title: Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial.
abstract: OBJECTIVE
  The objective of this study was to evaluate whether women with knee osteoarthritis performing a rehabilitation programme consisting of low-load exercises combined with PVO exhibited the same results in changes in quadriceps strength, pain relief, and functional improvement when compared to women receiving a programme consisting of high-load exercises without PVO.
  
  
  METHODS
  Thirty-four women (mean age, 61 years) with a diagnosis of knee osteoarthritis were randomly assigned to a conventional or occlusion group. The women in the conventional group (n = 17) performed a 6-week quadriceps strengthening and stretching programme using a load around 70 % of the 1-repetition maximum (RM). The women in the occlusion group (n = 17) performed the same programme, however, only using a load around 30 % of the 1-RM, while PVO was induced. The PVO was achieved using a pressure cuff applied to the upper third of the thigh and inflated to 200 mmHg during the quadriceps exercise. An 11-point Numerical Pain Rating Scale (NPRS), the Lequesne questionnaire, the Timed-Up and Go (TUG) test, and muscle strength measurement using a hand-held dynamometer were used as outcome measures at baseline (pretreatment) and at the end of the 6-week of treatment. Pain, using the NPRS, was also assessed when performing the quadriceps exercises during the exercise sessions.
  
  
  RESULTS
  At baseline, demographic, strength, pain, and functional assessment data were similar between groups. Patients from both the conventional and occlusion groups had a higher level of function (Lequesne and TUG test), less pain (NPRS), and higher quadriceps strength at the 6-week evaluation when compared to baseline (all P < 0.05). However, the between-group analysis showed no differences for all outcomes variables at posttreatment (n.s.). Patients in the occlusion group experienced less anterior knee discomfort during the treatment sessions than those in the high-load exercise group (P < 0.05).
  
  
  CONCLUSIONS
  A rehabilitation programme that combined PVO to low-load exercise resulted in similar benefits in pain, function, and quadriceps strength than a programme using high-load conventional exercise in patients with knee osteoarthritis. However, the use of PVO combined with low-load exercise resulted in less anterior knee pain during the training sessions.
  
  
  METHODS
  I.
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia (ISCMSP), São Paulo, Brazil.
authors.forename: Flavio Fernandes
authors.initials: FF
authors.lastname: Bryk
authors.affiliation: TRATA Institute - Knee and Hip Rehabilitation, Rua Martinico Prado, 26 - Cj 141, São Paulo, 01224-010, Brazil.
authors.forename: Amir Curcio
authors.initials: AC
authors.lastname: Dos Reis
authors.affiliation: TRATA Institute - Knee and Hip Rehabilitation, Rua Martinico Prado, 26 - Cj 141, São Paulo, 01224-010, Brazil.
authors.forename: Deborah
authors.initials: D
authors.lastname: Fingerhut
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia (ISCMSP), São Paulo, Brazil.
authors.forename: Thomas
authors.initials: T
authors.lastname: Araujo
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia (ISCMSP), São Paulo, Brazil.
authors.forename: Marcela
authors.initials: M
authors.lastname: Schutzer
authors.affiliation: Orthopaedic and Traumatology Department, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
authors.forename: Ricardo de Paula Leite
authors.initials: Rde P
authors.lastname: Cury
authors.affiliation: Orthopaedic and Traumatology Department, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
authors.forename: Aires
authors.initials: A
authors.lastname: Duarte
authors.affiliation: TRATA Institute - Knee and Hip Rehabilitation, Rua Martinico Prado, 26 - Cj 141, São Paulo, 01224-010, Brazil. fukuda@institutotrata.com.br.
authors.forename: Thiago Yukio
authors.initials: TY
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007717:Knee / Q000098:blood supply / Q000503:physiopathology; D007719:Knee Joint / Q000098:blood supply* / Q000503:physiopathology; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D052097:Quadriceps Muscle / Q000503:physiopathology; D020127:Recovery of Function; D060205:Therapeutic Occlusion / Q000379:methods*; D014111:Tourniquets
keywords: Ischaemia; Muscle strength; Occlusion; Rehabilitation; Resistance training