Is there an increased risk for VTE with BFR?

A potential risk for clotting or venous thromboembolism (VTE) has been a commonly voiced concern since the early days of BFR application. This is an understandable concern given the publications that highlight an increased incidence rate of VTE after surgery, and many common orthopedic procedures involve tourniquet use. (Sweetland et al. 2009)

This raises a few questions:

- What causes VTE?

- Does the application of a tourniquet for surgery increase the incidence of VTE post-surgically?

- Would the use of a tourniquet for BFR increase risk of VTE?

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How New Technology is Improving Physical Therapy

Recently, Johnny was able to team up with clinicians from the University of Colorado Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation and the Sports Medicine Division, United States Olympic & Paralympic Committee, to write a paper on "How Technology is Improving Physical Therapy" in Current Reviews in Musculoskeletal Medicine. The paper includes sections on Blood Flow Restriction, exoskeletons for high energy lower extremity trauma, force plates, motion capture and biofeedback, musculoskeletal ultrasound, instrumented insoles, patient-centered tools, and personalized reference charts. It covers musculoskeletal injuries ranging from Sports Medicine to Total Joint Arthroplasty.

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Should I measure LOP in the position I am exercising?

The measurement of Limb Occlusion Pressure (LOP) takes into account variables related to the tourniquet as well as variables specific to the individual. Individual variables such as limb circumference, tissue characteristics under the cuff, and systolic blood pressure all influence LOP. Blood pressure is influenced by body position, and of course rises when transitioning from supine to sitting or standing. The increase in blood pressure is a result of mechanical deformation of the vessel and stimulation of group III/IV afferents. This has led many to ask, “should LOP be assessed in the position the patient is exercising to more accurately determine LOP and subsequently the relative occlusion pressure used during the exercise?”

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