ArticleInternational journal of sports physical therapy2026
Factors Affecting Clinical Decision Making for Blood Flow Restriction Training in Pediatric and Adolescent Patients Following Anterior Cruciate Ligament Injury.
Article in International journal of sports physical therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Research evaluating the effectiveness of blood flow restriction training (BFRT) in patients post anterior cruciate ligament (ACL) injury is growing, but the application of BFRT within clinical settings remains unknown. Understanding how BFRT is used in the pediatric and adolescent populations and what exercise prescription is followed is necessary to discern if there is concordance between research and clinical practice. Hypothesis/Purpose: To describe the influence of patient clinical presentation on BFRT use in pediatric and adolescent patients after anterior cruciate ligament reconstruction. Study Design: Cross-sectional survey study. Methods: A web-based survey was sent to physical therapists (PTs) who treat pediatric and adolescent patients after ACL injury, via social media and email sent out by rehabilitation continuing education providers. Case vignettes were utilized to understand clinical decisions related to BFRT utilization. Descriptive statistics were utilized to summarize frequency of responses. Results: One hundred forty-seven PTs fully completed the survey. Nearly half (55%) of participants indicated they would not use BFRT on younger patients, mostly out of concern for patient tolerance (90%). Pain impacted BFRT application for 71% of participants, with only 19% of clinicians using BFRT with patients reporting pain greater than 6/10. Postoperatively, participants were most likely to initiate BFRT at week 4 with this population (97%), while only 52% of participants indicated that they have defined criteria for discontinuing BFRT. Conclusion: Younger age, pain, and time from surgery influenced decision making. There were no consistent criteria utilized to determine proper timing to discontinue use of BFRT. These findings support the need for additional research to identify optimal BFRT application within common clinical scenarios, which will help standardize practice and support clinical decision making when utilizing BFRT in adolescents after ACL reconstruction. Level of Evidence: 3.
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