Acute Effects of Blood Flow Restriction Training to Failure on Hypoalgesia in Patients With Severe Knee Osteoarthritis Using Dynamic or Fixed Occlusion Pressure

Inclusion Criteria: * Age between 50 and 85 years * Diagnosis of severe gonarthrosis according to the clinical and radiographic criteria of the American College of Rheumatology guidelines. * On the waiting list for unilateral total knee replacement (TKR) surgery Exclusion Criteria: * Pain in the contralateral leg with an intensity ≥80/100 mm on the visual analog scale (VAS) during daily activities. * Previous hip or knee replacement surgery and osteotomy within the last year. * Autoimmune arthritis * Medical conditions that contraindicate exercise. * Participation in exercise programs (\>2 days/week with training at intensities of 10-15 1RM) in the previous six months. * History of stroke, brain surgery, major depression, or self-reported cognitive impairment that could affect performance in the study. * Cardiovascular, thrombotic, or vascular risk factors (uncontrolled hypertension, peripheral arterial disease, history of deep vein thrombosis or pulmonary embolism, heart failure, severe varicose veins, or uncontrolled anticoagulant therapy). * Skin or local alterations at the cuff application site (ulcers, open wounds, infections, lymphedema, or severe edema). * Inability to communicate normally or with impaired communication skills.