The effects of resistance training with blood flow restriction on muscle strength, muscle hypertrophy and functionality in patients with osteoarthritis and rheumatoid arthritis: A systematic review with meta-analysis.
Study Goal
The researchers aimed to determine the effects of low-intensity resistance training combined with blood flow restriction (LIRTBFR) on muscle strength, muscle mass, and functionality in rheumatoid arthritis (RA) and osteoarthritis (OA) patients.
Results Summary
The study found no significant differences in muscle strength or functionality between LIRTBFR, moderate-intensity resistance training (MIRT), and high-intensity resistance training (HIRT). However, LIRTBFR showed similar muscle mass gains compared to HIRT and greater muscle strength improvements compared to low-intensity resistance training without blood flow restriction (LIRT).
Population
Predominantly women with rheumatoid arthritis (RA) and osteoarthritis (OA).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
moderate intensity resistance training | increase | muscle strength and muscle mass | RA and OA | - | are able to improve | #1 |
high intensity resistance training | increase | muscle strength and muscle mass | RA and OA | - | are able to improve | #2 |
low intensity resistance training combined with blood flow restriction | no change | muscle strength | - | SMD = -0.01[-0.57, 0.54], P = 0.96; I² = 58% | no significant differences in the effects | #3 |
low intensity resistance training combined with blood flow restriction | no change | functionality measured by tests with patterns similar to walking | - | SMD = -0.04[-0.39, 0.31], P = 0.82; I² = 0% | no significant differences in the effects | #4 |
low intensity resistance training combined with blood flow restriction | no change | muscle mass gain | - | - | was reported to be similar | #5 |
low intensity resistance training combined with blood flow restriction | increase | muscle strength | - | - | was reported to be higher | #6 |
low intensity resistance training combined with blood flow restriction | increase | muscle strength, muscle mass and functionality | a predominant sample of RA and OA women | - | appears to be a promising strategy for gains | #7 |
INTRODUCTION: Rheumatoid arthritis(RA) and osteoarthritis(OA) patients showed systemic manifestations that may lead to a reduction in muscle strength, muscle mass and, consequently, to a reduction in functionality. On the other hand, moderate intensity resistance training(MIRT) and high intensity resistance training(HIRT) are able to improve muscle strength and muscle mass in RA and OA without affecting the disease course. However, due to the articular manifestations caused by these diseases, these patients may present intolerance to MIRT or HIRT. Thus, the low intensity resistance training combined with blood flow restriction(LIRTBFR) may be a new training strategy for these populations. OBJECTIVE: To perform a systematic review with meta-analysis to verify the effects of LIRTBFR on muscle strength, muscle mass and functionality in RA and OA patients. MATERIALS AND METHODS: A systematic review with meta-analysis of randomized clinical trials(RCTs), published in English, between 1957-2021, was conducted using MEDLINE(PubMed), Embase and Cochrane Library. The methodological quality was assessed using Physiotherapy Evidence Database scale. The risk of bias was assessed using RoB2.0. Mean difference(MD) or standardized mean difference(SMD) and 95% confidence intervals(CI) were pooled using a random-effects model. A P<0.05 was considered statistically significant. RESULTS: Five RCTs were included. We found no significant differences in the effects between LIRTBFR, MIRT and HIRT on muscle strength, which was assessed by tests of quadriceps strength(SMD = -0.01[-0.57, 0.54], P = 0.96; I² = 58%) and functionality measured by tests with patterns similar to walking(SMD = -0.04[-0.39, 0.31], P = 0.82; I² = 0%). Compared to HIRT, muscle mass gain after LIRTBFR was reported to be similar. When comparing LIRTBFR with low intensity resistance training without blood flow restriction(LIRT), the effect LIRTBFR was reported to be higher on muscle strength, which was evaluated by the knee extension test. CONCLUSION: LIRTBFR appears to be a promising strategy for gains in muscle strength, muscle mass and functionality in a predominant sample of RA and OA women.