Blood Flow Restriction Therapy to Restore Hand and Upper Extremity Function after Recovery Periods Prolonged by Joint Immobilization
Complex wrist and hand injuries requiring partial or complete immobilization of joints can prolong recovery periods and decrease return to function, especially in the multi-trauma setting. Weight bearing and range of motion limitations prevent risk of fracture displacement and allow for collagen maturation in the case of traumatic reconstructions. Muscle atrophy and hand restoration can be a challenge for these patients. Blood Flow Restriction Therapy (BFR) is a possible solution. BFR was first published in the late 1990’s, specifically in athletes. Later popularized with lower extremity injuries, it has recently been evidenced for the upper extremity. BFR has been found very useful to reduce the rate of muscle atrophy, decrease overall recovery times and promote earlier return to activities. After an introductory discussion on surgical treatment for complex articular fractures and ligamentous injuries that are treated with spanning or bridge plate fixation across traumatized joints, we will present several cases where we have undertaken BFR as part of the treatment when addressing muscle atrophy related to joint immobilization. We will also present a comparative analysis of these outcomes to similar treatments where BFR was not included. Evidence for or against the use of BFR for upper extremity rehabilitation will be discussed.
Discuss and gather knowledge of surgical indications for use of spanning plate fixation and other reconstruction principles that influence the need for joint immobilization.
Describe therapeutic indications and potential benefits of Blood Flow Restriction Therapy for patients with partial or complete immobilization of joints following injury and/or surgery.
Apply therapeutic principles and treatment parameters to specific patient cases who may benefit from Blood Flow Restriction Therapy.
Interpret self-reported and objective patient outcomes following the use of Blood Flow Restriction Therapy following wrist joint immobilization.