ClinicalTrials.gg
RecruitingNCT04554212BRAINSUpdated Aug 21, 2026

Blood Flow Restriction Training After Patellar INStability

An interventional study of Blood Flow Restriction Training and Sham Blood Flow Restriction Training in Patellar Dislocation, Knee Injuries and Leg Injury, sponsored by Caitlin Conley. Recruiting at 4 sites in United States. Open to participants aged 14 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-08-21.

Sponsored by Caitlin Conley · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2020; still recruiting 6 years 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
78
Allocation
Randomized
Ages
14 Years to 40 Years
Sex
All
01

Study summary

This research study is designed to allow health care professionals and researchers to answer many questions about whether a new type of physical therapy called blood flow restriction training (called BFRT) will improve recovery for those with patellar instability.

Read the detailed description

Participants will randomly be assigned to 1 of 2 groups. This means that neither the participant or their doctor will not choose the treatment, but that the treatment will be randomly selected (like a coin toss). The study treatments is blood flow restriction training (BFRT). BFRT uses an air cuff that is inflated around the top of the thigh. This temporarily limits blood flow to the muscles and may allow the participant to recover strength more quickly after injury. As will be described later, the participant will be closely monitored during all study treatments to make sure they are as safe as possible.

The two groups that participants could be assigned to are:

  1. Standard physical therapy
  2. Standard physical therapy and BFRT

Physical Therapy Sessions: We are comparing two physical therapy interventions, one is the standard of care and the other is the standard of care plus an additional treatment. Participants have a 50/50 chance of receiving either treatment. If randomized to receive BFRT, the air cuffs will then be placed on the participants' thighs and they will be doing a standardized exercise program that will vary depending on the stage of rehabilitation they are in and as determined by the study personnel. Participants will also complete a standardized course of physical therapy. Activities in physical therapy may include ice over the knee, range of motion exercises to maintain hip strength and gait training exercises as needed.

The following procedures may be performed. Some procedures may not be performed due to time constraints, availability of equipment, and/or by the decision of the investigator. Before initiating physical therapy, participants will be asked some questions including but not limited to the following: age, sex, level of activities, and expectations. Participants will also complete a Sports Activity Scale to determine their physical activity level.

Timeline of Study Visits:

Visit 1 Screening and enrollment: Upon arriving at the clinic or Biomotion Laboratory, potential subjects will have the following assessments: range of motion and knee instability, both of which are the standard of care for a patient with a suspected patellar instability.

After providing informed consent to participate in the study, we will ask you to provide a urine sample and will collect about 2 teaspoons of blood for laboratory testing. The blood will be collected from your arm using standard venipuncture. In addition, we will ask you questions about your medical history including current medications, demographic information, BMI, and smoking status. You will be asked to complete three study questionnaires: the Norwich Patella Instability Score which asks questions about your knee, the Cincinnati Occupational Rating Scale which asks questions about the physical demands of your job or daily life, and a Visual Analogue Scale that will ask you to rate your current pain. You will be randomized to either standard physical therapy or standard physical therapy with BFRT. You have a 50/50 chance of having BFRT. We will also schedule you to go to the BioMotion laboratory for baseline strength testing and to have your first study MRI at the MRISC.

Visit 2 (1 week)

  • Knee and Hip Strength
  • Walking Biomechanics
  • MRI

Visit 3 (5 weeks)

  • Knee and Hip Strength
  • Questionnaires

Visit 4 (9 weeks)

  • Lab specimens collected (urine and about 2 teaspoons of blood)
  • Knee and Hip Strength
  • Walking Biomechanics
  • Questionnaires

Visit 5 (6 months)

  • Lab specimens collected (urine and about 2 teaspoons of blood)
  • Knee and Hip Strength
  • Walking and Running Biomechanics
  • Questionnaires

Visit 6 (1 year)

  • Lab specimens collected (urine and about 2 teaspoons of blood)
  • Knee and Hip Strength
  • Walking, Running, and Jumping Biomechanics
  • Questionnaires
  • MRI

Visit 7 (2 years)

  • Lab specimens collected (urine and about 2 teaspoons of blood)
  • Knee and Hip Strength
  • Walking, Running, and Jumping Biomechanics
  • Questionnaires
  • MRI
02

Conditions studied

  • Patellar Dislocation
  • Knee Injuries
  • Leg Injury
  • Wounds and Injuries
03

In context

Patellar Dislocation

41 studies on the registry are indexed under Patellar Dislocation; 9 are open to participants now.

This study's planned enrollment of 78 is above the median of 50 across 22 interventional studies indexed under Patellar Dislocation.

Browse Patellar Dislocation studies →

Lead sponsor

This is the only study on the registry with Caitlin Conley as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
14 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Diagnosis of traumatic patellar instability (either primary or recurrent) determined by an American Board of Family Medicine certified physician with a Certificate of Added Qualifications in Sports Medicine or licensed Physical Therapist utilizing clinical examination, radiographic imaging, and patients' reports of instability
  • Age 14 to 40 years
  • Skeletally mature with closed growth plates visualized by radiograph
  • A score of 80 or more on the Sports Activity Scale, which corresponds to participating in "running, twisting, turning (tennis, racquetball, handball, ice hockey, field hockey, skiing, wrestling)" at least 1-3 times per week
  • Desire to resume pre-injury activity level

Exclusion criteria

Exclusion Criteria:

  • Concomitant osteochondral lesion requiring surgical fixation
  • Radiographic evidence of osteoarthritis (\< Kellgren-Lawrence Grade 2)
  • Previous ipsilateral or contralateral knee surgery
  • Most recent instability event more than 3 months before enrollment
  • History of any inflammatory disorder
  • > 35 kg/m2
  • Diabetes or uncontrolled hypertension
  • Varicose veins or a history of personal or immediate family history (parental or sibling) of deep vein thrombosis
  • Pre-existing conditions or previous surgeries that effect the ability to walk
  • Planned trips or vacations that will result in the inability to attend 4 consecutive physical therapy sessions
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
78 participants (estimated)

Study arms

  • Active comparator
    Standard Physical Therapy with Sham BFRT

    Participants will undergo 8 weeks of sham blood flow restriction training with cuff inflated to less than 10% occlusion.

    Device: Sham Blood Flow Restriction Training

  • Active comparator
    Standard Physical Therapy with BFRT

    Participants will undergo 8 weeks of blood flow restriction training with cuff inflated to 60% occlusion.

    Device: Blood Flow Restriction Training

Interventions

  • DeviceBlood Flow Restriction Training

    Participants will undergo 8 weeks of blood flow restriction training with cuff inflated to 60% occlusion.

  • DeviceSham Blood Flow Restriction Training

    Participants will undergo 8 weeks of sham blood flow restriction training with cuff inflated to less than 10% occlusion.

06

What researchers measure

Primary outcomes

  1. The Norwich Patellar Instability Scale

    The Norwich Patellar Instability (NPI) Scale is a 19-item scale that asks subjects to rate their perceived patellar instability during different tasks, and has been demonstrated to be a valid and responsive tool for assessing patient-reported outcomes for those being treated conservatively or surgically following patellar dislocation. The NPI is scored on a scale of 0 to 100, with lower scores being indicative of less perceived instability

    Time frame: Baseline

  2. The Norwich Patellar Instability Scale

    The Norwich Patellar Instability (NPI) Scale is a 19-item scale that asks subjects to rate their perceived patellar instability during different tasks, and has been demonstrated to be a valid and responsive tool for assessing patient-reported outcomes for those being treated conservatively or surgically following patellar dislocation. The NPI is scored on a scale of 0 to 100, with lower scores being indicative of less perceived instability

    Time frame: 5 Weeks

  3. The Norwich Patellar Instability Scale

    The Norwich Patellar Instability (NPI) Scale is a 19-item scale that asks subjects to rate their perceived patellar instability during different tasks, and has been demonstrated to be a valid and responsive tool for assessing patient-reported outcomes for those being treated conservatively or surgically following patellar dislocation. The NPI is scored on a scale of 0 to 100, with lower scores being indicative of less perceived instability

    Time frame: 9 Weeks

  4. The Norwich Patellar Instability Scale

    The Norwich Patellar Instability (NPI) Scale is a 19-item scale that asks subjects to rate their perceived patellar instability during different tasks, and has been demonstrated to be a valid and responsive tool for assessing patient-reported outcomes for those being treated conservatively or surgically following patellar dislocation. The NPI is scored on a scale of 0 to 100, with lower scores being indicative of less perceived instability

    Time frame: 6 Months

  5. The Norwich Patellar Instability Scale

    The Norwich Patellar Instability (NPI) Scale is a 19-item scale that asks subjects to rate their perceived patellar instability during different tasks, and has been demonstrated to be a valid and responsive tool for assessing patient-reported outcomes for those being treated conservatively or surgically following patellar dislocation. The NPI is scored on a scale of 0 to 100, with lower scores being indicative of less perceived instability

    Time frame: 12 Months

  6. Quadriceps Strength Symmetry

    Isokinetic Dynamometer will be used. The primary analysis may include the comparison of these observations over multiple time points, with a particular interest in whether there are between-group or within-patient differences.

    Time frame: 1 Week

  7. Quadriceps Strength Symmetry

    Isokinetic Dynamometer will be used. The primary analysis may include the comparison of these observations over multiple time points, with a particular interest in whether there are between-group or within-patient differences.

    Time frame: 5 Weeks

  8. Quadriceps Strength Symmetry

    Isokinetic Dynamometer will be used. The primary analysis may include the comparison of these observations over multiple time points, with a particular interest in whether there are between-group or within-patient differences.

    Time frame: 9 Weeks

  9. Quadriceps Strength Symmetry

    Isokinetic Dynamometer will be used. The primary analysis may include the comparison of these observations over multiple time points, with a particular interest in whether there are between-group or within-patient differences.

    Time frame: 6 Months

  10. Quadriceps Strength Symmetry

    Isokinetic Dynamometer will be used. The primary analysis may include the comparison of these observations over multiple time points, with a particular interest in whether there are between-group or within-patient differences.

    Time frame: 12 Months

  11. MRI T1rho

    Increased T1rho relaxation times have been associated with loss of proteoglycan content. This then corresponds with MRI changes associated with the loss of proteoglycan content. Patients with patellofemoral pain and maltracking have been demonstrated to have significantly greater T1rho relaxation times in the lateral facet of the patella when compared to healthy volunteers.

    Time frame: 1 Week

  12. MRI T1rho

    Increased T1rho relaxation times have been associated with loss of proteoglycan content. This then corresponds with MRI changes associated with the loss of proteoglycan content. Patients with patellofemoral pain and maltracking have been demonstrated to have significantly greater T1rho relaxation times in the lateral facet of the patella when compared to healthy volunteers.

    Time frame: 12 Months

Secondary outcomes

  1. MRI Muscle Volume

    Quadriceps muscle volume (cm2)

    Time frame: 12 Months

  2. The Norwich Patellar Instability Scale

    The Norwich Patellar Instability (NPI) Scale is a 19-item scale that asks subjects to rate their perceived patellar instability during different tasks, and has been demonstrated to be a valid and responsive tool for assessing patient-reported outcomes for those being treated conservatively or surgically following patellar dislocation. The NPI is scored on a scale of 0 to 100, with lower scores being indicative of less perceived instability

    Time frame: 24 Months

  3. Quadriceps Strength Symmetry

    Isokinetic Dynamometer will be used. The primary analysis may include the comparison of these observations over multiple time points, with a particular interest in whether there are between-group or within-patient differences.

    Time frame: 24 Months

  4. MRI Muscle Volume

    Quadriceps muscle volume (cm2)

    Time frame: 24 Months

  5. MRI T1rho

    Increased T1rho relaxation times have been associated with loss of proteoglycan content. This then corresponds with MRI changes associated with the loss of proteoglycan content. Patients with patellofemoral pain and maltracking have been demonstrated to have significantly greater T1rho relaxation times in the lateral facet of the patella when compared to healthy volunteers.

    Time frame: 24 Months

07

Study locations

4 of 4 sites recruiting
  • UK Healthcare at Turfland
    Lexington, Kentucky 40504, United States
    Recruiting
  • University of Kentucky Biomotion Laboratory
    Lexington, Kentucky 40536, United States
    Recruiting
  • Center for Sports Performance and Research
    Foxborough, Massachusetts 02035, United States
    Recruiting
  • Foxboro Sports Medicine Clinic
    Foxborough, Massachusetts 02035, United States
    Recruiting
08

References and documents

Publications

  • Brightwell BD, Stone A, Li X, Hardy P, Thompson K, Noehren B, Jacobs C. Blood flow Restriction training After patellar INStability (BRAINS Trial). Trials. 2022 Jan 28;23(1):88. doi: 10.1186/s13063-022-06017-1. PubMed 35090543 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04554212
Lead sponsor
Caitlin Conley
Responsible party
Caitlin Conley (Assistant Professor, University of Kentucky) — Sponsor-investigator
First posted
Sep 18, 2020
Start date
Sep 9, 2020
Primary completion
Jun 30, 2027 (estimated)
Completion
Jun 30, 2027 (estimated)
Last update
Aug 21, 2026

Study contacts

Caitlin Conley, PhD
Contact
caitlin.conley2@uky.edu
8592571939
Natalie Corey
Contact
natalie.corey@uky.edu
Caitlin Conley, PhD
study director · University of Kentucky

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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