Wedig Isaac J, Durocher John J, McDaniel John, Elmer Steven J
Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States.
Health Research Institute, Michigan Technological University, Houghton, MI, United States.
Front Physiol. 2023 Jul 21;14:1235172. doi: 10.3389/fphys.2023.1235172. eCollection 2023.
Accumulating evidence indicates that some COVID-19 survivors display reduced muscle mass, muscle strength, and aerobic capacity, which contribute to impairments in physical function that can persist for months after the acute phase of illness. Accordingly, strategies to restore muscle mass, muscle strength, and aerobic capacity following infection are critical to mitigate the long-term consequences of COVID-19. Blood flow restriction (BFR), which involves the application of mechanical compression to the limbs, presents a promising therapy that could be utilized throughout different phases of COVID-19 illness. Specifically, we hypothesize that: 1) use of passive BFR modalities can mitigate losses of muscle mass and muscle strength that occur during acute infection and 2) exercise with BFR can serve as an effective alternative to high-intensity exercise without BFR for regaining muscle mass, muscle strength, and aerobic capacity during convalescence. The various applications of BFR may also serve as a targeted therapy to address the underlying pathophysiology of COVID-19 and provide benefits to the musculoskeletal system as well as other organ systems affected by the disease. Consequently, we present a theoretical framework with which BFR could be implemented throughout the progression from acute illness to outpatient rehabilitation with the goal of improving short- and long-term outcomes in COVID-19 survivors. We envision that this paper will encourage discussion and consideration among researchers and clinicians of the potential therapeutic benefits of BFR to treat not only COVID-19 but similar pathologies and cases of acute critical illness.
越来越多的证据表明，一些新冠病毒疾病幸存者的肌肉质量、肌肉力量和有氧能力有所下降，这导致身体功能受损，且在疾病急性期过后可能持续数月。因此，感染后恢复肌肉质量、肌肉力量和有氧能力的策略对于减轻新冠病毒疾病的长期后果至关重要。血流限制（BFR），即对肢体施加机械压迫，是一种很有前景的治疗方法，可在新冠病毒疾病的不同阶段使用。具体而言，我们假设：1）使用被动血流限制方式可减轻急性感染期间出现的肌肉质量和肌肉力量损失；2）血流限制下的运动可作为无血流限制的高强度运动的有效替代方法，用于在康复期恢复肌肉质量、肌肉力量和有氧能力。血流限制的各种应用还可作为一种靶向治疗方法，以解决新冠病毒疾病的潜在病理生理学问题，并为受该疾病影响的肌肉骨骼系统以及其他器官系统带来益处。因此，我们提出一个理论框架，通过该框架可在从急性疾病到门诊康复的整个过程中实施血流限制，目标是改善新冠病毒疾病幸存者的短期和长期预后。我们设想，本文将鼓励研究人员和临床医生讨论和考虑血流限制在治疗新冠病毒疾病以及类似病理情况和急性危重病病例方面的潜在治疗益处。
