The Efficacy of Blood Flow Restriction Therapy Versus Platelt-Rich Plasm Injection in the Treatment of Lower Extremity Tendinopathies: A Critically Appraised Topic




Espindola, Adrian

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Clinical Scenario: Tendinopathy causes pain and functional limits, accounts for 30% of all musculoskeletal conditions. The patellar and Achilles tendons are the most injured. Tendons are made up of highly organized collagen fibers, proteoglycans, and glycoproteins that equip mechanical stability and strength to the tissue. However, the limited blood flow and nutrient supply to tendons make it challenging to heal. Blood flow restriction (BFR) therapy and Platelet rich plasma (PRP) injections are potential treatments that operate differently to improve tendon healing. BFR therapy decreases blood flow during resistance training to stimulate the production of growth factors, while PRP injections target the underlying biology of the healing process by supplying concentrated platelets and growth factors to the affected tissue. Both treatments may improve outcomes for patients with tendinopathy, but additional research is required to confine optimal treatment protocols and factors impacting treatment success. Focused Clinical Question: Are current BFR protocols and PRP injection therapy effective treatments for lower extremity tendinopathies? Summary of Key Findings: Of the five total studies discovered (two randomized control trials, two systematic review and one meta-analysis of randomized control trials), three supported the efficacy of BFR for tendinopathy, and two focused on PRP injections as an intervention. One of the two PRP injections found that PRP was not superior to placebo, leaving clinical findings unclear. Clinical Bottom Line: BFR therapy and PRP injections work differently, targeting the mechanical environment and underlying biology of the healing process. These treatments may improve outcomes for patients by promoting tissue healing and remodeling, reducing the risk of chronic injuries, and improving blood flow and nutrient delivery to the affected tissue. Strength of Recommendation: The Oxford Center for Evidence-Based Medicine recommends a grade A for Level 2 evidence or higher with findings.



blood flow restriction, BFR, platelet rich plasma, PRP, Honors College


Espindola, A. (2023). The efficacy of Blood Flow Restriction therapy versus platelt-rich plasm injection in the treatment of lower extremity tendinopathies: A critically appraised topic. Honors College, Texas State University.


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