Eccentric vs Low-Load Blood Flow Restriction Training in Knee Osteoarthritis in Knee Osteoarthritis (the)
Comparison of Eccentric and Low-Load Blood Flow Restriction Training on Neuromuscular Adaptations in Knee Osteoarthritis
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
Osteoarthritis (OA) is a chronic disease affecting the joint and its tissues, primarily leading to progressive damage to articular cartilage and, subsequently, to the subchondral bone and surrounding synovial structures. This chronic degenerative disease affects approximately one-third of adults, and its prevalence increasing with advancing age. The knee is one of the most common joints affected by the OA. Systematic reviews indicate a global prevalence of knee osteoarthritis (KOA) is 22.9% among individuals aged 40 and older, affecting an estimated 654.1 million people worldwide, with variations across countries and increasing with age.
Knee osteoarthritis (KOA) is a multi etiological, chronic disabling disease that affects the entire knee joint, which is the most common site of involvement in OA. KOA patients mostly suffer from progressive stiffness and knee pain. Gradually, they have some difficulties in performing daily activities, such as walking, squatting, and climbing and doing housework, as the disease progresses. Ultimately, pain and disability associated with the disease lead to a loss of functional independence and a profound reduction in quality-of- life. Impairments that are caused by KOA include knee pain, limited ROM of the knee, muscle weakness and knee instability.
The gastrocnemius muscle plays a crucial role in knee joint stability and ankle-knee biomechanics through its biarticular function, contributing to both knee flexion and ankle plantarflexion. During the stance phase of gait, the gastrocnemius co-activates with the tibialis anterior and quadriceps muscles, providing dynamic stability, reducing medial knee laxity, and assisting in forward propulsion.
The impaired neuromuscular recruitment of the gastrocnemius may result in reduced push-off strength, prolonged ground contact time, and diminished functional performance, ultimately contributing to functional limitations in patients with knee osteoarthritis. However, surface electromyography (sEMG) enables the assessment of gastrocnemius motor unit recruitment and fatigue characteristics, providing objective insight into neuromuscular adaptations before and after targeted interventions.
OA of the knee is characterized by changes in gait kinematics. In patients with knee OA, deficits in gastrocnemius strength and endurance can exacerbate difficulties in activities such as stair climbing, walking, and balance maintenance. Eccentric and low-load blood flow restriction (LL-BFR) training protocols have been proposed to optimize gastrocnemius activation, enhance muscle strength, and improve functional performance, offering clinically relevant rehabilitation strategies for enhancing lower limb function and reducing disability in knee osteoarthritis.
This study is to find the effects of eccentric and low-load blood flow restriction training on neuromuscular adaptations, muscle strength, functional performance, and disability in individuals affected by the knee OA.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:KINZA ANWAR, MS-OMPT
- 電話番号:+92-3239735427
- メール:kinza.anwar@riphah.edu.pk
研究場所
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Punjab Province
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Rawalpindi、Punjab Province、パキスタン、46000
- 募集
- Railway General Hospital, Rawalpindi
-
コンタクト:
- KINZA ANWAR, MS-OMPT
- 電話番号:+92-3239735427
- メール:kinza.anwar@riphah.edu.pk
-
コンタクト:
- SEHRISH MALIK, MS-OMPT*
-
副調査官:
- SEHRISH MALIK, MS-OMPT*
-
-
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age group 40-70
- Both genders male and female
- Clinical diagnosis of knee OA (Kellgren-Lawrence grade 1-3) of the most symptomatic knee.
- Pain stable enough to permit exercise on Numeric Pain Rating Scale 3/10.
- Participants must demonstrate a gastrocnemius muscle strength of grade ≥3 on the Manual Muscle Testing (MMT) scale (0-5), assessed using the standard standing heel-rise position.
- Participants must be able to ambulate independently and participate in supervised exercise.
Exclusion Criteria:
• Presence of a prosthetic knee in the affected limb.
- Inflammatory arthritis (e.g., rheumatoid arthritis) or active flare-up of OA.
- Cardiovascular disease contraindicating exercise (e.g., unstable angina, recent MI, uncontrolled hypertension ≥160/100 mmHg).
- Pulmonary disease that limits safe participation (e.g., severe COPD, recent exacerbation).
- History of deep vein thrombosis (DVT), peripheral vascular disease, or bleeding/clotting disorders.
- Current anticoagulant therapy that increases bleeding risk (unless cleared by physician).
- Any pathology causing significant muscle weakness (e.g., neuromuscular disorders, severe neuropathy).
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Eccentric Training
Eccentric Gastrocnemius Strengthening Exercises
|
Eccentric Gastrocnemius Strengthening Exercises .1.
Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 3 sets 10 reps in session 1-2). 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 5 sets 15 reps in session 3-4).
Total duration is 3 sessions per week for 4 consecutive weeks.
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|
実験的:Low-Load Blood Flow Restriction Training
|
Low-load blood flow restriction training including 1-Low-intensity gastrocnemius strengthening with BFR cuff 2-Controlled exercise with intermittent vascular occlusion (inflated 50-70% for 4 weeks, 3 rep. 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 3 sets 10 reps in session 1-2). 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 5 sets 12 reps in session 3-4). Total duration is 3 sessions per week for 4 consecutive weeks. |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Surface Electromyography
時間枠:Baseline and 4th week
|
The Electromyography (EMG) is an objective assessment tool used to measure the electrical activity of muscles during contraction.
Motor unit recruitment will be analyzed through the amplitude of EMG signals (root mean square, RMS), reflecting the number and synchronization of active motor units during contraction.
Fatigue characteristics will be assessed using changes in EMG frequency parameters (mean or median frequency), indicating alterations in muscle fiber conduction velocity and fatigue onset that will be assessed pre and post sessions.
|
Baseline and 4th week
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
時間枠:4 weeks
|
The WOMAC is a widely used, validated questionnaire assessing pain, stiffness, and physical function in patients with knee osteoarthritis.
It consists of 24 items divided into three subscales: Pain (5 items), Stiffness (2 items), and Physical Function (17 items).
|
4 weeks
|
|
Timed Up and Go (TUG)
時間枠:4 weeks
|
The Timed Up and Go (TUG) test assesses mobility and fall risk by timing how quickly a person can stand up from a standard armchair, walk 3 meters (10 feet) at a normal pace, turn around, walk back, and sit down again.
Individuals can use their routine walking aids, but receive no physical help during the test; completing the maneuver in under 10 seconds indicates normal independence, whereas taking 30 seconds or longer points to an elevated risk of falling.
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4 weeks
|
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Heel Raise Endurance Test
時間枠:4 weeks
|
The Heel Raise Endurance Test measures the number of consecutive heel raises a participant can perform (or the time sustained) while standing, usually at a controlled pace until fatigue.
It assesses calf muscle endurance, ankle plantar-flexor strength, and functional lower-limb performance, relevant for gait and mobility assessment.
The duration for which the position is maintained is recorded.
|
4 weeks
|
協力者と研究者
捜査官
捜査官
- 主任研究者:KINZA ANWAR, MS-OMPT、Riphah International University
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- SEHRISH MALIK
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