Autoimmune Diseases Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
PLoS One. 2021 Nov 10;16(11):e0259574. doi: 10.1371/journal.pone.0259574. eCollection 2021.
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.
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.
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.
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.
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.
类风湿关节炎（RA）和骨关节炎（OA）患者表现出全身性表现，可能导致肌肉力量下降、肌肉质量下降，进而导致功能下降。另一方面，中等强度抗阻训练（MIRT）和高强度抗阻训练（HIRT）能够在不影响疾病进程的情况下提高 RA 和 OA 患者的肌肉力量和肌肉质量。然而，由于这些疾病引起的关节表现，这些患者可能对 MIRT 或 HIRT 不耐受。因此，低强度抗阻训练结合血流限制（LIRTBFR）可能是这些人群的一种新的训练策略。
进行系统评价和荟萃分析，以验证 LIRTBFR 对 RA 和 OA 患者肌肉力量、肌肉质量和功能的影响。
对 1957 年至 2021 年期间发表的英文随机临床试验（RCT）进行系统评价和荟萃分析，检索 MEDLINE（PubMed）、Embase 和 Cochrane 图书馆。使用物理治疗证据数据库量表评估方法学质量。使用 RoB2.0 评估偏倚风险。使用随机效应模型汇总均数差（MD）或标准化均数差（SMD）和 95%置信区间（CI）。P<0.05 被认为具有统计学意义。
纳入了 5 项 RCT。我们发现，LIRTBFR、MIRT 和 HIRT 对肌肉力量的影响没有显著差异，肌肉力量通过股四头肌力量测试（SMD=-0.01[-0.57, 0.54]，P=0.96；I²=58%）和类似于行走的模式的功能测试（SMD=-0.04[-0.39, 0.31]，P=0.82；I²=0%）来评估。与 HIRT 相比，报告 LIRTBFR 后肌肉质量增加相似。与低强度无血流限制抗阻训练（LIRT）相比，LIRTBFR 对肌肉力量的影响更高，这是通过膝关节伸展测试来评估的。
LIRTBFR 似乎是 RA 和 OA 女性获得肌肉力量、肌肉质量和功能的有前途的策略。
