Authors: (including presenting author): :
LEE WYA, WONG MHH, POON WYM
Affiliation: :
Physiotherapy Department, Hong Kong Buddhist Hospital
Keyword 1: :
Physiotherapy
Keyword 4: :
Blood flow restriction
Introduction: :
Knee osteoarthritis(OA) is a common degenerative condition causing pain, muscle weakness, reduced endurance, and hence affect patient’s quality of life(QoL). Exercise-based rehabilitation aims at improving muscle strength to reduce joint loading and enhancing aerobic capacity to optimize patient ‘s physical function and hence maintain QoL. However, patients with moderate to severe pain often cannot tolerate high loads needed for optimal exercise effect. Blood flow restriction training(BFRT) addresses this limitation and serve as a valuable adjunct to improve muscle strength and function with lower loads through induced metabolic stress. Integrating BFR into stratified physiotherapy knee care may therefore enhance treatment outcomes amongst patients with moderate to severe pain.
Objectives: :
This pilot study aims to evaluate the effectiveness of an enhanced rehabilitation program incorporating low-load BFRT in improving clinical and functional outcomes amongst patients with knee osteoarthritis
Methodology: :
This was a pretest-posttest pilot study. Patients with diagnosis of knee OA having moderate knee pain(onset >3 months, pain level of NPRS ≥5/10) were recruited. Enhanced rehabilitation program comprised five weekly sessions of strengthening and aerobic training incorporating low-load BFRT. Outcomes measures included 1.Pain intensity(Numeric Pain Rating Scale-NPRS); 2.Knee Injury and Osteoarthritis Outcome Score(KOOS) for pain, physical symptoms and quality of life; 3.Quadriceps isometric strength; 4. aerobic capacity(2-minute step test), and 5. Lower limb strength and endurance(30-second chair stand test, 30CST). Numeric Global Rating of Change Scale(NGRCS) was also used to assess perceived overall improvement of the condition. All data were analyzed by Wilcoxon Signed-Rank Test.
Result & Outcome: :
Seventeen patients, aged 40-85, completed the program during November 2025 to January 2026. The patients reported significant pain reduction from 6 to 3 by NPRS(p< 0.001) and improvement in KOOS-pain, physical symptoms and QoL from 50 to 63, from 61 to 68 and from 34 to 43(p< 0.05) respectively. There was also significant quadriceps strength gained from 10 to 11 kilogram-force(p< 0.001); improved lower limb strength and endurance in 30CST from 8 to 10 repetitions (p< 0.001); and increased aerobic capacity in 2-minute step test from 31 to 36 repetitions(p< 0.001). Patients reported improvement with 6 out of 10 by NGRCS(p< 0.001). This enhanced BFR rehabilitation program significantly improved pain, strength, function, and QoL in knee OA with less perceived exertion. Larger studies were needed for exploring effectiveness for preparing implementation similar training model in primary care.
