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EFFECT OF ADDING BLOOD FLOW RESTRICTION TRAINING TO CLOSED CHAIN EXERCISE IN KNEE OSTEOARTHRITIS

2026年10月30日 更新者:Rasha Abdel Kader Abdel Azeem Khtab

Knee osteoarthritis is a common joint condition that causes knee pain, stiffness, muscle weakness, and difficulty performing daily activities such as walking, climbing stairs, and standing up from a chair. Exercise therapy is commonly used to improve muscle strength, reduce pain, and restore physical function. However, some patients may find traditional strengthening exercises difficult because of pain and increased stress on the knee joint.

Blood flow restriction (BFR) training is a rehabilitation technique that uses a specialized cuff placed around the upper thigh to partially restrict blood flow during exercise. This technique may help improve muscle strength while using lighter exercise loads.

The purpose of this study is to investigate whether adding blood flow restriction training to traditional physical therapy and closed kinetic chain exercises provides additional benefits for patients with knee osteoarthritis.

This randomized controlled trial will include 60 male and female participants aged 40 to 60 years with mild to moderate knee osteoarthritis. Participants will be randomly assigned to one of two groups, with 30 participants in each group.

The first group will receive traditional physical therapy exercises combined with closed kinetic chain exercises, such as mini-squats, step-ups, step-downs, partial lunges, and wall slides.

The second group will receive the same exercise program with the addition of blood flow restriction training.

Both groups will participate in supervised treatment sessions twice weekly for eight weeks, for a total of 16 sessions.

The researchers will assess knee pain, knee range of motion, quadriceps muscle strength, knee function, mobility and fall risk, quality of life, and patient satisfaction. Assessments will be conducted before treatment, immediately after the eight-week intervention, and one month after completing treatment.

The study aims to determine whether adding blood flow restriction training to closed kinetic chain exercises can improve rehabilitation outcomes in individuals with knee osteoarthritis.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

Knee osteoarthritis (KOA) is a chronic degenerative joint disorder characterized by progressive cartilage deterioration, pain, stiffness, reduced muscle strength, and functional limitations. Quadriceps muscle weakness is a major contributing factor to impaired knee stability and reduced physical performance in individuals with knee osteoarthritis.

Closed kinetic chain (CKC) exercises are commonly used in knee osteoarthritis rehabilitation because they involve functional weight-bearing movements that promote coordinated muscle activation, joint stability, and neuromuscular control. However, conventional resistance training may be difficult for patients who experience pain or cannot tolerate high mechanical loads.

Blood flow restriction (BFR) training is a rehabilitation approach that involves applying a pneumatic cuff to the proximal thigh during low-load exercise. By partially restricting blood flow, BFR training may stimulate muscular adaptations while reducing the need for high external resistance.

This study will investigate the effectiveness of adding blood flow restriction training to closed kinetic chain exercises in patients with mild to moderate knee osteoarthritis.

Study Design:

This study will be conducted as a randomized controlled trial involving 60 male and female participants diagnosed with mild to moderate knee osteoarthritis (Kellgren-Lawrence grades II-III).

Participants will be aged between 40 and 60 years and have a body mass index ranging from 25 to 29.9 kg/m².

Eligible participants will be recruited from outpatient physical therapy clinics in Cairo, Egypt.

Participants will be randomly allocated into two equal groups using a computer-generated randomization method.

Intervention:

Group A (Control Group):

Thirty participants will receive a traditional therapeutic exercise program combined with closed kinetic chain exercises.

Traditional exercises will include seated knee extensions, hip adduction and abduction exercises, straight leg raises, short-arc knee extensions, ankle pumps, and hamstring curls.

Closed kinetic chain exercises will include mini-squats, step-ups, step-downs, partial lunges, and wall slides.

Group B (Experimental Group):

Thirty participants will receive the same traditional and closed kinetic chain exercise program with the addition of blood flow restriction training.

Blood flow restriction will be applied using a specialized pneumatic cuff positioned around the proximal thigh during low-load resistance and closed kinetic chain exercises.

Both groups will receive 16 supervised treatment sessions over eight weeks, with two sessions per week.

Outcome Assessment:

The effectiveness of the interventions will be evaluated using the following measures:

  1. Pain intensity using the Numeric Pain Rating Scale (NPRS).
  2. Knee range of motion using a smartphone-based digital inclinometer.
  3. Quadriceps muscle strength using a hand-held dynamometer.
  4. Knee function using the Knee Injury and Osteoarthritis Outcome Score (KOOS).
  5. Functional mobility and fall risk using the Timed Up and Go (TUG) test.
  6. Health-related quality of life using the Short Form-36 (SF-36) questionnaire.
  7. Patient satisfaction using the Patient Satisfaction Questionnaire Short Form (PSQ-18).

Outcome assessments will be performed at baseline, immediately after the eight-week intervention, and at a one-month follow-up.

The study will compare changes in clinical and functional outcomes between the two groups to determine whether adding blood flow restriction training provides additional therapeutic benefits compared with traditional and closed kinetic chain exercises alone.

研究の種類

介入

入学 (推定)

60

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • Cairo Governorate
      • Cairo、Cairo Governorate、エジプト、11511
        • Outpatient Physical Therapy Clinics in Cairo, Egypt
        • コンタクト:
        • 主任研究者:
          • Rasha A Khattab, MSc

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

40年~60年 (大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

Participants diagnosed with mild to moderate knee osteoarthritis (Kellgren-Lawrence grades II-III).

Participants aged between 40 and 60 years.

Body mass index (BMI) ranging from 25 to 29.9 kg/m².

Presence of chronic knee pain for at least three months.

Pain intensity of ≥3/10 on the Visual Analog Scale (VAS) or equivalent WOMAC pain score.

Ability to ambulate independently and perform closed kinetic chain exercises.

Participants who are medically fit to participate in low-load resistance exercise with or without blood flow restriction training.

Willingness to participate and provide written informed consent.

Exclusion Criteria:

History of knee surgery within the previous 12 months.

Presence of severe knee osteoarthritis (Kellgren-Lawrence grade IV).

Diagnosis of inflammatory joint diseases, such as rheumatoid arthritis.

Presence of cardiovascular, vascular, or neurological disorders that contraindicate blood flow restriction training.

Participation in any other structured lower limb strengthening or blood flow restriction training program during the study period.

Cognitive impairment or inability to understand and follow exercise instructions.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

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:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
アクティブコンパレータ:Traditional Exercise and Closed Kinetic Chain Exercises

Participants in the control group will receive a traditional therapeutic exercise program combined with closed kinetic chain exercises, including seated knee extensions, hip adduction and abduction, straight leg raises, short-arc knee extensions, ankle pumps, hamstring curls, mini-squats, step-ups, step-downs, partial lunges, and wall slides. Treatment will be delivered twice weekly for eight weeks, for a total of 16 supervised sessions.

A supervised therapeutic exercise program consisting of traditional strengthening exercises and closed kinetic chain exercises, including mini-squats, step-ups, step-downs, partial lunges, and wall slides. The program will be performed twice weekly for eight weeks.

実験的:Blood Flow Restriction Training Combined with Closed Kinetic Chain Exercises

Participants in the experimental group will receive the same traditional therapeutic exercise and closed kinetic chain exercise program as the control group, with the addition of blood flow restriction training. Blood flow restriction will be applied using a pneumatic cuff positioned around the proximal thigh during low-load resistance or closed kinetic chain exercises. Treatment will be delivered twice weekly for eight weeks, for a total of 16 supervised sessions.

A supervised therapeutic exercise program consisting of traditional strengthening exercises and closed kinetic chain exercises, including mini-squats, step-ups, step-downs, partial lunges, and wall slides. The program will be performed twice weekly for eight weeks.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change in Knee Pain Intensity Measured by the Numeric Pain Rating Scale (NPRS)
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Knee pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. Changes from baseline will be assessed after treatment and at follow-up.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).
Change in Knee Range of Motion Measured by a Smartphone Digital Inclinometer
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Knee joint range of motion will be measured in degrees using a smartphone-based digital inclinometer application. Knee flexion and extension angles will be assessed to evaluate changes in joint mobility following the intervention. Changes from baseline will be evaluated at week 8 and week 12.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).
Change in Quadriceps Muscle Strength Measured by a Hand-Held Dynamometer
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Quadriceps muscle strength will be assessed using a hand-held dynamometer to measure isometric muscle force during voluntary contraction. The assessment will be performed using standardized testing procedures. Changes in quadriceps muscle strength from baseline will be evaluated after treatment and at follow-up.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

二次結果の測定

結果測定
メジャーの説明
時間枠
Change in Knee Function Measured by the Knee Injury and Osteoarthritis Outcome Score (KOOS)
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Knee-related function will be assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), a 42-item questionnaire covering five subscales: pain, symptoms, activities of daily living, sport and recreation, and knee-related quality of life. Each subscale is transformed to a score ranging from 0 to 100, with higher scores indicating better knee-related outcomes.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).
Change in Functional Mobility Measured by the Timed Up and Go (TUG) Test
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Functional mobility will be assessed using the Timed Up and Go (TUG) test. Participants will be instructed to stand up from a chair, walk three meters, turn around, return to the chair, and sit down. The time required to complete the task will be recorded in seconds. Lower completion times indicate better functional mobility.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).
Change in Health-Related Quality of Life Measured by the Short Form-36 (SF-36)
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Health-related quality of life will be assessed using the Short Form-36 (SF-36) questionnaire, which consists of 36 items evaluating physical and mental health domains. Scores range from 0 to 100, with higher scores indicating better health-related quality of life. Changes from baseline will be evaluated following treatment and at follow-up.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).
Change in Patient Satisfaction Measured by the Patient Satisfaction Questionnaire (PSQ-18)
時間枠:Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

Patient satisfaction with healthcare services will be assessed using the Patient Satisfaction Questionnaire Short Form (PSQ-18). The questionnaire contains 18 items covering seven dimensions: general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with the healthcare provider, and accessibility and convenience. Items are rated using a five-point Likert scale.

Baseline, week 8 (post-treatment), and week 12 (one-month follow-up).

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Rasha A Khattab, MSc、Cairo University, Faculty of Physical Therapy

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年12月1日

一次修了 (推定)

2027年12月31日

研究の完了 (推定)

2028年2月28日

試験登録日

最初に提出

2026年10月30日

QC基準を満たした最初の提出物

2026年10月30日

最初の投稿 (実際)

2026年11月4日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月4日

QC基準を満たした最後の更新が送信されました

2026年10月30日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • BFR training on Osteoarthritis
  • P.T.REC/012/006531 (その他の識別子:Cairo University, Faculty Of Physical Therapy Research Ethical Committee)

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個々の参加者データ (IPD) を共有する予定はありますか?

未定

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