Efficacy and Safety of Blood Flow Restriction Training in Patients With Knee Osteoarthritis: A Systematic Review and <scp>Meta‐Analysis</scp>

Wang, Haonan; Chen, Yan; Cheng, Lin; Cai, Yihui; Li, Wei; Ni, Guo-Xin

doi:10.1002/acr.24787

Cited by 13 publications

(7 citation statements)

References 47 publications

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“…In addition to physical functions, we also focused on the quality of life, but our summary results indicate that there was no signi cant improvement in the BFRT group as opposed to the control group. This is consistent with previous meta-analysis results [30].…”

Section: Discussionsupporting

confidence: 94%

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Effects of blood flow restriction training in patients with knee osteoarthritis: A meta- analysis

Li,

Wen,

Zhang

et al. 2023

Preprint

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Background. Knee osteoarthritis (KOA) is a common degenerative disease.Resistance training is considered as an effective approach to reduce the risk of muscle weakness in patients with KOA. Blood flow restriction training (BFRT) with low-load resistance training has better clinical outcomes than low-load resistance training alone. However, the degree of BFRT which works more effectively withlow-load resistance training has not been determined. The purpose of this study is to provide a comprehensive overview of the existing data regarding the impact of blood flow restriction training (BFRT) on quadriceps strength, muscle size, pain, physical function, biomarkers, quality of life, and adverse events in patients with KOA. Method. A comprehensive search was conducted in five English-language electronic databases to identify randomized controlled trials (RCTs) comparing BFRT with conventional resistance training in patients with KOA. The selection of studies was based on predetermined inclusion and exclusion criteria. The methodological quality and evidence quality of the selected studies were evaluated. The retrieval period for the literature was from the creation of the database to June 2023. Results. A total of six RCTs were included in this meta-analysis, examining the effects of BFRT compared with those of conventional resistance training on KOA. The pooled results indicated a significant difference between the BFRT group and the control group in terms of quadriceps strength (SMD 0.39 (95% CI 0.18, 0.60), p = 0.01) and biomarkers (SMD 1.31 (95% CI 0.73, p = 0.00). However, BFRT did not show a significant difference compared to conventional resistance training in muscle size (ES = −0.47 (95% CI −1.51, 0.58), p = 0.45), pain (SMD −0.02, (95% CI −0.29, 0.25), p = 0.88), physical function (ES −0.09 (95% CI −0.37, 0.20), p = 0.14), quality of life (SMD 0.30 (95% CI −0.13, 0.73), p = 0.30) or adverse events (RR 0.45 (95% CI 0.20, 1.01), p = 0.05). Conclusions. The evidence reviewed suggests that BFRT may be beneficial for improving muscle strength and biomarkers compared to control training, but it may not be more effective in treating other symptoms of patients with osteoarthritis of the knee, including those related to muscle size, pain, physical function, quality of life, and adverse events. More high-quality evidence is needed to further investigate its therapeutic effects.

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Section: Discussionsupporting

confidence: 94%

“…However, two studies did not nd a marked improvement compared with the control group. These ndings align with those of previous meta-analyses involving older individuals [30,31].…”

Section: Discussionsupporting

confidence: 91%

Effects of blood flow restriction training in patients with knee osteoarthritis: A meta- analysis

Li,

Wen,

Zhang

et al. 2023

Preprint

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“…In a study conducted in patients with sporadic inclusion body myositis, a disease is also associated with decreased muscle strength, as is the case with neurological disorders [ 47 ], the training protocol with BFR did not improve objective physical function but it had a preventive (retaining effect) effect on the leg muscle strength [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Blood Flow Restriction in Neurological Disorders: A Systematic Review

et al. 2022

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There is scientific evidence that Blood Flow Restriction (BFR) is beneficial in healthy people, the elderly and patients with musculoskeletal disorders. A systematic review was conducted to evaluate the effectiveness of BFR in patients with neurological disorders. The literature search was conducted up until July 2022 in the following databases: PubMed, Web of Science (WOS), Physiotherapy Evidence Database (PEDro), LILACS, Scopus, Cumulative Index of Nursing and Allied Literature Complete (CINAHL), the Cochrane Library and Scientific Electronic Library Online (SciELO). The PEDro scale was used to analyze the methodological quality of the studies, and the Cochrane Collaboration’s tool was employed to evaluate the risk of bias. A total of seven articles were included. BFR seems to be beneficial in neurological disorders. Improvements have been found in sensorimotor function, frequency and step length symmetry, perceived exertion, heart rate and gait speed, walking endurance, fatigue, quality of life, muscles thickness, gluteus density and muscle edema. No improvements were found in lower limb strength or balance. However, results must be taken with caution due to the small number of articles and to the large heterogeneity. More clinical trials are needed. These studies should homogenize the protocols used in larger samples, as well as improve their methodological quality.

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“…Another recent meta-analysis including nine studies on various knee disorders found that muscle strength increases were comparably superior for LL-BFRT, and HL-RT compared to LL-RT, with pain improvement superior for LL-BFRT compared to LL-RT and HL-RT [142]. Systematic reviews have also found benefit of LL-BFRT for increasing muscle strength and function in clinical patients during rehabilitation for pre-and post-operative anterior cruciate ligament (ACL) reconstruction [143][144][145][146][147], knee surgery [148], osteoarthritis [149,150], various knee conditions [151][152][153][154], muscular atrophy [155], sarcopenia [156], and elderly patients at risk for various musculoskeletal conditions [113][114][115][116]. The safety of BFRT in musculoskeletal rehabilitation has also been assessed as comparable to standard exercise therapy, with a systematic review of 19 studies finding that the likelihood of adverse events is not increased with BFRT, despite suggestions of potential safety concerns [88].…”

Section: Bfrt Musculoskeletal Rehabilitation Outcomesmentioning

confidence: 99%

Blood Flow Restriction Training for Tendinopathy Rehabilitation: A Potential Alternative to Traditional Heavy-Load Resistance Training

Burton¹

2022

Rheumato

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Tendinopathy is a chronic tendon disease which can cause significant pain and functional limitations for individuals, and which collectively places a tremendous burden on society. Resistance training has long been considered the treatment of choice in the rehabilitation of chronic tendinopathies, with both eccentric and heavy slow resistance training demonstrating positive clinical effects. The application of progressive tendon loads during rehabilitation is essential to not compromise tendon healing, with the precise dosage parameters of resistance training and external loading a critical consideration. Blood-flow restriction training (BFRT) has become an increasingly popular method of resistance training in recent years and has been shown to be an effective method for enhancing muscle strength and hypertrophy in healthy populations and in musculoskeletal rehabilitation. Traditional resistance training for tendinopathy requires the application of heavy training loads, whereas BFRT utilises significantly lower loads and training intensities, which may be more appropriate for certain clinical populations. Despite evidence confirming the positive muscular adaptations derived from BFRT and the clinical benefits found for other musculoskeletal conditions, BFRT has received a dearth of attention in tendon rehabilitation. Therefore, the purpose of this narrative review was threefold: firstly, to give an overview and analysis of the mechanisms and outcomes of BFRT in both healthy populations and in musculoskeletal rehabilitation. Secondly, to give an overview of the evidence to date on the effects of BFRT on healthy tendon properties and clinical outcomes when applied to tendon pathology. Finally, a discussion on the clinical utility of BFRT and its potential applications within tendinopathy rehabilitation, including as a compliment to traditional heavy-load training, is presented.

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Efficacy and Safety of Blood Flow Restriction Training in Patients With Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

Cited by 13 publications

References 47 publications

Effects of blood flow restriction training in patients with knee osteoarthritis: A meta- analysis

Effects of blood flow restriction training in patients with knee osteoarthritis: A meta- analysis

Effectiveness of Blood Flow Restriction in Neurological Disorders: A Systematic Review

Blood Flow Restriction Training for Tendinopathy Rehabilitation: A Potential Alternative to Traditional Heavy-Load Resistance Training

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