Safety, feasibility, and neuromuscular activity of acutelow-load resistance exercise with or without blood flowrestriction in patients with severe hemophilia

Joaquin Calatayud, Daniel C Ogrezeanu, Juan J Carrasco*, Eduardo Martinez Valdes, Sofia Perez-Alenda, Carlos Cruz-Montecinos, Lars L Andersen, Per Aagaard, Luis Suso-Marti, Jose Casana

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objective
To compare the safety, feasibility, and neuromuscular activity of acute low-load resistance exercise with/without blood flow restriction (BFR) in people with severe hemophilia (PwH).

Methods
Eight PwH under prophylaxis (5 with resistance training experience) performed 6 randomly ordered conditions of 3 intensity-matched knee extensions: no external load and no BFR, no external load and light BFR (20% of arterial occlusion pressure [AOP]), no external load and moderate BFR (40% AOP), external low load and no BFR, external low load with light BFR, and external low load with moderate BFR. Rated perceived exertion, pain, exercise tolerability, and adverse effects were assessed. Normalized root-mean-square (nRMS), nRMS spatial distribution, and muscle fiber-conduction velocity (MFCV) were determined using high-density surface electromyography for the vastus medialis and lateralis.

Results
Exercises were tolerated, without pain increases or adverse events. Externally resisted conditions with/without BFR provided greater nRMS than nonexternally resisted conditions (p 
Conclusions
In these patients, knee extensions with low external resistance and BFR at 20% or 40% AOP appear safe, feasible and do not cause acute/delayed pain. However, BFR during three consecutive repetitions does not increase nRMS nor changes nRMS spatial distribution or MFCV.
Original languageEnglish
Pages (from-to)47-56
Number of pages10
JournalEuropean journal of haematology
Volume111
Issue number1
Early online date23 Mar 2023
DOIs
Publication statusPublished - 7 Jun 2023

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