The immediate effects of wrist extensor training with blood flow restriction on pain perception in middle-aged patients with lateral elbow tendinopathy: A cross-over randomized controlled trial

Blood flow restriction (BFR) training provides a new means of musculoskeletal rehabilitation, suggesting significant outcomes in muscle hypertrophy, strength intensity, and pain reduction. We aimed to evaluate the immediate hypolagesic effects of a single wrist extensor training session with BFR compared to non-BFR training in patients with lateral elbow tendinopathy (LET). Twenty patients with LET (12 men and 8 women; mean age: [49.6 ​± ​6.6] years) participated in the study. Participants performed a wrist extensor exercise (30-15-15-15 repetitions) in a randomized order, using either a BFR or a non-BFR condition, one week apart. The primary outcome was the change in pressure pain thresholds (PPTs) at local and distal body sites immediately after training. Secondary outcomes included pain-free grip strength (PFGS), blood pressure, and rating of perceived exertion. No significant differences were found between BFR and non-BFR conditions in PPTs at any measurement site ( p ​> ​0.05). While there was a statistically significant difference in PFGS favoring BFR training (4.4, 95% Confidence Intervals [ CI ]: 1.9 to 16.9; p ​< ​0.001), this was influenced by participants’ baseline characteristics (i.e., age and body mass index). No significant differences were found in blood pressure or perceived exertion between interventions ( p ​> ​0.05). A single session of wrist extensor training with BFR does not produce a significant reduction in pain sensitivity compared to the same training without BFR in patients with LET. Further research is needed to investigate the long-term effects of the method in LET management.