The addition of blood flow restriction to resistance exercise in individuals with knee pain: a systematic review and meta-analysis

Abstract

Background: Blood flow restriction (BFR) is an effective clinical intervention used to increase strength in healthy individuals. However, its effects on pain and function in individuals with knee pain are unknown. Objective: To determine the effectiveness of adding BFR to resistance exercise for pain relief and improvement of function in patients with knee pain. Methods: Systematic review with meta-analysis of randomized clinical trials. Medline, Central, Embase, PEDro, Lilacs, CINAHL, SPORTDiscus, and Web of Science databases were searched from inception to May 2019. Randomized clinical trials that compared resistance exercise with or without BFR to treat knee pain and function in individuals older than 18 years of age with knee pain were included. Results: Eight randomized clinical trials met the eligibility criteria and for the quantitative synthesis, five studies were included. The pooled standardized mean difference (SMD) estimate showed that resistance exercises with BFR was not more effective than resistance exercises for reducing pain (SMD: −0.37 cm, 95% CI = −0.93, 0.19) and improving knee function (SMD = −0.23 points, 95% CI = −0.71, 0.26) in patients with knee pain.

Reply to letter to the Editor about the article “The addition of blood flow restriction to resistance exercise in individuals with knee pain: a systematic review and meta-analysis”

“…We appreciate the comments on our article ''The addition of blood flow restriction to resistance exercise in individuals with knee pain: a systematic review and meta-analysis'' (Cuyul-Vásquez et al 1 ). We would like to take the opportunity to address several points raised in these comments.…”

Comparison of Blood Flow Restriction Training versus Non-Occlusive Training in Patients with Anterior Cruciate Ligament Reconstruction or Knee Osteoarthritis: A Systematic Review

“…Blood flow restriction (BFR) or Kaatsu, consists of partially restricting the arterial inflow and completely restricting the venous return flow during exercise [ 1 ]. Restrictive straps or a blood pressure cuff are placed on the proximal area of the limb [ 2 ], and then inflated to a pressure capable of restricting venous return allowing arterial entry while exercising [ 3 , 4 ]. The physiological mechanisms that are activated by BFR are currently unclear.…”

“…The reviewed literature suggests that muscle hypertrophy occurs after training with BFR, in both healthy and injured people [ 18 , 19 ], achieving results similar to those of classic muscle mass gain training, but reducing joint stress and therefore increasing exercise tolerance [ 2 , 4 ]. Additionally, lower levels of pain and perceived exertion have been observed during and after BFR training.…”

Reply to second letter to the editor about the article “The addition of blood flow restriction to resistance exercise in individuals with knee pain: a systematic review and meta-analysis”

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LETTER TO THE EDITORReply to second letter to the editor about the article ''The addition of blood flow restriction to resistance exercise in individuals with knee pain: a systematic review and meta-analysis''We appreciate the comments by Korokakis et al 1 on our article 'The addition of blood flow restriction to resistance exercise in individuals with knee pain: a systematic review and meta-analysis'. 2 We would like to take the opportunity to address several points raised in these comments which adds to the discussion that this review already generated. 3,4 First, we do not agree with the comment 'Although the authors reported that they conducted the review following recommendations in the Cochrane Handbook, there are some important departures, which have likely introduced biases and inconsistencies.

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