EFFECT OF ADDING BLOOD FLOW RESTRICTION TRAINING TO CLOSED CHAIN EXERCISE IN KNEE OSTEOARTHRITIS

Knee osteoarthritis is a common joint condition that causes knee pain, stiffness, muscle weakness, and difficulty performing daily activities such as walking, climbing stairs, and standing up from a chair. Exercise therapy is commonly used to improve muscle strength, reduce pain, and restore physical function. However, some patients may find traditional strengthening exercises difficult because of pain and increased stress on the knee joint. Blood flow restriction (BFR) training is a rehabilitation technique that uses a specialized cuff placed around the upper thigh to partially restrict blood flow during exercise. This technique may help improve muscle strength while using lighter exercise loads. The purpose of this study is to investigate whether adding blood flow restriction training to traditional physical therapy and closed kinetic chain exercises provides additional benefits for patients with knee osteoarthritis. This randomized controlled trial will include 60 male and female participants aged 40 to 60 years with mild to moderate knee osteoarthritis. Participants will be randomly assigned to one of two groups, with 30 participants in each group. The first group will receive traditional physical therapy exercises combined with closed kinetic chain exercises, such as mini-squats, step-ups, step-downs, partial lunges, and wall slides. The second group will receive the same exercise program with the addition of blood flow restriction training. Both groups will participate in supervised treatment sessions twice weekly for eight weeks, for a total of 16 sessions. The researchers will assess knee pain, knee range of motion, quadriceps muscle strength, knee function, mobility and fall risk, quality of life, and patient satisfaction. Assessments will be conducted before treatment, immediately after the eight-week intervention, and one month after completing treatment. The study aims to determine whether adding blood flow restriction training to closed kinetic chain exercises can improve rehabilitation outcomes in individuals with knee osteoarthritis.

Inclusion Criteria: Participants diagnosed with mild to moderate knee osteoarthritis (Kellgren-Lawrence grades II-III). Participants aged between 40 and 60 years. Body mass index (BMI) ranging from 25 to 29.9 kg/m². Presence of chronic knee pain for at least three months. Pain intensity of ≥3/10 on the Visual Analog Scale (VAS) or equivalent WOMAC pain score. Ability to ambulate independently and perform closed kinetic chain exercises. Participants who are medically fit to participate in low-load resistance exercise with or without blood flow restriction training. Willingness to participate and provide written informed consent. Exclusion Criteria: History of knee surgery within the previous 12 months. Presence of severe knee osteoarthritis (Kellgren-Lawrence grade IV). Diagnosis of inflammatory joint diseases, such as rheumatoid arthritis. Presence of cardiovascular, vascular, or neurological disorders that contraindicate blood flow restriction training. Participation in any other structured lower limb strengthening or blood flow restriction training program during the study period. Cognitive impairment or inability to understand and follow exercise instructions.