Knee OsteoarthristisNCT07426549
Close Chain and Open Chain Exercises With Blood Flow Restriction in Knee Osteoarthritis
A study testing Closed kinetic chain exercises with blood flow restriction and Open kinetic chain exercises with blood flow restriction in people with Knee Osteoarthristis, run by Riphah International University at 2 sites in Pakistan.
Trial 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. Read more about this study
- Who is it for?
- Ages 45 to 75 years
- Conditions the study is for
- Knee Osteoarthristis
- What is being tested?
- Closed kinetic chain exercises with blood flow restriction and Open kinetic chain exercises with blood flow restriction
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 2 sitesPakistan
- Study dates
- 30 Jun 2026to 7 Nov 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 45 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan2 sites, 2 recruiting
- Recruiting
Medistic Medical and Dental Center
Rawalpindi
Neha Maqsood, DPT, 03091115301, nehamaqsood08@gmail.com
Neha Maqsood, DPT
- Not yet recruiting
Pakistan Railway General Hospital
Rawalpindi
Muhammad Affan Iqbal, PhD*, 03336754837, affan.iqbal@riphah.edu.pk
Neha Maqsood, DPT
About this study
Official title: Comparison of Close Chain and Open Chain Exercises With Blood Flow Restriction in Knee Osteoarthritis
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
- Being tested
- Closed kinetic chain exercises with blood flow restriction, Open kinetic chain exercises with blood flow restriction
- Keywords
- Knee Osteoarthritis, Blood Flow Restriction, Blood Flow Resriction Therapy, Knee Joint
- Medical subject headings
- Osteoarthritis, Knee
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Closed kinetic chain exercises with blood flow restrictionOther
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.
Open kinetic chain exercises with blood flow restrictionOther
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
| Study group | Role | What they receive |
|---|---|---|
| Closed kinetic chain exercises with blood flow restriction | Active comparator | Closed kinetic chain exercises with blood flow restriction and conservative therapy Receives: 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. Receives: Other: Open kinetic chain exercises with blood flow restriction |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Secondary outcomes (5)
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Changes from baseline pain, stiffness, and physical function will be assessed using the Western Ontario and McMaster Universities Osteoarthritis Index, a validated questionnaire for individuals with knee osteoarthritis.
Measured: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Knee Range of Motion (Flexion)
Changes from baseline knee flexion range of motion will be measured using a universal goniometer following standard procedures.
Measured: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Knee Range of Motion (Extension)
Changes from baseline knee extension range of motion will be measured using a universal goniometer in a standardized position.
Measured: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Knee Muscle Strength
Changes from baseline knee extensor muscle strength will be assessed using a crane scale (dynamometer) in a standardized testing position.
Measured: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
30 Second Chair Stand Test
Changes from baseline functional lower limb strength will be assessed using the 30 second chair stand test, which measures the number of sit to stand repetitions completed in 30 seconds.
Measured: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Feb 2026
- Study start30 Jun 2026
- Primary completion30 Oct 2026 (estimated)
- Study completion7 Nov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Knee OsteoarthristisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Muhammad Affan Iqbal, PhD*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07426549
- Sponsor's protocol ID
- RCRAHS-ISB/REC/MS-PT/02420
- Status last verified
- Jul 2026
- First submitted
- 17 Feb 2026
- Last updated
- 20 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Close Chain and Open Chain Exercises With Blood Flow Restriction in Knee Osteoarthritis
- ClinicalTrials.gov ID
- NCT07426549
- Acronym / sponsor ID
- RCRAHS-ISB/REC/MS-PT/02420
- Conditions
- Knee Osteoarthristis
- Keywords
- Knee Osteoarthritis, Blood Flow Restriction, Blood Flow Resriction Therapy, Knee Joint
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 30 Jun 2026 (actual)
- Primary completion
- 30 Oct 2026 (estimated)
- Study completion
- 7 Nov 2026 (estimated)
- First posted
- 23 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Closed kinetic chain exercises with blood flow restriction | Active comparator | Other: Closed kinetic chain exercises with blood flow restrictionClosed kinetic chain exercises with blood flow restriction and conservative therapy |
| Open kinetic chain exercises with blood flow restriction | Active comparator | Other: Open kinetic chain exercises with blood flow restrictionOpen kinetic chain exercises with blood flow restriction and conservative therapy. |
Who may qualify
- Ages
- 45 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- 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.
Key exclusion criteria (6 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Closed kinetic chain exercises with blood flow restrictionClosed 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. | Other | Closed kinetic chain exercises with blood flow restriction |
| Open kinetic chain exercises with blood flow restrictionOpen 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 | Other | Open kinetic chain exercises with blood flow restriction |
Primary outcome
Numeric Pain Rating Scale (NPRS)
Time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
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.
5 secondary outcomes
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Knee Range of Motion (Flexion)
Time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Knee Range of Motion (Extension)
Time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Knee Muscle Strength
Time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
30 Second Chair Stand Test
Time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Muhammad Affan Iqbal, PhD* principal investigator
Riphah International University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Closed kinetic chain exercises with blood flow restriction and Open kinetic chain exercises with blood flow restriction in people with Knee Osteoarthristis, run by Riphah International University at 2 sites in Pakistan.
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 4 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 20 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Pakistan. 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?
Contact Imran Amjad, PhD (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (NPRS) (time frame: [Time Frame: Pre intervention (Week 1) and Post intervention (Week 4)]). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 20 Jul 2026.