Introduction and Aim. Quadriceps strength is crucial for physical function in patients with knee osteoarthritis (KOA). This study aimed to investigate the effect of combining blood flow restriction (BFR) with low-intensity training (LIT) on quadricep strength in patients with advanced KOA. Methods. Patients with advanced KOA were block randomized by gender into the control or BFR group. The control group received LIT with leg press (LP) and knee extension (KE) at 30% of 1-repetition maximum (1-RM), while the BFR group underwent the same training with 70% limb occlusion. Physical function and patient-reported outcomes were assessed up to 16 weeks. Results. A total of 42 patients were analyzed: 22 in the BFR group (9 males, 13 females) and 20 in the control group (8 males, 12 females). In the BFR group, males exhibited increased KE power from the 4th to the 16th week (p<0.05) and LP power from the 4th to the 12th week (p<0.05). Females in the BFR group showed increased KE power in the 4th and 12th weeks (p<0.05), and LP power increased from the 4th to the 16th week (p<0.05). Males also had improved TSS at the 12th week, while females had improved TSS from the 8th to the 16th week. In the control group, males did not experience an increase in quadricep power. Females, however, had increased KE power in the 4th, 12th, and 16th weeks (p<0.05), and LP power from the 4th to the 12th week (p<0.05). Females in the control group also had improved TSS at the 4th week. Patient-reported outcomes did not differ, and all patients tolerated the training without any dropouts or adverse events. Conclusion. Combining BFR with LIT significantly improved quadricep power and physical function in both genders of KOA patients without exacerbating symptoms

Abstract. Source of Study: London, United Kingdom. This intervention study was conducted to assess two developing protocols for quadriceps and hamstring rehabilitation: Blood Flow Restriction (BFR) and Neuromuscular Electrical Stimulation Training (NMES). BFR involves the application of an external compression cuff to the proximal thigh. In NMES training a portable electrical stimulation unit is connected to the limb via 4 electrodes. In both training modalities, following device application, a standardised set of exercises were performed by all participants. BFR and NMES have been developed to assist with rehabilitation following lower limb trauma and surgery. They offer an alternative for individuals who are unable to tolerate the high mechanical stresses associated with traditional rehabilitation programmes. The use of BFR and NMES in this study was compared across a total of 20 participants. Following allocation into one of the training programmes, the individuals completed training programmes across a 4-week period. Post-intervention outcomes were assessed using Surface Electromyography (EMG) which recorded EMG amplitude values for the following muscles: Vastus Medialis, Vastus Lateralis, Rectus Femoris and Semitendinosus. Increased Semitendinosus muscle activation was observed post intervention in both BFR and NMES training groups. Statistically significant differences between the two groups was not identified. Larger scale randomised-controlled trials are recommended to further assess for possible treatment effects in these promising training modalities