Blood flow restriction training for people with chronic obstructive pulmonary disease or heart failure; A scoping review

Abstract: Background: Blood flow restriction training (BFRT) is an effective way of training that enables training with low external load while receiving similar effects to high load training. The lack of knowledge of BFRT for people with chronic obstructive pulmonary disease (COPD) or heart failure (HF) led to the making of this scoping review.  Objective: This scoping review aims to map the existing knowledge, effects, safety, and feasibility of BFRT for people with COPD or heart failure HF. Method: The review followed PRISMAs structure for scoping review. Selection involved title and abstract screening, followed by full text analysis and peer-review by both authors.  Results: A wide variety of study designs was included in this scoping review. Of 11 included studies all were original intervention studies-, whereof 8/11 studies were focused on HF. A large majority of participants were male. Training methods used in intervention studies varied from exercises like leg extensions, leg press and cycling, all while using vascular blood flow restriction. All studies followed different training protocols. The reported outcomes indicated promising improvements like increased functional exercise capacity, muscle strength, reduced symptom burden, and several positive physiological changes for both people with COPD and HF. Some concerns remain regarding the safety of BFRT, but no serious adverse events were reported directly linked to BFRT.  Conclusion: With many reported improvements, BFRT could be a safe and feasible alternative rehabilitation method for people with COPD or HF. Furthermore, with minimal reported adverse events, the method appears safe for both groups. Despite this, the included studies all had small sample sizes, so more high-quality studies with larger sample sizes are needed to give a better understanding on BFRTs effects on both short- and long term. Better studies including females are also needed.