Qualitative Evaluation of Patient Experiences with Low-Load Blood Flow Restriction and Heavy-Load Resistance Training Post-ACL Reconstruction

Background Low-load blood flow restriction training (LL-BFRT) has been suggested as an alternative to heavy-load resistance training (HLRT) following anterior cruciate ligament (ACL) reconstruction. While current research primarily focuses on the clinical outcomes of LL-BFRT and HLRT, patients’ experiences with these rehabilitation methods remain unexplored. Such an exploration may provide insights that can contribute to more patient-centered rehabilitation approaches. Purpose This study aims to explore patients’ experiences with strength rehabilitation using LL-BFRT or HLRT following ACL reconstruction. Study design: Qualitative Cohort study. Methods Patients who had undergone primary bone-patellar tendon-bone ACL reconstruction and completed an LL-BFRT or HLRT protocol within the prior six months were contacted to participate in semi-structured interviews. All interviews were audio-recorded, transcribed verbatim, and anonymized. An inductive thematic analysis was conducted to identify key themes and patterns. Results Ten participants were interviewed, with five in the LL-BFRT group and five in the HLRT group. The interviews were conducted, on average, four months after completion of the strength rehabilitation protocol. The inductive thematic analysis revealed four main themes: experiences with strength training, perceived benefits, challenges encountered, and impact on the recovery process. All participants experienced progression in muscle strength. Three participants in the LL-BFRT group reported thigh muscle pain, whereas four participants in the HLRT group noted knee pain during strength rehabilitation. Overall, participants had positive views on their recovery process, except for two participants in the HLRT group who reported negative effects on their recovery due to persistent knee pain. Conclusion The results of this study highlights patients’ experiences with LL-BFRT and HLRT following ACL reconstruction. The findings indicate that LL-BFRT may be suitable in the early rehabilitation phase, as knee pain in the HLRT group may negatively affect the recovery process. Level of evidence NA