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Ankle ReconstructionBFRankle reconNCT07451210

Evaluating the Efficacy of Blood Flow Restriction Therapy in a Randomized Clinical Trial for Postoperative Rehabilitation Following Ankle Ligament Reconstruction

A study testing blood flow restriction in people with Ankle Reconstruction and Blood Flow Restriction Therapy, run by Texas Tech University Health Sciences Center at 5 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this single blinded clinical trial is to investigate blood flow restriction (BFR) for rehabilitation of patients after ankle ligament reconstruction surgery. Outcome measures will be compared between the standard of care (SoC) and BFR groups at the end of the study intervention. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
blood flow restriction
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
105 participants
Where
5 sitesUnited States
Study dates
1 Mar 2026to 31 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18-65 years.
  • Post ankle ligament reconstruction surgery (medial or lateral, with or without ankle scope).
  • Capability of paying for physical therapy or having insurance coverage for at least 6 weeks of therapy.

Who cannot join

  • Major cardiac or connective tissue disorders (e.g., Ehlers-Danlos syndrome, Marfan syndrome).
  • Autoimmune disorders.
  • History of stroke or deep vein thrombosis (DVT).
  • Bleeding or coagulation disorders.
  • Congenital or developmental musculoskeletal disorders (e.g., cerebral palsy, Parkinson's disease).
  • Pregnancy (current or planning to become pregnant in the next 4 months)
Show all 12Show fewer
  • Malignancy (cancer).
  • Professional athletes.
  • Workers compensation insurance status as worker's compensation often does not cover the necessary duration of physical therapy (minimum of 4 weeks).
  • Be currently enrolled or have been enrolled in another interventional clinical research study within the past 30 days (at time of consent); or
  • Be deemed unsuitable for inclusion in the study at the discretion of the Investigators
  • Cognitively not able to consent or participate in research (dementia; severe developmental delay; language/communication limitations; brain injury; etc.)

Trial locations and contacts

5 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Jenny Hudnall, MS BME contact

806-743-2260

jennifer.hudnall@ttuhsc.edu

Evan Hernandez, MBA contact

806-743-4600

Evan.J.Hernandez@ttuhsc.edu

5 sites in 1 country

United States5 sites, 2 recruiting
  • Physical Therapy Today (PTT)

    Lubbock, Texas, 79407

    Active, not recruiting
  • University Medical Center

    Lubbock, Texas, 79415

    Active, not recruiting
  • Northstar Surgery Center

    Lubbock, Texas, 79416

    Active, not recruiting
  • The Center for Orthopedic Surgery

    Lubbock, Texas, 79416

    Kenneth Stephenson, MD, (806) 797-4985, ken4feet@aol.com

    Kenneth Stephenson, MD

    Recruiting
  • Texas Tech University Health Sciences Center

    Lubbock, Texas, 79430

    Jerry Grimes MD, MD, +18067432465, Jerry.Grimes@ttuhsc.edu

    Jenny Hudnall, MS BME, jennifer.hudnall@ttuhsc.edu

    Recruiting

Other trials in United States

About this study

The goal of this single blinded clinical trial is to investigate blood flow restriction (BFR) for rehabilitation of patients after ankle ligament reconstruction surgery. Outcome measures will be compared between the standard of care (SoC) and BFR groups at the end of the study intervention.

Following standard surgical procedures, both groups will undergo physical therapy by a certified physical therapist for a minimum of 6 weeks. The SOC group will receive standard physical therapy without use of BFR. The BFR group will receive physical therapy with BFR. Outcome measures of interest will be taken at the start of physical therapy (time 0) and at the end of physical therapy (minimum of 6 weeks of PT) for both groups.

Read more

Outcome measures of interest include:

  • muscle atrophy;
  • ankle function;
  • fatigability/manual muscle testing;
  • pain scores;
  • cardiovascular effects (heart rate, blood pressure).
Read the detailed description

Study Aims:

To evaluate the efficacy of Blood Flow Restriction (BFR) therapy compared to the current standard of care (SOC) in improving muscle atrophy, strength recovery, ankle functionality, and pain management in patients undergoing rehabilitation after ankle ligament reconstruction.

Objectives:

Evaluate Muscle Atrophy: To compare the extent of muscle recovery in the quadriceps and gastrocnemius muscles between patients receiving BFR therapy and those receiving the current standard of care. This will be done by comparing muscle circumference

Assess Fatigability Recovery: To determine whether BFR therapy accelerates the recovery of dynamic lower extremity fatigability more effectively than the current standard of care as measured by manual muscle testing (MMT)

Measure Functional Outcomes: To use the Foot and Ankle Disability Index (FADI) to evaluate improvements in ankle functionality and activities of daily living between the two treatment groups.

Monitor Pain Levels: To compare perceived pain levels during treatment and daily activities in patients undergoing BFR therapy versus those receiving standard care using a visual analog scale (VAS)

Analyze Cardiovascular Impact: To investigate changes in resting heart rate and blood pressure to identify any cardiovascular benefits associated with BFR therapy compared to the current standard of care

Study overview:

This study is designed as a randomized clinical trial to evaluate the efficacy of Blood Flow Restriction (BFR) therapy in postoperative rehabilitation following ankle ligament reconstruction.

Patients who have undergone ankle ligament reconstruction surgery performed by participating orthopedic surgeons will be randomized to either the treatment group (BFR therapy) or standard of care (SOC) group. Patients will then receive physical therapy (PT) managed by treatment physical therapists (t-PT). These therapists will perform BFR during the weekly PT sessions and provide the same at home exercises for participants in both groups. These physical therapists will not be part of the study team and will not collect study related data.

Patients in the treatment group will begin BFR therapy at least 28 days post-op (+7 days). The therapy will be performed on the affected limb, focusing on hip and knee strength, with ankle strengthening in plantarflexion and dorsiflexion in a seated position. Additional exercises include multi-joint hip and knee strengthening, such as straight leg raises, side-lying external rotation hip exercises (clam shells), short arc quads, long arc quads, hamstring curls, and hip bridges. Manual therapy including soft tissue mobilization and joint mobilization for ROM restoration will be provided as needed at the discretion of the physical therapist.

The SOC group will receive traditional physical therapy methods without BFR at least 28 days post-op (+ 7 days). The protocol will include similar exercises to those in the BFR group but without occlusion. Manual therapy including soft tissue mobilization and joint mobilization for ROM restoration will be provided as needed at the discretion of the t-PT.

Follow-up assessments and outcomes of interest will be collected by the study physical therapists (s-PT). s-PTs collecting study visit data will be blinded to the patient's treatment group. These measures include: muscle circumference (quadriceps and gastrocnemius), manual muscle testing (MMT) for fatigability recovery, Foot and Ankle Disability Index (FADI) for functional outcomes, pain levels using a visual analog scale (VAS), and cardiovascular measures (resting heart rate and blood pressure).

Assessments will be conducted at multiple time points for both the treatment and SOC groups:

Baseline: At initiation of physical therapy (28 days post-op + 7 days)) Visit 2: 63-70 days post-op Visit 3 (optional): At the end of the study (for patients continuing beyond the standard 6-weeks of physical therapy)

Being tested
blood flow restriction
Keywords
ankle reconstruction, physical therapy, blood flow restriction therapy, BFR

What participants receive

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

  • blood flow restrictionDevice

    Also called BFR, Kaatsu

    The intervention group will receive the standard of care PT performed with BFR on affected limb.

    The intervention group will be treated with a BFR Smarttools SmartCuffs versions 3.0 or higher. During the baseline visit, the device will be placed over the affected limb's greater trochanter and inflated to 60% of their limb occlusion pressure. This will be titrated up to 80% over the first week to ensure subject comfort. During the remaining physical therapy sessions, patients will perform exercises prescribed by a licensed t-PT to perform under occlusion with a load of 30% of the subjects estimated 1-rep max.

Study groups in NCT07451210
Study groupRoleWhat they receive
Standard of Care (SOC) groupNo interventionstandard course of physical therapy; no BFR
Blood flow restriction (BFR) groupExperimentalBFR device added during physical therapy
Receives: Device: blood flow restriction

What is being measured

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

  1. Muscle atrophy measurement - gastrocnemius

    Measurement location: maximal circumference of the gastrocnemius muscle Unit: cm Range: varies by participant

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

  2. Muscle atrophy measurement - quadriceps

    Measurement location: 10 cm and 20 cm above the superior aspect of the patella Unit: cm Range: varies by participant

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

  3. Fatigability recovery using manual muscle testing (MMT)

    Measurement description: Manual muscle testing (MMT) will be used to evaluate plantar flexion fatigability with the ankle in a neutral position, unweighted. This will help determine the effectiveness of BFR therapy in restoring muscle fatigability compared to the standard of care.

    Score range: 5 - 10+ (higher score indicates better fatigability recovery)

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

  4. Foot and Ankle Disability Index (FADI)

    Measurement description: Manual muscle testing (MMT) will be used to evaluate plantar flexion fatigability with the ankle in a neutral position, unweighted. This will help determine the effectiveness of BFR therapy in restoring muscle fatigability compared to the standard of care.

    Score range: 5 - 10+ (higher score indicates better fatigability recovery)

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

  5. Pain Management - Visual analog scale

    Measurement description: Pain will be assessed using a visual analog scale (VAS), rated from 0-10, and recorded during the study visits to help evaluate the effectiveness of BFR therapy in reducing pain during rehabilitation. They will also be verbally asked during each therapy session to ensure subject comfort.

    Score range: 0 - 10 (higher score indicates higher levels of pain)

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

  6. Cardiovascular impact - heart rate

    Measurement description: Resting heart rate will be measured u to determine if BFR therapy provides any incidental cardiovascular benefits.

    Measurement tool: automatic cuff (Omron Bronze, OMRON HEALTHCARE CO Kyoto, Japan) Range: varies by participant Units: beats per minute (bpm)

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

  7. Cardiovascular impact - blood pressure

    Measurement description: Resting blood pressure will be measured u to determine if BFR therapy provides any incidental cardiovascular benefits.

    Measurement tool: automatic cuff (Omron Bronze, OMRON HEALTHCARE CO Kyoto, Japan) Range: varies by participant Units: systolic/diastolic in mmHg

    Measured: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)

Timeline

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

  1. First posted5 Mar 2026
  2. Study start1 Mar 2026 (estimated)
  3. Primary completion30 Jun 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

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
Single blinded (assessor); Cohort study
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
105 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07451210
Sponsor's protocol ID
FY2024-335
Acronym
BFRankle recon
Status last verified
Mar 2026
First submitted
13 Jan 2026
Last updated
17 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing blood flow restriction in people with Ankle Reconstruction and Blood Flow Restriction Therapy, run by Texas Tech University Health Sciences Center at 5 sites in United States.

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

Who may be eligible to take part?

The sponsor lists 3 inclusion and 12 exclusion criteria. 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: looking for participants now, as of the sponsor's last update on 17 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Jenny Hudnall, MS BME (806-743-2260, jennifer.hudnall@ttuhsc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Muscle atrophy measurement - gastrocnemius (time frame: baseline/Visit 1 (28 days + 7 days post-op), Visit 2 (63-70 days post op), Visit 3 (optional - upon completion of PT)). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 17 Mar 2026.

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