Reumatología: Investigación actual
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abstracto

Blood Flow Restricted Low-Load Resistance Exercise in Patients with Persistent Knee Symptoms despite Previous Rehabilitation Efforts: A Pilot Study

Stian Langgard Jorgensen1*, Marie Bagger Bohn2

Introduction: Low-load exercise training with concurrent venous occlusion (Low-Load Blood-Flow-Restricted Exercise: LL-BFRE) has gained interest in clinical rehabilitation. Various orthopedic patients suffering from knee joint disorders would benefit from either i) maintaining or ii) increasing lower limb muscle strength and skeletal muscle mass. Due to the low load, and concurrent ability to increase muscle strength and promote muscle hypertrophy, LL-BFRE seems relevant to apply in clinical rehabilitation. The aim of the present study was to investigate the feasibility of LL-BFRE as a clinical rehabilitation method in patients suffering from various knee joint-related injuries. A secondary objective was to analyze change in functional performance, knee muscle strength and patient-reported outcomes.

Methods: Patients suffering from i) knee osteoarthritis (n=3), ii) persistent postoperative knee pain, or persistent functional performance deficits after surgery were included (n=9). LL-BRFE was performed twice weekly for 4-8 weeks as unilateral leg press at 30% 1 Repetition Maximum (RM) with partial venous occlusion (40% complete limb occlusion pressure) around the proximal part of the thigh. Timed Up and Go, 30-second chair-stand-test, Thigh Circumference (TC), isometric knee extensor strength, and the Knee Osteoarthritis Outcome Score (KOOS) was performed at baseline and follow-up.

Results: Four patients dropped out due to i) pain aggravation, ii) ruptured Baker's cyste, iii) loss of motivation, iv) personal reasons. Adherence to training was 95.6%. Significant improvements were achieved in both Timed Up and Go and 30 seconds sit to stand (p ≤ 0.03). As did isometric knee extension strength on the affected limb (p=0.05), and 5 RM on the affected limb (p<0.01). Three out of five KOOS subscales improved more than 10 points, while no significant change was seen for thigh circumference (p=0.08).

Conclusion: The study indicates that LL-BFRE is feasible in patients suffering from various orthopedic knee joint disabilities and can be a part of a physical therapy rehabilitation program. Furthermore, the patients achieved both functional improvement, increased muscle strength, and demonstrated clinical meaningful improvements in their experience of knee pain, knee symptoms, and participation in sport and recreation activities.