The impact of blood flow restriction therapy on orthopaedic conditions of the upper extremity: a systematic review of randomized controlled trials.

Abstract

<h4>Background</h4>Blood flow restriction therapy (BFRT) has gained recognition in recent years as an adjunct to rehabilitation to maximize results for patients with poor strength and endurance. However, literature on the effects of BFRT for conditions afflicting the upper extremity is limited. The purpose of this study was to analyze the available literature regarding the role of BFRT in upper extremity conditions and evaluate its influence on functional and patient reported outcomes.<h4>Methods</h4>PubMed, Embase, and Cochrane Trials were searched in July 2024. Only randomized controlled trials (RCTs) with upper-extremity BFRT were included. Several variables were extracted, including number of patients per study, patient demographics, type of pathology, and functional outcomes. The risk of bias for each eligible RCT was evaluated using the Revised Cochrane Risk-of-Bias Tool for Randomized Trials. Standard descriptive statistics were used to report outcomes for all the included study findings. BFRT protocols were reviewed and presented in a narrative manner.<h4>Results</h4>The systematic literature search yielded 605 articles, of which four RCTs involving 133 patients met the inclusion criteria. The conditions evaluated included distal radius fractures, osteoarthritis of the hand, and lateral elbow tendinopathy. The evidence for all studies was deemed low risk of bias. Overall, patients who received BFRT demonstrated marginally greater strength, improved pain control, and improved patient-reported outcome measures (PROMs) when compared to a non-BFRT counterpart.<h4>Conclusions</h4>A comprehensive review of the literature examining BFRT as an adjunct treatment for upper extremity conditions was conducted. Patients treated with BFRT may experience greater strength, improved pain control, and improved PROMs when compared to a non-BFRT counterpart. Future, large-scale studies are necessary to further define the benefits of BFRT in orthopaedic conditions of the upper extremity.