Comparative Effects of Blood Flow Restriction Resistance Training Versus Blood Flow Restriction Cycling on Pain, Quadriceps Strength, and Functional Outcomes in Athletes With Patellofemoral Pain

NCT07585305 | Not Yet Recruiting DMC

• 1 other identifier: IIUI/RERC/ADT/2026/04/286
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial compares blood flow restriction (BFR) resistance training (leg press and seated knee extension at 30% 1RM) versus BFR cycling (stationary cycling at low resistance) in 60 athletes (aged 18-40 years) diagnosed with patellofemoral pain syndrome. Both interventions are delivered over 8 weeks (3 sessions/week) with a pneumatic cuff set at 80% limb occlusion pressure. Primary outcomes include pain intensity (NPRS), quadriceps strength (handheld dynamometer), and functional ability (Kujala Anterior Knee Pain Scale), assessed at baseline and post-intervention.

Conditions

Patello Femoral Pain Syndrome

Keywords

Patellofemoral pain; Blood flow restriction training; Quadriceps strength; Athletic Performance; resistance training

Outcome Measures

Primary Outcomes (2)

• Quadriceps Strength - Handheld Dynamometer

  Isometric quadriceps muscle strength measured in Newtons using a calibrated handheld dynamometer (ICC \> 0.90). Measurement taken in a standardized seated position at 60° knee flexion.

  Baseline (Week 0) and Post-intervention (Week 8)

• Pain Intensity - Numeric Pain Rating Scale (NPRS)

  Self-reported pain intensity rated on a 0-10 scale (0 = no pain, 10 = worst imaginable pain). The NPRS has excellent test-retest reliability (ICC 0.95).

  Baseline (Week 0) and Post-intervention (Week 8)

Secondary Outcomes (1)

• Functional Outcomes - Kujala Anterior Knee Pain Scale (AKPS)

  Baseline (Week 0) and Post-intervention (Week 8)

Study Arms (2)

BFR Resistance Training Group

ACTIVE COMPARATOR

Participants perform leg press and seated knee extension exercises at 30% of 1RM with a pneumatic cuff (12 cm wide, Delfi Medical) applied to the proximal thigh at 80% limb occlusion pressure (LOP). Protocol: 1 set of 30 + 3 sets of 15 repetitions, with 60-second rest between sets (cuff deflated). Frequency: 3 sessions/week for 8 weeks (24 sessions total). 1RM re-estimated every 2 weeks for progressive load adjustment. Warm-up: 10 min low-resistance cycling (no BFR). Cool-down: 5 min lower-limb stretching.

Device: Blood Flow Restriction Resistance Training

BFR Cycling Group

EXPERIMENTAL

Participants perform stationary cycling at low resistance targeting RPE 11-13, with a pneumatic cuff (12 cm wide, Delfi Medical) applied to the proximal thigh at 80% LOP. Protocol: 4 x 5-minute cycling intervals at 70-80 RPM, with 1-minute rest between intervals (cuff deflated). Frequency: 3 sessions/week for 8 weeks (24 sessions total). Cadence increased by 5 RPM if RPE \<11. Warm-up: 10 min low-resistance cycling (no BFR). Cool-down: 5 min lower-limb stretching.

Device: Blood Flow Restriction Cycling

Interventions

Blood Flow Restriction Resistance Training DEVICE

Participants will undergo blood flow restriction (BFR) resistance training using a pneumatic cuff applied to the proximal thigh at 80% limb occlusion pressure. Exercises include leg press and seated knee extension performed at 30% of one-repetition maximum (1RM). Training will be conducted for 8 weeks, with supervised sessions 3 times per week. Cuff pressure will be monitored and adjusted using BP cuff. The aim is to improve quadriceps strength and reduce pain in patients with patellofemoral pain.

BFR Resistance Training Group

Blood Flow Restriction Cycling DEVICE

Participants will perform stationary cycling combined with blood flow restriction (BFR) applied to the proximal thigh at 80% limb occlusion pressure. Cycling will be performed at low resistance with controlled cadence for 8 weeks, 3 sessions per week under physiotherapist supervision. The protocol includes structured cycling intervals with rest periods and continuous monitoring of pain and perceived exertion. The intervention aims to improve quadriceps strength, reduce pain, and enhance functional outcomes in patients with patellofemoral pain.

BFR Cycling Group

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female athletes aged 18-40 years
• Clinically diagnosed with patellofemoral pain syndrome
• Anterior or retropatellar knee pain of at least 3 months duration
• Pain provoked by at least two functional activities (e.g., squatting, stair climbing, running, prolonged sitting)
• Willingness to participate and provide written informed consent

You may not qualify if:

• History of knee surgery or significant knee trauma in the past 6 months
• Presence of ligament, meniscal, or cartilage injuries
• Neurological, vascular, or systemic inflammatory conditions
• Contraindications to BFR training (e.g., deep vein thrombosis, uncontrolled hypertension)
• Pregnancy

Sponsors & Collaborators

• Ibadat International University, Islamabad: lead

Study Sites (1)

Ibadat International University, Islamabad (Iiui)

Islamabad, 46000, Pakistan

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Hafsah Gul Khattak, DPT, MS-NMPT

  IBADAT INTERNATIONAL UNIVERSITY, ISLAMABAD (IIUI)

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Haroon Khan, MS. Sports Physical Therapy

CONTACT

+923000526711; haroonkhan2k00@gmail.com

Hafsah Gul Khattak, DPT, MS-NMPT

CONTACT

923457170732; hafsahgull_khattak@yahoo.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: This is a single-blinded study in which the outcome assessor is blinded to group allocation. Participants and treating physiotherapists are aware of the assigned intervention due to the nature of exercise-based rehabilitation. Efforts are made to standardize instructions and interaction across both groups to minimize bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: This study is a parallel-group randomized controlled trial comparing two active intervention arms: blood flow restriction resistance training and blood flow restriction cycling in patients with patellofemoral pain.

Study Record Dates

• First Submitted: May 7, 2026
• First Posted: May 13, 2026
• Study Start: May 10, 2026
• Primary Completion (Estimated): July 10, 2026
• Study Completion (Estimated): July 25, 2026
• Last Updated: May 18, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)