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Knee OsteoarthritisNCT06637124

Different Levels of Blood Flow Restriction Versus Moderate Intensity Exercises in Patients With Knee Osteoarthritis

A study testing Blood Flow Restriction Therapy Device and 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine. in people with Knee Osteoarthritis and Blood Flow Restriction Therapy, run by Cairo University at 1 site in Egypt.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This clinical trail will be conducted to investigate the effect of blood flow restriction (BFR) with different load levels between low blood occlusion percentage (50%) group and high blood occlusion percentage (70%) compared to moderate intensity training (60% of 1 RM) in patients with chronic knee osteoarthritis. Read more about this study

Who is it for?
Ages 40 to 65 years
What is being tested?
Blood Flow Restriction Therapy Device and 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine.
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
75 participants
Where
1 siteEgypt
Study dates
15 Oct 2024to 6 May 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients diagnosed with chronic knee osteoarthritis referred by orthopedic surgeons participants of both genders age are 40-65.
  • Patients with grade 2 and 3 OA of the knee, according to radiologic evaluation
  • If both knees diagnosed as OA, the most affected one will be selected.
  • Diagnosis of Knee OA who had knee pain and functional disabilities for at least three months, according to American College of Rheumatology classification at screening visit.
  • Visual Analogue Scale (VAS) at rest score of ≥40 mm.
  • Arabic version of the western WOMAC (ArWOMAC) scores (average 37).
  • Moderate Physical activity score on the IPAQ (between 3.0 and 7.9 METS).

Who cannot join

  • Moderate to significant knee synovitis
  • Hot or red knee
  • History and/or physical examination findings compatible with the internal derangement of knee.
  • Knee pain that is initiated or increased with knee activity/exercise and finished or decreased with knee resting.
  • Other muscular, articular, or neurological condition affecting lower limb function.
  • Patients with any previous knee surgeries or fractures of lower limb
Show all 11Show fewer
  • Patients who had undergone arthroscopy or treatment with intra-articular hyaluronic acid during the previous 6 months.
  • Psychological or psychiatric disorders that may affect a subject's participation in the study.
  • Participants with congenital musculoskeletal lower limb deformity.
  • Participated in other intervention studies on the past 6 months to screening
  • Participants with contraindications to blood flow Restriction Training.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • CairoU

    Cairo, Giza Governorate, 12611

Other trials in Egypt

About this study

Official title: Blood Flow Restriction With Different Loads Versus Moderate Resistive Exercises in Patients With Knee Osteoarthritis: A Double Blinded Randomized Controlled Trial

This clinical trail will be conducted to investigate the effect of blood flow restriction (BFR) with different load levels between low blood occlusion percentage (50%) group and high blood occlusion percentage (70%) compared to moderate intensity training (60% of 1 RM) in patients with chronic knee osteoarthritis.

The main questions it aims to answer are:

Read more
  1. Will there be no difference between the effect of (70% vs 50%) of BFR versus traditional moderate resistive training exercises on pain intensity in knee osteoarthritis ?
  2. Will there be no difference between the effect of (70% vs 50%) of BFR versus traditional moderate resistive training exercises on quadriceps muscle strength in knee osteoarthritis ?
  3. Will there be no difference difference between the effect of (70% vs 50%) of BFR versus traditional moderate resistive training exercises on rate of perceived exertion in knee osteoarthritis ?
  4. Will there be no difference between the effect of (70% vs 50%) of BFR versus traditional moderate resistive training exercises on functional ability in knee osteoarthritis ?
  5. Will there be no difference between the effect of (70% vs 50%) of BFR versus traditional moderate resistive training exercises on physical function in knee osteoarthritis ?

All participants will receive:

  1. 16 sessions of supervised intervention 2 times per week for 8 weeks.
  2. The assessment will be at 3 time points, baseline and at 4 weeks and at 8 weeks.
Read the detailed description

Knee osteoarthritis (KOA) is a prevalent degenerative musculoskeletal condition that primarily causing pain, stiffness, and disability. It is a multifactorial disease influenced by a combination of genetic, biomechanical, and environmental factors Osteoarthritis Research Society International (ORSI) recommended strength training as a possible treatment method to slow progression of knee OA. Strength training, as recommended by the American College of Sports Medicine (ACSM), must be performed at a minimum resistance training load of 60% to 70% 1-repetition maximum (1RM) for strength improvement.

Only 13% of older patients with knee OA satisfactorily can perform moderate to vigorous physical activity.

Unfortunately, risk factors of knee OA (as obesity, knee pain, knee injury/surgery) also contribute to a perceived reduced tolerance to the resistive training programs recommended for eliciting strength gains.

An alternative to traditional strength training that may be well tolerated by patients with Knee OA is Blood flow restriction (BFR) training.

This reduced blood flow creates a unique physiological environment, inducing a state of metabolic stress and cellular hypoxia in the muscles.

Although the advantages of BFRT in musculoskeletal rehabilitation that reported in the literature, there are conflicting results compared to traditional exercises, as the different protocols parameters, exercises, high risk of bias across previous studies contribute to different conclusions.

Consequently, it raises the question if BFR without exercises can be effective in comparison with traditional exercises that focus on having an efficient intensity to produce muscle strength gain.

Yet, up to authors knowledge, no study has assessed whether BFR at rest could also promote similar gains in muscle strength for the knee OA treatment, which theoretically would increase patient's adherence to KOA treatment based on conclusions of systemic review of BFR without exercises for immobilized patients after orthopedic surgery (Cerqueira et al., 2019).

Another relevant issue is the proper blood flow restriction level for optimal results. Thus, pushes the need for determining a pressure load with the least adverse effects.

Therefore, the main purpose of this study is to assess different protocols of BFR without additional exercises compared to MI-RT for pain reduction in patients with KOA. The secondary purpose is to compare two load levels (70% vs 50%) of BFRT regarding pain, quadriceps muscle strength, rate of perceived exertion, self reported physical function, and functional ability.

Being tested
Blood Flow Restriction Therapy Device, 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine.
Keywords
Blood Flow Restriction, Knee osteoarthritis, Moderate Intenstity Exercise
Medical subject headings
Osteoarthritis, Knee

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood Flow Restriction Therapy DeviceDevice

    Also called Smart cuffs 4.0

    Blood Flow Restriction (BFR) therapy involves units use standardized cuffs of varying widths and lengths which are physically attached to the devices and provide the capability of precisely controlling the amount of pressure applied to each limb during exercise or at rest.

    We will be using Smart Cuffs® 4.0 which allows for a fast, hassle-free personalized pressure calculation. With the built-in pressure sensor and on-board computer, it will calculate and set the optimal pressure for each participant's limb. There is no need for an external doppler probe or hand pump. Made in the USA, SmartCuffs® are registered with the FDA as a Class 1 Medical Device.

    Blood flow restriction therapy is commonly paired with resistive training, so this study will explore the effect of blood flow restriction at rest for patients with osteoarthritis at different restriction levels (50% for first group and 70% for second group).

  • 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine.Device

    Patients assigned to group will receive strengthening of the lower limb musculature through moderate intensity resistance training (60% of 1RM) using a 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine.

Study groups in NCT06637124
Study groupRoleWhat they receive
50% Blood Flow Restriction GroupExperimentalThe Blood Flow Restriction device will be set to restrict blood flow at level of 50% of arterial occlusion pressure at rest. Blood Flow Restriction sessions will be 5 sets of 5 mins of occlusion and 3 mins of free flow , 2 sessions per week for eight weeks exercises to assess its effects on knee osteoarthritis-related outcomes.
Receives: Device: Blood Flow Restriction Therapy Device
70% Blood Flow Restriction GroupExperimentalThe Blood Flow Restriction device will be set to restrict blood flow at level of 70% of arterial occlusion pressure at rest. Blood Flow Restriction sessions will be 5 sets of 5 mins of occlusion and 3 mins of free flow , 2 sessions per week for eight weeks exercises to assess its effects on knee osteoarthritis-related outcomes.
Receives: Device: Blood Flow Restriction Therapy Device
Moderate Intensity Exercise training GroupActive comparatorPatients assigned to this group will receive strengthening of the lower limb musculature through moderate intensity resistance training (60% of 1RM) for a total of 16 treatment sessions according to exercise guidelines for seniors with OA. MIRT protocols consists of 3 sets for every exercise, 12 repetitions per set, rest period between sets 2 mins, 2 session per week for 8 weeks. Resistance exercises will be performed using a 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine.
Receives: Device: 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in pain intensity

    Measured by the Visual Analog Scale (VAS)which is a pain intensity assessment tool.

    • Represented with a 10 cm line with 0 indicating no pain and on the other end 10 indicating severe pain.
    • The patient is asked to move a marker on the line to the position which best describes their pain.
    • That it will serve as a subjective measure of their current level of knee pain intensity.

    The closer the mark to zero is better.

    Measured: Measured 3 times at basline, 4 weeks and 8 weeks

  2. Measure change in quadriceps muscle strength

    Hand-held dynamometer (HHD) will be used to measure the strength in quadriceps muscle.

    • The maximum force or pressure exerted by the quadriceps muscle during the contraction will be recorded.
    • Typically, this measurement is expressed in kilograms (kg) and then transferred to Newtons (N)
    • To enhance reliability, 3 trials may be conducted, and average will be taken to obtain a more representative measurement of muscle strength.
    • The higher the measurement the higher the muscle strength.

    Measured: Measured 3 times at baseline, 4 weeks and 8 weeks

Secondary outcomes (3)
  1. Change in functional ability

    Measured by Timed Up and Go Test (TUG) to assess participants' mobility, balance, and functional performance.

    • The time taken by the patient to complete the entire sequence from rising from the chair to returning to a seated position will be measured.
    • This time will be recorded in seconds, representing the TUG test score.
    • 3 times will be conducted to ensure the accuracy of the TUG test score.
    • The average time from these trials will be calculated for a more reliable result.
    • High Risk of fall (\>13.5 seconds)
    • None/low/moderate (\<13.5 seconds) The lower the number the better as it represents better mobility, balance and functional performance.

    Measured: Measured 3 times at baseline, 4 weeks and 8 weeks

  2. Change in physical function levels

    Measured by Arabic version of Western Ontario McMaster Universities Osteoarthritis Index for Knee Function (ArWOMAC).

    The WOMAC questionnaire will be handed out to the participants. They will be informed that it consists of a series of questions related to their knee symptoms and how these symptoms affect their daily activities.

    WOMAC is assigned a numerical score of 0-4 corresponding to severity (none, mild, moderate, severe, and extreme). The minimum score is 0, and the maximum score is 96 (20 points for pain, 8 points for joint stiffness, and 68 points for physical function).

    The lower the score the better.

    Measured: Measured 3 times at baseline, 4 weeks and 8 weeks

  3. Change in Rate of perceived exertion scale (RPE)

    Measured by Arabic version of Omnibus Resistance Exercise 0-10 (OMNI-RES) as a scale for measuring an individual's effort and exertion, breathlessness and fatigue during physical work.

    • The OMNI Picture System is a collection of category scales used for rating of perceived exertion (RPE) as the subjective intensity of a person's feelings of effort, strain, discomfort, and/or fatigue when engaged in exercise or other physical activities.
    • With OMNI exertion scales, users select a number from 0 to 10 that best corresponds to their perceived intensity of physical exertion.
    • 0 represents extremely easy and 10 represents extremely hard.
    • The lower the number the better.

    Measured: Measured 3 times at basline , 4 weeks and 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Oct 2024
  2. Study start15 Oct 2024
  3. Primary completion26 Feb 2025
  4. Study completion6 May 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
75 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06637124
Sponsor's protocol ID
P.T.REC/012/005029
Status last verified
Sep 2025
First submitted
24 Sep 2024
Last updated
6 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: * The risk that sharing prevents the exploitation of the entire potential of the data obtained. * Possible failures in patients' privacy protection. * Technical barriers such as the lack of standard formats and possible data misinterpretation. * Issues regarding data ownership. * Reuse of data for unfair commercial purposes.

Publications

  • Tahoon AM, El Gamal FFG, Metawee SM, Khaled N, Abdelkader NA. Blood flow restriction with different loads versus moderate intensity resistive exercises in patients with knee osteoarthritis: a single-blind randomized controlled trial. BMC Sports Sci Med Rehabil. 2026 Oct 7;18(1):473. doi: 10.1186/s13102-026-02068-y.

    PubMed 42859165

Questions about this trial

What is this clinical trial studying?

A study testing Blood Flow Restriction Therapy Device and 45° leg-press machine, 90°-0° of knee flexion knee extension machine, leg curl machine and calf raise machine. in people with Knee Osteoarthritis and Blood Flow Restriction Therapy, run by Cairo University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in pain intensity (time frame: Measured 3 times at basline, 4 weeks and 8 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06637124, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.

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