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Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The objective of this study was to evaluate whether women with knee osteoarthritis performing a rehabilitation programme consisting of low-load exercises combined with PVO exhibited the same results in changes in quadriceps strength, pain relief, and functional improvement when compared to women receiving a programme consisting of high-load exercises without PVO.

Methods

Thirty-four women (mean age, 61 years) with a diagnosis of knee osteoarthritis were randomly assigned to a conventional or occlusion group. The women in the conventional group (n = 17) performed a 6-week quadriceps strengthening and stretching programme using a load around 70 % of the 1-repetition maximum (RM). The women in the occlusion group (n = 17) performed the same programme, however, only using a load around 30 % of the 1-RM, while PVO was induced. The PVO was achieved using a pressure cuff applied to the upper third of the thigh and inflated to 200 mmHg during the quadriceps exercise. An 11-point Numerical Pain Rating Scale (NPRS), the Lequesne questionnaire, the Timed-Up and Go (TUG) test, and muscle strength measurement using a hand-held dynamometer were used as outcome measures at baseline (pretreatment) and at the end of the 6-week of treatment. Pain, using the NPRS, was also assessed when performing the quadriceps exercises during the exercise sessions.

Results

At baseline, demographic, strength, pain, and functional assessment data were similar between groups. Patients from both the conventional and occlusion groups had a higher level of function (Lequesne and TUG test), less pain (NPRS), and higher quadriceps strength at the 6-week evaluation when compared to baseline (all P < 0.05). However, the between-group analysis showed no differences for all outcomes variables at posttreatment (n.s.). Patients in the occlusion group experienced less anterior knee discomfort during the treatment sessions than those in the high-load exercise group (P < 0.05).

Conclusion

A rehabilitation programme that combined PVO to low-load exercise resulted in similar benefits in pain, function, and quadriceps strength than a programme using high-load conventional exercise in patients with knee osteoarthritis. However, the use of PVO combined with low-load exercise resulted in less anterior knee pain during the training sessions.

Level of evidence

I.

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Authors and Affiliations

  1. Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia (ISCMSP), São Paulo, Brazil

    Flavio Fernandes Bryk, Thomas Araujo & Marcela Schutzer

  2. Orthopaedic and Traumatology Department, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil

    Ricardo de Paula Leite Cury & Aires Duarte Jr.

  3. TRATA Institute – Knee and Hip Rehabilitation, Rua Martinico Prado, 26 – Cj 141, São Paulo, 01224-010, Brazil

    Amir Curcio dos Reis, Deborah Fingerhut & Thiago Yukio Fukuda

Authors
  1. Flavio Fernandes Bryk
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  2. Amir Curcio dos Reis
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  3. Deborah Fingerhut
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  4. Thomas Araujo
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  6. Ricardo de Paula Leite Cury
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  8. Thiago Yukio Fukuda
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Correspondence to Thiago Yukio Fukuda.

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Bryk, F.F., dos Reis, A.C., Fingerhut, D. et al. Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial. Knee Surg Sports Traumatol Arthrosc 24, 1580–1586 (2016). https://doi.org/10.1007/s00167-016-4064-7

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  • DOI: https://doi.org/10.1007/s00167-016-4064-7

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