Effects of Blood Flow Restriction Training and Instrument-Assisted Soft Tissue Mobilization for Pain, Strength, Range of Motion, and Kinesiophobia Among ACL Reconstruction Patients.

Summary

This randomized clinical trial aims to compare the effects of Blood Flow Restriction Training (BFR) and Instrument-Assisted Soft Tissue Mobilization (IASTM) on pain, quadriceps muscle strength, knee range of motion (ROM), and kinesiophobia in patients following anterior cruciate ligament reconstruction (ACLR). ACLR patients commonly experience persistent muscle weakness, limited ROM, pain, and fear of movement, which can delay functional recovery and return to activity. A total of 46 participants (8-16 weeks post-ACLR) will be randomly allocated into two groups: a BFR group and an IASTM group. Both groups will receive interventions twice weekly for 8 weeks alongside standard physiotherapy. The BFR group will perform low-load resistance exercises under controlled vascular occlusion, while the IASTM group will receive soft tissue mobilization using specialized instruments combined with conventional rehabilitation. Outcome measures will include quadriceps strength (handheld dynamometer), pain (Numeric Pain Rating Scale), knee ROM (goniometer), and kinesiophobia (Tampa Scale of Kinesiophobia), assessed at baseline and post-intervention. The study aims to determine which intervention provides superior improvements in physical and psychological outcomes during early rehabilitation after ACL reconstruction.

Eligibility

Inclusion Criteria:

* Age between 18 and 40 years.
* Both genders.
* Undergoing Primary Unilateral ACLR (using autologous tendon graft).
* Medically cleared for low load rehabilitation (Wound healed, stable graft per surgeon).
* Active knee flexion of ≥100° on the operative limb.
* 8-16 weeks after reconstructive surgery.
* Willing to comply with all rehabilitation sessions and follow up assessments; give informed consent

Exclusion Criteria:

* Significant meniscectomy requiring protected weight-bearing
* Active DVT, vascular disease, uncontrolled hypertension or other BFR contraindications
* Patients exhibiting extension lag (inability to achieve full active knee extension) on the operated limb.
* Neuromuscular disorders
* Skin lesions preventing IASTM
* Pregnancy
* Contraindications to exercise

Conditions2

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