Blood Flow Restricted Walking in Elderly Individuals with Knee Osteoarthritis: A Feasibility Study

Objective: To investigate whether blood flow restricted walking exercise is feasible in patients with knee osteoarthritis, and to examine changes in functional performance and self-reported function.Design: Feasibility study.Patients and methods: Fourteen elderly individuals diagnosed with knee osteoarthritis participated in 8–10 weeks of outdoor walking (4 km/h, 20 min/session, 4 times/week) with partial blood flow restriction applied to the affected leg. Adherence, dropouts and adverse events were registered. Timed Up and Go test, 30-s sit-to-stand performance, 40-m fast-paced walk speed, stair-climbing and Knee Osteoarthritis Outcome Score were assessed pre- and post-training.Results: Nine participants completed the intervention, while 5 participants withdrew (4 due to intervention-related reasons). In non-completing participants baseline body mass index (BMI) (p = 0.05) and knee pain (p = 0.06) were higher, while gait performance (p = 0.04) was lower. Considering completed case data, the training-adherence rate was 93%, while mean knee pain in the affected leg was 0.7 on a numerical rating scale of 0–10. Functional performance improved, while self-reported function remained unchanged.Conclusion: Blood flow restricted walking exercise appeared feasible in patients with knee osteoarthritis. Participants who completed the intervention protocol demonstrated improvements in functional performance, with no changes in self-reported function. LAY ABSTRACTPatients with knee osteoarthritis typically experience knee joint pain and functional disability. Consequently, it is beneficial for these patients to engage in tolerable exercise programmes to enhance their functional performance. This study examined the feasibility of 8–10 weeks of blood flow restricted (BFR) walking exercise in patients with long-term knee osteoarthritis. The exercise programme was feasible, did not exacerbate knee pain or provoke cuff discomfort, and produced improved functional performance in those participants (9/14) who completed the intervention protocol (93% adherence rate). Notably however, 4 patients withdrew from the study due to intervention-related reasons. In this study, feasibility and adherence to BFR-walking appeared to depend on individual factors, with high body mass index, high perceived knee pain, and low baseline levels of fast-paced walking, predisposing to low adherence to training. Thus, these individual characteristics must be taken into account when administering BFR-walking exercise in patients with knee osteoarthritis.