Acute and chronic cardiometabolic responses induced by resistance training with blood flow restriction in HIV patients

Thiago Cândido Alves, Pedro Pugliesi Abdalla, Lucimere Bohn, Leonardo Santos Lopes Da Silva, André Pereira Dos Santos, Márcio Fernando Tasinafo Júnior, Ana Cláudia Rossini Venturini, Jorge Mota, Dalmo Roberto Lopes Machado, Thiago Cândido Alves, Pedro Pugliesi Abdalla, Lucimere Bohn, Leonardo Santos Lopes Da Silva, André Pereira Dos Santos, Márcio Fernando Tasinafo Júnior, Ana Cláudia Rossini Venturini, Jorge Mota, Dalmo Roberto Lopes Machado

Abstract

Resistance training with blood flow restriction (RTBFR) allows physically impaired people living with HIV (PWH) to exercise at lower intensities than traditional resistance training (TRT). But the acute and chronic cardiac and metabolic responses of PWH following an RTBFR protocol are unknown. The objective was to compare the safety of acute and chronic effects on hemodynamic and lipid profiles between TRT or RTBFR in PWH. In this randomized control trial, 14 PWH were allocated in RTBFR (GRTBFR; n = 7) or TRT (GTRT; n = 7). Both resistance training protocols had 36 sessions (12 weeks, three times per week). Protocol intensity was 30% (GRTBFR) and 80% (GTRT). Hemodynamic (heart rate, blood pressure) and lipid profile were acutely (rest and post exercise 7th, 22nd, and 35th sessions) and chronically (pre and post-program) recorded. General linear models were applied to determine group * time interaction. In the comparisons between groups, the resistance training program showed acute adaptations: hemodynamic responses were not different (p > 0.05), regardless of the assessment session; and chronicles: changes in lipidic profile favors GRTBFR, which significantly lower level of total cholesterol (p = 0.024), triglycerides (p = 0.002) and LDL (p = 0.030) compared to GTRT. RTBFR and TRT induced a similar hemodynamic adaptation in PWH, with no significant risks of increased cardiovascular stress. Additionally, RTBFR promoted better chronic adequacy of lipid profile than TRT. Therefore, RTBFR presents a safe resistance training alternative for PWH.Trial registration: ClinicalTrials.gov ID: NCT02783417; Date of registration: 26/05/2016.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Figure 1
Figure 1
Mechanisms responsible for the efficiency of the RTBFR. H: hydrogen; O2: oxygen; GH: growth hormone; IGF-1: insulin-like growth factor I; mTOR: mammalian target of rapamycin; MAPK: mitogen-activated protein-kinase; S6K1: mitogen-stimulated protein kinase p70 ribosomal protein S6 kinase 1.
Figure 2
Figure 2
Training protocol and assessments during the intervention period. CON = concentric; ECC = eccentric; 1RM = one repetition maximum; BP = blood pressure; HR = heart rate; DP = double product; * = for each exercise and muscle grouping (upper or lower); A 3-min rest occurred in the transition between upper to lower limbs exercises.
Figure 3
Figure 3
Study flowchart.
Figure 4
Figure 4
Within and between-group comparison for acute hemodynamic responses (rest versus post-exercise sessions) controlled for antihypertensive treatment. #p < 0.05: Statistically significant difference between rest and immediately post-exercise (within groups comparisons; paired t-test or Wilcoxon test). *p < 0.05: Statistically significant difference between groups (general linear models-GLM with SIDAK post hoc test adjusted for antihypertensive treatment). †p < 0.05: Statistically significant group-by-time interactions. (a) Blood pressure; (b) heart rate; (c): double product. RTBFR: resistance training with blood flow restriction; TRT: traditional resistance training; ES: effect size; SBP: systolic blood pressure; DBP: diastolic blood pressure; MBP: mean blood pressure; HR: heart rate; DP: double product. Obs: acute intra-exercise hemodynamic responses in the middle of the session (intermediate) were not displayed for figure resolution purposes. These values were displayed in Table S1.
Figure 5
Figure 5
Chronic effects between and within groups (pre vs post-training) for lipids (a), blood pressure (b), heart rate (c), and double product (d). *p < 0.05: Statistically significant difference between groups (general linear models-GLM with SIDAK post hoc test) cardiovascular variables at rest. RTBFR: resistance training with blood flow restriction; TRT: traditional resistance training; SBP: systolic blood pressure; DBP: diastolic blood pressure; MBP: mean blood pressure; HR: heart rate; DP: double product; TC: total cholesterol; HDL: high-density lipoprotein cholesterol; LDL: low-density lipoprotein cholesterol; TG: triglycerides.

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