ClinicalTrials.gg
Not yet recruitingNCT04819672Updated Jun 4, 2024

Effect of Low Intensity Training Combined With Partial Restriction of Blood Flow in Individuals With Knee Osteoarthritis

An interventional study of Low Intensity Training associated with Partial Blood Flow and Low Intensity Training associated with Partial Blood Flow-Sham in Osteoarthritis, Knee, sponsored by Universidade Federal do Ceara. Not yet recruiting. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2024-06-04.

Sponsored by Universidade Federal do Ceara · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Dec 2024, 1 year 11 months ago, but the record still lists the study as not yet recruiting.
Phase
Not applicable
Study type
Interventional
Enrollment
66
Allocation
Randomized
Ages
50 Years and older
Sex
All
01

Study summary

Osteoarthritis (OA) is a chronic degenerative infection that presents clinical features such as pain and limited range of motion. A weakness of the quadriceps makes this joint more susceptible to wear and tear to the articular cartilage, especially in the medial compartment of the knee. As a result, it is necessary to promote an increase of at least 30% in quadriceps strength for a beneficial effect on pain and 40% in functional capacity. Therapeutic exercises are used to increase strength muscle, in addition to high intensity exercises, to decrease joint pain, low to moderate intensity resistance training has been included, with the new approach of using partial blood flow restriction.

Read the detailed description

Physical therapy sessions will be individual and supervised, will last 30-40 minutes, twice a week, for eight weeks.

Participants will warm up with a walk or bike for 5 minutes. Then, a single series of sustained stretching will be performed for a period of 40 seconds for the following muscle groups: hamstrings, quadriceps femoris, hip abductors, hip adductors and gastrocnemius. After the stretches, active muscle strengthening exercises will be performed focusing on the quadriceps femoris muscle. The knee extension and squat exercises will be performed in four sets, with the first set being thirty repetitions or even volitional fatigue, and the following three sets will be fifteen to twenty-four repetitions, with 90 seconds of rest between each series, and two minutes of rest at the end of the four series. Both groups will perform these exercises with 30% of 1RM. The maximum load that will be lifted until volitional fatigue between 7 to 10 repetitions will be used instead of direct 1RM measurement.

Regarding the intensity of the exercises, this will be monitored by the physical therapist according to the perception of the level of effort and difficulty reported by the participant when completing the series of knee extension and squat, according to the specifications of the modified Borg scale (CR-10) . The exercises will be carried out with a load between 60-80% of the capacity and level of effort reported by the participant. The load will be increased by 2-10% when the patient is able to perform 24 complete repetitions in the last series of the exercise with perceived effort \<60%. During the exercises, a metronome will be used for the time under tension, 2 seconds for the eccentric and concentric phase.

Partial blood flow restriction will be used during knee extension and squat exercises as follows: Arterial occlusion pressure will be measured by placing a cuff on the proximal thigh in a standing position. The measurement of insufflation for each patient will be established as follows: with the participant in the supine position, the pulse of the pedal will be located with the LOGIQ e (GE Healthcare) Ultrasound. The cuff pressure will be increased until the pedal pulse can no longer be identified, and then the arterial occlusion pressure will be recorded when the pulse is restored. The RPFS will be performed at 60% of the arterial occlusion pressure for the experimental group and there will be no arterial occlusion pressure for the sham group.

02

Conditions studied

  • Osteoarthritis, Knee

Keywords

  • Osteoarthritis, Knee
  • Ischemic Preconditioning
  • Exercise
03

In context

Osteoarthritis, Knee

3,292 studies on the registry are indexed under Osteoarthritis, Knee; 623 are open to participants now.

This study's planned enrollment of 66 is close to the median of 68 across 2,714 interventional studies indexed under Osteoarthritis, Knee.

Browse Osteoarthritis, Knee studies →

Lead sponsor

Universidade Federal do Ceara is the lead sponsor of 22 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Confirmation of clinical diagnosis of osteoarthritis according to the criteria established by the American College of Rheumatology;
  • OA knee radiograph grades 2 - 4 according to the Kellgren-Lawrence scale;
  • Reporting knee pain with minimum intensity of 3 on Numerical Pain Scale;
  • Complaints of pain and functional reduction in the last three months;

Exclusion criteria

Exclusion Criteria:

  • Diabetes type I or decompensated;
  • Peripheral vascular disease;
  • Uncontrolled hypertension;
  • History of deep vein thrombosis;
  • History of stroke;
  • History of cancer;
  • Cardiac pacemaker;
  • Cognitive disorders;
  • Neurological deficits (sensory or motor)
  • above 40 kg/m2
  • Hip symptomatic osteoarthritis
  • Low back pain
  • Use of painkillers in the last 24 hours;
  • Intra-articular infiltration with hyaluronic acid and in the last 6 months;
  • Orthopedic surgery on lower limbs;
  • Systemic inflammatory disease;
  • Not able to walk
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
66 participants (estimated)

Study arms

  • Experimental
    Low Intensity Training associated with Partial Blood Flow

    In the experimental group, a cuff with compression at 60% of the pressure required for total arterial occlusion will be placed, 16 treatment sessions in 8 weeks: warm-up, stretching of the lower limbs, strengthening of the quadriceps (knee extension and squat). The cuff with partial blood flow restriction will be used during knee extension and squat exercises.

    Other: Low Intensity Training associated with Partial Blood Flow

  • Sham comparator
    Low Intensity Training associated with Partial Blood Flow-Sham

    In the sham group, the cuff will be placed, but there will be no arterial occlusion pressure, 16 treatment sessions in 8 weeks: warm-up, stretching of the lower limbs, strengthening of the quadriceps (knee extension and squat). The cuff without partial blood flow restriction will be used during knee extension and squat exercises.

    Other: Low Intensity Training associated with Partial Blood Flow-Sham

Interventions

  • OtherLow Intensity Training associated with Partial Blood Flow

    16 treatment sessions in 8 weeks: warm-up, stretching of the lower limbs, strengthening of the quadriceps, hamstrings, sural triceps, abductors and adductors of the hip. The Partial blood flow restriction will be used during knee extension and squat exercises. During the exercises, a metronome will be used for the time under tension, 2 seconds for the eccentric and concentric phase.

  • OtherLow Intensity Training associated with Partial Blood Flow-Sham

    16 treatment sessions in 8 weeks: warm-up, stretching of the lower limbs, strengthening of the quadriceps, hamstrings, sural triceps, abductors and adductors of the hip. The Partial blood flow restriction will be used during knee extension and squat exercises. During the exercises, a metronome will be used for the time under tension, 2 seconds for the eccentric and concentric phase.

06

What researchers measure

Primary outcomes

  1. Pain subscale - Knee Injury and Osteoarthritis Outcome Score

    Pain subscale - KOOS was assessed, where 0 corresponded to no pain and 100 corresponded to worst pain.

    Time frame: 8-week follow-up

  2. Activities of daily living subscale - Knee Injury and Osteoarthritis Outcome Score

    Activities of daily living subscale - KOOS was assessed, where 0 corresponded to normal function and 100 corresponded to worst function.

    Time frame: 8-week follow-up

  3. Numeric Pain Scale

    Pain was assessed by use of an 11-point Numeric Pain Scale, where 0 corresponded to no pain and 10 corresponded to worst imaginable pain.

    Time frame: 8-week follow-up

Secondary outcomes

  1. Timed Up And Go Test (TUG-Test)

    This test quantifies the functional capacity in seconds by the time the individual needs to perform the task of getting up from a chair with a backrest without the aid of arms, walking three meters, turning, going back to the chair and sitting again, wearing regular shoes and without walking assist devices. A tape will be used to mark the distance of three meters. The patient will perform a practical test and two effective tests, assuming the shortest time for statistical analysis.

    Time frame: 4- and 8-weeks follow-up

  2. 30 Seconds Chair Stand Test

    This test quantifies the maximum number of repetitions that the individual is able to get up and sit without using the armrest in a 44 cm chair in a period of 30 seconds. The patient must have his arms crossed over his chest and his feet at the shoulder line to perform the test.

    Time frame: 4- and 8- weeks follow-up

  3. Global Perceived Effect Scale

    Scale of 11 points ranging from minus five points (extremely worse), zero (no change) to five points (completely recovered). For all measures of the perceived global effect, participants will be asked: "compared to starting treatment, how would you describe your knee today?". Positive scores represent better recovery, negative scores indicate worsening of symptoms and zero without change.

    Time frame: 4- and 8- weeks follow-up; and 6-month follow up

  4. Assessment of strength of the quadriceps femoris using the isokinetic dynamometer

    Strength assessment will be measured by the Isokinetic Dynamometer by a blind assessor. The positioning will be carried out as follows: when seated in the chair, the popliteal fossa will be positioned 2 cm from the end of the seat, the hip positioned at 85 ° of flexion, the axis of movement of the device was aligned with the intercondylar line of the knee, and the lever arm kept 2 cm above the lateral malleolus. Belts will be placed to stabilize the trunk, abdomen and thigh of the evaluated member. After that, the limits of maximum range of motion and flexion will be established, the adequacy of the initial knee position at 90° of flexion and the weighing of the lower limb to be evaluated. The participant will be registered in the device system, with information such as dominance and limb injury. The protocol that will be used involves five concentric repetitions with maximum intensity at 60 °/s for strength assessment.

    Time frame: 4- and 8-weeks follow-up

  5. Numeric Pain Scale

    Pain was assessed by use of an 11-point Numeric Pain Scale, where 0 corresponded to no pain and 10 corresponded to worst imaginable pain

    Time frame: 4-week and 6-month follow-up

  6. Pain subscale - Knee Injury and Osteoarthritis Outcome Score

    Pain subscale - KOOS was assessed, where 0 corresponded to no pain and 100 corresponded to worst pain.

    Time frame: 4-week and 6-month follow-up

  7. Activities of daily living subscale - Knee Injury and Osteoarthritis Outcome Score

    Activities of daily living subscale - KOOS was assessed, where 0 corresponded to normal function and 100 corresponded to worst function.

    Time frame: 4-week and 6-month follow-up

  8. Others subscales - Knee Injury and Osteoarthritis Outcome Score

    It contains 42 items, divided into five subscales: other symptoms (7 questions), function in sport (5 questions) and recreation and quality of life related to the knee (4 questions) ). Its score ranges from 0 (extreme problem) to 100 (without problems) separately within each subscale.

    Time frame: 4- and 8-weeks follow-up; and 6-month follow up

  9. Amount of non-hormonal anti-inflammatory and/or analgesics ingested

    The amount of non-hormonal anti-inflammatory drugs and/or painkillers will be counted as clinical outcomes in all assessments.

    Time frame: 4- and 8-weeks follow-up; and 6-month follow up

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2024; primary completion for Dec 2024, 2 months later.

Of 1,111 non-industry interventional studies with no phase under Osteoarthritis, Knee, half reached primary completion within 18 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 36. This study's planned 2 months is below that.

Counting every sponsor, half of 1,251 studies reached it within 18 months; a quarter within 8 and three quarters within 36.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 23, 2021
First posted
Mar 29, 2021
StartEst.
Oct 5, 2024
Primary completionEst.
Dec 2024
CompletionEst.
Dec 2025
Last update
Jun 4, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 4, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04819672
Lead sponsor
Universidade Federal do Ceara
Responsible party
Gabriel Peixoto Leão Almeida (PhD, Universidade Federal do Ceara) — Principal investigator
First posted
Mar 29, 2021
Start date
Oct 5, 2024 (estimated)
Primary completion
Dec 2024 (estimated)
Completion
Dec 2025 (estimated)
Last update
Jun 4, 2024

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion