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- Ensaio Clínico NCT07668921
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.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Mathieu Marillier, PhD
- Número de telefone: +33681552231
- E-mail: mmarillier@chu-grenoble.fr
Estude backup de contato
- Nome: Bruno Degano, MD, PhD
- Número de telefone: +33664810986
- E-mail: bdegano@chu-grenoble.fr
Locais de estudo
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Auvergne-Rhône-Alpes
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La Tronche, Auvergne-Rhône-Alpes, França, 38700
- CReSI - Laboratoire HP2
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Contato:
- Mathieu Marillier, PhD
- Número de telefone: +33681552231
- E-mail: mmarillier@chu-grenoble.fr
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Contato:
- Bruno Degano, MD, PhD
- Número de telefone: +33664810986
- E-mail: bdegano@chu-grenoble.fr
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição cruzada
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: 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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Comparador Ativo: 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. |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Muscle fatigue
Prazo: 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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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Flow Mediated Dilation (FMD)
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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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Colaboradores e Investigadores
Patrocinador
Publicações e links úteis
Publicações Gerais
- 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.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Processos Patológicos
- Doença crônica
- Atributos da doença
- Doenças Respiratórias
- Doenças Pulmonares Obstrutivas
- Condições Patológicas, Sinais e Sintomas
- Doenças pulmonares
- Doença Pulmonar Obstrutiva Crônica
- Terapêutica
- Modalidades de fisioterapia
- Atendimento ao paciente
- Terapia de exercícios
- Reabilitação
- Cuidados posteriores
- Continuidade do atendimento ao paciente
- Terapia de restrição de fluxo sanguíneo
Outros números de identificação do estudo
- EssaiClinique_2BFREEaigu
- 2026-A00501-50 (Identificador de registro: CPP Sud-Méditerranée I)
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