HomeBFR-COPD
Research type
Research Study
Full title
Home-based body weight-exercise with blood flow restriction (BFR): feasibility of a novel rehabilitation intervention in COPD patients.
IRAS ID
312789
Contact name
Richard Ferguson
Contact email
Sponsor organisation
Research & Innovation office
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 5 months, 31 days
Research summary
Research Summary
Exercise training, as part of pulmonary rehabilitation (PR) programme, is an important component of the treatment of chronic obstructive pulmonary disease (COPD), as it demonstrates clinically important improvements in exercise capacity, muscle structure and function and health related quality of life. However, despite the clear benefits of PR, there are significant issues with access, uptake, and completion; only patients with significant dyspnoea (MRC 3 or above) are referred for PR, and of those assessed, physical, psychological, or financial factors pose barriers to uptake and adherence to PR.
Additionally, the COVID-19 pandemic has had a significant impact upon the provision of PR. In response, services have developed a range of different delivery models to support individuals with COPD.
Low-intensity exercise with BFR has been shown in healthy individuals to yield positive adaptive responses within the skeletal muscle (including muscle strength and endurance) despite a greatly reduced exercise load. This research will investigate the feasibility and acceptability of a 6-week home-based exercise intervention of body weight exercise with blood flow restriction in patients with COPD. The research will also investigate the effect of the 6-week home-based body weight exercise with BFR intervention on measures of physical function and health related quality of life in 20 COPD patients and compare this group with 20 patients who receive the same exercise protocol but without blood flow restriction. Whilst we do not propose BFR exercise as a replacement for traditional PR, it has the potential to provide an alternative treatment option delivered in a home setting and could be used to target those not able or willing to attend traditional PR programmes.Lay summary of study results
This study tested whether it is feasible, acceptable, and safe for people with chronic obstructive pulmonary disease (COPD) to take part in a new type of exercise program at home. COPD is a long-term lung condition that makes breathing difficult. Alongside breathlessness, reduced heart function, muscle weakness, and fatigue often make it even harder for people with COPD to stay active.
Exercise is a key part of pulmonary rehabilitation (PR) and has been shown to be highly effective for people with COPD. However, traditional PR often faces challenges with access, uptake, and long-term adherence. As a result, there is growing interest in low-intensity exercise programs that can be done at home, which may help more people stay active in a way that is practical.
The exercise in this study combined simple body weight movements, like repeatedly sitting down and standing up from a chair, with a technique called blood flow restriction (BFR). BFR uses a special device to gently reduce blood flow to the muscles for short periods during exercise. This makes the muscles work harder, even during low-intensity exercise, which may help improve strength and fitness in individuals who cannot tolerate high-intensity workouts.
We invited 164 people with COPD, identified through a COPD clinic or pulmonary rehabilitation waiting list, to take part in a 6-week home-based programme with remote support. Of these, 71 agreed to learn more, and 27 provided full consent to participate, resulting in an enrollment rate of 24% among the eligible patients.
20 participants completed the program, which is 80% of those who started.
People completed 85% (as per protocol analysis) of the recommended exercise sessions on average, demonstrating good adherence.
Mild adverse events (such as mild/moderate aches or exacerbation) were reported by 46% in the BFR group and 54% in the control group (same exercise, no BFR), but only one serious health event occurred in the control group, and it was not linked to the study intervention.
Most participants in both groups reported being satisfied with the program, according to a post-intervention survey.
Among those who chose not to participate initially, common reasons included a lack of interest, logistical barriers (such as travel or scheduling difficulties), pre-existing health concerns, feeling already satisfied with their current care, or having responsibilities as a caregiver that limited their availability.
Additionally, among those who started but later withdrew from the study, reasons included lack of motivation (reported in both groups), intolerance to BFR in the intervention group, an unexplained withdrawal, and an acute exacerbation in the control group.
In summary:
This feasibility study suggests that home-based, low-intensity exercise with blood flow restriction is a practical and safe option for people with COPD. However, a larger trial is needed to confirm its effectiveness and determine whether it leads to long-term health improvements.REC name
East of England - Cambridge East Research Ethics Committee
REC reference
23/EE/0069
Date of REC Opinion
21 Jun 2023
REC opinion
Further Information Favourable Opinion