{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:51:53Z","timestamp":1787014313676,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Haemophilic knee arthropathy leads to a reduction in muscle mass and strength. Blood flow restriction (BFR) involves the application of a compressive cuff that enables strength training with reduced loads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate safety as the primary outcome and the efficacy (muscle strength and activation, functional capacity and quality of life) as secondary outcomes of a quadriceps strengthening programme using BFR in patients with haemophilia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomised clinical trial was conducted with 33 participants assigned to either an experimental group (strength training with BFR) or a control group. The 4\u2010week intervention included three weekly sessions and two strength exercises (leg extension and squat). Outcomes assessed were safety (clinical hemarthrosis), strength (dynamometry), muscle activation (surface electromyography), pain threshold (pressure algometry), range of motion (goniometry), functional capacity (Timed Up and Go) and quality of life (36\u2010Item Short Form Survey). Follow\u2010up assessments were performed 4 weeks post\u2010intervention to evaluate effect persistence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty participants completed the study. No participants experienced clinical hemarthrosis or hematomas during the intervention, confirming safety as the primary outcome. Additionally, BFR training produced significant gains in quadriceps strength (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001; \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>p<\/jats:italic>\n                      = 0.19) and activation (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001; \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>p<\/jats:italic>\n                      = 0.28). Further improvements (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05) were observed in pain threshold, knee range of motion and the physical component of quality of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BFR strength training is safe for patients with haemophilia. It may enhance quadriceps strength and activation, raise pain thresholds and improve knee mobility. Patients show better physical functioning, less bodily pain and improved physical quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70197","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T07:18:28Z","timestamp":1766819908000},"page":"522-533","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low\u2010Load Quadriceps Strengthening With Blood Flow Restriction in Adults With Haemophilic Knee Arthropathy: A Randomised Controlled Trial"],"prefix":"10.1111","volume":"32","author":[{"given":"Mar","family":"Villal\u00f3n\u2010Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Department of Physiotherapy University of Murcia  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-1845","authenticated-orcid":false,"given":"Ra\u00fal","family":"P\u00e9rez\u2010Llanes","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy University of Murcia  Murcia Spain"},{"name":"InHeFis Research Group Instituto Asturiano de Investigaci\u00f3n Sanitaria (ISPA)  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1347-7759","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"L\u00f3pez\u2010Pina","sequence":"additional","affiliation":[{"name":"Department of Basic Phycology and Methodology University of Murcia.  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4276-6982","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Cuesta\u2010Barriuso","sequence":"additional","affiliation":[{"name":"InHeFis Research Group Instituto Asturiano de Investigaci\u00f3n Sanitaria (ISPA)  Oviedo Spain"},{"name":"Department of Surgery and Medical\u2010Surgical Specialties University of Oviedo  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6974-9704","authenticated-orcid":false,"given":"Elena","family":"Donoso\u2010\u00dabeda","sequence":"additional","affiliation":[{"name":"InHeFis Research Group Instituto Asturiano de Investigaci\u00f3n Sanitaria (ISPA)  Oviedo Spain"},{"name":"Department of Physiotherapy Catholic University San Antonio\u2010UCAM  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15444"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13868"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.15067"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13938"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.00533"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-014-0264-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001567"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2025.2497964"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2024.2334752"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.32.120"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11206216"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1519\/JPT.0000000000000028"},{"key":"e_1_2_11_14_1","first-page":"152p","volume-title":"American Academy of Orthopaedic Surgeons, Editores. 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