Department of Physiotherapy of University Center Cenecista of Bento Gonçalves, Bento Gonçalves, Rio Grande do Sul, Brazil.
Clin Rehabil. 2020 Nov;34(11):1378-1390. doi: 10.1177/0269215520943650. Epub 2020 Aug 10.
To synthesize evidence on the effects of blood flow restriction (BFR) comparing with high (HLT) and low load (LLT), and on the influence of different forms of application in individuals with knee osteoarthritis.
The CENTRAL, PEDro, PubMed and BVS, which include Lilacs, Medline and SciELO, until April 2020.
A systematic review and meta-analysis of randomized trials used the PRISMA guidelines, whose main keywords were: Therapeutic Occlusion, Resistance Training, and Knee Osteoarthritie, blood flow restriction and Kaatsu training. Method quality was evaluated with the PEDro scale. When studies demonstrated homogeneity on outcome measures, the mean differences or standardized mean differences with 95% confidence interval were calculated and pooled in a meta-analysis for pooled synthesis.
Five articles were eligible in this review with moderate to low risk bias. Our results, showed no difference between BFR and HLT in knee strength (SMD = 0.00, 95% CI, -0.54 to 0.54, = 1.00), function (SMD = -0.20, 95% CI, -0.45 to 0.06, = 0.13), pain and volume. But, when compared BFR and LLT, the descriptive analysis demonstrated significant results in favor BFR to muscle strength (71.4% of measurement) and volume (MD = 1.66, 95% CI, 0.93 to 2.38, < 0.00001), but not in pain or function.
BFR can be used as a strategy in the rehabilitation of osteoarthritis due to gains in strength and volume with low mechanical stress. However, its application must be safe and individualized, since they can attenuate the stimuli offered by BFR.
综合评估血流限制（BFR）与高（HLT）、低负荷（LLT）的效果，并比较不同应用形式对膝骨关节炎患者的影响。
CENTRAL、PEDro、PubMed 和 BVS，包括 Lilacs、Medline 和 SciELO，检索截至 2020 年 4 月。
采用 PRISMA 指南对随机试验进行系统评价和荟萃分析，主要关键词包括：治疗性阻断、抗阻训练、膝骨关节炎、血流限制和加压器训练。采用 PEDro 量表评估方法质量。当研究在结局指标上表现出同质性时，计算并汇总平均值差异或标准化平均值差异（95%置信区间），并进行荟萃分析以进行综合分析。
本次综述有 5 篇文章符合条件，偏倚风险为中低度。我们的结果显示，BFR 与 HLT 在膝关节力量方面（SMD = 0.00，95%CI：-0.54 至 0.54， = 1.00）、功能（SMD = -0.20，95%CI：-0.45 至 0.06， = 0.13）、疼痛和容量方面没有差异。但是，当比较 BFR 和 LLT 时，描述性分析表明 BFR 在肌肉力量（71.4%的测量值）和容量（MD = 1.66，95%CI：0.93 至 2.38， < 0.00001）方面具有显著优势，但在疼痛或功能方面没有优势。
BFR 可作为骨关节炎康复的一种策略，因为它可以在低机械应激下增强力量和容量。然而，其应用必须安全且个体化，因为它可能会减弱 BFR 提供的刺激。
