An interventional study of Eccentric Gastrocnemius Strengthening Exercises and Low-Load Blood Flow Restriction Training in Knee Arthritis, Osteoarthritis, sponsored by Riphah International University. Recruiting at 1 site in Pakistan. Open to participants aged 40 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-08-07.
Sponsored by Riphah International University · Not applicable, Interventional, and Treatment
The aim of this randomized controlled trial is to find the effects of eccentric and low-load blood flow restriction training on neuromuscular adaptations, muscle strength, functional performance, and disability in patients with knee osteoarthritis
Osteoarthritis (OA) is a chronic disease affecting the joint and its tissues, primarily leading to progressive damage to articular cartilage and, subsequently, to the subchondral bone and surrounding synovial structures. This chronic degenerative disease affects approximately one-third of adults, and its prevalence increasing with advancing age. The knee is one of the most common joints affected by the OA. Systematic reviews indicate a global prevalence of knee osteoarthritis (KOA) is 22.9% among individuals aged 40 and older, affecting an estimated 654.1 million people worldwide, with variations across countries and increasing with age.
Knee osteoarthritis (KOA) is a multi etiological, chronic disabling disease that affects the entire knee joint, which is the most common site of involvement in OA. KOA patients mostly suffer from progressive stiffness and knee pain. Gradually, they have some difficulties in performing daily activities, such as walking, squatting, and climbing and doing housework, as the disease progresses. Ultimately, pain and disability associated with the disease lead to a loss of functional independence and a profound reduction in quality-of- life. Impairments that are caused by KOA include knee pain, limited ROM of the knee, muscle weakness and knee instability.
The gastrocnemius muscle plays a crucial role in knee joint stability and ankle-knee biomechanics through its biarticular function, contributing to both knee flexion and ankle plantarflexion. During the stance phase of gait, the gastrocnemius co-activates with the tibialis anterior and quadriceps muscles, providing dynamic stability, reducing medial knee laxity, and assisting in forward propulsion.
The impaired neuromuscular recruitment of the gastrocnemius may result in reduced push-off strength, prolonged ground contact time, and diminished functional performance, ultimately contributing to functional limitations in patients with knee osteoarthritis. However, surface electromyography (sEMG) enables the assessment of gastrocnemius motor unit recruitment and fatigue characteristics, providing objective insight into neuromuscular adaptations before and after targeted interventions.
OA of the knee is characterized by changes in gait kinematics. In patients with knee OA, deficits in gastrocnemius strength and endurance can exacerbate difficulties in activities such as stair climbing, walking, and balance maintenance. Eccentric and low-load blood flow restriction (LL-BFR) training protocols have been proposed to optimize gastrocnemius activation, enhance muscle strength, and improve functional performance, offering clinically relevant rehabilitation strategies for enhancing lower limb function and reducing disability in knee osteoarthritis.
This study is to find the effects of eccentric and low-load blood flow restriction training on neuromuscular adaptations, muscle strength, functional performance, and disability in individuals affected by the knee OA.
3,292 studies on the registry are indexed under Osteoarthritis, Knee; 623 are open to participants now.
This study's planned enrollment of 48 is below the median of 68 across 2,714 interventional studies indexed under Osteoarthritis, Knee.
Browse Osteoarthritis, Knee studies →Riphah International University is the lead sponsor of 2,193 studies on the registry; 650 are open to participants now.
Compared within Osteoarthritis, Knee, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Osteoarthritis. The counts are of registry records indexed under each term, refreshed daily. How we classify →
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.
Exclusion Criteria:
Presence of a prosthetic knee in the affected limb.
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.
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
COPD
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Eccentric Gastrocnemius Strengthening Exercises
Other: Eccentric Gastrocnemius Strengthening Exercises
Low-Load Blood Flow Restriction Training
Other: Low-Load Blood Flow Restriction Training
Eccentric Gastrocnemius Strengthening Exercises .1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 3 sets 10 reps in session 1-2). 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 5 sets 15 reps in session 3-4). Total duration is 3 sessions per week for 4 consecutive weeks.
Low-load blood flow restriction training including 1-Low-intensity gastrocnemius strengthening with BFR cuff 2-Controlled exercise with intermittent vascular occlusion (inflated 50-70% for 4 weeks, 3 rep. 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 3 sets 10 reps in session 1-2). 1. Eccentric Heel Drop 2. leg press calf lowering 3. Eccentric Stair Descent (Frequency: 5 sets 12 reps in session 3-4). Total duration is 3 sessions per week for 4 consecutive weeks.
Surface Electromyography
The Electromyography (EMG) is an objective assessment tool used to measure the electrical activity of muscles during contraction. Motor unit recruitment will be analyzed through the amplitude of EMG signals (root mean square, RMS), reflecting the number and synchronization of active motor units during contraction. Fatigue characteristics will be assessed using changes in EMG frequency parameters (mean or median frequency), indicating alterations in muscle fiber conduction velocity and fatigue onset that will be assessed pre and post sessions.
Time frame: Baseline and 4th week
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
The WOMAC is a widely used, validated questionnaire assessing pain, stiffness, and physical function in patients with knee osteoarthritis. It consists of 24 items divided into three subscales: Pain (5 items), Stiffness (2 items), and Physical Function (17 items).
Time frame: 4 weeks
Timed Up and Go (TUG)
The Timed Up and Go (TUG) test assesses mobility and fall risk by timing how quickly a person can stand up from a standard armchair, walk 3 meters (10 feet) at a normal pace, turn around, walk back, and sit down again. Individuals can use their routine walking aids, but receive no physical help during the test; completing the maneuver in under 10 seconds indicates normal independence, whereas taking 30 seconds or longer points to an elevated risk of falling.
Time frame: 4 weeks
Heel Raise Endurance Test
The Heel Raise Endurance Test measures the number of consecutive heel raises a participant can perform (or the time sustained) while standing, usually at a controlled pace until fatigue. It assesses calf muscle endurance, ankle plantar-flexor strength, and functional lower-limb performance, relevant for gait and mobility assessment. The duration for which the position is maintained is recorded.
Time frame: 4 weeks
Plan to share: No
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Started Jul 2026 (actual). Primary completion is estimated for Dec 2026, 5 months after the start.
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 5 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.
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