Blood flow restricted exercise in people with PAD.
Research type
Research Study
Full title
Effect of low-intensity lower-body resistance exercise with blood flow restriction on functional performance in people with peripheral arterial disease: A feasibility study
IRAS ID
260419
Contact name
Thomas Parkington
Contact email
Sponsor organisation
Sheffield Hallam University
Duration of Study in the UK
0 years, 7 months, 30 days
Research summary
A consequence of peripheral arterial disease (PAD) is reduced functional performance due to a myopathy in the lower extremities. Low-intensity resistance exercise with blood flow restriction (BFR) is now popular in clinical practice for musculoskeletal rehabilitation as substantial research suggests it can induce muscle hypertrophy, increase muscle strength, improve muscular endurance and improve arterial function in young and older adults. It is plausible following an intervention of low-intensity resistance exercise with BFR that improved muscle function will transfer to increased functional performance in people with PAD. However, the research team is concerned there may be a perception that the intervention may be harmful or exacerbate PAD symptoms which could potentially make participant recruitment and retention challenging. Therefore, before undertaking a large scale and adequately powered randomised controlled trial to assess the effect of low-intensity lower-body resistance exercise with BFR on functional performance in people with PAD, the proposed study will assess feasibility outcomes and tolerability of exercise from a 12-week intervention.\n\nThe study will adopt a randomised control trial research design; forty-five volunteers with PAD will be randomly allocated into either resistance exercise with BFR group, resistance exercise without BFR group or a non-exercising control group. The outcomes of feasibility are rates of screening, eligibility, recruitment, retention, attendance and adverse events. The outcomes of tolerability of exercise are perceptual responses of exertion, discomfort and muscle soreness. The secondary aim of the study is to explore the effects and trends of the intervention on functional performance in people with PAD. Functional performance outcomes are maximal isometric concentric knee extensor strength, 6-minute walk test distance, short physical performance battery (SPPB) score and walking impairment questionnaire score.\n
Thirty people with claudication took part in the study. Participants were randomly allocated to either a blood flow restriction exercise group or a comparison group performing the same exercises without blood flow restriction. Both groups attended supervised exercise sessions twice a week for eight weeks.
The results showed that the programme was safe and well tolerated. Most participants attended the majority of exercise sessions and completed the study. No serious adverse events related to the exercise programme occurred.
Participants who completed blood flow restriction exercise showed encouraging improvements in walking ability and reported better health-related quality of life. Many participants were able to walk for longer before the onset of leg pain, and several measures of daily wellbeing improved. Participants also reported that the exercise programme was acceptable and manageable.
As this was a small feasibility study, it was not designed to definitively determine whether blood flow restriction exercise is better than existing treatments. However, the findings suggest that this approach is safe and practical and may help improve outcomes for people with claudication.
The results support the need for a larger study to confirm the benefits of blood flow restriction exercise and establish whether it should be considered as a treatment option within NHS services.
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
20/YH/0039
Date of REC Opinion
18 Mar 2020
REC opinion
Further Information Favourable Opinion