scholarly journals The effect of passive mobilization associated with blood flow restriction and combined with electrical stimulation on cardiorespiratory safety, neuromuscular adaptations, physical function, and quality of life in comatose patients in an ICU: a randomized controlled clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Thaís Marina Pires de Campos Biazon ◽  
Cleiton Augusto Libardi ◽  
Jose Carlos Bonjorno Junior ◽  
Flávia Rossi Caruso ◽  
Tamara Rodrigues da Silva Destro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Intensive Care ◽  
Electrical Stimulation ◽  
Physical Function ◽  
Cardiovascular Safety ◽  
Flow Restriction ◽  
Neuromuscular Adaptations ◽  
Passive Mobilization

Abstract Background Intensive care unit-acquired atrophy and weakness are associated with high mortality, a reduction in physical function, and quality of life. Passive mobilization (PM) and neuromuscular electrical stimulation were applied in comatose patients; however, evidence is inconclusive regarding atrophy and weakness prevention. Blood flow restriction (BFR) associated with PM (BFRp) or with electrical stimulation (BFRpE) was able to reduce atrophy and increase muscle mass in spinal cord-injured patients, respectively. Bulky venous return occurs after releasing BFR, which can cause unknown repercussions on the cardiovascular system. Hence, the aim of this study was to investigate the effect of BFRp and BFRpE on cardiovascular safety and applicability, neuromuscular adaptations, physical function, and quality of life in comatose patients in intensive care units (ICUs). Methods Thirty-nine patients will be assessed at baseline (T0–18 h of coma) and randomly assigned to the PM (control group), BFRp, or BFRpE groups. The training protocol will be applied in both legs alternately, twice a day with a 4-h interval until coma awake, death, or ICU discharge. Cardiovascular safety and applicability will be evaluated at the first training session (T1). At T0 and 12 h after the last session (T2), muscle thickness and quality will be assessed. Global muscle strength and physical function will be assessed 12 h after T2 and ICU and hospital discharge for those who wake up from coma. Six and 12 months after hospital discharge, physical function and quality of life will be re-assessed. Discussion In view of applicability, the data will be used to inform the design and sample size of a prospective trial to clarify the effect of BFRpE on preventing muscle atrophy and weakness and to exert the greatest beneficial effects on physical function and quality of life compared to BFRp in comatose patients in the ICU. Trial registration Universal Trial Number (UTN) Registry UTN U1111-1241-4344. Retrospectively registered on 2 October 2019. Brazilian Clinical Trials Registry (ReBec) RBR-2qpyxf. Retrospectively registered on 21 January 2020, http://ensaiosclinicos.gov.br/rg/RBR-2qpyxf/

scholarly journals Comparison of Blood Flow Restriction Training versus Non-Occlusive Training in Patients with Anterior Cruciate Ligament Reconstruction or Knee Osteoarthritis: A Systematic Review

2020 ◽  
Vol 10 (1) ◽  
pp. 68
Author(s):  
Cristina Bobes Álvarez ◽  
Paloma Issa-Khozouz Santamaría ◽  
Rubén Fernández-Matías ◽  
Daniel Pecos-Martín ◽  
Alexander Achalandabaso-Ochoa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Blood Flow ◽  
Anterior Cruciate Ligament ◽  
Knee Osteoarthritis ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Flow Restriction ◽  
Anterior Cruciate

Patients undergoing anterior cruciate ligament (ACL) reconstruction and patients suffering from knee osteoarthritis (KOA) have been shown to have quadriceps muscle weakness and/or atrophy in common. The physiological mechanisms of blood flow restriction (BFR) training could facilitate muscle hypertrophy. The purpose of this systematic review is to investigate the effects of BFR training on quadriceps cross-sectional area (CSA), pain perception, function and quality of life on these patients compared to a non-BFR training. A literature research was performed using Web of Science, PEDro, Scopus, MEDLINE, Dialnet, CINAHL and The Cochrane Library databases. The main inclusion criteria were that papers were English or Spanish language reports of randomized controlled trials involving patients with ACL reconstruction or suffering from KOA. The initial research identified 159 publications from all databases; 10 articles were finally included. The search was conducted from April to June 2020. Four of these studies found a significant improvement in strength. A significant increase in CSA was found in two studies. Pain significantly improved in four studies and only one study showed a significant improvement in functionality/quality of life. Low-load training with BFR may be an effective option treatment for increasing quadriceps strength and CSA, but more research is needed.

scholarly journals Effect of Low-load resistance training with different degrees of blood flow restriction in patients with knee osteoarthritis: study protocol for a randomized trial

2021 ◽  
Author(s):  
Haonan Wang ◽  
Lin Cheng ◽  
Yan Chen ◽  
Shen-Tao Wang ◽  
De-Xin Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Load Resistance ◽  
Flow Restriction ◽  
Education Group ◽  
Low Load ◽  
High Degree

Abstract Background: Knee osteoarthritis (KOA) is a common degenerative disease that causes pain, functional impairment, and a reduced quality of life. Resistance training is considered an effective approach to reduce the risk factor of muscle weakness in patients with KOA. Blood flow restriction (BFR) with low-load resistance training have better clinical outcomes than low-load resistance training alone. However, the effective degree of BFR with low-load resistance training has not been determined. The purpose of this study will be to evaluate the effectiveness of different degrees of BFR with low-load resistance training in patients with KOA on pain, self-reported function, physical function performance, muscle strength, muscle mass, and quality of life.Methods: This is a study protocol for a single-blind, randomized, controlled trial. One hundred individuals will be indiscriminately assigned into the following groups: two training groups with a BFR at 40% and 80% limb occlusion pressure (LOP), a training group without BFR, and a health education group. The three intervention groups will perform strength training for the quadriceps muscles twice a week for 12 weeks. The health education group will attend sessions once a week for 12 weeks. The primary outcomes will include pain, self-reported function, and adverse events. The secondary outcomes will include physical function performance, muscle strength of the knee extensors, muscle mass of quadriceps, and quality of life. The intention-to-treat analysis will be conducted for individuals who withdraw during the trial.Discussion: Previous studies have shown that BFR with low-load resistance training is more effective than low-load resistance training alone; however, a high degree of BFR may cause discomfort during training. If a 40% LOP for BFR will produce similar clinical outcomes as an 80% LOP for BFR, resistance training with a low degree of BFR can be chosen for those patients with KOA who are intolerant to a high degree of BFR.Trial registration: Chinese Clinical Trial Registry, ChinCTR2000037859. Registered on 2 September 2020.

scholarly journals Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report

2021 ◽  
Vol 3 ◽  
Author(s):  
Maíra Camargo Scarpelli ◽  
João Guilherme Almeida Bergamasco ◽  
Estevan A. de Barros Arruda ◽  
Summer B. Cook ◽  
Cleiton Augusto Libardi
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Mass ◽  
Vastus Lateralis ◽  
Blood Flow Restriction ◽  
Vastus Lateralis Muscle ◽  
Timed Up And Go ◽  
Flow Restriction

In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.

Addition of blood flow restriction to passive mobilization reduces the rate of muscle wasting in elderly patients in the intensive care unit: a within-patient randomized trial

2018 ◽  
Vol 33 (2) ◽  
pp. 233-240 ◽  
Author(s):  
Matheus Barbalho ◽  
Angel Caroline Rocha ◽  
Thamires Lorenzet Seus ◽  
Rodolfo Raiol ◽  
Fabrício Boscolo Del Vecchio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Blood Flow ◽  
Intensive Care ◽  
Randomized Trial ◽  
Muscle Wasting ◽  
Muscle Thickness ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Control Limb ◽  
Passive Mobilization

Objective: To evaluate the addition of blood flow restriction to passive mobilization in patients in the intensive care unit. Design: The study was a within-patient randomized trial. Setting: Two intensive care units in Belém, from September to October 2017. Subjects: In total, 34 coma patients admitted to the intensive care unit sector, and 20 patients fulfilled the study requirements. Interventions: All participants received the passive mobilization protocol for lower limbs, and blood flow restriction was added only for one side in a concurrent fashion. Intervention lasted the entire patient’s hospitalization time. Main outcome measurement: Thigh muscle thickness and circumference. Results: In total, 34 subjects were enrolled in the study: 11 were excluded for exclusion criteria, 3 for death, and 20 completed the intervention (17 men and 3 women; mean age: 66 ± 4.3 years). Despite both groups presented atrophy, the atrophy rate was lower in blood flow restriction limb in relation to the control limb (–2.1 vs. –2.8 mm, respectively, in muscle thickness; P = 0.001). In addition, the blood flow restriction limb also had a smaller reduction in the thigh circumference than the control limb (–2.5 vs. –3.6 cm, respectively; P = 0.001). Conclusion: The use of blood flow restriction did not present adverse effects and seems to be a valid strategy to reduce the magnitude of the rate of muscle wasting that occurs in intensive care unit patients.

scholarly journals Effects of Functional Electrical Stimulation on Gait Function and Quality of Life for People with Multiple Sclerosis Taking Dalfampridine

2015 ◽  
Vol 17 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Lori Mayer ◽  
Tina Warring ◽  
Stephanie Agrella ◽  
Helen L. Rogers ◽  
Edward J. Fox
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Physical Function ◽  
Functional Electrical Stimulation ◽  
Sf 36 ◽  
Gait Dysfunction ◽  
Gait Function ◽  
The Impact

Background: Multiple sclerosis (MS) can adversely affect gait, causing gait slowing, loss of balance, decreased functional mobility, and gait deficits, such as footdrop. Current treatments for gait dysfunction due to MS are pharmacologic, using dalfampridine, or orthotic, using an ankle-foot orthosis. Functional electrical stimulation (FES) to the fibular nerve stimulates active dorsiflexion and provides an alternative treatment for gait dysfunction caused by footdrop. The objective of this study was to determine the effect of FES on gait function and the impact of MS on walking and quality of life for people with MS taking a stable dalfampridine dose. Methods: Participants demonstrating gait slowing and footdrop completed the Timed 25-Foot Walk (T25FW) test, 6-Minute Walk (6MW) test, GaitRite Functional Ambulation Profile, 12-item Multiple Sclerosis Walking Scale (MSWS-12), and 36-item Short Form Health Status Survey (SF-36) at screening without FES; the measures were repeated with FES at baseline, 1 month, and 3 months. Results: Twenty participants (8 men and 12 women) completed this unblinded case series study. The mean age, duration of MS, and time taking dalfampridine were 51.7, 15.8, and 1.4 years, respectively. Changes from screening to baseline and screening to 3 months were analyzed. Significant improvement was noted from screening to baseline for the MSWS-12 (P = .024) and SF-36 Physical Function domain (P = .028) and from screening to 3 months for the T25FW (P = .015), MSWS-12 (P = .003), and SF-36 Physical Function (P = .032) and Role Limitation–Physical Health (P = .012) domains. Conclusions: Improvements above those induced pharmacologically suggest that FES can augment pharmacologic intervention and significantly improve gait function, decrease the impact of MS on walking, and improve quality of life for people with MS.

scholarly journals Effect of low-load resistance training with different degrees of blood flow restriction in patients with knee osteoarthritis: study protocol for a randomized trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Hao-Nan Wang ◽  
Yan Chen ◽  
Lin Cheng ◽  
Shen-Tao Wang ◽  
De-Xin Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Load Resistance ◽  
Flow Restriction ◽  
Education Group ◽  
Low Load ◽  
High Degree

Abstract Background Knee osteoarthritis (KOA) is a common degenerative disease that causes pain, functional impairment, and reduced quality of life. Resistance training is considered as an effective approach to reduce the risk of muscle weakness in patients with KOA. Blood flow restriction (BFR) with low-load resistance training has better clinical outcomes than low-load resistance training alone. However, the degree of BFR which works more effectively with low-load resistance training has not been determined. The purpose of this study is to evaluate the effectiveness of different degrees of BFR with low-load resistance training in patients with KOA on pain, self-reported function, physical function performance, muscle strength, muscle thickness, and quality of life. Methods This is a study protocol for a randomized, controlled trial with blinded participants. One hundred individuals will be indiscriminately assigned into the following groups: two training groups with a BFR at 40% and 80% limb occlusion pressure (LOP), a training group without BFR, and a health education group. The three intervention groups will perform strength training for the quadriceps muscles twice a week for 12 weeks, while the health education group will attend sessions once a week for 12 weeks. The primary outcome is pain. The secondary outcomes include self-reported function, physical function performance, muscle strength of the knee extensors, muscle mass of the quadriceps, quality of life, and adverse events. Intention-to-treat analysis will be conducted for individuals who withdraw during the trial. Discussion Previous studies have shown that BFR with low-load resistance training is more effective than low-load resistance training alone; however, a high degree of BFR may cause discomfort during training. If a 40% LOP for BFR could produce similar clinical outcomes as an 80% LOP for BFR, resistance training with a low degree of BFR can be chosen for patients with KOA who are unbearable for a high degree of BFR. Trial registration Chinese Clinical Trial Registry ChiCTR2000037859 (http://www.chictr.org.cn/edit.aspx?pid=59956&htm=4). Registered on 2 September 2020

Abstract 12286: Electrical Muscle Stimulation Improves Neurovascular Control and Exercise Tolerance in Hospitalised Advanced Heart Failure Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Raphaela V Groehs ◽  
Ligia M Antunes-Correa ◽  
Thais S Nobre ◽  
Maria-Janieire N Alves ◽  
Maria Urbana P Rondon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Blood Flow ◽  
Electrical Stimulation ◽  
Muscle Strength ◽  
Exercise Tolerance ◽  
Advanced Heart Failure ◽  
Control Group ◽  
And Control

Introduction: Advanced heart failure (HF) patients may stay for a long period of time in the hospital for the treatment of HF and prolonged inactivity causes complications that result in worsening of exercise tolerance. On the other hand, there is evidence that treatment with muscle low-frequency electrical stimulation (FES) provides important benefits for HF patients. This study investigated the effects of FES on neurovascular control and exercise tolerance in HF hospitalized patients. Methods and results: Thirty hospitalized patients for treatment of decompensated HF, functional class IV NYHA and ejection fraction ≤ 30% were consecutively randomised into two groups: 1) FES(n= 15; 54±2 years) and control(n= 15; 49±2 years). Muscle sympathetic nerve activity (MSNA) was directly recorded via microneurography and blood flow by venous occlusion plethysmography. Heart rate and blood pressure were evaluated on a beat-to-beat basis (Finometer). Exercise tolerance by six-minute walk test, quadriceps muscle strength by a dynamometer and quality of life by Minnesota Questionnaire. FES consisted of stimulating the lower limbs at 10 Hz frequency, 150 ms pulse width and 70 mA intensity for 60 min/day for 7 days/week for 10 consecutive days. The control group underwent electrical stimulation at intensity of 20 mA. Baseline characteristics were similar between groups, except age that was higher in FES group. FES significantly decreased MSNA burst frequency (49 ±5 vs. 35±5, P= 0.002) and burst incidence (61 ±6 vs. 49±7, P= 0.04). In addition, FES significantly increased leg blood flow (0.88 ±0.09 vs. 1.47 ±0.14, P<0.001) and muscle strength (13 ±1 to 21 ±2, P<0.001). No changes were found in control group. Walking distance (304 ±25 to 436 ±26, P<0.001 vs. 320 ±22 to 358 ±22, P= 0.001) and quality of life (69 ±5 to 26 ±3, P<0.001 vs. 70 ±3 to 45 ±3, P<0.001) improved in FES and control groups, respectively. However, these changes were greater in FES group. Conclusion: FES improves MSNA and vasoconstriction and increases exercise tolerance, muscle strength and quality of life in hospitalised HF patients. These findings support the use of FES as an adjuvant therapy for patients hospitalised to achieve the stabilisation of HF.

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