Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Health Sciences


Rehabilitation Sciences

First Advisor

Brian Noehren, Ph.D., PT


Both patellofemoral dislocation and anterior cruciate ligament (ACL) ruptures have a significant impact on an athlete’s ability to regain function and return to play. Surgical repair of the medial patellofemoral ligament (MPFL) and ACL ligament reconstructions result in a sequala of quadriceps weakness. Persistent quadriceps weakness following reconstruction can create a cascade effect of muscular atrophy and weakness resulting in significant knee and leg impairments. An abundance of research has shown that blood flow restrictive training (BFRT) has demonstrated significant results in post-surgical rehabilitation by increasing muscular strength and improving function. What is unclear is the effect of deflating or not deflating the BFRT cuff between exercises when rehabilitating MPFL and ACL reconstruction patients. The purpose of this dissertation was to test whether deflating or not deflating the BFRT cuff between exercises results in greater quadriceps strength, increased leg symmetry on a battery of functional tests, and functional outcomes following MPFL or ACL reconstruction. The second purpose was to determine if patients in the deflated BFRT protocol group reported significantly greater effort and less discomfort ratings during the BFRT exercises than the non-deflate group.

The results of this dissertation indicated there were no significant differences between groups for both effort and discomfort ratings during BFRT exercises except the deflate group experienced significantly less discomfort during biking. The Functional test showed no significant differences between groups for measurements of knee pain, knee range of motion, gait ability, ability to jog in a straight line, and all strength tests except the prone plank hold time was significantly longer in the non-deflate group. There were no significant differences between groups for all PROs except with the 2000 International Knee Documentation Committee (IKDC) subjective knee evaluation measurement was significantly greater in the non-deflate group. Both groups significantly increased the lower extremity functional scale and the IKDC scores during the 12-week rehabilitation period indicating significant functional improvements. MPFLR patients significantly decreased their perceived rating of knee instability over time. Both BFRT groups demonstrated the ability to improve patient report function, restore knee range of motion, normalized gait, and improve strength. Neither group reported any adverse effects from BFRT treatments.

Digital Object Identifier (DOI)

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