Strength training with blood flow restriction – a novel therapeutic approach for older adults with sarcopenia? A case report

Abstract

Karynne Grutter Lopes,1,2 Daniel Alexandre Bottino,1,2 Paulo Farinatti,3–5 Maria das Graças Coelho de Souza,1,2 Priscila Alves Maranhão,2 Clara Maria Soares de Araujo,2 Eliete Bouskela,1,2 Roberto Alves Lourenço,6 Ricardo Brandão de Oliveira1,5,71Graduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil; 2Laboratory for Clinical and Experimental Research on Vascular Biology, Department of Physiological Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil; 3Graduate Program in Physical Activity Sciences, Department of Physical Education, Salgado de Oliveira University, Niteroi, Brazil; 4Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil; 5Graduate Program in Exercise and Sport Sciences, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil; 6Research Laboratory on Human Aging, Internal Medicine Department, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil; 7Laboratory of Active Living, Rio de Janeiro State University, Institute of Physical Education and Sports, Rio de Janeiro, BrazilIntroduction: A 91-year-old sedentary man presenting exhaustion, lower-limb weakness, hypertension, and history of multiple falls was diagnosed with sarcopenia – appendicular skeletal muscle mass index (ASM) of 7.10 kg/m2.Purpose: To investigate the effects of strength training performed with low intensity in isolation (LI) or with blood flow restriction (LI-BFR) on strength, muscle mass, IGF-1, endothelial function, microcirculation, inflammatory biomarkers, and oxidative stress.Methods: In the first 3 months, LI was performed with intensity corresponding to 30% of 1 repetition maximum, followed by 1 month of inactivity, and another 3 months of LI-BFR (similar load than LI concomitant to BFR equivalent to 50% of resting systolic blood pressure).Results: LI-BFR, but not LI improved muscle mass, ASM, 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 LI and LI-BFR. Endothelin-1 and oxidative stress increased after LI-BFR, and lowered after LI.Conclusion: LI-BFR, but not LI improved strength, muscle mass, IGF-1, endothelial function, and selected inflammatory markers in a nonagenarian sarcopenic patient. These results are promising and suggest that LI-BFR should be considered as an alternative to prevent muscle loss and improve functional fitness in frail older populations.Keywords: aging, muscle mass, resistance exercise, vascular occlusion, endothelial function, microcirculation

Keywords

• aging
• muscle mass
• resistance exercise
• vascular occlusion
• endothelial function
• microcirculation.