A Useful Blood Flow Restriction Training Risk Stratification for Exercise and Rehabilitation.

Autor:	Nascimento DDC; Department of Physical Education, Catholic University of Brasília (UCB), Brasília, Brazil.; Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil., Rolnick N; The Human Performance Mechanic, Lehman College, New York, NY, United States., Neto IVS; Laboratory of Molecular Analysis, Graduate Program of Sciences and Technology of Health, University of Brasília, Brasília, Brazil., Severin R; Department of Physical Therapy, College of Applied Health Sciences, The University of Illinois at Chicago, Chicago, IL, United States.; Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States., Beal FLR; Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil.; Department of Nutrition, Health and Medicine School, Catholic University of Brasília (UCB), Brasília, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in physiology [Front Physiol] 2022 Mar 11; Vol. 13, pp. 808622. Date of Electronic Publication: 2022 Mar 11 (Print Publication: 2022).
DOI:	10.3389/fphys.2022.808622
Abstrakt:	Blood flow restriction training (BFRT) is a modality with growing interest in the last decade and has been recognized as a critical tool in rehabilitation medicine, athletic and clinical populations. Besides its potential for positive benefits, BFRT has the capability to induce adverse responses. BFRT may evoke increased blood pressure, abnormal cardiovascular responses and impact vascular health. Furthermore, some important concerns with the use of BFRT exists for individuals with established cardiovascular disease (e.g., hypertension, diabetes mellitus, and chronic kidney disease patients). In addition, considering the potential risks of thrombosis promoted by BFRT in medically compromised populations, BFRT use warrants caution for patients that already display impaired blood coagulability, loss of antithrombotic mechanisms in the vessel wall, and stasis caused by immobility (e.g., COVID-19 patients, diabetes mellitus, hypertension, chronic kidney disease, cardiovascular disease, orthopedic post-surgery, anabolic steroid and ergogenic substance users, rheumatoid arthritis, and pregnant/postpartum women). To avoid untoward outcomes and ensure that BFRT is properly used, efficacy endpoints such as a questionnaire for risk stratification involving a review of the patient's medical history, signs, and symptoms indicative of underlying pathology is strongly advised. Here we present a model for BFRT pre-participation screening to theoretically reduce risk by excluding people with comorbidities or medically complex histories that could unnecessarily heighten intra- and/or post-exercise occurrence of adverse events. We propose this risk stratification tool as a framework to allow clinicians to use their knowledge, skills and expertise to assess and manage any risks related to the delivery of an appropriate BFRT exercise program. The questionnaires for risk stratification are adapted to guide clinicians for the referral, assessment, and suggestion of other modalities/approaches if/when necessary. Finally, the risk stratification might serve as a guideline for clinical protocols and future randomized controlled trial studies. Competing Interests: NR is the founder of THE BFR PROS, a BFR education company that provides BFR training workshops to fitness and rehabilitation professionals across the world using a variety of BFR devices. NR has no financial relationships with any cuff manufacturers/distributors. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Nascimento, Rolnick, Neto, Severin and Beal.)
Databáze:	MEDLINE
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