CLINICAL TRIAL article
Front. Physiol.
Sec. Exercise Physiology
This article is part of the Research TopicImpact of Blood Flow Restriction Device Features and Methodological Considerations on Acute- and Longitudinal Responses to Blood Flow Restricted Exercise - Volume IIView all 4 articles
Occlusion pressure and blood pressure adaptations following low-load blood flow restriction training versus moderate-load training: a pilot randomized clinical trial in patients with knee osteoarthritis
Provisionally accepted
Mikhail Santos Cerqueira1*
Rafael Pereira1
Daniel Germano Maciel2Cláudia Thais Pereira Pinto1
Nicholas Rolnick3Wouber Hérickson de Brito Vieira4- 1Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Brazil
- 2Universidade Federal da Paraiba, João Pessoa, Brazil
- 3Lehman College, New York, United States
- 4Universidade Federal do Rio Grande do Norte, Natal, Brazil
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: This pilot study investigated the potential adaptations in limb occlusion pressure (LOP) and to compare LOP between low-load resistance training with blood flow restriction (LL-BFR) and traditional moderate-load training (ML) over nine weeks of resistance training in knee osteoarthritis (KOA) patients. Secondarily, we compared systolic (SBP) and diastolic blood pressure (DBP) adaptations between these groups. Methods: Seventeen KOA patients were randomly assigned to the LL-BFR or ML groups. The LL-BFR group performed 75 repetitions (10% 1RM; 60% of LOP). The ML group performed 24 repetitions (60% 1RM; 10% [SHAM] of LOP). In both groups, exercises involving LOP were bilateral hack machine squat and knee extension exercises. LOP, SBP, and DBP were measured before and every 3 weeks until the ninth training week. Results: After nine weeks, there were no statistically significant changes in LOP, SBP, or DBP within or between groups. LOP decreased by −32.9 mmHg (95% CI: −68.9 to 3.2) in LL-BFR and by −17.2 mmHg (95% CI: −49.0 to 14.6) in ML, achieving the clinical significance (relative error variance [REV] = 14.6 mmHg). SBP decreased by −7.5 mmHg (95% CI: −15.6 to 0.6) in LL-BFR and −1.1 mmHg (95% CI: −8.2 to 6.0) in ML. DBP decreased by −3.7 mmHg (95% CI: −9.2 to 1.7) in LL-BFR and −1.9 mmHg (95% CI: −6.8 to 2.9) in ML. Conclusion: We observed a non-significant trend towards a reduction in LOP following nine weeks of LL-BFR in patients with KOA, with a mean point estimate that exceeded a pre-defined threshold for clinical significance, although the wide confidence intervals indicate substantial uncertainty. Furthermore, SBP and DBP showed no significant changes, and no group differences emerged across outcomes. Practically, these findings suggest that LOP remains stable throughout a rehabilitation program, potentially reducing the burden of frequent LOP reassessment in clinical LL-BFR applications. Trial registration: Registro Brasileiro de Ensaios Clínicos (REBEC), RBR-6pcrfm. Registered on July 10, 2018.
Keywords: Vascular occlusion exercise, Kaatsu training, arterial hypertension, Pain, Resistance Training
Received: 26 Aug 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 Cerqueira, Pereira, Maciel, Pinto, Rolnick and Vieira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mikhail Santos Cerqueira
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.