Loss of muscle mass and strength is a problem for those with the autoimmune disease rheumatoid arthritis. Sore, swollen joints mean that exercising can be painful, so many sufferers will avoid it, growing weaker and less fit as a result, and gradually experiencing a decline in what they are capable of doing.
To maintain their quality of life, people with this debilitating condition need a form of physical activity that improves strength and mobility without aggravating painful joints. Hunter Bennett, a lecturer in exercise and sport science at the University of South Australia, is hoping Blood Flow Restriction (BFR) training may provide a solution.
In the technique, people wear pressurised bands around the top of a limb – much like blood pressure cuffs – while they are training. The cuff allows blood flow into the limb but slows its exit, which helps build muscle without the need to lift heavy weights. The technique originated in Japan in the 1960s and was originally known as Kaatsu training.
“It is often used in rehabilitation scenarios,” says Bennett. “If you are coming back from an injury and can’t lift heavy weights because there is a risk of re-injuring the muscle tissue or joint, then this is a light, low-risk exercise that still causes a positive response. Athletes might also use it in the run-up to a competition so they can train without inducing fatigue that may affect their performance.”
BFR training has already helped people with osteoarthritis, the most common form of arthritis, which is caused by the wearing away of the smooth cartilage surface of the joint.
Rheumatoid arthritis affects about 2% of the population and is distinctly different. More common in women, it occurs when the body’s immune system attacks its own healthy tissue, causing inflammation that thickens the synovium, a thin membrane that lines the joints. The result is swelling and pain as well as joint degradation.
The condition is treated with a range of medications that can damp down inflammation, reduce pain and slow damage, but these drugs won’t address the loss of muscle strength and function.
Bennett has embarked on a new trial to find out if BFR training can help as part of a treatment plan. Participants are being measured for things like muscle strength, walking speed, handgrip strength and pain levels. Then they train using this method twice-weekly for eight weeks, before being tested again to see if there has been any change. “We’re also getting them to do an in-depth survey to see how well they tolerate the intervention and whether they like this type of exercise,” says Bennett.
It’s still early days, but the feedback from research assistants is that participants have found the first couple of sessions challenging but then have started to enjoy the programme, which involves three lower-body and two upper-body exercises.
“We’ve been really pleased with the strength and quality of life measures that we’re taking. And anecdotally we’ve heard of some people being able to reduce medications or simply feeling like they’re able to manage their daily life better.”
BFR training works by trapping lactic acid in the muscle tissue. That sends a signal to the brain, essentially tricking it into thinking that you are working much harder than you are and putting your body under stress. As a result, you can build muscle more easily.
“It still involves some effort and feels like exercise but you can use much lighter weights or lighter intensity than you would normally,” says Bennett.
The cuffs are straightforward to use and simply require inflating to create pressure for each set of exercises. The only professional help that may be needed is to identify the optimal pressure, as that will vary from person to person.
Given our ageing population, Bennett believes there is scope for BFR training to help a lot more people. “If we can find modes of exercise that are effective and safer, and that require less effort or less time, then I think that’s a win, for sure.”
