Low‐load resistance training with blood flow restriction increases muscle function, mass and functionality in women with rheumatoid arthritis

Objective: To evaluate the effects of a low‐load resistance training program associated with partial blood flow restriction in patients with rheumatoid arthritis (RA).

Methods: Forty‐eight women with RA were randomized into one of the three groups: high‐load resistance training (HL‐RT: 70% one repetition maximum [1RM]); low‐load resistance training (30% 1RM) with partial blood flow restriction (BFRT) and control group. Patients completed a 12‐week supervised training program and were assessed for lower‐limb 1RM, quadriceps cross‐sectional area (CSA), physical function (timed‐stands test [TST], timed‐up‐and‐go test [TUG], Health Assessment Questionnaire [HAQ]) and quality of life (Short Form Health Survey [SF‐36]) at baseline and after the intervention.

Results: BFRT and HL‐RT were similarly effective in increasing maximal dynamic strength in both leg press (+22.8% and +24.2%, all p<0.0001) and knee extension (+19.7% and +23.8%; all p<0.0001). Quadriceps CSA was also significantly increased in both BFRT and HL‐RT (+9.5% and +10.8%; all p<0.0001, respectively). Comparable improvements in TST (+11.2% and +14.7%; all p<0.0001) and TUG (‐6.8%, p<0.0053 and ‐8.7%, p<0.0001) were also observed in BFRT and HL‐RT, respectively. Improvements in both groups were significantly greater than those of CG (all p<0.05). SF‐36 role physical, bodily pain and HAQ scores were improved only in BFRT (+45.7%, +22.5% and ‐55.9%, respectively; all p<0.05). HL‐RT resulted in one case of withdrawal and several cases of exercise‐induced pain, which did not occur in BFRT.

Conclusion: BFRT was effective in improving muscle strength, mass, function and health‐related quality of life in patients with RA, emerging as a viable therapeutic modality in RA management.