Low‐Load Resistance Training With Blood‐Flow Restriction in Relation to Muscle Function, Mass, and Functionality in Women With Rheumatoid Arthritis

Abstract

Objective. To evaluate the effects of a low-load resistance training program associated with partial blood-flow restriction in patients with rheumatoid arthritis (RA).Methods. Forty-eight women with RA were randomized into 1 of 3 groups: high-load resistance training (HL-RT; 70% 1 repetition maximum [1RM]), low-load resistance training (30% 1RM) with partial blood-flow restriction training (BFRT), and a control group. Patients completed a 12-week supervised training program and were assessed for lower-extremity 1RM, quadriceps cross-sectional area (CSA), physical function (timed-stands test [TST], timedup-and-go test [TUG], and Health Assessment Questionnaire [HAQ]), and quality of life (Short Form 36 health survey ) at baseline and after the intervention.Results. BFRT and HL-RT were similarly effective in increasing maximum dynamic strength in both leg press (22.8% and 24.2%, respectively; P < 0.0001 for all) and knee extension (19.7% and 23.8%, respectively; P < 0.0001 for all). Quadriceps CSA was also significantly increased in both BFRT and HL-RT (9.5% and 10.8%, respectively; P < 0.0001 for all). Comparable improvements in TST (11.2% and 14.7%; P < 0.0001 for all) and TUG (-6.8% [P < 0.0053] and -8.7% [P < 0.0001]) were also observed in BFRT and HL-RT, respectively. Improvements in both groups were significantly greater than those of the control group (P < 0.05 for all). SF-36 role physical and bodily pain and HAQ scores were improved only in BFRT (45.7%,22.5%, and -55.9%, respectively; P < 0.05 for all). HL-RT resulted in 1 case of withdrawal and several cases of exercise-induced pain, which did not occur in BFRT.Conclusion. BFRT was effective in improving muscle strength, mass, function, and health-related quality of life in patients with RA, emerging as a viable therapeutic modality in RA management.Clinicaltrials.gov identifier: NCT01483157.

Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis

“…To date, blood flow restriction training has been largely applied in healthy populations [233], but it is an attractive intervention for OA, as it has the potential to accelerate muscle hypertrophy and strength gains while also notably reducing the mechanical load placed on the affected joint(s) during training—thus potentially minimizing exercise-induced flares in joint pain. Preliminary evidence in populations that are relevant to OA suggests that blood flow restriction training is associated with less pain during exercise [234,235,236] and may produce similar [234,235,236,237] or greater [238] gains in muscle strength than resistance training performed without blood flow restriction.…”

Low intensity blood flow restriction exercise: Rationale for a hypoalgesia effect

“…For load compromised and rehabilitating populations with chronic pain that cannot withstand high intensity exercise or low intensity exercise to failure, BFR exercise would therefore have a dual effect for pain and other adaptations. For example, BFR exercise has recently been shown to improve pain reduction and physical function to a greater extent than heavy load resistance training in individuals with rheumatoid arthritis [45] and following surgery for ligament repair [46].…”

Sarcopenia in rheumatoid arthritis: Is it a common manifestation?

“…3,5 Rheumatoid arthritis (RA) is a chronic inflammatory arthritis with articular and extra-articular manifestations and the disease may lead to joint destruction, disability, loss of joint function, and decrease quality of life. 6 Proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1 play a key role in the pathogenesis of RA. 7 An imbalance in skeletal muscle remodeling and muscle damage cycle, which is related to increased levels of proinflammatory cytokines may lead to the development of sarcopenia.…”