COMPARISON THE EFFECTS OF BLOOD FLOW RESTRICTION TRAINING WITH CONVENTIONAL TRAINING IN KNEE OSTEOARTHRITIS IN TERMS OF MUSCLE THICKNESS

G. Ergezen¹, M. Sahin², N.E. Evren³, C. Algun¹

¹Istanbul Medipol University, Physiotherapy and Rehabilitation Department, Istanbul, Turkey, ²School of Medicine/ Istanbul Medipol University, Department of Orthopedics and Traumatology, Istanbul, Turkey, ³School of Medicine/ Istanbul Medipol University, Department of Radiology, Istanbul, Turkey

Background: High-intensity resistance training (HIRT) of the quadriceps, which is one of the primary treatment methods, can aggravate the pain in painful knee osteoarthritis (OA) and cause the participant to abandon the exercise.

Purpose: The aim of the study was to investigate the effects of progressive blood flow restriction (BFRT) training on quadriceps hypertrophy, volume and functionality in individuals with chronic knee OA and to compare this with traditional HIRT.

Methods: Individuals (N=38) who were diagnosed with OA were randomly assigned to the low intensity BFRT (BFRT; n=19) and HIRT (HI-RT; n=19) groups by a blinded assessor. All participants performed the same strengthening exercise training at different resistance intensities (BFRT: 30% of 1-RM; HI-RT: 70% of 1-RM) for 24 sessions. Quadriceps cross-sectional area (CSA) and quadriceps volume (QV) measured by magnetic resonance imaging (MRI), 30-second sit to stand test (SST) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for functionality were the outcome measurements repeated before initiation and after 8 weeks training. The feasibility of the exercises was examined with 3-week strength gain rates based on the increase in 1-RM. Safety was monitored for exercise-related adverse events (worsening of knee pain, falls, knee joint effusion, onset of pain in other joints).

Results: The findings demonstrated that BFRT and HI-RT resulted in comparable changes in CSA, QV and function between groups (p<0.05). According to the effect sizes of CSA, QV and 30 seconds sit to stand test among functionality measurement were significant between the groups in favor of BFRT. It has been reached from patient reports that BFRT exercises are feasible and safe enough to have no side effects.

Conclusions: The present results support the notion that use of BFRT in individuals with knee OA may show similar or even some superior effects to HI-RT. Low resistance loads used in BFRT exercises can induce gains, sustaining pain-free exercise. Lastly, it needs to be mentioned that our findings from adult individuals (40-65yrs) with knee OA, may not be representative of findings in healthy populations or individuals from different range of age groups.

Implications: It has been demonstrated that the use of BFRT in clinics can be an effective and safe method in the management of painful OA.

Funding acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Keywords:
Osteoarthritis
Muscle Hypertrophy
Vascular Occlusion

Topics:
Musculoskeletal: lower limb
Rheumatology
Orthopaedics

Did this work require ethics approval? Yes

Institution: Istanbul Medipol University

Committee: Non-Interventional Ethic Comitee

Ethics number: 10840098-772.02-E.34224