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http://dspace.ufdpar.edu.br/jspui/handle/prefix/673| metadata.dc.type: | Artigo de Periódico |
| Título : | Effects of vascular occlusion in the lower limbs on rehabilitation after anterior cruciate ligament reconstruction: an integrative review |
| metadata.dc.creator: | Saboya, Felipe Oliveira Oliveira, Thiago Silva Alves de Costa, Matheaus Oliveira da Craveiro, Artur da Costa e Silva Cunha, Vitor de Assis Silva, Marcos William Cabral |
| metadata.dc.description.resumo: | The anterior cruciate ligament (ACL) is an important component of the knee responsible for limiting varus and valgus stresses, hyperextension and preventing anterior translation of the tibia in exion, in addition to providing stability to the knee. It originates anteriorly to the intercondylar eminence of the tibia, on the lateral surface of the medial tibial plateau, and inserts on the medial surface of the lateral femoral condyle, following a superior-posterior path (SACCO; TANAKA, 2008). Abnormal anterior-posterior displacement movements of the tibia relative to the femur are referred to as drawer movements. In cases of ACL rupture or injury, the tibial displacement is anterior, resulting in a positive anterior drawer sign. The typical mechanism of ACL injury involves a combination of valgus stress, lateral rotation of the femur in a closed kinetic chain, and knee exion—movements frequently observed in sports activities during pivots and directional changes with a xed foot (SACCO; TANAKA, 2008). The injury occurs when the ligament is stretched beyond its elastic capacity, and can be classi ed into three grades according to the extent of the rupture. A grade 1 injury occurs when there is a slight ligament injury with maintenance of the joint stability. In a grade 2 injury, a partial rupture of the ligament bers occurs, resulting in ligament laxity. A grade 3 injury involves a complete rupture of the ligament structure, thus generating instability (PINHEIRO; SOUSA, 2015). Studies indicate that ACL injuries are more common among individuals who engage in sports activities, especially at a professional level. Lima, et al (2020) demonstrated that knee injuries, including ACL injuries, are the fth most frequent type of injury in soccer. Global epidemiology on the subject is well-documented. According to Pinheiro and Souza (2015), in Germany in 2015, the incidence of ACL ruptures in the general population was 30 cases per 100,000 inhabitants and around 70 cases per 100,000 among athletes. Similarly, according to the authors, the United States recorded around 200,000 ACL injuries, of which 100,000 required surgical treatment. The diagnosis is based on clinical history, physical examination and imaging studies. Patients with ACL injuries present pain, edema, redness, loss of range of motion and a sensation of knee instability. Tests are always performed bilaterally, compared with the healthy knee. The Lachman, Pivot Shift, Mac-Intosh and Anterior Drawer tests can be used in clinical practice (PINHEIRO; SOUSA, 2015). Several techniques are employed for Anterior Cruciate Ligament Reconstruction (ACLR) such as autografts using the quadriceps tendon, hamstring tendons, and allograft materials. The gold standard is the patellar tendon autograft, which involves arthroscopy for graft harvesting, graft preparation, intercondylar notchplasty, drilling of tibial and femoral tunnels, graft passage, and femoral and tibial graft fixation (SCOTT, 2019). Muscle atrophy and weakness are common in patients undergoing anterior cruciate ligament reconstruction, and efforts to minimize these effects are a challenge in the treatment of this surgery. Strength development depends on the external load exerting traction on the muscle and the number of repetitions performed, in which, to achieve hypertrophy, a load <60% and repetitions between 8 and 12 would be required. However, training at this intensity soon after anterior cruciate ligament reconstruction stresses the damaged tissues, delaying the healing process and prolonging rehabilitation time (LORENZ et al., 2021). This highlighted the need for a technique capable of providing low-intensity training, while producing positive effects on muscle strengthening, using lower loads, with repetitions until failure, to minimize excessive stress on healing tissues, without compromising effectiveness compared to conventional strength training. Blood Flow Restriction Training (BFRT) is synonymous with terms such as Kaatsu (Kaatsu Global, Inc), ow occlusion training, and hypoxic training. The test is performed using a cuff to promote partial occlusion of the affected limb. The loads achieved in training are generally lower (20% to 30% of 1-RM; 15 to 30 repetitions per set) due to the low blood supply oxygenating the muscle during the test, consequently leading to fatigue more quickly (LORENZ et al., 2021). Therefore, there is optimism regarding the applications of the technique, as numerous studies are being conducted on the subject. Despite using lower loads, BFRT generates a high perception of effort while preserving surgical sites and reducing shear forces. However, there are still uncertainties in the literature about the effects of this technique in patients undergoing ACLR. |
| Resumen : | Introduction: Blood Flow Restriction Training consists of practicing physical exercises with partial restriction of blood ow. Signicant muscle hypertrophy and strength adaptations can be achieved using light external loads. This effect has been observed in several clinical populations with load limitations. However, there are still uncertainties in the literature about the effects of this technique in patients undergoing rehabilitation after Anterior Cruciate Ligament Reconstruction. Objectives: To analyze the effects of the vascular occlusion technique on the lower limbs in patients undergoing rehabilitation after Anterior Cruciate Ligament Reconstruction. Methods: This is an integrative review, with searches performed in the PubMed, Scopus and Embase databases using the English descriptors blood ow restriction therapy; anterior cruciate ligament; resistance training and their variations in the same language, connected through the Boolean operator AND. Articles that referred to the topic addressed and/or related themes in full and publications in Portuguese or English were included, and incomplete texts and those that were not available in full were excluded. Result and Discussion: Ten manuscripts were selected for full analysis. Four publications demonstrated benefits related to increased muscle strength, four demonstrated improvement in atrophy or preservation of muscle mass volume, and three articles discussed improvements in pain perception. Conclusion: The technique of blood ow restriction therapy in post-surgical rehabilitation of the anterior cruciate ligament has shown promising potential regarding strength improvement, atrophy reduction and of pain relief. However, there is still a lack of protocols that can guide the indications of this therapy. |
| Palabras clave : | blood flow restriction therapy; anterior cruciate ligament; resistance training. |
| metadata.dc.subject.cnpq: | CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
| metadata.dc.language: | por |
| metadata.dc.publisher.country: | Brasil |
| Editorial : | Universidade Federal do Delta do Parnaíba |
| metadata.dc.publisher.initials: | UFDPar |
| metadata.dc.rights: | Acesso Aberto |
| URI : | http://dspace.ufdpar.edu.br/jspui/handle/prefix/673 |
| Fecha de publicación : | 12-may-2025 |
| Aparece en las colecciones: | Bacharelado em Fisioterapia |
Ficheros en este ítem:
| Fichero | Descripción | Tamaño | Formato | |
|---|---|---|---|---|
| Felipe Oliveira Saboya_artigo.pdf | 581,25 kB | Adobe PDF | Visualizar/Abrir |
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