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Acute Muscular and Vascular Responses to a Single Session of Exercise With BFR in COPD (2BFREE_aigu)
Blood Flow Restriction (BFR): a Novel Approach to Potentiate the Effects of Rehabilitative Exercise Training in COPD? Study of Acute - Muscular, and Vascular - Responses to a Single Session of Exercise With BFR
Exercise training is a cornerstone of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). However, some patients derive limited benefits from conventional exercise programs. Previous studies suggest that the magnitude of exercise-induced muscle fatigue is associated with training effectiveness, with patients unable to develop significant muscle fatigue ("non-fatiguers") showing smaller improvements in functional capacity and quality of life.
Blood flow restriction (BFR) exercise consists in performing physical exercise while applying external pressure to the proximal part of the exercising limb, thereby reducing oxygen delivery to the muscles and limiting metabolite clearance. This approach has been shown to induce significant muscular adaptations despite the use of low exercise intensities. Because exercise intensity in COPD patients is often constrained by ventilatory limitations, BFR training may enhance muscle adaptations while reducing respiratory stress, potentially improving the effectiveness of PR.
The primary objective of this monocentric randomized crossover study is to compare lower-limb muscle fatigue induced by a single exercise session performed with BFR versus a standard exercise session in patients with COPD.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Mathieu Marillier, PhD
- Telefoonnummer: +33681552231
- E-mail: mmarillier@chu-grenoble.fr
Studie Contact Back-up
- Naam: Bruno Degano, MD, PhD
- Telefoonnummer: +33664810986
- E-mail: bdegano@chu-grenoble.fr
Studie Locaties
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Auvergne-Rhône-Alpes
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La Tronche, Auvergne-Rhône-Alpes, Frankrijk, 38700
- CReSI - Laboratoire HP2
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Contact:
- Mathieu Marillier, PhD
- Telefoonnummer: +33681552231
- E-mail: mmarillier@chu-grenoble.fr
-
Contact:
- Bruno Degano, MD, PhD
- Telefoonnummer: +33664810986
- E-mail: bdegano@chu-grenoble.fr
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Negative pregnancy test and use of an acceptable contraceptive method throughout the study duration for women of childbearing potential
- Established COPD defined as obstructive ventilatory defect (FEV1/FVC < 0.70 or below the 5th percentile)
- Resting lung hyperinflation defined as functional residual capacity > 2.5 z-scores according to the Global Lung Function Initiative (GLI)
- Clinical stability of COPD for at least 3 months, with no recent exacerbation requiring treatment modification
- Covered by a national health insurance system
- Able and willing to provide written informed consent
Non-inclusion Criteria:
- Presence of a medical device incompatible with magnetic stimulation
- Inability to perform an exercise test on a cycle ergometer
Any usual contraindication to exercise testing, including:
- Recent myocardial infarction (3-5 days)
- Unstable coronary insufficiency
- Severe stenotic valvular disease
- Uncontrolled arrhythmia with hemodynamic instability
- Recent unexplained syncope
- Uncontrolled heart failure
- Uncontrolled arterial hypertension (systolic blood pressure ≥200 mmHg and/or diastolic blood pressure ≥110 mmHg at rest)
- Acute thromboembolic disease and/or pulmonary edema
Conditions contraindicating the use of blood flow restriction (BFR), including:
- Coagulation disorder
- Peripheral neuropathy
- Uncontrolled hypertension (>160/100 mmHg)
- Peripheral arterial disease
- History of venous thrombosis
- Intensive care unit stay within the last 3 months
- Participation in another study during an exclusion period
- Inability to be contacted in case of emergency
- Individuals covered under Articles L1121-5 to L1121-8 of the French Public Health Code (protected populations, including pregnant or breastfeeding women, prisoners, minors, individuals under legal protection, psychiatric inpatients, etc.)
- Staff members with a hierarchical relationship with the principal investigator
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Crossover-opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Blood flow restricted exercise session
Sub-study 1: resistance exercise session with Blood Flow Restriction (RE-BFR); Sub-study 2: aerobic endurance exercise session with Blood Flow Restriction (END-BFR).
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Sub-study 1 (RE-BFR): Resistance training consisting of 1 × 30 repetitions followed by 3 × 15 repetitions at 30% 1-RM, performed with thigh BFR to 50-60% of arterial occlusion pressure (AOP). Sub-study 2 (END-BFR): Low-intensity cycling exercise (~30% peak aerobic power) performed with thigh BFR to 50-60% of AOP. |
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Actieve vergelijker: Standard exercise session
Sub-study 1: resistance exercise session (RE); Sub-study 2: aerobic endurance exercise session (END).
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Sub-study 1 (RE): Resistance exercise consisting of 4 × 10 repetitions at 60-70% 1-RM. Sub-study 2 (END): Conventional aerobic endurance cycling exercise performed at ~50% peak aerobic power. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Muscle fatigue
Tijdsspanne: Assessed 15-minutes before, and 3, 30, 60-minutes after exercise
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Muscle fatigue assessed by magnetic stimulation of the femoral nerve
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Assessed 15-minutes before, and 3, 30, 60-minutes after exercise
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Flow Mediated Dilation (FMD)
Tijdsspanne: 30-minutes pre-exercise, and 10 and 75-minutes post-exercise
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Brachial artery FMD assessed by ultrasound
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30-minutes pre-exercise, and 10 and 75-minutes post-exercise
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Symptoms of dyspnea
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Modified Borg scale: ranging from 0 (nothing at all) to 10 (maximal)
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Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Affective valence
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Feeling scale: ranging from -5 (very bad) to 5 (very good)
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Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Affective intensity
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Felt Arousal Scale: ranging from 1 (low activation state) to 6 (high activation state)
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Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
|
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Oxygen uptake
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
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Using metabolic chart, in L/min
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Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
|
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Carbon dioxide output
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
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Using metabolic chart, in L/min
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Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
|
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Minute ventilation
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
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Using metabolic chart, in L/min
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Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
|
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Breathing pattern
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
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Tidal volume (in L) and respiratory rate (in breaths per minute), using metabolic chart
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Assessed at the end of each exercise set/bout (sub-study 1) or continuously throughout exercise (sub-study 2).
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Heart rate
Tijdsspanne: Continuous monitoring throughout the exercise session.
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Using electrocardiogram, in beats/min
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Continuous monitoring throughout the exercise session.
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Blood pressure
Tijdsspanne: Continuous monitoring throughout the exercise session.
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Using digital cuff system, in mmHg
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Continuous monitoring throughout the exercise session.
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Cardiac output
Tijdsspanne: Continuous monitoring throughout the exercise session.
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Using impedance cardiography, in L/min
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Continuous monitoring throughout the exercise session.
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Leg discomfort
Tijdsspanne: Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Modified Borg scale: ranging from 0 (nothing at all) to 10 (maximal)
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Assessed at the end of each exercise set/bout (sub-study 1) or every 2 minutes throughout exercise (sub-study 2)
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Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Algemene publicaties
- Kilgas MA, Yoon T, McDaniel J, Phillips KC, Elmer SJ. Physiological Responses to Acute Cycling With Blood Flow Restriction. Front Physiol. 2022 Mar 11;13:800155. doi: 10.3389/fphys.2022.800155. eCollection 2022.
- Burtin C, Saey D, Saglam M, Langer D, Gosselink R, Janssens W, Decramer M, Maltais F, Troosters T. Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J. 2012 Aug;40(2):338-44. doi: 10.1183/09031936.00111811. Epub 2011 Dec 1.
- Spruit MA, Augustin IM, Vanfleteren LE, Janssen DJ, Gaffron S, Pennings HJ, Smeenk F, Pieters W, van den Bergh JJ, Michels AJ, Groenen MT, Rutten EP, Wouters EF, Franssen FM; CIRO+ Rehabilitation Network. Differential response to pulmonary rehabilitation in COPD: multidimensional profiling. Eur Respir J. 2015 Dec;46(6):1625-35. doi: 10.1183/13993003.00350-2015. Epub 2015 Oct 9.
- Mador MJ, Mogri M, Patel A. Contractile fatigue of the quadriceps muscle predicts improvement in exercise performance after pulmonary rehabilitation. J Cardiopulm Rehabil Prev. 2014 Jan-Feb;34(1):54-61. doi: 10.1097/HCR.0000000000000023.
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Studieregistratiedata
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Chronische ziekte
- Ziekte attributen
- Ziekten van de luchtwegen
- Longziekten, obstructief
- Pathologische aandoeningen, tekenen en symptomen
- Longziekten
- Longziekte, chronisch obstructief
- Therapeutica
- Modaliteiten fysiotherapie
- Patiëntenzorg
- Transporttherapie
- Revalidatie
- Nazorg
- Continuïteit van patiëntenzorg
- Bloedstroombeperkingstherapie
Andere studie-ID-nummers
- EssaiClinique_2BFREEaigu
- 2026-A00501-50 (Register-ID: CPP Sud-Méditerranée I)
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