Vascular occlusion for optimising the functional improvement in patients with knee osteoarthritis: a randomised controlled trial.

IF 20.3 1区 医学 Q1 RHEUMATOLOGY Annals of the Rheumatic Diseases Pub Date : 2024-10-30 DOI:10.1136/ard-2024-226579
Ewoud Jacobs, Lenka Stroobant, Jan Victor, Dirk Elewaut, Thomas Tampere, Steven Wallaert, Erik Witvrouw, Joke Schuermans, Evi Wezenbeek
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Abstract

Objectives: Knee osteoarthritis (KOA) is a leading cause of global disability with conventional exercise yielding only modest improvements. Here we aimed to investigate the benefits of integrating blood flow restriction (BFR) into traditional exercise programmes to enhance treatment outcomes.

Methods: The Vascular Occlusion for optimizing the Functional Improvement in patients with Knee Osteoarthritis randomised controlled trial enrolled 120 patients with KOA at Ghent University Hospital, randomly assigning them to either a traditional exercise programme or a BFR-enhanced programme over 24 sessions in 12 weeks. Assessments were conducted at baseline, 6 weeks, 12 weeks and 3 months postintervention using linear mixed models with Dunn-Sidak corrections for multiple comparisons. Primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at 3 months follow-up with knee strength, Pain Catastrophizing Scale questionnaire and functional tests as secondary outcomes. Analysis followed an intention-to-treat approach (NCT04996680).

Results: The BFR group showed greater improvements in KOOS pain subscale (effect size (ES)=0.58; p=0.0009), quadriceps strength (ES=0.81; p<0.0001) and functional tests compared with the control group at 12 weeks. At 3 months follow-up, the BFR group continued to exhibit superior improvements in KOOS pain (ES=0.55; p=0.0008), symptoms (ES=0.59; p=0.0004) and quality of life (QoL) (ES=0.66; p=0.0001) with sustained benefits in secondary outcomes. Drop-out rates were similar in both groups.

Conclusion: Incorporating BFR into traditional exercise programmes significantly enhances short-term and long-term outcomes for patients with KOA demonstrating persistent improvements in pain, symptoms, QoL and functional measures compared with conventional exercise alone. These findings suggest that BFR can provide the metabolic stimulus needed to achieve muscle strength and functional gains with lower mechanical loads. Reduced pain and increased strength support a more active lifestyle, potentially maintaining muscle mass, functionality and QoL even beyond the supervised intervention period.

Trial registration number: NCT04996680.

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通过血管闭塞优化膝关节骨性关节炎患者的功能改善:随机对照试验。
目标:膝关节骨性关节炎(KOA)是导致全球残疾的主要原因之一,而传统的锻炼方法只能起到一定的改善作用。在此,我们旨在研究将血流限制(BFR)纳入传统锻炼计划对提高治疗效果的益处:血管闭塞优化膝关节骨关节炎患者功能改善随机对照试验在根特大学医院招募了 120 名膝关节骨关节炎患者,将他们随机分配到传统锻炼计划或 BFR 增强计划中,在 12 周内进行 24 次训练。在基线、6周、12周和干预后3个月进行评估,采用线性混合模型,并对多重比较进行邓恩-西达克校正。主要结果是随访3个月时的膝关节损伤和骨关节炎结果评分(KOOS)问卷,次要结果是膝关节力量、疼痛灾难化量表问卷和功能测试。分析采用意向治疗法(NCT04996680):结果:BFR 组在 KOOS 疼痛分量表(效应大小 (ES)=0.58; p=0.0009)、股四头肌力量(ES=0.81; pConclusion)方面有更大改善:与单独进行传统锻炼相比,在传统锻炼计划中加入阻力训练可显著提高 KOA 患者的短期和长期疗效,在疼痛、症状、生活质量和功能测量方面均有持续改善。这些研究结果表明,BFR 可提供所需的新陈代谢刺激,以较低的机械负荷实现肌肉力量和功能的提高。疼痛的减轻和力量的增强可支持更积极的生活方式,甚至在监督干预期结束后仍能保持肌肉质量、功能和 QoL:NCT04996680.
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来源期刊
Annals of the Rheumatic Diseases
Annals of the Rheumatic Diseases 医学-风湿病学
CiteScore
35.00
自引率
9.90%
发文量
3728
审稿时长
1.4 months
期刊介绍: Annals of the Rheumatic Diseases (ARD) is an international peer-reviewed journal covering all aspects of rheumatology, which includes the full spectrum of musculoskeletal conditions, arthritic disease, and connective tissue disorders. ARD publishes basic, clinical, and translational scientific research, including the most important recommendations for the management of various conditions.
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