Resistance Training with Vascular Occlusion in Inclusion Body Myositis

Gualano, Bruno; Neves, Manoel; Lima, Fernanda Rodrigues; Pinto, Ana Lúcia de Sá; Laurentino, Gilberto; Borges, Claudia; Baptista, Luciana de Pádua Silva; Artioli, Guilherme Giannini; Aoki, Marcelo Saldanha; Moriscot, Anselmo Sigari; Lancha, Antônio Herbert; Bonfá, Eloísa; Ugrinowitsch, Carlos

doi:10.1249/mss.0b013e3181b18fb8

Cited by 93 publications

(104 citation statements)

References 19 publications

(26 reference statements)

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“…We have found that after a 12-wk training program, an IBM patient's leg press one-repetition maximum, balance and mobility function, and thigh cross-sectional area increased 15.9%, 60%, and 4.7%, respectively. Health Survey Questionnaire subscales demonstrated improvements ranging from 18% to 600% and mRNA expression of mechanogrowth factor increased 3.97-fold, whereas that of atrogin-1 decreased 0.62-fold 4,5 . This video describes in details the protocol of a resistance training program with vascular occlusion for this population.…”

Section: Discussionmentioning

confidence: 98%

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

Gualano

Ugrinowitsch

Neves

et al. 2010

JoVE

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Inclusion body myositis (IBM) is a rare idiopathic inflammatory myopathy. It is known to produces remarkable muscle weakness and to greatly compromise function and quality of life. Moreover, clinical practice suggests that, unlike other inflammatory myopathies, the majority of IBM patients are not responsive to treatment with immunosuppressive or immunomodulatory drugs to counteract disease progression 1 . Additionally, conventional resistance training programs have been proven ineffective in restoring muscle function and muscle mass in these patients 2,3 . Nevertheless, we have recently observed that restricting muscle blood flow using tourniquet cuffs in association with moderate intensity resistance training in an IBM patient produced a significant gain in muscle mass and function, along with substantial benefits in quality of life 4 . Thus, a new non-pharmacological approach for IBM patients has been proposed. Herein, we describe the details of a proposed protocol for vascular occlusion associated with a resistance training program for this population. Protocol Determination of full vascular occlusion pressure Resistance training with vascular occlusion DiscussionWe presented a novel, and likely the first, non pharmacological therapeutic tool able to counteract the muscle atrophy and decline of strength that usually occurs in patients with IBM under conventional treatment. Resistance training with vascular occlusion is a relatively novel training method, but results are very encouraging. We have found that after a 12-wk training program, an IBM patient's leg press one-repetition maximum, balance and mobility function, and thigh cross-sectional area increased 15.9%, 60%, and 4.7%, respectively. Health Survey Questionnaire subscales demonstrated improvements ranging from 18% to 600% and mRNA expression of mechanogrowth factor increased 3.97-fold, whereas that of atrogin-1 decreased 0.62-fold 4,5 . This video describes in details the protocol of a resistance training program with vascular occlusion for this population. The appropriate determination of full vascular occlusion pressure is essential for the correct implementation of this training modality and it may be applied to any patient undergoing regular resistance exercise program. Equipments required consist of a vascular Doppler, two customized tourniquets cuffs with pressure manometers and a regular training facility. Moreover, we recommend that each training session is supervised by at least one physical trainer in order to ensure the safety and efficacy of the proposed method. 1. In order to determine the blood pressure of vascular occlusion, in mmHg, a vascular Doppler is used 2. The patient lies in a supine position while a customized blood pressure cuff (180mm length x 80mm width) is fixed on his thigh. 3. After detection of the tibial artery location, the Doppler's probe is then placed over the determined spot in the patient's leg. 4. A sound signal is generated by the Doppler machine as it captures the artery pulse. 5. The customized blood...

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Section: Discussionmentioning

confidence: 98%

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

Gualano

Ugrinowitsch

Neves

et al. 2010

JoVE

Self Cite

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“…In another context, in a case report about an individual with inclusion body myositis, our group recently demonstrated that lower limb RE (knee extension) with VO for 12 weeks induced an increase of 11.6% in one repetition maximum strength tests (1RM), of 60% in mobility and of 4.7% in thigh CSA. Importantly, no side effects were observed (47).…”

Section: Resistance Exercise With Vascular Occlusionmentioning

confidence: 91%

Functional and morphological effects of resistance exercise on disuse-induced skeletal muscle atrophy

Nicastro

Zanchi

Luz

et al. 2011

Braz J Med Biol Res

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“…Some studies have analysed the activity of mTOR [1, 2,12,13] or the expression of mRNA [47,48] for this specific protein and its targets downstream and upstream.…”

Section: Mtor Signalling Pathwaymentioning

confidence: 99%

Strength training with vascular occlusion: a review of possible adaptive mechanisms

Castro¹,

Aquino²,

Berti³

et al. 2018

Hum Mov.

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Strength training with blood flow restriction, or KAATSU training, has been shown to be as effective as conventional strength training to promote muscular strength and hypertrophy. Several mechanisms have been suggested as hypotheses to explain the adaptations arising from this training method. Among these is metabolic stress, which exerts important physiological effects and may influence the training adaptations in question. In addition, hypoxia produced by the technique may change the neural recruitment pattern. Growth hormone (GH) concentrations increase as a result of practicing this method, which can trigger an increase in plasmatic and, perhaps, muscular insulin-like growth factor-1 (IGF-1) concentrations. The increase in concentrations of these factors can play a leading role in responses to KAATSU training. Among the effects of the GH/IGF-1 axis in muscle cells is the increase in the signalling pathway activity of the mammalian target of rapamycin (mTOR), which has been associated with increased protein synthesis. On the other hand, the decrease in the activity of the myostatin pathway, which has an antagonistic effect to mTOR, has been demonstrated after training with occlusion. Other factors, such as increases in the expression of heat shock proteins, may play an important role in adaptations to exercise. Nitric oxide synthase could increase nitric oxide concentration, which in turn has an effect on satellite cells and blood flow. However, despite the results obtained, the transfer to other situations (e.g. speed sports) is not yet clear.

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Resistance Training with Vascular Occlusion in Inclusion Body Myositis

Abstract: We describe a novel, and likely the first, nonpharmacological therapeutic tool that might be able to counteract the muscle atrophy and the declining strength that usually occur in IBM.

Cited by 93 publications

References 19 publications

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

Functional and morphological effects of resistance exercise on disuse-induced skeletal muscle atrophy

Strength training with vascular occlusion: a review of possible adaptive mechanisms

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