Summary of the best evidence on blood flow restriction training for patients after anterior cruciate ligament reconstruction surgery.

OBJECTIVE: This study systematically retrieved, evaluated, and synthesized the best available evidence on blood flow restriction training for patients following anterior cruciate ligament reconstruction, aiming to provide evidence-based guidance for clinical implementation of this training modality among healthcare professionals. METHODS: A systematic search was conducted to identify the best available evidence on blood flow restriction training for patients undergoing anterior cruciate ligament reconstruction. The search encompassed multiple types of literature, including clinical guidelines, expert consensus statements, systematic reviews, meta-analyses, and evidence summaries. The following databases were searched up to April 2025: UpToDate, BMJ Best Practice, and the Cochrane Library. Two researchers independently screened the retrieved literature, assessed methodological quality using standardized tools [Appraisal of Guidelines for Research and Evaluation II (AGREE II) for guidelines and Joanna Briggs Institute (JBI) critical appraisal checklists for other study types], and graded the level of evidence according to prespecified criteria. RESULTS: A total of 18 studies were included in this review, consisting of two clinical guidelines, one evidence summary, two expert consensus statements, and 13 systematic reviews. In total, 21 evidence points were extracted and categorized into 11 thematic categories: multidisciplinary team involvement, training principles, applicable populations, contraindications, assessment indicators, training equipment, training protocols, training intensity, training frequency and duration, real-time assessment and monitoring, and safety precautions. CONCLUSIONS: The evidence summary on blood flow restriction training for patients following anterior cruciate ligament reconstruction is both scientifically rigorous and comprehensive, providing a robust evidence-based foundation for clinical implementation. Healthcare providers should tailor the training to individual patient circumstances to ensure both safety and therapeutic efficacy. SYSTEMATIC REVIEW REGISTRATION: identifier ES20257963.