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

Figures & data

Figure 1 Experimental design.

Abbreviations: LI, low intensity; BFR, blood flow restriction.

Table 1 Body composition, handgrip, and isokinetic strength before and after strength training performed without (LI) and with blood flow restriction (LI-BFR) in a 91-year-old sarcopenic patient

Variable	LI			LI-BFR
	Before	After	∆ %	Before	After	∆ %
Total composition
Height (cm)	165.5	165.5	0.0	165.0	165.0	0.0
Body mass (kg)	59.1	55.8	−5.6	56.8	55.3	−2.7
Body mass index (kg/m^2)	21.6	20.4	−5.6	20.9	20.3	−2.7
Fat mass (kg)	13.0	10.8	−16.9	11.0	11.1	1.3
Fat free mass (kg)	46.1	45.0	−2.4	45.8	44.2	−3.6
Bone mineral density (kg)	2.61	2.59	−0.7	2.58	2.60	0.9
ASM (kg)	19.4	18.9	−2.7	18.5	18.9	2.3
SMM (kg)	21.8	21.2	−2.7	22.4	22.9	2.1
Sarcopenia cut points
ASM index (kg/m^2)	7.1	6.9	−2.7	6.8	6.9	2.4
SMM index (kg/m^2)	7.9	7.7	−2.8	8.2	8.4	2.1
Handgrip strength (kgf)	29.0	28.0	−3.4	28.0	33.0	17.9
Isokinetic strength
Peak torque ext (nm)	78.7	65.4	−16.9	78.8	82.4	4.6
Total work ext (I)	651.1	593.8	−8.8	657.9	668.0	1.5
Work fatigue ext (%)	32.3	25.7	−20.4	28.0	35.7	27.5

Abbreviations: LI, low intensity; BFR, blood flow restriction; ASM, appendicular skeletal muscle mass; SMM, total skeletal muscle mass; Ext, extension; Δ%, percent variation from baseline.

Table 2 Hemodynamic outcomes, vasoreactivity, microvascular function, and blood biomarkers before and after strength training performed without (LI) and with blood flow restriction (LI-BFR) in a 91-year-old sarcopenic patient

Variable	LI			LI-BFR
	Before	After	∆ %	Before	After	∆ %
Hemodynamic parameters
HR (bpm)	69	57	−17.39	83	78	−6.02
SBP (mmHg)	149	141	−5.37	130	130	0
DBP (mmHg)	77	65	−15.58	68	75	10.29
MBP (mmHg)	101	90	−10.89	88	93	5.68
Vasoreactivity
FBF bas 1 (mL/min/100 mL)	0.56	0.78	39.29	1.63	1.95	19.63
FBF hyper (ml/min/100 mL)	5.23	10.72	104.97	8.26	10.80	30.75
FBF bas 2 (mL/min/100 mL)	0.42	0.93	121.43	1.12	1.27	13.39
FBF nitro (mL/min/100 mL)	1.44	1.48	2.78	2.75	2.78	1.09
Microvascular function
RBCVmax/RBCVbas (mm/s)	1.27	1.40	10.24	1.40	1.75	25.27
Blood biomarkers
hs-CRP (mg/di)	0.12	0.02	−83.33	0.13	0.06	−53.85
TNF-a (pg/mL)	1.36	1.37	0.56	1.21	1.44	19.30
IL-6 (pg/mL)	2.73	2.76	0.88	6.75	3.20	−52.55
sVCAM-1 (ng/mL)	1272.33	1337.76	5.14	1134.40	1123.98	−0.92
sICAM-1 (ng/mL)	243.20	223.72	−8.01	264.86	222.39	−16.03
ET-1 (pg/m1)	2.16	1.80	−16.87	2.00	2.22	10.91
oxLDL (μ/L)	30.46	26.60	−12.86	37.25	40.21	7.96
IGF-1 (na/m1)	24.00	18.66	−22.25	10.68	12.66	18.54

Abbreviations: LI, low intensity; BFR, blood flow restriction; HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; MBP, mean blood pressure; FBF, forearm blood flow; Bas, baseline; Hyper, hyperemia; Nitro, nitroglycerin; RBCVmax/RBCVbas, increment RBCVmax of baseline; hs-CRP, high sensitivity c-reactive protein; TNF-α, tumor necrosis factor-alpha; IL-6, interleukin-6; sVCAM-1, soluble vascular cell adhesion molecule-1; sICAM-1, soluble intercellular adhesion molecule-1; ET-1, endothelin-1; oxLDL, oxidized low density lipoprotein; IGF-1, insulin-like growth factor-1; Δ%, percent variation from baseline.