Is Low-load Resistance Training With Blood Flow Restriction More Effective Than Traditional Rehabilitation of Military Personnel With Lower Limb Injuries

Inclusion Criteria:

• Serving UK military personnel,

• Aged 18-55,

• Has unilateral lower limb injury whereby pain is the primary limiting factor hindering progression, as diagnosed by relevant consultant and team,

• Reduced occupational employability and function,

• Scheduled to attend DMRC Stanford Hall for 3 week residential rehabilitation course.

MSK-Specific Exclusion Criteria

• Any medical contraindication related to BFR*

• Non-musculoskeletal or serious pathological condition (i.e. Inflammatory arthropathy, infection or tumour)

• Spinal or referred pain from non-local pain source

• Any pre-diagnosed physical impairment or co-morbidities (including cardio-vascular disease) precluding the safe participation in the rehabilitation programme and/or assessment procedures

• Corticosteroid or analgesic injection intervention to the affected area within the previous 7 days

• Currently pregnant, or have not yet completed a return to work assessment following the birth of your child.

*Medical-Related Exclusion Criteria

• History of cardiovascular disease (hypertension, peripheral vascular disease, thrombosis/embolism, ischaemic heart disease, myocardial infarction),

• History of the following musculoskeletal disorders: rheumatoid arthritis, avascular necrosis or osteonecrosis, severe osteoarthritis

• History of the following neurological disorders: Alzheimer's disease, amyotrophic lateral sclerosis, peripheral neuropathy, Parkinson's disease, severe traumatic brain injury,

• Varicose veins in the lower limb,

• Acute viral or bacterial upper or lower respiratory infection at screening, Known or suspected lower limb chronic exertional compartment syndrome (CECS) (tourniquet raises intra-compartmental muscle pressure),

• Surgical insertion of metal components at the position of cuff inflation,

• History of any of the following conditions or disorders not previously listed:

diabetes, active cancer,

• History of elevated risk of unexplained fainting or dizzy spells during physical activity and/or exercise that causes loss of balance,

• Increased risk of haemorrhagic stroke, exercise induced rhabdomyolysis,

• Currently pregnant.