Blood flow restricted resistance training in older adults at risk of mobility limitations

Exp Gerontol. 2017 Dec 1:99:138-145. doi: 10.1016/j.exger.2017.10.004. Epub 2017 Oct 5.

Abstract

High-load resistance training (HL) may be contraindicated in older adults due to pre-existing health conditions (e.g. osteoarthritis). Low-load blood flow restricted (BFR) resistance training offers an alternative to HL with potentially similar strength improvement.

Purpose: To compare muscle strength, cross-sectional area (CSA), physical function, and quality of life (QOL) following 12-weeks of HL or BFR training in older adults at risk of mobility limitations.

Methods: Thirty-six males and females (mean: 75.6years 95% confidence interval: [73.4-78.5], 1.67m [1.64-1.70], 74.3kg [69.8-78.8]) were randomly assigned to HL (70% of one repetition maximum [1-RM]) or low-load BFR (30% 1-RM coupled with a vascular restriction) exercise for the knee extensors and flexors twice per week for 12weeks. A control (CON) group performed light upper body resistance and flexibility training. Muscle strength, CSA of the quadriceps, 400-m walking speed, Short Physical Performance Battery (SPPB), and QOL were assessed before, midway and after training.

Results: Within 6-weeks of HL training, increases in all strength measures and CSA were evident and the gains were significantly greater than the CON group (P<0.05). The BFR group had strength increases in leg extension and leg press 1-RM tests, but were significantly lower in leg extension isometric maximum voluntary contraction (MVC) and leg extension 1-RM than the HL group (P<0.01). At 12-weeks HL and BFR training did not differ in MVC (P=0.14). Walking speed increased 4% among all training groups (P<0.01) and no changes were observed for overall SPPB score and QOL (P>0.05).

Conclusion: Both training programs resulted in muscle CSA improvements and HL training had more pronounced strength gains than BFR training after 6-weeks and were more similar to BFR after 12-weeks of training. These changes in both groups did not transfer to improvements in QOL, SPPB, and walking speed. Since both programs result in strength and CSA gains, albeit at different rates, future research should consider using a combination of HL and BFR training in older adults with profound muscle weakness and mobility limitations.

Keywords: Blood flow restriction; Elderly; Physical function; Resistance training; Strength.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging
  • Exercise Test
  • Exercise Tolerance
  • Female
  • Geriatric Assessment
  • Humans
  • Ischemia*
  • Isometric Contraction*
  • Magnetic Resonance Imaging
  • Male
  • Mobility Limitation*
  • Muscle Strength*
  • Quadriceps Muscle / blood supply*
  • Quadriceps Muscle / diagnostic imaging
  • Quality of Life
  • Recovery of Function
  • Regional Blood Flow
  • Resistance Training / adverse effects
  • Resistance Training / methods*
  • Time Factors
  • Treatment Outcome
  • Walking Speed