Title: Blood flow restricted exercise training: Perspectives of people with chronic obstructive pulmonary disease and health professionals

Abstract

Objective This descriptive qualitative study explored perspectives of people with chronic obstructive pulmonary disease (COPD) and health professionals concerning blood flow restricted exercise (BFRE) training. Methods People living with COPD and health professionals (exercise physiologists, physiotherapists, and hospital-based respiratory nurses and doctors) participated in interviews or focus groups, which included information about BFRE training and a facilitated discussion of positive aspects, barriers and concerns about BFRE training as a possible exercise-based intervention. Sessions were audio-recorded, and transcript data analysed using inductive content analysis. Results Thirty-one people participated (people with COPD n = 6; health professionals n = 25). All participant groups expressed positive perceptions of BFRE as a potential alternative low-intensity exercise mode where health benefits might be achieved. Areas of overlap in perceived barriers and concerns included the need to address the risk of potential adverse events, suitability of training sites and identifying processes to appropriately screen potential candidates. Discussion While potential benefits were identified, concerns about determining who is safe and suitable to participate, delivery processes, health professional training and effects on a variety of health-related outcomes need to be addressed before implementation of BFRE training for people with COPD.

Current Implementation and Barriers to Using Blood Flow Restriction Training: Insights From a Survey of Allied Health Practitioners

“…There is a growing body of literature to support the utility of BFR exercise for specific patients, including those with multiple sclerosis (13), rheumatoid arthritis (25), sporadic inclusion body myositis (11), chronic kidney disease (26), and following anterior cruciate ligament surgery (30), along with promising case reports for patients with Parkinson's disease (7) and sarcopenia (17). Interview and focus group data indicate that patients with chronic obstructive pulmonary disease and their health care professionals have positive perceptions of using BFR exercise for health benefits; however, further evidence of the suitability and appropriate prescription of BFR for specific conditions is still required (23).…”

CRD Editor’s corner archive: October-December

“…Modified exercise training techniquesgetting the patient's view November 25th, 2021 The pulmonary rehabilitation literature is littered with studies investigating novel training methodologies aimed at enhancing efficacy and/or comfort for people undertaking rehabilitation. In many cases the focus of such investigations is the clinical outcome of the intervention but in the journal this month, Pereira-Neto et al 5 provide a welcome insight into the patient and therapist perspective of one such methodology, blood flow restricted exercise. They highlight potential concerns about safety, supervision and location of treatment among patients with chronic respiratory disease.…”

Effect on muscle strength after blood flow restriction resistance exercise in early in-patient rehabilitation of post-chronic obstructive pulmonary disease acute exacerbation, a single blinded, randomized controlled study

“…16 A recent descriptive qualitative study showed that patients with COPD and health professionals recognized BFR-RE with low load as an alternative exercise method with potential health benefits since the adherence of training might be compromised by the traditional high load and showed concerns on the adverse events during BFR-RE. 17 A review demonstrated the sideeffects were minimal and the cardiovascular complications were not elevated by BFR with appropriate application by trained practitioners after careful case selection and contraindication screening. 18 The effect of BFR-RE on muscle strength in hospitalized patient with post-COPDAE, which has not been studied, was the primary outcome of this study.…”