An Exploration Of Factors Associated With Blood Flow Restriction Implementation Among Rehabilitative Professionals

Although blood flow restriction (BFR) is considered an effective and tolerable modality for musculoskeletal rehabilitation, little is known about its implementation among rehabilitative professionals. PURPOSE: To explore factors associated with implementation of BFR among rehabilitative professionals. METHODS: Using the Consolidated Framework for Implementation Research an electronic survey was created and distributed to rehabilitative professionals via email. Respondents (n = 259) self-selected into one of four groups based on BFR use with their clients/patients: currently use BFR, do not currently use BFR but have previously, never used BFR but considering it, and never used BFR. Participants then answered questions (0-7 Likert-scale) regarding their perceptions of BFR across constructs of evidence strength & quality, relative advantage, adaptability, complexity, cost, patient needs & resources, access to knowledge & information, learning climate, knowledge & beliefs about the intervention, self-efficacy, and perceptions of safety for different populations. Each construct was considered a factor. Mean scores for each factor were calculated and compared across groups using ANOVA (α = 0.05), and a multinomial prediction model was applied to investigate factors associated with levels of BFR use. RESULTS: Professionals who currently use BFR had higher means (SD) of self-efficacy [6.27 (0.64)], patient needs & resources [5.74 (0.54)], evidence strength & quality [6.13 (0.58)], learning climate [6.52 (0.69)], adaptability [5.51 (0.81)], access to knowledge & information [5.95 (1.16)], and perceptions of safety for different populations [5.37 (0.73)] compared to all other groups. The prediction model showed that the odds ratios (reported as range) for factors of self-efficacy (0.079-0.322), patient needs & resources (0.041-0.120), evidence strength & quality (0.057-0.179), and learning climate (0.320-0.444) are significantly associated with current usage of BFR with clients/patients as compared to other usage levels while controlling for the other factors. CONCLUSION: The current findings suggest that differences in self-efficacy, patient needs & resources, evidence strength & quality, and learning climate are associated with rehabilitative professionals’ implementation of BFR.