scholarly journals 024 Resistance exercises with blood flow restriction in patients with sporadic inclusion body myositis

2019 ◽  
Vol 90 (e7) ◽  
pp. A9.1-A9
Author(s):  
Christina Liang ◽  
Melanie Burk ◽  
Abby Wall ◽  
Ryan Davis ◽  
Libby Augustine ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Inclusion Body ◽  
Inclusion Body Myositis ◽  
Muscle Disease ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Resistance Exercises ◽  
Sporadic Inclusion Body Myositis

IntroductionSporadic inclusion body myositis (sIBM) is the most common muscle disease affecting older adults with no disease-modifying treatment. Resistance exercises increase muscle hypertrophy, but weakness prevents exercising with higher resistance. In healthy subjects, augmentation of light-load training with blood flow restriction improved muscle strength1; and similar exercises were safe in the elderly.2 We therefore investigate whether resistance exercises with blood flow restriction is safe and helpful in sIBM patients. We explored methods for exercising weak leg muscles, and options for better outcome measures.MethodsA matched-control pilot study, with 12-week treatment and 4-week follow-up periods, where participants concentrated on lower limbs resistance exercises with 50% blood flow restriction 3 times/week, at 20%-30% of their repetition maximum. Patients are reviewed 4-weekly for muscle strength, blood biomarkers, 2-minute walk test (2MWT), timed up-and-go (TUG) test, minimal chair height standing ability test (MCHSAT), thigh girths, and quality of life scales.Results4 patients with varying abilities were on the exercise arm, and 3 acted as controls. Muscle groups with MRC score ≥2 were able to be exercised. We found strength testing by hand-held dynamometer was unreliable, whereas the 2MWT, TUG test and MCHSAT showed less variability. All patients could perform their exercises at significantly increased repetitions or weights by week 4, without concerning adverse events, with trend towards continued improvement over the 4-month period.ConclusionResistance exercises with blood flow restriction appear safe, and may be helpful in sIBM patients, even in weakened muscles, enabling improvement in muscle strength and endurance.ReferencesHughes L, Paton B, Rosenblatt B, Gissane C, Patterson SD. Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. Br J Sports 2017.Vechin FC, Libardi CA, Conceicao MS, et al. Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly. J Strength Cond Res 2015.

scholarly journals The immune system in sporadic inclusion body myositis patients is not compromised by blood-flow restricted exercise training

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Kasper Yde Jensen ◽  
Mikkel Jacobsen ◽  
Henrik Daa Schrøder ◽  
Per Aagaard ◽  
Jakob Lindberg Nielsen ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
T Cells ◽  
Blood Flow ◽  
Natural Killer ◽  
Inclusion Body ◽  
Inclusion Body Myositis ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Load ◽  
Sporadic Inclusion Body Myositis

Abstract Background Sporadic inclusion body myositis (sIBM) is clinically characterised by progressive proximal and distal muscle weakness and impaired physical function while skeletal muscle tissue displays abnormal cellular infiltration of T cells, macrophages, and dendritic cells. Only limited knowledge exists about the effects of low-load blood flow restriction exercise in sIBM patients, and its effect on the immunological responses at the myocellular level remains unknown. The present study is the first to investigate the longitudinal effects of low-load blood flow restriction exercise on innate and adaptive immune markers in skeletal muscle from sIBM patients. Methods Twenty-two biopsy-validated sIBM patients were randomised into either 12 weeks of low-load blood flow restriction exercise (BFRE) or no exercise (CON). Five patients from the control group completed 12 weeks of BFRE immediately following participation in the 12-week control period leading to an intervention group of 16 patients. Muscle biopsies were obtained from either the m. tibialis anterior or the m. vastus lateralis for evaluation of CD3-, CD8-, CD68-, CD206-, CD244- and FOXP3-positive cells by three-colour immunofluorescence microscopy and Visiopharm-based image analysis quantification. A linear mixed model was used for the statistical analysis. Results Myocellular infiltration of CD3−/CD8+ expressing natural killer cells increased following BFRE (P < 0.05) with no changes in CON. No changes were observed for CD3+/CD8− or CD3+/CD8+ T cells in BFRE or CON. CD3+/CD244+ T cells decreased in CON, while no changes were observed in BFRE. Pronounced infiltration of M1 pro-inflammatory (CD68+/CD206−) and M2 anti-inflammatory (CD68+/CD206+) macrophages were observed at baseline; however, no longitudinal changes in macrophage content were observed for both groups. Conclusions Low-load blood flow restriction exercise elicited an upregulation in CD3−/CD8+ expressing natural killer cell content, which suggests that 12 weeks of BFRE training evokes an amplified immune response in sIBM muscle. However, the observation of no changes in macrophage or T cell infiltration in the BFRE-trained patients indicates that patients with sIBM may engage in this type of exercise with no risk of intensified inflammatory activity.

Blood Flow Restriction Therapy Impact on Musculoskeletal Strength and Mass

2021 ◽  
Vol 1 (5) ◽  
pp. 263502542110326
Author(s):  
Steven R. Dayton ◽  
Simon J. Padanilam ◽  
Tyler C. Sylvester ◽  
Michael J. Boctor ◽  
Vehniah K. Tjong
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Load Resistance ◽  
High Load ◽  
Blood Flow Restriction ◽  
Occlusion Pressure ◽  
Total Occlusion ◽  
Flow Restriction ◽  
Low Load

Background: Blood flow restriction (BFR) training restricts arterial inflow and venous outflow from the extremity and can produce gains in muscle strength at low loads. Low-load training reduces joint stress and decreases cardiovascular risk when compared with high-load training, thus making BFR an excellent option for many patients requiring rehabilitation. Indications: Blood flow restriction has shown clinical benefit in a variety of patient populations including healthy patients as well as those with osteoarthritis, anterior cruciate ligament reconstruction, polymyositis/dermatomyositis, and Achilles tendon rupture. Technique Description: This video demonstrates BFR training in 3 clinical areas: upper extremity resistance training, lower extremity resistance training, and low-intensity cycling. All applications of BFR first require determination of total occlusion pressure. Upper extremity training requires inflating the tourniquet to 50% of total occlusion pressure, while lower extremity exercises use 80% of total occlusion pressure. Low-load resistance training exercises follow a specific repetition scheme: 30 reps followed by a 30-second rest and then 3 sets of 15 reps with 30-seconds rest between each. During cycle training, 80% total occlusion pressure is used as the patient cycles for 15 minutes without rest. Results: Augmenting low-load resistance training with BFR increases muscle strength when compared with low-load resistance alone. In addition, low-load BFR has demonstrated an increase in muscle mass greater than low-load training alone and equivalent to high-load training absent BFR. A systematic review determined the safety of low-load training with BFR is comparable to traditional high-intensity resistance training. The most common adverse effects include exercise intolerance, discomfort, and dull pain which are also frequent in patients undergoing traditional resistance training. Severe adverse effects including deep vein thrombosis, pulmonary embolism, and rhabdomyolysis are exceedingly rare, less than 0.006% according to a national survey. Patients undergoing BFR rehabilitation experience less perceived exertion and demonstrate decreased pain scores compared with high-load resistance training. Conclusion: Blood flow restriction training is an effective alternative to high-load resistance training for patients requiring musculoskeletal rehabilitation for multiple disease processes as well as in the perioperative setting. Blood flow restriction has been shown to be a safe training modality when managed by properly trained physical therapists and athletic trainers.

Early phase adaptations in muscle strength and hypertrophy as a result of low-intensity blood flow restriction resistance training

2018 ◽  
Vol 118 (9) ◽  
pp. 1831-1843 ◽  
Author(s):  
Ethan C. Hill ◽  
Terry J. Housh ◽  
Joshua L. Keller ◽  
Cory M. Smith ◽  
Richard J. Schmidt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Early Phase ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity

scholarly journals The effects of resistance training with blood flow restriction on muscle strength, muscle hypertrophy and functionality in patients with osteoarthritis and rheumatoid arthritis: A systematic review with meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259574
Author(s):  
Leonardo Peterson dos Santos ◽  
Rafaela Cavalheiro do Espírito Santo ◽  
Thiago Rozales Ramis ◽  
Juliana Katarina Schoer Portes ◽  
Rafael Mendonça da Silva Chakr ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Meta Analysis ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity

Introduction Rheumatoid arthritis(RA) and osteoarthritis(OA) patients showed systemic manifestations that may lead to a reduction in muscle strength, muscle mass and, consequently, to a reduction in functionality. On the other hand, moderate intensity resistance training(MIRT) and high intensity resistance training(HIRT) are able to improve muscle strength and muscle mass in RA and OA without affecting the disease course. However, due to the articular manifestations caused by these diseases, these patients may present intolerance to MIRT or HIRT. Thus, the low intensity resistance training combined with blood flow restriction(LIRTBFR) may be a new training strategy for these populations. Objective To perform a systematic review with meta-analysis to verify the effects of LIRTBFR on muscle strength, muscle mass and functionality in RA and OA patients. Materials and methods A systematic review with meta-analysis of randomized clinical trials(RCTs), published in English, between 1957–2021, was conducted using MEDLINE(PubMed), Embase and Cochrane Library. The methodological quality was assessed using Physiotherapy Evidence Database scale. The risk of bias was assessed using RoB2.0. Mean difference(MD) or standardized mean difference(SMD) and 95% confidence intervals(CI) were pooled using a random-effects model. A P<0.05 was considered statistically significant. Results Five RCTs were included. We found no significant differences in the effects between LIRTBFR, MIRT and HIRT on muscle strength, which was assessed by tests of quadriceps strength(SMD = -0.01[-0.57, 0.54], P = 0.96; I² = 58%) and functionality measured by tests with patterns similar to walking(SMD = -0.04[-0.39, 0.31], P = 0.82; I² = 0%). Compared to HIRT, muscle mass gain after LIRTBFR was reported to be similar. When comparing LIRTBFR with low intensity resistance training without blood flow restriction(LIRT), the effect LIRTBFR was reported to be higher on muscle strength, which was evaluated by the knee extension test. Conclusion LIRTBFR appears to be a promising strategy for gains in muscle strength, muscle mass and functionality in a predominant sample of RA and OA women.

Effect of moderate intensity resistance training with blood flow restriction on muscle strength and girth in young adults –a randomized control trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanya Gujral ◽  
Jeyanthi Subburaj ◽  
Kiran Sharma
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Exercise Training ◽  
Blood Flow Restriction ◽  
Moderate Intensity ◽  
Control Group ◽  
Flow Restriction ◽  
Group A ◽  
Group B

Abstract Objectives To examine the effects of moderate intensity resistance training with blood flow restriction on muscle strength and forearm girth. Methods Total of 39 students enrolled in this study were divided into three groups that is group A (control group), group B and group C. Group A performed exercise training without restrictive pressure, group B & C performed exercise training with 50 and 75 mmHg respectively. Both the outcome measures were evaluated on day 1 and day 12th with the help of digital dynamometer and measuring tape. Results Repeated measure ANOVA with Post hoc analysis was done using SPSS software version 20. The result of the study showed significant (p≤0.05) within subject improvement in muscle strength and muscle girth in all the three groups. However, significant improvement in muscle strength was found in between group analysis (p≤0.05). Conclusions The results of the study can be concluded as the partial blood flow restriction (50 mmHg) with moderate intensity resistance training resulted in greater handgrip strength than the other two groups. No difference was found in forearm girth among the three groups, however within the group difference was found.

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