Department of Occupational and Physical Therapy, Horsens Regional Hospital, Horsens, Denmark.
H-HIP, Department of Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark.
Scand J Med Sci Sports. 2024 Nov;34(11):e14750. doi: 10.1111/sms.14750.
The trial aimed to examine the effect of eight weeks preoperative low-load blood flow restricted resistance training (BFR-RT) on physical function, lower limb strength, and patient-reported outcomes in knee OA patients 3 and 12 months after total knee arthroplasty (TKA) compared with preoperative usual care. An assessor blinded randomized controlled trial (RCT) was conducted. Eighty-six patients scheduled for TKA who were allocated to 8 weeks BFR-RT on the affected leg 3x/week or preoperative usual care involving no exercise (CON).
30-s sit to stand (30STS).
Timed Up&Go, 40-m walk test (40mWT), knee range of motion (ROM) 1-repetition maximum (1RM) leg press and knee extensor strength, maximal isometric contraction (MVIC) for the knee extensors and flexors, Knee injury and Osteoarthritis Outcome Score (KOOS), and Euroqol 5-dimensions (EQ-5D-L5) questionnaire. Data were collected at baseline (12 weeks pre-surgery), ~3 days pre-surgery, 3 and 12 months postoperatively. Intention-to-treat analysis revealed no significant between-group differences in the change from baseline to 3 and 12 months postoperatively on 30STS, TUG, or 40mFWT. Significant between-group differences were observed at 3 but not 12 months postoperatively for the corresponding changes in 1RM leg press strength, 1RM knee extensor strength, and MVIC knee extensor favoring BFR-RT. No between-group differences were observed for the delta changes from baseline in knee ROM, KOOS subscales or EQ-5D-L5 at any postoperative time points. These findings suggest that preoperative BFR-RT offered no superior effects compared with usual preoperative care on postoperative physical function or patient-reported outcomes. Preoperative BFR-RT produced amplified gains in lower limb muscle strength at 3 months postoperatively.
NCT04081493.
本试验旨在比较膝关节骨关节炎（OA）患者术前 8 周低负荷血流限制阻力训练（BFR-RT）与术前常规护理对全膝关节置换术（TKA）后 3 个月和 12 个月的身体功能、下肢力量和患者报告的结局的影响。方法：进行了一项评估员盲法随机对照试验（RCT）。86 例拟行 TKA 的患者被分配到受影响的腿每周 3 次接受 8 周的 BFR-RT 或术前不运动的常规护理（CON）。
30 秒坐站（30STS）。
计时起立行走测试（TUG）、40 米步行测试（40mWT）、膝关节活动度（ROM）1 次重复最大（1RM）腿举和膝关节伸肌力量、最大等长收缩（MVIC）的膝关节伸肌和屈肌、膝关节损伤和骨关节炎结果评分（KOOS）和欧洲五维健康量表（EQ-5D-L5）问卷。数据在基线（术前 12 周）、术前约 3 天、术后 3 个月和 12 个月收集。意向治疗分析显示，从基线到术后 3 个月和 12 个月，30STS、TUG 或 40mFWT 的变化在组间无显著差异。在术后 3 个月而不是 12 个月时，BFR-RT 组在腿举 1RM 力量、膝关节伸肌 1RM 力量和膝关节伸肌 MVIC 的相应变化上显示出组间差异。在任何术后时间点，膝关节 ROM、KOOS 亚量表或 EQ-5D-L5 的基线差值变化均无组间差异。这些发现表明，与术前常规护理相比，术前 BFR-RT 对术后身体功能或患者报告的结局没有更好的效果。术前 BFR-RT 在术后 3 个月时产生了下肢肌肉力量的显著增强。
NCT04081493。
