basketball, volleyball, football, soccer, gymnastics, skiing. wrestling) Running, twisting, turning (racquet sports, baseball, hockey)
- Completion of postoperative rehabilitation following standard protocols
- Orthopedic surgical intervention and physical therapy completed at Connecticut Children's.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Adam P Weaver, PT, DPT
- Phone Number: 79296 8602840296
- Email: aweaver@connecticutchildrens.org
Study Contact Backup
- Name: Arthur Fredericks, MSPT
- Phone Number: 79296 8602840296
- Email: afredericks@connecticutchildrens.org
Study Locations
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Connecticut
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Farmington, Connecticut, United States, 06032
- Recruiting
- Connecticut Children's Sports Physical Therapy
-
Contact:
- Adam P Weaver, PT, DPT
- Phone Number: 79296 860-284-0246
- Email: aweaver@connecticutchildrens.org
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Prior to surgery participated in >50 hours/year of level I or II sports as defined by Noyes et al and planned to return to prior level.
Level I Sports (4-7 days/week) Jumping, hard pivoting, cutting (basketball, volleyball,football, soccer, gymnastics, skiing. wrestling)
- Level II sports (1-3 days/week) Jumping, hard pivoting, cutting (basketball, volleyball,football, soccer, gymnastics, skiing. wrestling)
- Completion of postoperative rehabilitation following standard protocols
- Orthopedic surgical intervention and physical therapy completed at Connecticut Children's.
Exclusion Criteria:
- An additional lower extremity injury at time of knee injury or previous surgical intervention on the knee (ipsilateral and contralateral)
- Multiple ligament ruptures or trauma
- Weight bearing restrictions for greater than 4 weeks after surgery due to concomitant pathology such as meniscal root/radial repair, chondral pathology, or multi-ligament pathology
- Follow-up surgical procedures including, but not limited to, post-operative arthrofibrosis Inability to attend regular physical therapy sessions (≥80% of patient treatment sessions and all assessment visits
- Contraindications to performing BFRT including known history of central or peripheral neurologic impairments, cardiac or metabolic condition or history of deep vein thrombosis (DVT).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: BFR Intervention Group
In addition to the standard ACL rehabilitation protocol, the experimental group will complete 2 exercises using the Delfi BFR cuff 2x/week for 8 weeks during their treatment session at Connecticut Children's Sports Physical Therapy on the second post-operative visit. Cuff size will be determined by patient thigh circumference Limb occlusion pressure will be determined in supine position and all exercises will be completed at 80% occlusion. Long Arc Quadriceps (LAQ) progression Shuttle progression Post-op visit 2- 2 weeks Quadriceps Set Standing Straight Leg Raise 2 weeks-4 weeks Available range LAQ Standing terminal knee extension 4 weeks-8 weeks LAQ (0-90°) Single Limb Shuttle/Leg Press |
The Delfi Tourniquet System is designed to be used in conjunction with exercise.
The system automatically determines the degree of occlusion and allows for safe regulation of pressure.
Patients will then complete exercises with the use of this device.
Other Names:
|
No Intervention: No Intervention/Control Group
In addition to the standard ACL rehabilitation protocol, the control group will complete the same exercises as the experimental group starting on the second post-operative visit. Long Arc Quadriceps (LAQ) progression Shuttle progression Post-op visit 2- 2 weeks Quadriceps Set Standing Straight Leg Raise 2 weeks-4 weeks Available range LAQ Standing terminal knee extension 4 weeks-8 weeks LAQ (0-90°) Single Limb Shuttle/Leg Press |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Range of Motion
Time Frame: Change in range of motion at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Active knee range of motion: Knee AROM will be measured in supine position using a goniometer and standardized procedures reported by Norkin and White
|
Change in range of motion at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isometric Quad strength Peak Torque
Time Frame: Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isometric strength testing to measure peak torque quadriceps strength (unit: ft-lbs) as reported by isokinetic dynamometer on involved and uninvolved limb.
|
Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isometric Quadriceps Strength limb symmetry index
Time Frame: Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Quadriceps limb symmetry index is calculated by taking the values from outcome 1. [ ( peak torque quadriceps involved limb (ft/lbs)/ peak torque quadriceps uninvolved limb (ft-lbs))*100] as reported by isokinetic dynamometer.
This value is expressed as a percentage.
100% would equal perfect symmetry.
|
Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isometric Hamstring Strength Peak Torque
Time Frame: Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isometric strength testing to measure peak torque hamstring strength (unit: ft-lbs) as reported by isokinetic dynamometer on involved and uninvolved limb.
|
Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isometric Hamstring Strength Limb Symmetry Index
Time Frame: Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Hamstring limb symmetry index is calculated by taking the values from outcome 3 [ ( peak torque hamstring involved limb (ft/lbs) / peak torque hamstring uninvolved limb (ft-lbs))*100] as reported by isokinetic dynamometer.
This value is expressed as a percentage.100%
would equal perfect symmetry.
|
Change in strength at Pre-op, 3 months post-op, 6 months post-op, 9 months post-op
|
Isokinetic Quadriceps strength
Time Frame: Change in strength at 6 months and 9 months post-op
|
Isokinetic strength testing to measure peak torque quadriceps strength (unit: ft-lbs) as reported by isokinetic dynamometer on involved and uninvolved limb.
|
Change in strength at 6 months and 9 months post-op
|
Isokinetic Quadriceps Strength limb symmetry index
Time Frame: Change in strength at 6 months and 9 months post-op
|
Quadriceps limb symmetry index is calculated by taking the values from outcome 1. [ ( peak torque quadriceps involved limb (ft/lbs)/ peak torque quadriceps uninvolved limb (ft-lbs))*100] as reported by isokinetic dynamometer.
This value is expressed as a percentage.
100% would equal perfect symmetry.
|
Change in strength at 6 months and 9 months post-op
|
Isokinetic Hamstrings Strength
Time Frame: Change in strength at 6 months and 9 months post-op
|
Isokinetic strength testing to measure peak torque hamstring strength (unit: ft-lbs) as reported by isokinetic dynamometer on involved and uninvolved limb.
|
Change in strength at 6 months and 9 months post-op
|
Isokinetic Hamstring Strength limb symmetry index
Time Frame: Change in strength at 6 months and 9 months post-op
|
Hamstring limb symmetry index is calculated by taking the values from outcome 1. [ ( peak torque quadriceps involved limb (ft/lbs)/ peak torque quadriceps uninvolved limb (ft-lbs))*100] as reported by isokinetic dynamometer.
This value is expressed as a percentage.
100% would equal perfect symmetry.
|
Change in strength at 6 months and 9 months post-op
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quadriceps Hypertrophy
Time Frame: Change in strength at Pre-op, 8 weeks, 3months post-op, 6months, 9 months post-op
|
Thigh Circumference measured at location 10cm superior to patella and measured in cm comparing involved to uninvolved lower extremity
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Change in strength at Pre-op, 8 weeks, 3months post-op, 6months, 9 months post-op
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Pediatric International Knee Documentation Committee
Time Frame: Tracking change at Pre-op, 3months post-op, 6 months post-op, 9 months post-op. 2 years post-op
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Patient Reported Outcome Measure- Scores range from 0 points (lowest level of function or highest level of symptoms) to 100 points (highest level of function and lowest level of symptoms).
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Tracking change at Pre-op, 3months post-op, 6 months post-op, 9 months post-op. 2 years post-op
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Knee Outcomes and Osteoarthritis Scale
Time Frame: Tracking change at Pre-op, 3months post-op, 6 months post-op, 9 months post-op. 2 years post-op
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Patient Reported Outcome Measure- The score is a percentage score from 0 to 100, with 0 representing extreme problems and 100 representing no problems.
This scoring direction, 100 indicating no problems
|
Tracking change at Pre-op, 3months post-op, 6 months post-op, 9 months post-op. 2 years post-op
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Anterior Cruciate Ligament- Return to Sport after Injury
Time Frame: Tracking change at Pre-op, 3months post-op, 6 months post-op, 9 months post-op. 2 years post-op
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Patient Reported Outcome Measure- The scores range from 0 to 100, with higher scores representing patients who are more ready to return to sport
|
Tracking change at Pre-op, 3months post-op, 6 months post-op, 9 months post-op. 2 years post-op
|
Tegner Activity Scale
Time Frame: changes from pre-operative, 9 months, and 2 years post-operative
|
Tegner activity scale will measure sport level- higher level equals higher sport competitive level
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changes from pre-operative, 9 months, and 2 years post-operative
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Adam Weaver, PT, DPT, Physical Therapist
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 22-139
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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