Key result
Preoperative blood flow restricted resistance training did not significantly improve physical function on the 30-s sit to stand test at 3 and 12 months post-TKA compared with usual care.
Why the study?
The study examined the effect of preoperative low-load blood flow restricted resistance training on physical function, lower limb strength, and patient-reported outcomes after total knee arthroplasty compared with usual care.
Does preoperative low-load blood flow restricted resistance training improve postoperative physical function in patients scheduled for total knee arthroplasty?
RCT (n=86)
assessor blinded
randomized
Does preoperative low-load blood flow restricted resistance training improve postoperative physical function in patients scheduled for total knee arthroplasty?
Preoperative blood flow restricted resistance training does not improve postoperative physical function or patient-reported outcomes compared to usual care in patients undergoing total knee arthroplasty, though it may temporarily improve lower limb strength at 3 months.
The trial aimed to examine the effect of eight weeks preoperative low-load blood flow restricted resistance training (BFR-RT) on physical function, lower limb strength, and patient-reported outcomes in knee OA patients 3 and 12 months after total knee arthroplasty (TKA) compared with preoperative usual care. An assessor blinded randomized controlled trial (RCT) was conducted. Eighty-six patients scheduled for TKA who were allocated to 8 weeks BFR-RT on the affected leg 3x/week or preoperative usual care involving no exercise (CON). PRIMARY OUTCOME: 30-s sit to stand (30STS). SECONDARY OUTCOMES: Timed Up&Go, 40-m walk test (40mWT), knee range of motion (ROM) 1-repetition maximum (1RM) leg press and knee extensor strength, maximal isometric contraction (MVIC) for the knee extensors and flexors, Knee injury and Osteoarthritis Outcome Score (KOOS), and Euroqol 5-dimensions (EQ-5D-L5) questionnaire. Data were collected at baseline (12 weeks pre-surgery), ~3 days pre-surgery, 3 and 12 months postoperatively. Intention-to-treat analysis revealed no significant between-group differences in the change from baseline to 3 and 12 months postoperatively on 30STS, TUG, or 40mFWT. Significant between-group differences were observed at 3 but not 12 months postoperatively for the corresponding changes in 1RM leg press strength, 1RM knee extensor strength, and MVIC knee extensor favoring BFR-RT. No between-group differences were observed for the delta changes from baseline in knee ROM, KOOS subscales or EQ-5D-L5 at any postoperative time points. These findings suggest that preoperative BFR-RT offered no superior effects compared with usual preoperative care on postoperative physical function or patient-reported outcomes. Preoperative BFR-RT produced amplified gains in lower limb muscle strength at 3 months postoperatively. TRIAL REGISTRATION: NCT04081493.
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Jørgensen et al. (2024) conducted an RCT in knee osteoarthritis (n=86). low-load blood flow restricted resistance training (BFR-RT) vs. preoperative usual care involving no exercise was evaluated on 30-s sit to stand (30STS). Preoperative blood flow restricted resistance training did not significantly improve physical function on the 30-s sit to stand test at 3 and 12 months post-TKA compared with usual care.
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