Blood flow restriction training in patients with knee osteoarthritis: Systematic review of randomized controlled trials

J Bodyw Mov Ther. 2021 Jul:27:477-486. doi: 10.1016/j.jbmt.2021.04.015. Epub 2021 Apr 23.

Abstract

Introduction: Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders in the elderly. The patient experiences reduction in muscle strength, pain, joint stiffness and consequently a reduction in quality of life. Whereas high intensity training (HI-TR) is the most effective in the general elderly population, in KOA patients, painless alternatives might be more suitable, since pain can be a deterrent for exercising. Research interest has increased in blood flow restriction training (BFR-TR) due to the observation that, in this specific population, BFR-TR results in equal muscular adaptions to HI-TR but with less join discomfort/pain.

Objective: We aimed to: (1) determine the value of BFR-TR in patients with KOA and (2) examine which exercise guidelines applied to healthy elderly populations can be adopted for patients suffering from this knee pathology.

Methodology: We searched the literature from the database inception to 2019 through PubMed, Cochrane, and Medline (EBSCO). The inclusion criteria were determined using PICOS principles. We assessed methodology using the Risk of Bias 2 tool and the Pedro scale. Conclusions were extracted with the use of best evidence synthesis.

Results: The literature search yielded 45 articles. After screening, three studies matched the inclusion criteria. The included studies were analyzed and discussed. All the included studies reported within group improvements for BFR-TR regarding pain and strength.

Conclusion: Although the evidence of BFR-TR efficacy on KOA remains scarce, the results favor its use for muscle strengthening and pain reduction in KOA. Further high-quality studies with larger samples are required.

Keywords: BFR; Blood flow restriction; Exercise; Knee osteoarthritis; Occlusion; Pain; Rehabilitation; Strength; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Humans
  • Knee Joint
  • Muscle Strength
  • Osteoarthritis, Knee*
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Regional Blood Flow
  • Resistance Training*