The Effect of Blood Flow Restriction in Low-Intensity Load Exercise on Visual Analog Scales in Knee Osteoarthritis Patients at Dr. Soetomo General Hospital Surabaya

Purpose: Pain in knee osteoarthritis (KOA) causes life quality decrease and is the common complaint of patient with KOA. Cartilage destruction in KOA induced inflammation process that caused pain. Pain and tissue injury around the knee joint caused quadriceps weakness due to neural inhibition on quadriceps activation (Arthrogenic Muscle Inhibition (AMI)). Combination of blood flow restriction (BFR) and low intensity resistance training (LIRT) significantly showed improvement of visual analog scale (VAS), but the prescription is so variative and limited in Indonesia. Patients and methods: This was clinical experimental study with randomized control trial with pre-test and post-test design. Subjects were 28 KOA patient (50-70 years old). Intervention group (n=14) received combination of LIRT (30% 1-RM; 75 repetitions) and BFR (50 mmHg). Control group (n=14) received LIRT (30% 1-RM; 75 repetitions). Both groups received training twice a week with q-bench machine for 6 weeks. Visual analog scale was assessed before and after the training program. Results: There was the significant improvement of VAS before and after training program in both groups (intervention group, p=0.000; control group, p=0.000). There was the significant improvement of delta VAS between both groups (p=0.000) and post-test between both groups (p=0.000). The effect size value of intervention group was 10.08 (very large) and control group was 3.42 (very large). Conclusions: BFR addition to LIRT quadriceps muscle for 6 weeks can improve visual analog scale more than LIRT alone in patient with knee osteoarthritis.