PMID- 38129116
OWN - NLM
STAT- MEDLINE
DCOM- 20240318
LR  - 20240324
IS  - 1468-3296 (Electronic)
IS  - 0040-6376 (Print)
IS  - 0040-6376 (Linking)
VI  - 79
IP  - 4
DP  - 2024 Mar 15
TI  - Low-load blood flow restriction strength training in patients with COPD: a 
      randomised single-blind pilot study.
PG  - 340-348
LID - 10.1136/thorax-2023-220546 [doi]
AB  - OBJECTIVE: The objective of this study is to compare the effectiveness of lower 
      limb low-load blood flow restriction training (LL-BFRT) with high-load strength 
      training (HL-ST) as part of an outpatient pulmonary rehabilitation programme on 
      leg strength in patients with chronic obstructive pulmonary disease (COPD). 
      METHODS: Participants were randomised to LL-BFRT or HL-ST (24 sessions). LL-BFRT 
      was done at 30% 1-repetition maximum (1-RM) with 70% arterial occlusion pressure. 
      HL-ST was done at 70% 1-RM. Primary outcome was isometric strength of knee 
      extensors and flexors. Secondary outcomes were 1-RM, functional exercise 
      capacity, physical activity, symptom burden and health-related quality of life. 
      Perceptions of dyspnoea and leg fatigue were recorded after every exercise. We 
      compared groups with t-tests. RESULTS: We included 30 participants (13 women, 17 
      men, 64 (9) years, forced expiratory volume in 1 s 47 (18)% pred.), 24 completed 
      the study. Isometric knee extensor strength improved to a clinically relevant 
      degree in both legs in both groups (LL-BFRT: right leg 9 (20) Nm, left leg 10 
      (18) Nm; HL-ST: right leg 15 (26) Nm, left leg 16 (30) Nm, data are mean (SD)), 
      without statistically significant or clinically relevant between-group 
      differences (right leg mean difference= -6.4, 95% CI= -13.20 to 25.92 Nm, left 
      leg mean difference= -5.6, 95% CI= -15.44 to 26.55 Nm). 1 min sit-to-stand test 
      performance improved to a clinically relevant degree only in the LL-BFRT group (4 
      (4) vs 1 (5) repetitions). Interestingly, physical activity improved to a 
      clinically relevant degree only in the LL-BFRT group (1506 (2441) vs -182 (1971) 
      steps/day). LL-BFRT lowered perceived in-exercise dyspnoea and increased leg 
      fatigue compared with HL-ST in the initial 12 trainings. CONCLUSION: In patients 
      with stable COPD undergoing outpatient pulmonary rehabilitation, LL-BFRT was not 
      superior to HL-ST in improving leg strength. LL-BFRT led to similar strength 
      gains as HL-ST while reducing perceptions of dyspnoea in the initial training 
      phase. TRIAL REGISTRATION NUMBER: NCT04151771.
CI  - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Kohlbrenner, Dario
AU  - Kohlbrenner D
AUID- ORCID: 0000-0001-6674-5193
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland 
      dario.kohlbrenner@usz.ch.
AD  - Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
FAU - Kuhn, Manuel
AU  - Kuhn M
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
AD  - Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
FAU - Manettas, Anastasios
AU  - Manettas A
AD  - Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, 
      Switzerland.
AD  - Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical 
      Education and Sport Science, University of Thessaly, Trikala, Greece.
FAU - Aregger, Celine
AU  - Aregger C
AD  - Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Peterer, Matthias
AU  - Peterer M
AD  - Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Greco, Nicola
AU  - Greco N
AD  - Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Sievi, Noriane A
AU  - Sievi NA
AUID- ORCID: 0000-0003-1758-4586
AD  - Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
FAU - Clarenbach, Christian
AU  - Clarenbach C
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
AD  - Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
LA  - eng
SI  - ClinicalTrials.gov/NCT04151771
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20240315
PL  - England
TA  - Thorax
JT  - Thorax
JID - 0417353
SB  - IM
CIN - doi: 10.1136/thorax-2023-221218
MH  - Male
MH  - Humans
MH  - Female
MH  - *Resistance Training
MH  - Pilot Projects
MH  - Quality of Life
MH  - Blood Flow Restriction Therapy
MH  - Single-Blind Method
MH  - *Pulmonary Disease, Chronic Obstructive/rehabilitation
MH  - Dyspnea/etiology
MH  - Fatigue
MH  - Muscle Strength
PMC - PMC10958309
OTO - NOTNLM
OT  - exercise
OT  - pulmonary rehabilitation
COIS- Competing interests: DK, MK, AM, CA, MP, NG and NAS have nothing to disclose. CC 
      reports personal fees from Roche, personal fees from Novartis, personal fees from 
      Boehringer, personal fees from GSK, personal fees from Astra Zeneca, personal 
      fees from Sanofi, personal fees from Vifor, personal fees from Mundipharma, 
      personal fees from Daiichi Synkyo, personal fees from CSL Behring, all outside 
      the submitted work.
EDAT- 2023/12/22 00:42
MHDA- 2024/03/18 06:44
PMCR- 2024/03/22
CRDT- 2023/12/21 21:22
PHST- 2023/06/01 00:00 [received]
PHST- 2023/11/18 00:00 [accepted]
PHST- 2024/03/18 06:44 [medline]
PHST- 2023/12/22 00:42 [pubmed]
PHST- 2023/12/21 21:22 [entrez]
PHST- 2024/03/22 00:00 [pmc-release]
AID - thorax-2023-220546 [pii]
AID - 10.1136/thorax-2023-220546 [doi]
PST - epublish
SO  - Thorax. 2024 Mar 15;79(4):340-348. doi: 10.1136/thorax-2023-220546.