Optimizing the potential effects of blood flow restriction training in individuals with knee osteoarthritis: bibliometric analysis and systematic review

Abstract Objective: this study presents a bibliometric analysis highlighting the rapid growth of blood flow restriction training (BFRT) in knee osteoarthritis-related publications, followed by a systematic review evaluating the methodologies and insights of these studies. Methods: a scoping review was conducted, supplemented by a bibliometric analysis using the VOS-viewer tool. The analysis focused on identifying country contributions, frequently used keywords, and co-cited authors through network visualisation. Data were sourced using an automation tool from SCOPUS and PubMed, and the PRISMA guidelines were followed in conducting the review. Eight studies met the eligibility requirements, including six randomised controlled trials (RCTs), one scoping review, and one systematic review with meta-analysis. The PEDro scale was used to evaluate the quality of RCTs, and the AMSTAR-2 checklist was applied to the reviews. Additionally, risk of bias assessments were performed for all included studies. Results: the United States, China, and Brazil led global contributions. VOS-viewer visualisations showed strong international collaborations and identified central authors such as Melaniani, highlighting evolving research and global scientific cooperation. Notably, potential outcomes of BFRT were observed within six weeks, with low resistance and minimal adverse effects, and without worsening joint pain. Conclusion: BFRT with low-load strength training is a clinically effective rehabilitation approach for knee osteoarthritis. When applied under proper parameters and safety guidelines, it significantly reduces pain, improves muscle strength, range of motion, functional ability, and daily activity levels. Clinical evidence indicates meaningful benefits within 4-6 weeks, making BFRT a valuable alternative to high-load training.