Effects of blood flow restriction therapy on functional outcomes in patients with distal radius fracture: A systematic review with meta-analysis.

Abstract

BackgroundNo previous systematic reviews have evaluated the effects of blood flow restriction therapy (BFRT) in addition to other therapeutic interventions on clinical outcomes in patients with distal radius fractures (DRFs).ObjectiveTo determine the clinical effects of BFRT on functional outcomes in patients with DRFs.MethodsAn electronic search was performed using the MEDLINE, CENTRAL, EMBASE, Web of Science, PEDro, CINAHL, SPORTDiscus, and LILACS databases. The eligibility criteria included randomized clinical trials (RCTs) investigating the effects of BFRT with or without other therapeutic interventions on functional outcomes in patients with DRFs. Two authors independently performed the searches, study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2.0. Data were pooled using a Hartung-Knapp-Sidik-Jonkman random-effects method or Mantel-Haenszel fixed-effects model. Certainty of evidence was assessed using GRADE.ResultsFour RCTs met the eligibility criteria. For the comparison of BFRT plus standard rehabilitation versus standard rehabilitation alone, at four weeks and six to eight weeks, the overall mean difference (MD) for PRWE was -5.41 points (<i>p</i>&#x2009;=&#x2009;0.39), DASH was 1.94 points (<i>p</i>&#x2009;=&#x2009;0.84), grip strength was -2.47% (<i>p</i>&#x2009;=&#x2009;0.66), pinch strength was 0.28&#x2005;kg (<i>p</i>&#x2009;=&#x2009;0.59), wrist flexion-extension range of motion was 4.30 degrees (<i>p</i>&#x2009;=&#x2009;0.33), and VAS was 0.43&#x2005;cm (<i>p</i>&#x2009;=&#x2009;0.09).ConclusionsGiven the limited available evidence, the effectiveness of adding BFRT to standard rehabilitation remains uncertain. Preliminary findings suggest that BFRT did not improve any of the functional outcomes. More clinical trials, in both quantity and quality, are needed to confirm the clinical effects of BFRT in patients with DRFs.<b>PROSPERO registration:</b> CRD42021260589.