024 Resistance exercises with blood flow restriction in patients with sporadic inclusion body myositis

Abstract

IntroductionSporadic inclusion body myositis (sIBM) is the most common muscle disease affecting older adults with no disease-modifying treatment. Resistance exercises increase muscle hypertrophy, but weakness prevents exercising with higher resistance. In healthy subjects, augmentation of light-load training with blood flow restriction improved muscle strength1; and similar exercises were safe in the elderly.2 We therefore investigate whether resistance exercises with blood flow restriction is safe and helpful in sIBM patients. We explored methods for exercising weak leg muscles, and options for better outcome measures.MethodsA matched-control pilot study, with 12-week treatment and 4-week follow-up periods, where participants concentrated on lower limbs resistance exercises with 50% blood flow restriction 3 times/week, at 20%-30% of their repetition maximum. Patients are reviewed 4-weekly for muscle strength, blood biomarkers, 2-minute walk test (2MWT), timed up-and-go (TUG) test, minimal chair height standing ability test (MCHSAT), thigh girths, and quality of life scales.Results4 patients with varying abilities were on the exercise arm, and 3 acted as controls. Muscle groups with MRC score ≥2 were able to be exercised. We found strength testing by hand-held dynamometer was unreliable, whereas the 2MWT, TUG test and MCHSAT showed less variability. All patients could perform their exercises at significantly increased repetitions or weights by week 4, without concerning adverse events, with trend towards continued improvement over the 4-month period.ConclusionResistance exercises with blood flow restriction appear safe, and may be helpful in sIBM patients, even in weakened muscles, enabling improvement in muscle strength and endurance.ReferencesHughes L, Paton B, Rosenblatt B, Gissane C, Patterson SD. Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. Br J Sports 2017.Vechin FC, Libardi CA, Conceicao MS, et al. Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly. J Strength Cond Res 2015.

Blood Flow Restriction Enhances Rehabilitation and Return to Sport: The Paradox of Proximal Performance

“…Both groups examined similar variables in their patientsdquality of life, strength, self-reported function, and endurance. Liang et al 103 found favorable results for the BFR group in all variables. Jørgensen et al 104 did not note significant differences in selfreported or objective outcomes, but they did find that the BFR group did not encounter diminished strength versus the controls.…”

“…Some notable studies have already set the groundwork for the use of BFR in patient populations outside of the orthopedic and sports realms. Liang et al 103 and Jørgensen et al 104 have performed similar randomized control trials in patient populations with sporadic inclusion-body myositis. Both groups examined similar variables in their patientsdquality of life, strength, self-reported function, and endurance.…”