Optimizing Rehabilitation After Achilles Tendon Rupture Repair: The Role of Blood Flow Restriction Training in Tendon and Muscle Recovery

Optimizing Rehabilitation After Achilles Tendon Rupture Repair: The Role of Blood Flow Restriction Training in Tendon and Muscle Recovery

The goal of this clinical trial is to investigate whether rehabilitation with blood flow restriction (BFR) offers added value compared to conventional rehabilitation in patients undergoing surgical repair for Achilles tendon rupture. The study will include adult patients of all sexes who have undergone surgical treatment at two selected hospitals.

The main questions it aims to answer are:

Does BFR-enhanced rehabilitation improve functional recovery compared to conventional rehabilitation? What are the effects of BFR on muscle strength and tendon recovery?

Researchers will compare blood flow restriction (BFR) therapy with conventional rehabilitation to determine whether BFR leads to improved clinical, muscular, and tendon-related outcomes.

Participants will:

1. Undergo standard surgical repair of the Achilles tendon

2. Be randomly assigned to a 24-week exercise therapy program-either with or without blood flow restriction (BFR)-starting four weeks post-surgery

3. Take part in follow-up assessments at weeks 4, 8, 12, 18, 24, and 52, which will include:

   • Questionnaires on pain, quality of life, fear of movement, and return to sport
   • Medical imaging techniques such as ultrasound, MRI, shear wave elastography, and power Doppler
   • Muscle strength testing
   • Blood sample collection, along with a tendon tissue sample taken during surgery

Inclusion Criteria:

• patients with total midrupture Achilles tendon rupture
• surgical treatment
• > 18 years old
• able to understand and speak Dutch

Exclusion Criteria:

• Bilateral Achilles tendon rupture
• Previous Achilles tendon rupture
• Previous treatment with fluoroquinolones or cortisone
• other condition in either leg that would limit the ability to perform the exercises or evaluations
• Diabetes or rheumatic diseases
• History of deep venous thrombosis
• severe cardiovascular disease