Browsing by Subject "Blood flow restriction"

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Application of sport science-based prehabilitation in abdominal cancer patients undergoing surgery
(2020-08-11) Wooten, Savannah Victoria; Tanaka, Hirofumi, Ph. D.; Wolf, James; Fleming, Richard Y; Lalande, Sophie; Bartholomew, John B
Implementation of prehabilitation programs has been difficult and somewhat controversial in abdominal cancer patients due to complexities in organizing and executing supervised exercise and nutrition protocols as well as to the desire to not create delays in treatment. The overall objective of this dissertation is to investigate the use of a 4-week blood flow restriction (BFR) exercise training and sports nutrition prehabilitation intervention in abdominal cancer patients undergoing surgery. The central hypothesis is that the proposed innovative prehabilitation program will reduce surgical complications, length of hospital stay, and mortality at 90 days post-surgery, in patients with abdominal cancer. The rationale for this project is that BFR training and sport nutrition supplements have the potential to increase overall functional capacity in a short period of time while simultaneously alleviating the frail state of our patients. The central hypothesis will be tested by pursing two specific study aims: (1) to assess the feasibility and effectiveness of the use of blood flow restriction training and sports nutrition as a 4-week pre-surgical intervention to augment functional capacity, increase strength, and quality of life in abdominal cancer patients. (2) to evaluate the effect of sport science-based prehabilitation on improving surgical recovery; including decreased length of hospital stay, incidence of perioperative complications, and reduce mortality using a time effective a multidisciplinary, sport-science based, prehabilitation program. In the first study, we collected a series of measurements before and after a 4-week, home-based, blood flow restriction exercise training and sport nutrition intervention, as well as 30 days post-surgery. The measurements quantified maintenance and increases of physical function, body composition, and quality of life. The primary findings of the study one revealed significant improvements in appendicular muscle mass, physical function, and quality of life. This finding not only provides physiological insight into the effectiveness and feasibility of a sport science-based multimodal prehabilitation program in an older abdominal cancer patient population but also provided promise to improve post-surgical recovery. In the second study, after implementation of the 4-week home-based prehabilitation program, abdominal cancer patients were monitored for 90 days postoperatively. The primary findings from the second study revealed that prehabilitation was associated with a shorter length of hospital stay and fewer post-surgical complications. Taken together, the overall findings from this dissertation study provide tremendous support for the use of prehabilitation in older abdominal cancer patients to improve physical capacity and postoperative recovery. Future randomized controlled clinical trials are warranted to determine longitudinal impact in a larger sample size.
Walking with leg blood flow restriction : wide-rigid cuffs vs. narrow-elastic bands
(2019-05-13) Stray-Gundersen, Sten Oliver; Tanaka, Hirofumi, Ph. D.
Blood flow restriction (BFR) training is becoming a popular form of exercise. The concept is that light-load exercise performed with BFR elicits similar adaptations achieved with traditional heavy-load exercise. Walking exercise in combination with pressurized wide-rigid (WR) cuffs elicits higher cardiac workload and a vascular dysfunction due presumably to reperfusion injury to the endothelium. In contrast, narrow-elastic (NE) BFR bands may elicit different hemodynamic effects, as the limb is able to increase in diameter with increased blood flow accompanying exercise. Purpose: To compare the acute cardiovascular responses to two distinct forms of BFR training during light-intensity exercise. Methods: 15 young healthy participants (M=9, F=6) performed 5 bouts of 2-minute walking intervals at 0.9 m/s with a 1-minute rest and deflation period between bouts with either WR, NE, or no bands placed on both upper thighs. Cuff pressure was inflated to 160 mmHg in WR cuffs and 300 mmHg in NE bands while no cuffs were used for the control. Beat-by-beat blood pressure and heart rate were measured continuously using finger plethysmography. Blood lactate concentration, rating of perceived exertion (RPE), flow-mediated dilation (index of endothelium-dependent vasodilation), and cardio-ankle vascular index (measure of arterial stiffness) were assessed before and after the walking exercise. Results: At baseline, no significant differences existed in any of the variables between the three conditions. Increases in heart rate were greater (p<0.05) in the WR than the NE and control conditions. Increases in systolic and diastolic blood pressure were greater (p<0.05) in the WR than the NE and control conditions, and increases in systolic blood pressure were greater (p<0.05) in the control than the NE condition (150±16 / 85±15 mmHg vs. 127±10 / 66±12 mmHg vs. 130±15 / 66±13 mmHg, respectively). Double product, an index of myocardial oxygen demand, increased to a greater extent in the WR than in the NE and control conditions, and to a greater extent in the control than the NE condition. Increases in perceived exertion and blood lactate concentration were greater (p<0.05) in the WR compared with the NE and control conditions (p<0.05), while no differences were seen between the NE and control conditions. There were no changes (p>0.05) in arterial stiffness or endothelial function in all three trials. Conclusion: Use of wide-rigid BFR cuffs result in a marked increase in blood pressure and myocardial oxygen demand compared with narrow-elastic BFR bands, suggesting that narrow-elastic bands present a safer alternative for at-risk populations to perform BFR exercise.