Effects Of Low-Load Blood Flow Restriction Training Of The Upper Extremity In Patients With Chronic Obstructive Pulmonary Disease

Summary

Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent airflow limitation, progressive dyspnea, and peripheral muscle dysfunction, significantly impairing functional capacity and quality of life. Although the combined implementation of aerobic and resistance exercises is recommended in pulmonary rehabilitation programs, early-onset ventilatory limitation in individuals with COPD often hinders tolerance to high exercise intensities. This limitation increases the need for alternative exercise approaches targeting peripheral muscle adaptations. Low-load blood flow restriction training (LL-BFRT), which enables improvements in muscle strength with low mechanical loads, has emerged as a potential option for this patient population. However, evidence regarding the effects of LL-BFRT in individuals with COPD-particularly on upper extremity muscles-remains limited.

The aim of this study is to comparatively investigate the effects of LL-BFRT and sham-BFRT, both administered in addition to an aerobic exercise program in individuals diagnosed with stage II and III COPD, on upper extremity muscle strength, upper extremity functional capacity, activities of daily living performance, quality of life, functional exercise capacity, muscle oxygenation, and respiratory parameters. The study is designed as a randomized controlled, single-blind, quasi-experimental interventional trial.

The expected outcomes are that LL-BFRT may enhance upper extremity muscle strength and functional capacity, improve activities of daily living and quality of life, and increase exercise tolerance due to its applicability at low mechanical loads. Furthermore, findings related to muscle oxygenation and respiratory parameters are anticipated to provide clinical evidence regarding the physiological effects of LL-BFRT on peripheral muscle adaptations. These results are expected to guide the integration of LL-BFRT as an alternative and safe approach in upper extremity exercise prescription within pulmonary rehabilitation programs, support clinical decision-making processes, and establish a scientific foundation for future research.

Conditions

• Chronic Obstructive Pulmonary Disease (COPD)
• Blood Flow Restriction Training (BFRT)

Interventions

OTHER

Low-Load Blood Flow Restriction Training (LL-BFRT) + Aerobic Exercise

Participants will undergo an 8-week upper extremity aerobic exercise program combined with low-load blood flow restriction training (LL-BFRT). The aerobic exercise will be performed using an arm cycle ergometer at 60-70% of age-predicted maximum heart rate for 20 minutes, preceded and followed by 5 minutes of unloaded cycling. In addition, LL-BFRT will be applied to the proximal upper extremity with a pneumatic cuff at 30-40% of arterial occlusion pressure. Resistance exercises will be performed at 30% of one-repetition maximum (1RM) using a 4-set protocol (30-15-15-15 repetitions) with 45-second inter-set rest periods while maintaining cuff pressure. Target muscles include the biceps brachii, triceps brachii, and anterior deltoid.

OTHER

Sham Low-Load Blood Flow Restriction Training (LL-BFRT) + Aerobic Exercise

Participants will undergo the same 8-week upper extremity aerobic exercise program as the intervention group. Aerobic exercise will be performed using an arm cycle ergometer at 60-70% of age-predicted maximum heart rate for 20 minutes, preceded and followed by 5 minutes of unloaded cycling. In addition, sham blood flow restriction training will be applied with a pneumatic cuff placed proximally on the upper extremity. The cuff pressure will be set at a level insufficient to produce therapeutic blood flow restriction. The exercise structure, sets, repetitions, and muscle groups targeted will be identical to the intervention group.

Sponsors & Collaborators

• Inonu University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-02-15

Primary Completion

2026-12-25

Completion

2026-12-25

Countries

• Turkey (Türkiye)

Study Locations