BFR Training as an adjunct for elbow pain?

📄 A newly published study has explored the effect of Low-Load Blood Flow Restriction Resistance Training (BFR) in patients with Lateral Elbow Tendinopathy aka. Tennis elbow (LET).

📖 LET can develop as overuse or acutely after repeated action of the lateral muscles of the forearm.

🎯 Objective: To evaluate the effect of BFR VS LLRT + sham-BFR.

Design: RCT

⚗️⚙️ Methods: 46 patients were randomly assigned to BFR or LLRT.

All received soft tissue massage, general advice, a home exercise program, and either supervised exercises with BFR or sham-BFR (2/weekly for 6 weeks).

📌 Primary outcome measures were pain intensity, patient-rated tennis elbow evaluation (PRTEE) score, pain-free grip strength (PFGS), and global rating of change (GROC), measured at baseline, 6 weeks, and 12 weeks.

Between-group differences were assessed using mixed-effects models with participant-specific random effects for continuous data. GROC was analyzed using logistic regression.

📊 Results: Statistically significant between-group differences were found in favor of BFR compared to LLRT in pain intensity at 12 weeks (-1.54, 95% CI: -2.89 to -0.18; p=0.026).

PFGS at 6-weeks (0.20, 95% CI: 0.06 to 0.34; p=0.005).

PRTEE at 6- and 12-weeks follow-up (-11.92, 95% CI: -20.26 to -3.59; p=0.006) & (-15.23, 95% CI: -23.57 to -6.9; p<0.001), respectively.

At 6- and 12 weeks, patients in the BFR group had greater odds of reporting complete recovery or significant improvement (OR=6.0, OR=4.09), respectively.

💡 Conclusion: BFR was superior VS LLRT+sham-BFR for all primary outcomes. Considering the clinically significant between-group improvement (>11 points in PRTEE) and higher success rates in the BFR group. It seems that 12 weeks of low-load BFR resistance training is superior compared to conventional low-load resistance training in the management of LET. Thus, it would be interesting to see how BFR compares to Heavy Slow Resistance (HSR) Training in the treatment of Lateral Elbow Tendinopathy!?

Source: Karanasios et al. (2022) Low-load resistance training with blood flow restriction is effective for managing lateral elbow tendinopathy: a randomized, sham-controlled trial.
doi.org/10.2519/jospt.2022.11211