Blood Flow Restriction in Knee OA Exercise Yields Superior Pain Relief and Strength Gains: Study

Knee osteoarthritis is one of the most significant causes of disability globally. Exercise is very commonly prescribed, but typically, standard programs alone will only result in limited relief. This study aimed to assess whether BFR could complement exercise and enhance its effects on reducing KOA symptoms, muscle strength, and overall functionality.

The randomized controlled trial known as the Vascular Occlusion for optimizing Functional Improvement in patients with Knee Osteoarthritis, or VO-FIKOA, included 120 KOA patients. The randomization was made into a standard exercise program versus BFR-enhanced programs and conducted over 24 supervised sessions over 12 weeks. Outcomes were measured at baseline, 6 weeks, 12 weeks, and after 3 months post-intervention.

Main outcome measurements included the Knee Injury and Osteoarthritis Outcome Score pain subscale; secondary outcome measures were also assessed using quadriceps strength, the Pain Catastrophizing Scale, as well as functional performance-based measurements. Intention-to-treat principles will be followed for analysis.

• Pain subscale of KOOS significantly improved in the BFR group with an effect size of 0.58 at 12 weeks (p=0.0009).

• These improvements remained statistically significant at the 3-month follow-up with slightly decreased effect size of 0.55 (p=0.0008).

• The BFR group significantly increased the strength of quadriceps with an ES of 0.81 compared to the control group, considerably improved (p<0.0001).

• Reducing strain in knee joints is an essential step towards alleviating symptoms of KOA.

• Functional performance, as measured by KOOS functional tests, was improved significantly with the BFR group across the 12-week intervention period and retained its advantages at the 3-month post-intervention time.

• The improvement in quality of life was observed in the BFR group; hence, exercise with BFR can significantly impact daily life and overall well being.

The results of this study demonstrate that exercise plus BFR leads to larger improvements in pain, strength, and functional measures as compared to exercise alone. It will allow patients to increase their strength and diminish pain with less joint stress. BFR-supported programs may encourage a more active lifestyle, thereby improving muscle function and quality of life even after the end of the intervention.

Reference:

Jacobs, E., Stroobant, L., Victor, J., Elewaut, D., Tampere, T., Wallaert, S., Witvrouw, E., Schuermans, J., & Wezenbeek, E. (2024). Vascular occlusion for optimising the functional improvement in patients with knee osteoarthritis: a randomised controlled trial. Annals of the Rheumatic Diseases, ard-2024-226579. https://doi.org/10.1136/ard-2024-226579