Eccentric vs Low-Load Blood Flow Restriction Training in Knee Osteoarthritis in Knee Osteoarthritis

NCT07733518 | Not Yet Recruiting

• 1 other identifier: SEHRISH MALIK
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this randomized controlled trial is to find the effects of eccentric and low-load blood flow restriction training on neuromuscular adaptations, muscle strength, functional performance, and disability in patients with knee osteoarthritis

Conditions

Knee Arthritis, Osteoarthritis

Keywords

Eccentric training,; Low-load blood flow restriction training; Muscle weakness; knee Osteoarthritis

Outcome Measures

Primary Outcomes (1)

• Surface Electromyography

  The Electromyography (EMG) is an objective assessment tool used to measure the electrical activity of muscles during contraction. Motor unit recruitment will be analyzed through the amplitude of EMG signals (root mean square, RMS), reflecting the number and synchronization of active motor units during contraction. Fatigue characteristics will be assessed using changes in EMG frequency parameters (mean or median frequency), indicating alterations in muscle fiber conduction velocity and fatigue onset that will be assessed pre and post sessions.

  Baseline and 4th week

Secondary Outcomes (3)

• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

  4 weeks

• Timed Up and Go (TUG)

  4 weeks

• Heel Raise Endurance Test

  4 weeks

Study Arms (2)

Eccentric Training

EXPERIMENTAL

Eccentric Gastrocnemius Strengthening Exercises

Other: Eccentric Gastrocnemius Strengthening Exercises

Low-Load Blood Flow Restriction Training

EXPERIMENTAL

Low-Load Blood Flow Restriction Training

Other: Low-Load Blood Flow Restriction Training

Interventions

Eccentric Gastrocnemius Strengthening Exercises OTHER

Eccentric Gastrocnemius Strengthening Exercises .1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 3 sets 10 reps in session 1-2). 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 5 sets 15 reps in session 3-4). Total duration is 3 sessions per week for 4 consecutive weeks.

Eccentric Training

Low-Load Blood Flow Restriction Training OTHER

Low-load blood flow restriction training including 1-Low-intensity gastrocnemius strengthening with BFR cuff 2-Controlled exercise with intermittent vascular occlusion (inflated 50-70% for 4 weeks, 3 rep. 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 3 sets 10 reps in session 1-2). 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 5 sets 12 reps in session 3-4). Total duration is 3 sessions per week for 4 consecutive weeks.

Low-Load Blood Flow Restriction Training

Eligibility Criteria

• Age: 40 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age group 40-70
• Both genders male and female
• Clinical diagnosis of knee OA (Kellgren-Lawrence grade 1-3) of the most symptomatic knee.
• Pain stable enough to permit exercise on Numeric Pain Rating Scale 3/10.
• Participants must demonstrate a gastrocnemius muscle strength of grade ≥3 on the Manual Muscle Testing (MMT) scale (0-5), assessed using the standard standing heel-rise position.
• Participants must be able to ambulate independently and participate in supervised exercise.

You may not qualify if:

• Presence of a prosthetic knee in the affected limb.
• Inflammatory arthritis (e.g., rheumatoid arthritis) or active flare-up of OA.
• Cardiovascular disease contraindicating exercise (e.g., unstable angina, recent MI, uncontrolled hypertension ≥160/100 mmHg).
• Pulmonary disease that limits safe participation (e.g., severe COPD, recent exacerbation).
• History of deep vein thrombosis (DVT), peripheral vascular disease, or bleeding/clotting disorders.
• Current anticoagulant therapy that increases bleeding risk (unless cleared by physician).
• Any pathology causing significant muscle weakness (e.g., neuromuscular disorders, severe neuropathy).

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Railway General Hospital, Rawalpindi

Rawalpindi, Punjab Province, 46000, Pakistan

Location

MeSH Terms

Conditions

Osteoarthritis; Muscle Weakness; Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Muscular Diseases; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms

Study Officials

• KINZA ANWAR, MS-OMPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

KINZA ANWAR, MS-OMPT

CONTACT

+92-3239735427; kinza.anwar@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: July 24, 2026
• First Posted: July 29, 2026
• Study Start: July 21, 2026
• Primary Completion (Estimated): December 21, 2026
• Study Completion (Estimated): December 28, 2026
• Last Updated: July 29, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)