Jacobs Ewoud, Stroobant Lenka, Victor Jan, Elewaut Dirk, Tampere Thomas, Wallaert Steven, Witvrouw Erik, Schuermans Joke, Wezenbeek Evi
Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium.
Department of Orthopaedic Surgery, University Hospital Ghent, Ghent, Belgium.
Ann Rheum Dis. 2025 Feb;84(2):341-350. doi: 10.1136/ard-2024-226579. Epub 2025 Jan 2.
Knee osteoarthritis (KOA) is a leading cause of global disability with conventional exercise yielding only modest improvements. Here we aimed to investigate the benefits of integrating blood flow restriction (BFR) into traditional exercise programmes to enhance treatment outcomes.
The Vascular Occlusion for optimizing the Functional Improvement in patients with Knee Osteoarthritis randomised controlled trial enrolled 120 patients with KOA at Ghent University Hospital, randomly assigning them to either a traditional exercise programme or a BFR-enhanced programme over 24 sessions in 12 weeks. Assessments were conducted at baseline, 6 weeks, 12 weeks and 3 months postintervention using linear mixed models with Dunn-Sidak corrections for multiple comparisons. Primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at 3 months follow-up with knee strength, Pain Catastrophizing Scale questionnaire and functional tests as secondary outcomes. Analysis followed an intention-to-treat approach (NCT04996680).
The BFR group showed greater improvements in KOOS pain subscale (effect size (ES)=0.58; p=0.0009), quadriceps strength (ES=0.81; p<0.0001) and functional tests compared with the control group at 12 weeks. At 3 months follow-up, the BFR group continued to exhibit superior improvements in KOOS pain (ES=0.55; p=0.0008), symptoms (ES=0.59; p=0.0004) and quality of life (QoL) (ES=0.66; p=0.0001) with sustained benefits in secondary outcomes. Drop-out rates were similar in both groups.
Incorporating BFR into traditional exercise programmes significantly enhances short-term and long-term outcomes for patients with KOA demonstrating persistent improvements in pain, symptoms, QoL and functional measures compared with conventional exercise alone. These findings suggest that BFR can provide the metabolic stimulus needed to achieve muscle strength and functional gains with lower mechanical loads. Reduced pain and increased strength support a more active lifestyle, potentially maintaining muscle mass, functionality and QoL even beyond the supervised intervention period.
NCT04996680.
膝关节骨关节炎（KOA）是全球致残的主要原因，传统运动只能带来适度改善。在此，我们旨在研究将血流限制（BFR）纳入传统运动计划以提高治疗效果的益处。
膝关节骨关节炎患者功能改善优化血管闭塞随机对照试验在根特大学医院招募了120名KOA患者，在12周内随机将他们分配到传统运动计划组或BFR强化计划组，进行24次训练。在基线、干预后6周、12周和3个月时进行评估，使用线性混合模型并采用Dunn-Sidak校正进行多重比较。主要结局是在3个月随访时的膝关节损伤和骨关节炎结局评分（KOOS）问卷，次要结局包括膝关节力量、疼痛灾难化量表问卷和功能测试。分析采用意向性分析方法（NCT04996680）。
与对照组相比，BFR组在12周时KOOS疼痛子量表（效应量（ES）=0.58；p=0.0009）、股四头肌力量（ES=0.81；p<0.0001）和功能测试方面有更大改善。在3个月随访时，BFR组在KOOS疼痛（ES=0.55；p=0.0008）、症状（ES=0.59；p=0.0004）和生活质量（QoL）（ES=0.66；p=0.0001）方面继续表现出更优的改善，次要结局也持续受益。两组的退出率相似。
将BFR纳入传统运动计划可显著提高KOA患者的短期和长期结局，与单纯传统运动相比，在疼痛、症状、QoL和功能指标方面持续改善。这些发现表明，BFR可以提供在较低机械负荷下实现肌肉力量和功能提升所需的代谢刺激。疼痛减轻和力量增加有助于支持更积极的生活方式，甚至在监督干预期之后也可能维持肌肉质量、功能和QoL。
NCT04996680。
