Close Chain and Open Chain Exercises With Blood Flow Restriction in Knee Osteoarthritis

NCT07426549 | Not Yet Recruiting

• 1 other identifier: RCRAHS-ISB/REC/MS-PT/02420
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 2

Brief Summary

The aim of this research is to find and compare the effect of close chain and open chain exercises with blood flow restriction in knee osteoarthritis on pain, range of motion, strength and functional performance in patients with knee osteoarthritis. Randomized controlled trials done at Railway General Hospital and Medistic Medical and Dental Center, Rawalpindi. The sample size was 40. The subjects were divided in two groups, 20 subjects in close chain exercises with blood flow restriction group and 20 in open chain exercises with blood flow restriction group. Study duration was of 4 weeks. Sampling technique applied was purposive non probability sampling technique. Only 45-75 years individual with grade 1 or 2 knee osteoarthritis were included. Tools used in the study are Numeric pain rating scale (NPRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), goniometer, crane scale (dynamometer), 30 s chair stand test. Data was analyzed through SPSS 21.

Conditions

Knee Osteoarthristis

Keywords

Knee Osteoarthritis; Blood Flow Restriction; Blood Flow Resriction Therapy; Knee Joint

Outcome Measures

Primary Outcomes (1)

• Numeric Pain Rating Scale (NPRS)

  Changes from baseline pain intensity will be assessed using the Numeric Pain Rating Scale. The Numeric Pain Rating Scale is a subjective pain assessment tool ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Participants will be asked to rate their average knee pain intensity at rest and during activity. NPRS is widely used in clinical practice due to its simplicity, reliability, and responsiveness to change in musculoskeletal conditions.

  [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]

Secondary Outcomes (5)

• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

  [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]

• Knee Range of Motion (Flexion)

  [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]

• Knee Range of Motion (Extension)

  [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]

• Knee Muscle Strength

  [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]

• 30 Second Chair Stand Test

  [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]

Study Arms (2)

Closed kinetic chain exercises with blood flow restriction

ACTIVE COMPARATOR

Closed kinetic chain exercises with blood flow restriction and conservative therapy

Other: Closed kinetic chain exercises with blood flow restriction

Open kinetic chain exercises with blood flow restriction

ACTIVE COMPARATOR

Open kinetic chain exercises with blood flow restriction and conservative therapy.

Other: Open kinetic chain exercises with blood flow restriction

Interventions

Closed kinetic chain exercises with blood flow restriction OTHER

Closed kinetic chain exercises with blood flow restriction and conservative therapy. Participants in this group will receive conventional physiotherapy including hot pack application over the knee for 10 minutes and TENS applied medial and lateral to the knee for 10 minutes prior to exercises. Mulligan mobilization with movement will be performed using pain free sustained tibial glides during active knee flexion and extension. Closed kinetic chain quadriceps strengthening exercises will include seated heel press, mini squats, wall slides, step ups, and step downs performed under blood flow restriction. Exercises will be performed using a standardized blood flow restriction protocol of 4 sets with repetitions of 30, 15, 15, and 15 at low load. Sessions will be conducted 3 days per week for 4 weeks, with a total of 12 sessions, each session lasting approximately 40 minutes.

Closed kinetic chain exercises with blood flow restriction

Open kinetic chain exercises with blood flow restriction OTHER

Open kinetic chain exercises with blood flow restriction and conservative therapy. Participants in this group will receive conventional physiotherapy including hot pack application over the knee for 10 minutes and TENS applied medial and lateral to the knee for 10 minutes prior to exercises. Mulligan mobilization with movement will be performed using pain free sustained tibial glides during active knee flexion and extension. Open kinetic chain quadriceps strengthening exercises will include straight leg raises and knee extension exercises performed under blood flow restriction. Exercises will be performed using a standardized blood flow restriction protocol of 4 sets with repetitions of 30, 15, 15, and 15 at low load. Sessions will be conducted 3 days per week for 4 weeks, with a total of 12 sessions, each session lasting approximately 40 minutes

Open kinetic chain exercises with blood flow restriction

Eligibility Criteria

• Age: 45 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Radiologic confirmation of KOA demonstrating Kellgren-Lawrence grade 1 or 2.
• Exhibited symptoms of unilateral KOA.
• Not taking any medications for KOA or receiving other treatments (including physiotherapy).
• Willing to participate without any neurological symptoms were the main objects of study.

You may not qualify if:

• A history of knee surgery or scheduled surgery.
• Kellgren-Lawrence grade 3 or 4.
• Systolic blood pressure over 160 mm Hg or under 100 mm Hg.
• Use of nonsteroidal anti-inflammatory drugs in the past 3 months.
• Any known vascular disease or any diagnosed blood pathology.
• Concomitant symptomatic hip or ankle pathology that could influence knee pain or function.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (2)

Medistic Medical and Dental Center

Rawalpindi, Pakistan

Location

Pakistan Railway General Hospital

Rawalpindi, Pakistan

Location

MeSH Terms

Conditions

Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Officials

• Muhammad Affan Iqbal, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, PhD

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 17, 2026
• First Posted: February 23, 2026
• Study Start: February 28, 2026
• Primary Completion: May 20, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: February 23, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (2)