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Blood Flow Restriction Therapy*BFR*NCT07406763

Blood Flow Restriction in ACL Reconstruction Rehabilitation: A Double-Blinded RCT

A study testing traditional rehabilitation protocol and Blood Flow Restriction in people with Blood Flow Restriction Therapy and Anterior Cruciate Ligament (ACL), run by Ahmed Mohamed Mahmoud Abdelaziz Khalil at 2 sites in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this clinical trial is to learn whether adding blood flow restriction (BFR) training to a traditional rehabilitation protocol (TRP) can improve muscle strength, knee proprioception, range of motion, pain, and lower limb function after anterior cruciate ligament reconstruction (ACLR). Read more about this study

Who is it for?
Ages 18 to 35 years
What is being tested?
traditional rehabilitation protocol and Blood Flow Restriction
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
2 sitesEgypt
Study dates
1 Feb 2020to 1 Feb 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • All sexes
  • No healthy volunteers
  • Adult

Inclusion Criteria Male or female participants aged 18-35 years Undergoing primary unilateral anterior cruciate ligament reconstruction Reconstruction performed using semitendinosus tendon autograft Referred for postoperative rehabilitation by an orthopedic surgeon Medically cleared to participate in postoperative rehabilitation and exercise training Ability to understand and follow verbal instructions Willingness to participate and provide written informed consent Exclusion Criteria History of previous surgery on either knee Concomitant ligament injuries requiring surgical repair (e.g., PCL, MCL, LCL) Severe meniscal injury requiring repair or affecting rehabilitation progression Known cardiovascular, vascular, or thromboembolic disorders Peripheral vascular disease or conditions contraindicating blood flow restriction training Neurological disorders affecting lower limb function Uncontrolled systemic disease (e.g., uncontrolled diabetes or hypertension) Postoperative complications such as infection, deep vein thrombosis, or graft failure Inability to comply with the rehabilitation program or follow-up assessments

Trial locations and contacts

2 sites in 1 country.

Egypt2 sites
  • Cairo University

    Cairo, Cairo Governorate, 11511

  • Physical Therapy

    Giza, 12613

Other trials in Egypt

About this study

Official title: Effect of Adding Blood Flow Restriction to Traditional Program After Anterior Cruciate Ligament Reconstruction: A Double-Blinded Randomized Controlled Trial

The goal of this clinical trial is to learn whether adding blood flow restriction (BFR) training to a traditional rehabilitation protocol (TRP) can improve muscle strength, knee proprioception, range of motion, pain, and lower limb function after anterior cruciate ligament reconstruction (ACLR).

This study is conducted in male and female adults aged 18-35 years who underwent ACLR using a semitendinosus tendon autograft.

Read more

The main questions it aims to answer are:

Does adding BFR to a traditional rehabilitation protocol improve quadriceps and hamstring muscle strength after ACLR? Does adding BFR improve knee joint proprioception, range of motion, pain, and lower limb function after ACLR? Researchers compared a traditional rehabilitation protocol alone (control group) with the same protocol combined with blood flow restriction training (BFR group) to see if BFR provides superior improvements in postoperative outcomes.

Participants was: randomly assigned to either a traditional rehabilitation group or a BFR-assisted rehabilitation group Perform supervised rehabilitation exercises from the 2nd to the 12th postoperative week Undergo assessments of muscle strength, knee proprioception, range of motion, pain, and function Be evaluated 1 week before surgery and at 1.5 and 3 months after ACL reconstruction

Read the detailed description

Anterior cruciate ligament reconstruction (ACLR) is commonly followed by persistent quadriceps and hamstring weakness, reduced knee range of motion, impaired proprioception, pain, and limitations in lower limb function despite standard rehabilitation. Traditional postoperative rehabilitation protocols may not fully restore neuromuscular performance within the early months following surgery.

Blood flow restriction (BFR) training has emerged as a rehabilitation strategy that allows low-load exercise to produce strength gains comparable to high-load training by partially restricting arterial inflow and venous outflow during exercise. This approach may be particularly beneficial in the early postoperative phase after ACLR, when high mechanical loading is contraindicated.

This randomized controlled clinical trial investigates the effects of adding BFR training to a traditional rehabilitation protocol following ACL reconstruction. Participants are randomly allocated to either a traditional rehabilitation protocol alone or the same protocol combined with BFR applied to the operated limb during exercise sessions. Rehabilitation is initiated in the early postoperative period and continues for a standardized duration.

Clinical outcomes related to muscle performance, knee joint function, proprioceptive accuracy, range of motion, and pain are evaluated at multiple time points before and after surgery to examine short-term and mid-term recovery patterns. The study aims to determine whether the inclusion of BFR enhances functional recovery compared with conventional rehabilitation alone following ACLR.

Being tested
traditional rehabilitation protocol, Blood Flow Restriction
Keywords
ACLR, BFRT

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • traditional rehabilitation protocolOther

    The traditional rehabilitation protocol includes progressive therapeutic exercises aimed at restoring:

    Quadriceps and hamstring muscle strength Knee joint range of motion Neuromuscular control and functional performance

  • Blood Flow RestrictionDevice

    Blood flow restriction was applied to the proximal thigh of the operated limb using a specially designed sphygmomanometer cuff capable of partially restricting arterial inflow and venous outflow during exercise. BFR was used during low-load resistance exercises targeting the quadriceps and hamstring muscles, in accordance with postoperative safety guidelines.

Study groups in NCT07406763
Study groupRoleWhat they receive
Traditional Rehabilitation Protocol GroupActive comparatorParticipants in this group received a standard postoperative rehabilitation program following anterior cruciate ligament reconstruction (ACLR) from the 2nd to the 12th postoperative week.
Receives: Other: traditional rehabilitation protocol
Blood Flow Restriction (BFR) plus Traditional Rehabilitation GroupExperimentalParticipants in this group received the same traditional postoperative rehabilitation protocol as the control group from the 2nd to the 12th postoperative week, with the addition of blood flow restriction (BFR) training applied during selected strengthening exercises.
Receives: Other: traditional rehabilitation protocol; Device: Blood Flow Restriction

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Quadriceps Muscle Strength

    Assessed using a handheld dynamometer (HHD) Measured on the operated limb

    Measured: preoperative baseline, 1.5 months post-operative, and 3 months post-operative

  2. Hamstring Muscle Strength

    Assessed using a handheld dynamometer (HHD) Measured on the operated limb

    Measured: preoperative baseline, 1.5 months post-operative, and 3 months post-operative

Secondary outcomes (4)
  1. Knee Joint Proprioception (Joint Position Sense)

    Assessed using a digital inclinometer Evaluated as joint position sense accuracy

    Measured: preoperative baseline, 1.5 months post-operative, and 3 months post-operative

  2. Knee Joint Range of Motion (ROM)

    Flexion and extension measured using a digital goniometer

    Measured: preoperative baseline, 1.5 months post-operative, and 3 months post-operative

  3. Knee Joint Pain

    Assessed using the Visual Analog Scale (VAS)

    Measured: preoperative baseline, 1.5 months post-operative, and 3 months post-operative

  4. Lower Limb Function

    Assessed using the Arabic version of the Lower Extremity Functional Scale (LEFS)

    Measured: preoperative baseline, 1.5 months post-operative, and 3 months post-operative

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Feb 2026
  2. Study start1 Feb 2020
  3. Primary completion1 Feb 2021
  4. Study completion1 Feb 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Double-blinded randomized controlled trial
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07406763
Sponsor's protocol ID
P.T.REC/012/003141
Acronym
*BFR*
Status last verified
Feb 2026
First submitted
6 Feb 2026
Last updated
12 Feb 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Not applicable - the thesis does not describe a plan to share individual participant data with other researchers.

Publications

  • Abe T, Kearns CF, Sato Y. Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol (1985). 2006 May;100(5):1460-6. doi: 10.1152/japplphysiol.01267.2005. Epub 2005 Dec 8.

    PubMed 16339340
  • Kramer LC, Denegar CR, Buckley WE, Hertel J. Factors associated with anterior cruciate ligament injury: history in female athletes. J Sports Med Phys Fitness. 2007 Dec;47(4):446-54.

    PubMed 18091686
  • Elwood PC, Pickering J, Bayer A, Gallacher JE. Vascular disease and cognitive function in older men in the Caerphilly cohort. Age Ageing. 2002 Jan;31(1):43-8. doi: 10.1093/ageing/31.1.43.

    PubMed 11850307
  • Yip T, Wang Y, Mootoo C, Mirpuri S. Moderating the association between discrimination and adjustment: A meta-analysis of ethnic/racial identity. Dev Psychol. 2019 Jun;55(6):1274-1298. doi: 10.1037/dev0000708. Epub 2019 Mar 25.

    PubMed 30907605
  • Pletch A, Morcuende J, Barriga H, Segura J, Salas A. Photovoice and Clubfoot: Using a Participatory Research Method to Study Caregiver Adherence to the Ponseti Method in Peru. Iowa Orthop J. 2015;35:160-8.

    PubMed 26361460
  • Lepley AS, Grooms DR, Burland JP, Davi SM, Kinsella-Shaw JM, Lepley LK. Quadriceps muscle function following anterior cruciate ligament reconstruction: systemic differences in neural and morphological characteristics. Exp Brain Res. 2019 May;237(5):1267-1278. doi: 10.1007/s00221-019-05499-x. Epub 2019 Mar 9.

    PubMed 30852644
  • Herring AA, Stone MB, Frenkel O, Chipman A, Nagdev AD. The ultrasound-guided superficial cervical plexus block for anesthesia and analgesia in emergency care settings. Am J Emerg Med. 2012 Sep;30(7):1263-7. doi: 10.1016/j.ajem.2011.06.023. Epub 2011 Oct 24.

    PubMed 22030184
  • Laurentino GC, Loenneke JP, Mouser JG, Buckner SL, Counts BR, Dankel SJ, Jessee MB, Mattocks KT, Iared W, Tavares LD, Teixeira EL, Tricoli V. Validity of the Handheld Doppler to Determine Lower-Limb Blood Flow Restriction Pressure for Exercise Protocols. J Strength Cond Res. 2020 Sep;34(9):2693-2696. doi: 10.1519/JSC.0000000000002665.

    PubMed 29912080
  • Schlag J, Pouget A, Sadeghpour S, Schlag-Rey M. Interactions between natural and electrically evoked saccades. III. Is the nonstationarity the result of an integrator not instantaneously reset? J Neurophysiol. 1998 Feb;79(2):903-10. doi: 10.1152/jn.1998.79.2.903.

    PubMed 9463451
  • Felszeghy S, Modis L, Nemeth P, Nagy G, Zelles T, Agre P, Laurikkala J, Fejerskov O, Thesleff I, Nielsen S. Expression of aquaporin isoforms during human and mouse tooth development. Arch Oral Biol. 2004 Apr;49(4):247-57. doi: 10.1016/j.archoralbio.2003.09.011.

    PubMed 15003543
  • Krych AJ, Pitts RT, Dajani KA, Stuart MJ, Levy BA, Dahm DL. Surgical repair of meniscal tears with concomitant anterior cruciate ligament reconstruction in patients 18 years and younger. Am J Sports Med. 2010 May;38(5):976-82. doi: 10.1177/0363546509354055. Epub 2010 Mar 18.

    PubMed 20299545
  • Liu A, Xue GH, Sun M, Shao HF, Ma CY, Gao Q, Gou ZR, Yan SG, Liu YM, He Y. 3D Printing Surgical Implants at the clinic: A Experimental Study on Anterior Cruciate Ligament Reconstruction. Sci Rep. 2016 Feb 15;6:21704. doi: 10.1038/srep21704.

    PubMed 26875826
  • Lindstrom M, Strandberg S, Wredmark T, Fellander-Tsai L, Henriksson M. Functional and muscle morphometric effects of ACL reconstruction. A prospective CT study with 1 year follow-up. Scand J Med Sci Sports. 2013 Aug;23(4):431-42. doi: 10.1111/j.1600-0838.2011.01417.x. Epub 2011 Nov 23.

    PubMed 22107159
  • Loenneke JP, Abe T, Wilson JM, Thiebaud RS, Fahs CA, Rossow LM, Bemben MG. Blood flow restriction: an evidence based progressive model (Review). Acta Physiol Hung. 2012 Sep;99(3):235-50. doi: 10.1556/APhysiol.99.2012.3.1.

    PubMed 22982712
  • Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE. A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol). 2001 Jun;16(5):438-45. doi: 10.1016/s0268-0033(01)00019-5.

    PubMed 11390052

Questions about this trial

What is this clinical trial studying?

A study testing traditional rehabilitation protocol and Blood Flow Restriction in people with Blood Flow Restriction Therapy and Anterior Cruciate Ligament (ACL), run by Ahmed Mohamed Mahmoud Abdelaziz Khalil at 2 sites in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quadriceps Muscle Strength (time frame: preoperative baseline, 1.5 months post-operative, and 3 months post-operative). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07406763, which also lists 25 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Feb 2026.

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