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10-05-2019 | Rheumatology | News | Article

Low-load resistance training with blood flow restriction benefits women with RA

medwireNews: Supervised low-load resistance training combined with partial blood flow restriction (BFRT) is as effective as high‐load resistance training (HLRT) in improving muscle strength and function in women with rheumatoid arthritis (RA), study findings indicate.

The BFRT method also reduced pain and improved quality of life and is now “emerging as a viable therapeutic modality in RA management,” Hamilton Roschel (Universidade de São Paulo, Brazil) and colleagues remark.

Roschel and team found that the maximal dynamic strength, measured as one repetition maximum (1RM), increased by a significant 22.8% for leg press and 19.7% for knee extension among 16 women randomly assigned to receive 12 weeks of BFRT. The twice-weekly intervention involved performing four sets of 15 repetitions of each exercise at 30% 1RM with an air cuff placed at the inguinal fold to provide partial blood flow restriction.

For the 16 women assigned to HLRT (four sets of 10 repetitions at 70% 1RM), the improvements from baseline to week 12 were a significant 24.2% and 23.8% for leg press and knee extension, respectively.

By contrast, the 16 women assigned to the control group experienced a 1.1% reduction in 1RM for leg press, and a 0.4% improvement for knee extension.

Both intervention groups also experienced significant improvements in quadriceps cross-sectional area, at 9.5% and 10.8% for BFRT and HLRT, respectively, which the researchers say “is of important clinical relevance, as patients with RA have a marked loss of muscle mass, further compromising functionality.”

In addition, compared with baseline, timed-stands tests at 12 weeks improved by a significant 11.2% and 14.7% with BFRT and HLRT, respectively, while timed up-and-go tests improved by a corresponding 6.8% and 8.7%.

And the investigators report in Arthritis Care & Research that the improvements observed in both groups were all significantly greater than those seen in the control group.

Roschel and co-investigators also assessed the impact of the interventions on self-reported quality of life and found that scores for the role physical and bodily pain domains of the Short Form Health Survey (SF)-36 improved by a significant 45.7% and 22.5%, respectively, from baseline with BFRT, while Health Assessment Questionnaire scores improved by a significant 55.9%.

No such improvements were reported with HLRT but individuals in this group did experience a significant 14.0% improvement in physical function according to the SF-36.

One patient in the HLRT group withdrew from the study due to exercise-induced patellofemoral pain and an additional eight (50%) from the same group reported knee pain that required a reduction in the load or number of repetitions for up to two training sessions. By contrast, there were no adverse events related to joint pain in the BFRT.

Roschel and co-authors conclude that “future studies should address the effects of long-term BFRT on the symptoms and […] the natural disease’s course as well as its possible mechanisms of action, in contrast to conventional training programs.”

By Laura Cowen

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

Arthritis Care Res 2019; doi:10.1002/acr.23911

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