{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:14:00Z","timestamp":1785410040310,"version":"3.56.0"},"reference-count":70,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Blood flow restriction training (BFRT) has been found to reduce quadriceps atrophy and weakness after anterior cruciate ligament (ACL) surgery. However, the clinical benefit of BFRT as compared to general rehabilitation exercise (GRE) alone remains uncertain. This study aimed to compare the effects of BFRT and GRE on ACL reconstruction rehabilitation through a meta\u2010analysis of randomized controlled trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Web of Science, EMBASE, Elsevier and Biosis were searched for randomized controlled trials comparing BFRT and GRE following ACL reconstruction. Primary outcomes included muscle strength (extensor and flexor muscle general strength), Lysholm score, the International Knee Documentation Committee (IKDC) score, extensor muscle torque (peak torque and average torque) and muscle cross\u2010sectional area (CSA). The secondary outcomes included a range of motion (ROM), pain, Y<jats:italic>\u2010<\/jats:italic>balance and the Patient\u2010Reported Outcomes Measurement Information System (PROMIS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen randomized controlled trials involving 376 participants were included. The change in muscle strength (Mean difference, MD: 12.96, 95% confidence interval, [95% CI]: 7.02\u201318.91, heterogeneity, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200939%), Lysholm score (MD: 9.41, 95% CI: 8.93\u20139.88, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200940%) and IKDC score (MD: 9.88, 95% CI: 0.57\u201319.19, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200987%) of the BFRT group were superior to that of the GRE group at the time of last follow\u2010up. However, no significant difference was found between the BFRT and the GRE groups regarding the change in muscle CSA, ROM, extensor muscle torque, pain score, Y\u2010balance and PROMIS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BFRT seems to perform better than GRE in terms of functional improvement and muscle strength following ACL reconstruction, but there seems to be no significant difference between them in terms of joint mobility, pain relief, stability improvement and patient's perception of their disease and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level II.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12527","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:33:40Z","timestamp":1730288020000},"page":"2713-2728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of blood flow restriction training rehabilitation and general rehabilitation exercise after anterior cruciate ligament reconstruction: A meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4014-3707","authenticated-orcid":false,"given":"Luozhifei","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Third Xiangya Hospital of Central South University Changsha Hunan China"},{"name":"Department of Rehabilitation Third Xiangya Hospital of Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8301-025X","authenticated-orcid":false,"given":"Benjamin","family":"Rothrauff","sequence":"additional","affiliation":[{"name":"The Steadman Clinic and Steadman Philippon Research Institute Vail Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8572-9663","authenticated-orcid":false,"given":"Lili","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Third Xiangya Hospital of Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1862-4677","authenticated-orcid":false,"given":"Shirong","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Third Xiangya Hospital of Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7961-9647","authenticated-orcid":false,"given":"Sixian","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Third Xiangya Hospital of Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0277-3819","authenticated-orcid":false,"given":"Jinshen","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Third Xiangya Hospital of Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10010068"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2010.01516.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354658401200102"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-19861001-13"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941738118811337"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.70252\/NOIA5666"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2015.00652"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2021.01.015"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orthtr.2020.04.009"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.26603\/ijspt20200882"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118771286"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241232002"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.882472"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967121S00226"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520904008"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241248589"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzz062"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12121231"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318213fefb"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/19417381231208636"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.05.032"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/19417381211063847"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120970219"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20230804-02"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12217"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-017-0814-6"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097071"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2019.06.014"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-019-01137-2"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1054\/math.1997.0281"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000002384"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.26603\/001c.39798"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e3181df8d10"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jshs.2014.12.005"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/19417381221101006"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/app122312058"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13968"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.47750\/jptcp.2023.30.07.005"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967121S00559"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.26603\/001c.31873"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2019.08.009"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2018.1450898"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.2020-0479"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-023-06483-x"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-017-0795-y"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120906822"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291700009934"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-007-0474-x"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1805931"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0276154"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016470310013680"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231209694"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506296417"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2017.1284341"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-014-0264-9"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.2021-0128"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06631-7"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07442-8"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.26603\/001c.32479"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516629944"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e3182580cd0"},{"key":"e_1_2_13_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2022.08.031"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000001295"},{"key":"e_1_2_13_67_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200012000-00011"},{"key":"e_1_2_13_68_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002437"},{"key":"e_1_2_13_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmart.2022.05.001"},{"key":"e_1_2_13_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.06.027"},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.2340\/jrm.v54.2550"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.12527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T13:19:15Z","timestamp":1760879955000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.12527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,30]]},"references-count":70,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/ksa.12527"],"URL":"https:\/\/doi.org\/10.1002\/ksa.12527","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,30]]},"assertion":[{"value":"2024-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}