Exercise‐induced hypoalgesia with end‐stage knee osteoarthritis during different blood flow restriction levels: Sham‐controlled crossover study

Ogrezeanu, Daniel C.; López‐Bueno, Laura; Sanchís‐Sánchez, Enrique; Suso‐Martí, Luis; López‐Bueno, Rubén; Núñez‐Cortés, Rodrigo; Cruz‐Montecinos, Carlos; Pérez‐Alenda, Sofía; Casaña, José; Gargallo, Pedro; Calatayud, Joaquín

doi:10.1002/pmrj.13076

Cited by 4 publications

(3 citation statements)

References 54 publications

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“…These findings [15] are supported by those of another study [25], which sought to assess the effect of resistance training programs employing varying levels of BFR on exercise-induced hypoalgesia (EIH), i.e. acute post-exercise reduction in pain sensitivity, in patients with end-stage knee osteoarthritis.…”

Section: Harper (2019) [13]mentioning

confidence: 66%

“…acute post-exercise reduction in pain sensitivity, in patients with end-stage knee osteoarthritis. EIH can affect both exercising and non-exercising portions of the body, and is one potential benefit of treatment for knee OA patients [25]. However, despite experiencing a typical initial EIH following BFR training at 80% AOP, no differences in EIH were found between placebo (sham BFR), 40%, and 80% AOP.…”

Section: Harper (2019) [13]mentioning

confidence: 92%

“…However, despite experiencing a typical initial EIH following BFR training at 80% AOP, no differences in EIH were found between placebo (sham BFR), 40%, and 80% AOP. Nevertheless, the 80% AOP regimen quickly improved pressure pain thresholds (PPT) and decreased visual analogue scale (VAS) scores [25].…”

Section: Harper (2019) [13]mentioning

confidence: 99%

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A scoping review on outcomes, interventions and cuff parameters for blood flow restriction training in the treatment of knee osteoarthritis

Singh,

Hariramani,

Kothiyal

2024

areh

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The most common type of arthritis that alters a joint's mechanical and structural properties is osteoarthritis (OA). A new and promising non-pharmacological strategy for treating OA that has received recent attention is a combination of resistance training with blood flow restriction training (BFRT). This paper aims to identify the outcomes and outcome measures used for studying BFRT in knee OA, and to evaluate the cuff parameters and BFRT intervention used.The scoping review was based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. The review was based on material from the Cochrane Central Register of Controlled Trials, the Physiotherapy Evidence Database and PubMed.Eight studies were included. The range of outcomes used in the study were knee pain, function, strength, quadriceps cross-sectional area, quality of life, disease severity, growth hormone level, and range of motion. The included studies used interventions ranging from four to five sets of 10 to 15 repetitions at 20% to 30% of 1 repetition maximum load; progressive blood restriction ranged from 30%-80% of arterial occlusion pressure when the cuff was placed at the most proximal part of the thigh.When used with appropriate parameters, low-intensity exercise training combined with blood flow restriction (BFR) is a viable alternative to traditional strategies for improving pain, strength, muscle mass, hormone levels, functionality, range of motion, and overall quality of life among patients with knee OA.

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Section: Harper (2019) [13]mentioning

confidence: 66%

Section: Harper (2019) [13]mentioning

confidence: 92%

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A scoping review on outcomes, interventions and cuff parameters for blood flow restriction training in the treatment of knee osteoarthritis

Singh,

Hariramani,

Kothiyal

2024

areh

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Hydraulic theory of pathogenesis of posttraumatic osteoarthritis of knee joints and perspectives of therapeutic measures

Noskov,

Shepelyaeva,

Bashkina

et al. 2024

Vrach

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An original hydraulic theory of the pathogenesis of osteoarthritis of the knee joints is proposed. The hydraulic theory suggests the presence of an initial traumatic or domestic injury to the menisci, cruciate ligaments, and synovial membrane, followed by a post-traumatic increase in the volume of synovial fluid and, accordingly, hydrostatic pressure inside the synovial cavity. Damage to the cell layer of synovial macrophages, which form the basis of the intima and synovial barrier, leads to the leakage of synovial fluid into the subintima with the development of cellular alteration and the subsequent growth of fibrosis and the growth of uncontrolled hyperplasia, cellular hypertrophy and neoplasm of vessels and nerve endings. Later damage to the thick bone and cartilage barrier leads to intrusion of synovial fluid into the bone tissue with the formation of bone cysts and osteoarthritic damage/edema of the bone marrow. Restoration of barriers through the use of repair, including cellular, technologies in the near future is impossible due to the lack of regenerative potential in synovial macrophages and chondrocytes. Damage to the synovial and osteocartilage barrier suggests different medical tactics for the management of patients with osteoarthritis of the knee joints. The authors substantiate the undesirability of any type of analgesic therapy in case of damage to the synovial barrier and preservation of the integrity of the bone-cartilage barrier. The only effective and safe method of treatment at all stages of the disease is therapeutic exercise with an emphasis on exercises that accelerate lymphatic and venous outflow in order to achieve antifibrotic and antihypoxic effects.

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Blood Flow Restriction Exercise as a Novel Conservative Standard in Patients with Knee Osteoarthritis—A Narrative Review

Jacobs,

Witvrouw,

Calders

et al. 2024

Applied Sciences

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Knee osteoarthritis is a prevalent joint disease affecting millions of individuals globally. While total knee arthroplasty is an effective treatment for advanced stages of KOA, it may not be suitable for earlier stages or younger patients. Supervised exercise therapy has proven to be the first-line treatment of preference in tackling pain and disability caused by KOA. However, the high intensities required to induce positive muscle adaptations are not indicated in this population, as this is often accompanied by pain, discomfort, and frustration, leaving low-load resistance training as the only feasible method of treatment. Recently, the use of blood flow restriction training has begun to emerge as a substitute for high-load resistance training. With BFRT, a cuff is applied around the proximal aspect of the affected limb, causing partial arterial and full venous occlusion, thereby inducing localized hypoxia and the accumulation of metabolites, mimicking the effects of high-load resistance training, albeit with low loads. Consequently, BFRT might offer a suitable and more effective alternative for KOA patients who are not (yet) eligible for TKA compared to traditional exercise therapy. This review aims to summarize the current evidence as regards the application of Blood Flow Restriction in exercise therapy for knee osteoarthritis patients, with particular consideration of the underlying mechanisms and its safety, as well as general guidelines for practical implementation in clinical practice. In doing so, this narrative review aims to create a framework for translating from theory into practice.

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Exercise‐induced hypoalgesia with end‐stage knee osteoarthritis during different blood flow restriction levels: Sham‐controlled crossover study

Cited by 4 publications

References 54 publications

A scoping review on outcomes, interventions and cuff parameters for blood flow restriction training in the treatment of knee osteoarthritis

A scoping review on outcomes, interventions and cuff parameters for blood flow restriction training in the treatment of knee osteoarthritis

Hydraulic theory of pathogenesis of posttraumatic osteoarthritis of knee joints and perspectives of therapeutic measures

Blood Flow Restriction Exercise as a Novel Conservative Standard in Patients with Knee Osteoarthritis—A Narrative Review

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