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This case study included a 91 year-old frail inactive male diagnosed with sarcopenia in 2014 with complaints of excessive exhaustion, decreased lean mass, weakness, HTN, and a history of falls. Sarcopenia is a decline in skeletal muscle mass and muscle strength, related to aging and is highly predictive of adverse events, such as falls, hospitalization, morbidity, and mortality. Strength training is one way to mitigate the effects of sarcopenia, but heavy loading in clinical settings is not always feasible, particularly in the case of frail older patients.
Blood flow restriction training was implemented throughout the treatment plan. In the first 3 months, low intensity training was performed using 30% of 1 repetition maximum, followed by 1 month of inactivity, and another 3 months of low load BFR training using 50% limb occlusion pressure (LOP).
The results showed low intensity BFR training, but not low intensity free flow training, improved muscle mass, appendicular skeletal muscle mass index, handgrip strength, isokinetic peak torque, IL-6, and IGF-1. Endothelial function, red blood cell velocity, and concentrations of C-reactive protein, and soluble intercellular adhesion molecules-1 improved after both low intensity free flow training and low intensity BFR training. Endothelin-1 and oxidative stress increased after low intensity BFR training and lowered after low intensity free flow training.
The authors concluded that, “These results are promising and suggest that [low intensity BFR training] should be considered as an alternative clinical intervention to prevent muscle loss and improve functional fitness in very old sarcopenic populations, which are often refractory to [high intensity] exercise routines. Additional research is needed to ratify the present findings and to elucidate the mechanisms underlying the potential effects of BFR training upon muscle function and vascular health of frail elderly.”
What do you think? Should BFR training be included in the treatment of sarcopenia or is more research needed at this time?
Lopes, K. G., Bottino, D. A., Farinatti, P., de Souza, M., Maranhão, P. A., de Araujo, C., Bouskela, E., Lourenço, R. A., & de Oliveira, R. B. (2019). Strength training with blood flow restriction – a novel therapeutic approach for older adults with sarcopenia? A case report. Clinical interventions in aging, 14, 1461–1469. https://doi.org/10.2147/CIA.S206522
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****Remember, the use of BFR training should not be based solely on a success story. The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.