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Corrêa HDL, Deus LA, Nascimento DDC, Rolnick N, Neves RVP, Reis AL, de Araújo TB, Tzanno-Martins C, Tavares FS, Neto LSS, Santos CAR, Rodrigues-Silva PL, Souza FH, Mestrinho VMDMV, Santos RLD, Andrade RV, Prestes J, Rosa TDS. Response to Commentary by Dr. Matthew J. Clarkson on "Concerns on the application of blood-flow restriction resistance exercise and thrombosis risk in hemodialysis patients". JOURNAL OF SPORT AND HEALTH SCIENCE 2024:S2095-2546(24)00059-0. [PMID: 38697288 DOI: 10.1016/j.jshs.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/04/2024]
Affiliation(s)
- Hugo de Luca Corrêa
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Lysleine Alves Deus
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Dahan da Cunha Nascimento
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY 10011, USA
| | | | - Andrea Lucena Reis
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Thais Branquinho de Araújo
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | | | | | | | | | | | - Fernando Honorato Souza
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | | | - Rafael Lavarini Dos Santos
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Rosangela Vieira Andrade
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil; Graduate Program of Genomic Sciences and Biotechnology, Brasília 71966-700, Brazil
| | - Jonato Prestes
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Thiago Dos Santos Rosa
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil; Graduate Program of Genomic Sciences and Biotechnology, Brasília 71966-700, Brazil.
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Corrêa HDL, Deus LA, Nascimento DDC, Rolnick N, Neves RVP, Reis AL, de Araújo TB, Tzanno-Martins C, Tavares FS, Neto LSS, Santos CAR, Rodrigues-Silva PL, Souza FH, Mestrinho VMDMV, Santos RLD, Andrade RV, Prestes J, Rosa TDS. Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:S2095-2546(24)00023-1. [PMID: 38431193 DOI: 10.1016/j.jshs.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Hemodialysis (HD) per se is a risk factor for thrombosis. Considering the growing body of evidence on blood-flow restriction (BFR) exercise in HD patients, identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model. The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise (RE) with BFR on this molecule. METHODS Two hundred and six HD patients volunteered for this study (all with a glomerular filtration rate of <15 mL/min/1.73 m2). The RE + BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD (intradialytic exercise). RE repetitions included concentric and eccentric lifting phases (each lasting 2 s) and were supervised by a strength and conditioning specialist. RESULTS Several variables were associated with elevated levels of D-dimer, including higher blood glucose, citrate use, recent cardiovascular events, recent intercurrents, higher inflammatory status, catheter as vascular access, older patients (>70 years old), and HD vintage. Furthermore, RE + BFR significantly increases D-dimer after 4 h. Patients with borderline baseline D-dimer levels (400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range (≥500 ng/mL). CONCLUSION These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE + BFR. D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE + BFR.
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Affiliation(s)
- Hugo de Luca Corrêa
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Lysleine Alves Deus
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Dahan da Cunha Nascimento
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY 10011, USA
| | | | - Andrea Lucena Reis
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Thais Branquinho de Araújo
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | | | | | | | | | | | - Fernando Honorato Souza
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | | | - Rafael Lavarini Dos Santos
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Rosangela Vieira Andrade
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil; Graduate Program of Genomic Sciences and Biotechnology, Brasília 71966-700, Brazil
| | - Jonato Prestes
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil
| | - Thiago Dos Santos Rosa
- Post-graduate Program of Physical Education, Catholic University of Brasília, Brasília 71966-700, Brazil; Graduate Program of Genomic Sciences and Biotechnology, Brasília 71966-700, Brazil.
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Zhuang M, Shi J, Liu J, He X, Chen N. Comparing the efficacy of low-load resistance exercise combined with blood flow restriction versus conventional-load resistance exercise in Chinese community-dwelling older people with sarcopenic obesity: a study protocol for a randomised controlled trial. BMC Geriatr 2023; 23:874. [PMID: 38114934 PMCID: PMC10731711 DOI: 10.1186/s12877-023-04592-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Sarcopenic obesity (SO) is characterised by decreased muscle mass, diminished muscle strength and/or reduced physical performance and a high percentage of body fat (PBF). Conventional-load resistance exercise (CRE) may be difficult for older people with SO owing to their declining physical functions. Low-load resistance exercise (LRE) combined with blood flow restriction (BFR; LRE-BFR) is a viable alternative to CRE for improving muscle mass and strength and potential exercise mode for managing SO. This study has two objectives: (1) to comprehensively evaluate the efficacy of CRE and LRE-BFR in improving body composition, muscle strength, physical performance, haematological parameters, cardiovascular disease (CVD) risk factors and quality of life and (2) to compare the efficacy of CRE and LRE-BFR and explore their potential mechanisms. METHODS AND ANALYSIS This work is a 12-week assessor-blinded randomised clinical trial that will be conducted thrice a week. Sarcopenia will be defined using the Asian Working Group for Sarcopenia 2019, and obesity will be determined using the criteria developed by the World Health Organization. Community-dwelling older people aged ≥ 65 years will be screened as the participants using inclusion and exclusion criteria. A total of 33 participants will be randomised into a CRE group (n = 11), an LRE-BFR group (n = 11) and a control group that will be given only health education (n = 11). The primary outcomes will be knee extensor strength and PBF, and the secondary outcomes will be body composition, anthropometric measurements, muscle strength of upper limbs, physical performance, haematological parameters, CVD risk factors and quality of life. The outcomes will be measured at the baseline (week 0), end of the intervention (week 12) and follow up (week 24). All the collected data will be analysed following the intention-to-treat principle. ETHICS AND DISSEMINATION The Ethics Research Committee has approved this study (approval No. CMEC-2022-KT-51). Changes or developments in this study will be reported at www.chictr.org.cn . TRIAL REGISTRATION ChiCTR2300067296 (3 January 2023).
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Grants
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, “Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model”
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Affiliation(s)
- Min Zhuang
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Jinli Shi
- Community Health Service Center of Chengqiao Town, Chongming District, Shanghai, China
| | - Jian Liu
- Community Health Service Center of Gangxi Town, Chongming District, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Nan Chen
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Liu H, Zheng F, Yao W, Zhu J, Du X, Shi H, Zhu X, Zang X. The impact of aerobic exercise on health-related quality of life among patients undergoing maintenance hemodialysis. Medicine (Baltimore) 2023; 102:e35990. [PMID: 37960758 PMCID: PMC10637439 DOI: 10.1097/md.0000000000035990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
To investigate the effect of exercise on cardiopulmonary function and the life quality of maintenance hemodialysis patients. Eighty-four patients who underwent maintenance hemodialysis treatment for more than 3 months were randomly divided into experimental group and control group. The general data and nutritional indexes, including hemoglobin and plasma albumin, before and after the experiment. The differences in lung function, cardiac ultrasound, cardiopulmonary function, exercise endurance between the 2 groups before and after intervention were compared. The short form 36-item health survey (SF-36) and self-rating depression scale (SDS) were assessed. In our study, the experimental group had better Force vital capacity (FVC) and peak expiratory flow (PEF) after the intervention compared to the control group (P < .05). Anaerobic threshold and 6-minute walk test (6MWT) improved significantly in the experimental group (P < .05), and SF-36 showed better physical functioning, social functioning, general health, and vitality scores in the experimental group compared to the control group (P < .05). In addition, following 24 weeks of exercise, the Depression score of the exercise group showed a statistically significant improvement when compared to the control group (P < .05). After the intervention, hemoglobin improved significantly in the experimental group (P < .05). Intradialytic exercise can improve hemoglobin, Alb, pulmonary function, aerobic capacity, and exercise endurance in maintenance hemodialysis patients, so as to improve the quality of life, which is worthy of further promotion.
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Affiliation(s)
- Haiying Liu
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Feng Zheng
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Weixing Yao
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Juanmei Zhu
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Xiu Du
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Haiyan Shi
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Xuelian Zhu
- Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Xiujuan Zang
- Shanghai Songjiang District Central Hospital, Shanghai, China
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Ribeiro HS, Andrade FP, Leal DV, Oliveira JS, Wilund KR, Viana JL. How is exercise being prescribed for patients on hemodialysis? A scoping review. J Nephrol 2023; 36:1307-1319. [PMID: 36418777 DOI: 10.1007/s40620-022-01513-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Exercise is important for patients on hemodialysis, but details and descriptions on how it is prescribed are lacking. We reviewed the existing literature and described how exercise is being prescribed for patients on hemodialysis. METHODS A scoping review according to the JBI and PRISMA-ScR guidelines was conducted. MEDLINE, EMBASE and other databases were searched from inception until December 2021. Websites, books, and guidelines were also searched. We included evidence from patients on hemodialysis, describing exercise protocols, in all settings and designs. RESULTS Two hundred and eighty-five studies were included, yielding 327 exercise protocols. Aerobic (38.8%) and strength (21.4%) were the most prescribed exercise types. Exercise was mainly prescribed during dialysis (71.0%) and delivered within the first half of the session (94.6%). Although 33.3% of the exercise protocols did not report whether there was supervision or not, those that did were mostly delivered by physiotherapists (20.5%) and exercise physiologists (17.4%). The most followed exercise training principles were type (99.0%) and frequency (93.2%), whereas progression was adopted in 40.7% protocols. The most prescribed frequency and duration were three times/week (79.9%) and 30-60-min (69.2%) sessions, respectively. Exercise intensity was predominantly prescribed in moderate cut-offs (72.3%), mostly assessed by subjective methods (47.5%). CONCLUSIONS Aerobic and strength were the most prescribed exercise types, mainly during dialysis. Interventions were mostly supervised by physiotherapists and exercise physiologists. Future exercise protocols for patients on hemodialysis should adopt recommended exercise principles, especially with systematic progression.
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Affiliation(s)
- Heitor S Ribeiro
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal
- Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - Francini P Andrade
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal
- Ciências Pneumológicas Post-Graduation Program, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Diogo V Leal
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal
| | - Juliana S Oliveira
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Kenneth R Wilund
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, USA
| | - João L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal.
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Bhuvaneswari P, Tamilselvi S, Harini J, Harshini J, Parameshwari R. A study to assess the effectiveness of Intradialytic Stretching Exercises on Leg Muscle Cramp among Hemo Dialysis. CARDIOMETRY 2022. [DOI: 10.18137/cardiometry.2022.23.97102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION: Hemodialysis is a continuous treatment that might result in problems such as hypotension, leg muscle cramps, disequilibrium syndrome, and nausea. The most effective treatment is passive stretching of the shortened muscle. Stretching has numerous health benefits, including increasing stamina, relaxing the body and mind, improving focus and concentration, and lowering the chance of injury. OBJECTIVE: The goals of this study were to determine the severity of leg muscle cramps in Hemodialysis patients before and after intradialytic stretching exercises, to assess the effectiveness of intradialytic stretching exercises on leg muscle cramps in Hemodialysis patients, and to link the severity of leg muscle cramps with selected demographic variables following intradialytic stretching exercises. MATERIALS AND METHODS: Qualitative research approach was conducted at Saveetha Medical College and Hospital by using quasi experimental research design, the Sample size was 30 patients with leg muscle cramps undergoing Hemodialysis by using Purposive sampling technique. The muscle cramp questionnaire scale was created to determine the severity of leg muscle cramps before and after Hemodialysis. Pain Scores ranged from 0 to 10 on a numerical scale. Before the individuals were given the intradialytic stretching exercise, demographic data, clinical variables and muscle cramp status were measured as a pre-test. Then, every day after the intervention, the posttest muscle cramp was measured. RESULTS: The demographic and clinical variables data was analysed using descriptive and inferential statistics. The majority of the patients 17(56.7%) reported no pain during the post-test. There was no correlation between the severity of leg muscle cramping and any of the demographic variables. Data were categorized and analysed using descriptive (mean, percentage, and standard deviation) and inferential statistics (independent paired t test’, chi-square analysis). CONCLUSION: This study showed that regular stretching exercises on legs during the hemodialysis can help alleviate the leg muscle cramps.
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Bernier-Jean A, Beruni NA, Bondonno NP, Williams G, Teixeira-Pinto A, Craig JC, Wong G. Exercise training for adults undergoing maintenance dialysis. Cochrane Database Syst Rev 2022; 1:CD014653. [PMID: 35018639 PMCID: PMC8752366 DOI: 10.1002/14651858.cd014653] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Dialysis treatments weigh heavily on patients' physical and psychosocial health. Multiple studies have assessed the potential for exercise training to improve outcomes in adults undergoing dialysis. However, uncertainties exist in its relevance and sustainable benefits for patient-important outcomes. This is an update of a review first published in 2011. OBJECTIVES To assess the benefits and safety of regular structured exercise training in adults undergoing dialysis on patient-important outcomes including death, cardiovascular events, fatigue, functional capacity, pain, and depression. We also aimed to define the optimal prescription of exercise in adults undergoing dialysis. SEARCH METHODS In this update, we conducted a systematic search of the Cochrane Kidney and Transplant Register of Studies up to 23 December 2020. The Register includes studies identified from CENTRAL, MEDLINE, EMBASE, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov as well as kidney-related journals and the proceedings of major kidney conferences. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs of any structured exercise programs of eight weeks or more in adults undergoing maintenance dialysis compared to no exercise or sham exercise. DATA COLLECTION AND ANALYSIS Two authors independently assessed the search results for eligibility, extracted the data and assessed the risk of bias using the Cochrane risk of bias tool. Whenever appropriate, we performed random-effects meta-analyses of the mean difference in outcomes. The primary outcomes were death (any cause), cardiovascular events and fatigue. Secondary outcomes were health-related quality of life (HRQoL), depression, pain, functional capacity, blood pressure, adherence to the exercise program, and intervention-related adverse events. MAIN RESULTS We identified 89 studies involving 4291 randomised participants, of which 77 studies (3846 participants) contributed to the meta-analyses. Seven studies included adults undergoing peritoneal dialysis. Fifty-six studies reported aerobic exercise interventions, 21 resistance exercise interventions and 19 combined aerobic and resistance training within the same study arm. The interventions lasted from eight weeks to two years and most often took place thrice weekly during dialysis treatments. A single study reported death and no study reported long-term cardiovascular events. Five studies directly assessed fatigue, 46 reported HRQoL and 16 reported fatigue or pain through their assessment of HRQoL. Thirty-five studies assessed functional capacity, and 21 reported resting peripheral blood pressure. Twelve studies reported adherence to exercise sessions, and nine reported exercise-related adverse events. Overall, the quality of the included studies was low and blinding of the participants was generally not feasible due to the nature of the intervention. Exercise had uncertain effects on death, cardiovascular events, and the mental component of HRQoL due to the very low certainty of evidence. Compared with sham or no exercise, exercise training for two to 12 months may improve fatigue in adults undergoing dialysis, however, a meta-analysis could not be conducted. Any exercise training for two to 12 months may improve the physical component of HRQoL (17 studies, 656 participants: MD 4.12, 95% CI 1.88 to 6.37 points on 100 points-scale; I² = 49%; low certainty evidence). Any exercise training for two to 12 months probably improves depressive symptoms (10 studies, 441 participants: SMD -0.65, 95% CI -1.07 to -0.22; I² = 77%; moderate certainty evidence) and the magnitude of the effect may be greater when maintaining the exercise beyond four months (6 studies, 311 participants: SMD -0.30, 95% CI 0.14 to -0.74; I² = 71%). Any exercise training for three to 12 months may improve pain (15 studies, 872 participants: MD 5.28 95% CI -0.12 to 10.69 points on 100 points-scale; I² = 63%: low certainty evidence) however, the 95% CI indicates that exercise training may make little or no difference in the level of pain. Any exercise training for two to six months probably improves functional capacity as it increased the distance reached during six minutes of walking (19 studies, 827 participants: MD 49.91 metres, 95% CI 37.22 to 62.59; I² = 34%; moderate certainty evidence) and the number of sit-to-stand cycles performed in 30 seconds (MD 2.33 cycles, 95% CI 1.71 to 2.96; moderate certainty evidence). There was insufficient evidence to assess the safety of exercise training for adults undergoing maintenance dialysis. The results were similar for aerobic exercise, resistance exercise, and a combination of both aerobic and resistance exercise. AUTHORS' CONCLUSIONS It is uncertain whether exercise training improves death, cardiovascular events, or the mental component of HRQoL in adults undergoing maintenance dialysis. Exercise training probably improves depressive symptoms, particularly when the intervention is maintained beyond four months. Exercise training is also likely to improve functional capacity. Low certainty evidence suggested that exercise training may improve fatigue, the physical component of quality of life, and pain. The safety of exercise training for adults undergoing dialysis remains uncertain.
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Affiliation(s)
- Amelie Bernier-Jean
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Nadim A Beruni
- Resident Support Unit, Western Sydney Local Health District, Westmead, Australia
| | - Nicola P Bondonno
- School of Biomedical Sciences, The University of Western Australia, Royal Perth Hospital, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Gabrielle Williams
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
| | | | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
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Chen N, He X, Zhao G, Lu L, Ainsworth BE, Liu Y, Wu X. Efficacy of low-load resistance training combined with blood flow restriction vs. high-load resistance training on sarcopenia among community-dwelling older Chinese people: study protocol for a 3-arm randomized controlled trial. Trials 2021; 22:518. [PMID: 34348792 PMCID: PMC8336391 DOI: 10.1186/s13063-021-05495-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/27/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sarcopenia is accompanied by a decline in muscle mass, muscle strength, and muscle function. Resistance training is the most potential training method for the prevention and treatment of sarcopenia. However, the conventional high-load resistance training (CRT) recommended by the American College of Sports Medicine is a challenge for older people with sarcopenia. As a novel training method, low-load resistance training combined with blood flow restriction (LRT-BFR) may elicit similar muscle mass and muscle strength gains as CRT but with less effort. The objectives of this study are to assess and compare the efficacy and safety of 12-week LRT-BFR and CRT on muscle strength, muscle performance, body composition, pulmonary function, blood biomarkers, CVD risk factors, and quality of life in community-dwelling older Chinese people with sarcopenia. METHOD This is a 12-week, assessor-blinded, 3-arm randomized controlled trial with a non-exercise control group. Community-dwelling people over 65 years will be screened for sarcopenia according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Fifty-one subjects will be randomized into a LRT-BFR group (n = 17), a CRT group (n = 17), and a no-strength training control group (n = 17). The primary outcome is lower limb muscle strength. The secondary outcomes are body composition, upper limb muscle strength, pulmonary function, blood biomarkers, CVD risk factors, and quality of life. Post-intervention follow-up will be performed for 12 weeks. These indicators will be assessed at baseline (0 week), after the 12-week intervention (12 weeks), and at follow-up (24 weeks). The adverse events will also be reported. Data will be analyzed for all participants in an intent-to-treat plan. DISCUSSION This study is the first RCT that will systematically measure and compare the efficacy and safety of LRT-BFR and CRT in older people with sarcopenia on muscle strength, body composition, pulmonary function, blood biomarkers (inflammatory biomarkers, hormone, and growth factors), CVD risk factors, and quality of life. This study can provide an efficient and safe method to prevent the progression of sarcopenia in older people. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100042803 . Registered on 28 January 2021.
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Affiliation(s)
- Nan Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Guoyun Zhao
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Linqian Lu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | | | - Yu Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China.
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China.
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Low-load resistance training with blood flow restriction prevent renal function decline: The role of the redox balance, angiotensin 1-7 and vasopressin ✰,✰✰. Physiol Behav 2021; 230:113295. [PMID: 33340514 DOI: 10.1016/j.physbeh.2020.113295] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/28/2020] [Accepted: 12/12/2020] [Indexed: 02/04/2023]
Abstract
AIMS We sought to investigate the effect of resistance training (RT) and low-load RT with moderate blood flow restriction (RT+BFR) on blood pressure, exercise pressor response, redox balance and vasoactive peptides, body composition and muscle strength in patients with stage two of chronic kidney disease (CKD). METHODS We conducted a 6-month randomized controlled exercise intervention in 90 male and female hypertensive CKD patients (58±9 years with estimated glomerular filtration rate (eGFR; of 66.1 ± 1.2 mL/kg/1.73m2). Participants were randomized to one of three groups (n = 30/group); control group (CTL), RT, and RT+BFR. RT and RT+BFR performed three weekly training sessions using similar periodization for six months (two-month mesocycles), but of different intensities. RESULTS There was similarly effects between RT and RT+BFR in reducing systolic and diastolic blood pressure during daytime and 24hour period (RT: 10.4%; RT+BFR: 10.3% of decrease), fat mass, F2-isoprostanes, asymmetric dimethylarginine (ADMA) and vasopressin (p<0.05 pre-vs post). Also promoted the increase of angiotensin 1-7, nitric oxide (NO), catalase, Trolox equivalent and muscle strength (p<0.05). Both training models attenuated the decline of estimated glomerular filtration rate (p<0.0001 vs CTL). However, only RT+BFR was associated with lower discomfort during exercise (p<0.0001 pre-vs post). Statistical significance was considered with p < 0.05. CONCLUSION These findings suggest low-load RT+BFR as a promising non-pharmacological strategy to control blood pressure, oxidative stress, vasoactive peptides, and consequently, attenuate the decrease of the eGFR.
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Corrêa HL, Neves RVP, Deus LA, Souza MK, Haro AS, Costa F, Silva VL, Santos CAR, Moraes MR, Simões HG, Navalta JW, Prestes J, Rosa TS. Blood Flow Restriction Training Blunts Chronic Kidney Disease Progression in Humans. Med Sci Sports Exerc 2021; 53:249-257. [PMID: 32826635 DOI: 10.1249/mss.0000000000002465] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE This study aimed to verify the effect of 6 months of periodized resistance training (RT) with and without blood flow restriction (BFR) in patients with stage 2 chronic kidney disease (CKD) on glomerular filtration rate (GFR), uremic parameters, cytokines, and klotho-fibroblast growth factor 23 (FGF23) axis. METHODS A total of 105 subjects were randomized in three groups of 35 each: control (CTL), RT, and RT + BFR. A first visit was required for an anamnesis to evaluate the number of medications and anthropometric measurements (body weight, height, and body mass index). Muscle strength (one-repetition maximum) was assessed. Venous blood samples were collected at baseline and after 6 months of training in all patients for the analysis of markers of renal function and integrity, as well as for the determination of the inflammatory profile. Statistical significances were adopted with P < 0.05. RESULTS Both training therapies attenuated the decline of GFR (P < 0.05). The majority of CTL patients declined to stage 3 CKD (88.5%), whereas fewer incidents were noted with RT (25.7%) and RT + BFR (17.1%). Improved uremic parameters as well as inflammation (IL-6, IL-10, IL-15, IL-17a, IL-18, and TNF-α) and klotho-FGF23 axis in RT and RT + BFR (P < 0.05) were observed. Monocyte chemoattractant protein 1 was not changed (P > 0.05) but presented a large effect size (Cohen's d), demonstrating a propensity for improvement. CONCLUSION Six months of periodized RT with and without BFR in patients with stage 2 CKD attenuated the progression of the disease by maintaining GFR, improving uremic parameters, cytokine profile regulation, and klotho-FGF23 axis.
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Affiliation(s)
- Hugo Luca Corrêa
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
| | | | - Lysleine Alves Deus
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
| | - Michel Kendy Souza
- Department of Nephrology, Federal University of São Paulo, São Paulo, BRAZIL
| | - Anderson Sola Haro
- Department of Nephrology, Federal University of São Paulo, São Paulo, BRAZIL
| | - Fernando Costa
- Department of Nephrology, Federal University of São Paulo, São Paulo, BRAZIL
| | - Victor Lopes Silva
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
| | | | - Milton Rocha Moraes
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
| | - Herbert Gustavo Simões
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
| | | | - Jonato Prestes
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
| | - Thiago Santos Rosa
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, BRAZIL
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11
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Harhay MN, Rao MK, Woodside KJ, Johansen KL, Lentine KL, Tullius SG, Parsons RF, Alhamad T, Berger J, Cheng XS, Lappin J, Lynch R, Parajuli S, Tan JC, Segev DL, Kaplan B, Kobashigawa J, Dadhania DM, McAdams-DeMarco MA. An overview of frailty in kidney transplantation: measurement, management and future considerations. Nephrol Dial Transplant 2020; 35:1099-1112. [PMID: 32191296 DOI: 10.1093/ndt/gfaa016] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
The construct of frailty was first developed in gerontology to help identify older adults with increased vulnerability when confronted with a health stressor. This article is a review of studies in which frailty has been applied to pre- and post-kidney transplantation (KT) populations. Although KT is the optimal treatment for end-stage kidney disease (ESKD), KT candidates often must overcome numerous health challenges associated with ESKD before receiving KT. After KT, the impacts of surgery and immunosuppression represent additional health stressors that disproportionately impact individuals with frailty. Frailty metrics could improve the ability to identify KT candidates and recipients at risk for adverse health outcomes and those who could potentially benefit from interventions to improve their frail status. The Physical Frailty Phenotype (PFP) is the most commonly used frailty metric in ESKD research, and KT recipients who are frail at KT (~20% of recipients) are twice as likely to die as nonfrail recipients. In addition to the PFP, many other metrics are currently used to assess pre- and post-KT vulnerability in research and clinical practice, underscoring the need for a disease-specific frailty metric that can be used to monitor KT candidates and recipients. Although frailty is an independent risk factor for post-transplant adverse outcomes, it is not factored into the current transplant program risk-adjustment equations. Future studies are needed to explore pre- and post-KT interventions to improve or prevent frailty.
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Affiliation(s)
- Meera N Harhay
- Department of Medicine, Division of Nephrology, Drexel University College of Medicine, Philadelphia, PA, USA.,Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.,Tower Health Transplant Institute, Tower Health System, West Reading, PA, USA
| | - Maya K Rao
- Division of Nephrology, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | | | | | - Krista L Lentine
- Center for Abdominal Transplantation, St Louis University School of Medicine, St Louis, MO, USA
| | - Stefan G Tullius
- Department of Surgery, Division of Transplant Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ronald F Parsons
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Tarek Alhamad
- Division of Nephrology, Washington University School of Medicine, St Louis, MO, USA
| | - Joseph Berger
- Department of Internal Medicine, Division of Nephrology, UT Southwestern Medical Center, Dallas, TX, USA
| | - XingXing S Cheng
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Raymond Lynch
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Sandesh Parajuli
- Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jane C Tan
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bruce Kaplan
- Vice President System Office, Baylor Scott and White Health, Temple, TX, USA
| | - Jon Kobashigawa
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Darshana M Dadhania
- Department of Transplantation Medicine, New York Presbyterian Hospital - Weill Cornell Medical Center, New York, NY, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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12
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Clarkson MJ, Bennett PN, Warmington SA. Intradialytic exercise with blood flow restriction is more effective than conventional exercise in improving walking endurance in hemodialysis patients: comments on a randomized control trial. Clin Rehabil 2020; 34:1409-1411. [PMID: 32722941 DOI: 10.1177/0269215520945660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Matthew J Clarkson
- Institute of Physical Activity and Nutrition, School of exercise and nutrition sciences, Deakin University, Geelong, Victoria, Australia
| | - Paul N Bennett
- Medical & Clinical Affairs, Satellite Healthcare, San Jose, CA, USA.,Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Stuart A Warmington
- Institute of Physical Activity and Nutrition, School of exercise and nutrition sciences, Deakin University, Geelong, Victoria, Australia
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13
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Clarkson MJ, May AK, Warmington SA. Is there rationale for the cuff pressures prescribed for blood flow restriction exercise? A systematic review. Scand J Med Sci Sports 2020; 30:1318-1336. [PMID: 32279391 DOI: 10.1111/sms.13676] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/12/2020] [Accepted: 03/27/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Blood flow restriction exercise has increasingly broad applications among healthy and clinical populations. Ensuring the technique is applied in a safe, controlled, and beneficial way for target populations is essential. Individualized cuff pressures are a favored method for achieving this. However, there remains marked inconsistency in how individualized cuff pressures are applied. OBJECTIVES To quantify the cuff pressures used in the broader blood flow restriction exercise literature, and determine whether there is clear justification for the choice of pressure prescribed. METHODS Studies were included in this review from database searches if they employed an experimental design using original data, involved either acute or chronic exercise using blood flow restriction, and they assessed limb or arterial occlusion pressure to determine an individualized cuff pressure. Methodologies of the studies were evaluated using a bespoke quality assessment tool. RESULTS Fifty-one studies met the inclusion criteria. Individualized cuff pressures ranged from 30% to 100% arterial occlusion pressure. Only 7 out of 52 studies attempted to justify the individualized cuff pressure applied during exercise. The mean quality rating for all studies was 11.1 ± 1.2 out of 13. CONCLUSIONS The broader blood flow restriction exercise literature uses markedly heterogeneous prescription variables despite using individualized cuff pressures. This is problematic in the absence of any clear justification for the individualized cuff pressures selected. Systematically measuring and reporting all relevant acute responses and training adaptations to the full spectrum of BFR pressures alongside increased clarity around the methodology used during blood flow restriction exercise is paramount.
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Affiliation(s)
- Matthew J Clarkson
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Anthony K May
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Stuart A Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
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Functional strength exercise and blood-flow restriction protocols: a systematic review. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2020. [DOI: 10.18276/cej.2020.3-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Clarkson MJ, May AK, Warmington SA. Chronic Blood Flow Restriction Exercise Improves Objective Physical Function: A Systematic Review. Front Physiol 2019; 10:1058. [PMID: 31496953 PMCID: PMC6712096 DOI: 10.3389/fphys.2019.01058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/02/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Blood flow restriction or KAATSU exercise training is associated with greater muscle mass and strength increases than non-blood flow restriction equivalent exercise. Blood flow restriction exercise has been proposed as a possible alternative to more physically demanding exercise prescriptions (such as high-load/high-intensity resistance training) in a range of clinical and chronic disease populations. While the maintenance of muscle mass and size with reduced musculoskeletal tissue loading appeals in many of these physically impaired populations, there remains a disconnect between some of the desired clinical measures for chronic disease populations and those commonly measured in the literature examining blood flow restriction exercise. While strength does play a vital role in physical function, task-specific objective measures of physical function indicative of activities of daily living are often more clinically relevant and applicable for evaluating the success of medical and surgical interventions or monitoring age- and disease-related physical decline. Objective: To determine whether exercise interventions utilizing blood flow restriction are able to improve objective measures of physical function indicative of activities of daily living. Methods: A systematic search of Medline, Embase, CINAHL, SPORTDiscus, and Springer identified 13 randomized control trials utilizing an exercise intervention combined with blood flow restriction, while measuring at least one objective measure of physical function. Participants were ≥18 years of age. Systematic review of the literature and quality assessment of the included studies used the Cochrane Collaboration's tool for assessing risk bias. Results: Data from 13 studies with a total of 332 participants showed blood flow restriction exercise, regardless of modality, most notably increased performance on the 30 s sit-to-stand and timed up and go tests, and generally improved physical function on other tests including walking tests, variations of sit-to-stand tests, and balance, jumping, and stepping tests. Conclusions: From the evidence available, blood flow restriction exercise of multiple modalities improved objective measures of physical function indicative of activities of daily living.
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Affiliation(s)
- Matthew J Clarkson
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Anthony K May
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Stuart A Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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16
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Blood-Flow-Restriction Training: Validity of Pulse Oximetry to Assess Arterial Occlusion Pressure. Int J Sports Physiol Perform 2019; 14:1408-1414. [PMID: 30958065 DOI: 10.1123/ijspp.2019-0043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/22/2019] [Accepted: 03/24/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Setting the optimal cuff pressure is a crucial part of prescribing blood-flow-restriction training. It is currently recommended to use percentages of each individual's arterial occlusion pressure, which is most accurately determined by Doppler ultrasound (DU). However, the practicality of this gold-standard method in daily training routine is limited due to high costs. An alternative solution is pulse oximetry (PO). The main purpose of this study was to evaluate validity between PO and DU measurements and to investigate whether sex has a potential influence on these variables. METHODS A total of 94 subjects were enrolled in the study. Participants were positioned in a supine position, and a 12-cm-wide cuff was applied in a counterbalanced order at the most proximal portion of the right upper and lower limbs. The cuff pressure was successively increased until pulse was no longer detected by DU and PO. RESULTS There were no significant differences between the DU and PO methods when measuring arterial occlusion pressure at the upper limb (P = .308). However, both methods showed considerable disagreement for the lower limbs (P = .001), which was evident in both men (P = .028) and women (P = .008). No sex differences were detected. CONCLUSIONS PO is reasonably accurate to determine arterial occlusion pressure of the upper limbs. For lower limbs, PO does not seem to be a valid instrument when assessing the optimal cuff pressure for blood-flow-restriction interventions compared with DU.
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Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2019; 10:533. [PMID: 31156448 PMCID: PMC6530612 DOI: 10.3389/fphys.2019.00533] [Citation(s) in RCA: 287] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
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Affiliation(s)
- Stephen D. Patterson
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Luke Hughes
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jamie Burr
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada
| | - Brendan R. Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Cleiton Augusto Libardi
- MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gabriel Rodrigues Neto
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, Brazil
| | | | - Juan Martin-Hernandez
- I+HeALTH Research Group, Department of Health Sciences, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
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Isometric Resistance Training and Branched-Chain Amino Acids Supplementation Can Improve Dialysis Adequacy: A Clinical Trial. Nephrourol Mon 2019. [DOI: 10.5812/numonthly.91175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Conceição MS, Ugrinowitsch C. Exercise with blood flow restriction: an effective alternative for the non-pharmaceutical treatment for muscle wasting. J Cachexia Sarcopenia Muscle 2019; 10:257-262. [PMID: 30816026 PMCID: PMC6463473 DOI: 10.1002/jcsm.12397] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Significant muscle wasting is generally experienced by ill and bed rest patients and older people. Muscle wasting leads to significant decrements in muscle strength, cardiorespiratory, and functional capacity, which increase mortality rates. As a consequence, different interventions have been tested to minimize muscle wasting. In this regard, blood flow restriction (BFR) has been used as a novel therapeutic approach to mitigate the burden associated with muscle waste conditions. Evidence has shown that BFR per se can counteract muscle wasting during immobilization or bed rest. Moreover, BFR has also been applied while performing low intensity resistance and endurance exercises and produced increases in muscle strength and mass. Endurance training with BFR has also been proved to increase cardiorespiratory fitness. Thus, frail patients can benefit from exercising with BFR due to the lower cardiovascular and join stress compared with traditional high intensity exercises. Therefore, low intensity resistance and endurance training combined with BFR may be considered as a novel and attractive intervention to counteract muscle wasting and to decrease the burden associated with this condition.
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Affiliation(s)
- Miguel S Conceição
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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