Key result
Low-load blood flow restriction training matches conventional resistance training for strength in knee arthropathy.
Why the study?
Previous meta-analyses showed contrasting findings on blood flow restriction training in knee conditions, and no dose-response analysis had evaluated the dose required for maximal strength and functionality adaptations.
Does low-load resistance blood flow restriction training improve strength and functionality in patients with knee osteoarthritis or rheumatoid arthritis compared to moderate or high intensity resistance training?
Meta-Analysis (n=205)
Does low-load resistance blood flow restriction training improve strength and functionality in patients with knee osteoarthritis or rheumatoid arthritis compared to moderate or high intensity resistance training?
Low-load blood flow restriction training provides similar strength and functionality improvements as moderate-to-high intensity resistance training in knee arthropathies, with an optimal dose around 1800 to 2000 total repetitions per program.
Low-load BFRT provides comparable strength gains to moderate/high-intensity RT in knee arthropathies; reinforces its role as an alternative with optimal dosing near 2000 repetitions.
Background: Previous meta‐analyses show contrasting findings regarding the effects of blood flow restriction training (BFRT) in different knee conditions. Furthermore, no previous dose‐response analysis has been conducted to determine the dose of BFRT required for maximal strength and functionality adaptations. Objective: To analyze the evidence on the effects of BFRT on strength and functionality in patients with knee osteoarthritis or rheumatoid arthritis through a systematic review with dose‐response meta‐analysis. Methods: Included studies met the following criteria: participants with knee osteoarthritis or rheumatoid arthritis; low‐load resistance BFRT as intervention; control group with traditional moderate or high intensity resistance training (MIRT and HIRT); include muscle strength and functionality as primary and secondary outcome measures, respectively; and only randomized controlled trials. A random‐effects and a dose‐response model estimated strength and functionality using estimates of the total repetitions performed. Results: We included five studies with a sample of 205 participants. No statistically significant differences were found between BFRT and MIRT or HIRT for strength (SMD = −0.06; 95% CI = −0.78–0.67; and p > 0.05) and functionality (SMD = 0.07; 95% CI = −0.23–0.37; and p > 0.05). We found an inverted U‐shaped association between the increase in total repetitions and strength gain and between the increase in total repetitions and functional improvement. Conclusions: People with knee osteoarthritis or rheumatoid arthritis can use low‐load BFRT for strength and functionality as a similarly effective alternative to MIRT and HIRT. A total of 2000 repetitions per BFRT program are necessary to maximize strength gains in these patients, while functional improvement requires 1800 total repetitions.
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Ogrezeanu et al. (2025) conducted a meta-analysis in Knee osteoarthritis or rheumatoid arthritis (n=205). Blood flow restriction training (BFRT) vs. Moderate or high intensity resistance training (60%–80% 1RM) was evaluated on Muscle strength (SMD -0.06, 95% CI -0.78–0.67, p=>0.05). Low-load blood flow restriction training showed no significant difference compared to moderate/high-intensity resistance training for strength gains (SMD -0.06) in patients with knee arthropathies, with maximal strength benefits observed at 2000 total repetitions.
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