Banca de DEFESA: MIKHAIL SANTOS CERQUEIRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : MIKHAIL SANTOS CERQUEIRA
DATE: 18/06/2021
TIME: 08:30
LOCAL: REMOTO
TITLE:

 

APPLICATIONS OF BLOOD FLOW RESTRICTION MODALITIES IN DIFFERENT MUSCULOSKELETAL DISORDERS: PHYSIOLOGICAL, METHODOLOGICAL AND CLINICAL ASPECTS

KEY WORDS:

partial vascular occlusion; ischemic preconditioning; disuse; exercise-induced muscle damage; knee osteoarthritis; rehabilitation

PAGES: 250
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

BACKGROUND: Musculoskeletal disorders are common and can impair physical performance, physical function and quality of life. Among interventions that can be used in the management of musculoskeletal disorders, blood flow restriction (BFR) modalities have been gaining space in the scientific literature. AIMS: In general, the objective of this doctoral thesis is to investigate physiological aspects, prescription methods and clinical applications of different BFR modalities. METHODS AND RESULTS: BFR modalities considered were the BFR without concomitant exercise (passive BFR), pre-exercise BFR (ischemic preconditioning - IPC) and BFR combined with exercise. As musculoskeletal disorders, conditions that caused some type of functional impairment were considered. The present doctoral thesis consists of five chapters. Chapters 1 and 5 are, respectively, the background and final considerations of the thesis. Chapters 2, 3 and 4 consist of nine scientific articles involving four study models: systematic reviews (with and without meta-analysis), letters to the editor, narrative review and randomized clinical trials. Chapter 2 is a systematic review (article 1) on the effects of passive BFR to minimize losses of strength and muscle mass (disuse atrophy) in individuals subjected to unloading in the lower limbs. In chapter 2 we observed that although potentially useful, the high risk of bias presented in the original studies limits the indication of passive BFR as an effective modality against the atrophy following immobilization. Chapter 3 is a randomized and controlled clinical trial (article 2) that investigated the effects of IPC on protection against exercise-induced muscle damage in healthy people. Article 2 pointed out that PCI was not superior to sham to protect against exercise-induced muscle damage. Chapter 4 deals with physiological, methodological and clinical aspects of BFR combined with physical exercise. The first manuscript of chapter 4 (article 3) is a systematic review with meta-analysis that analyzed muscle excitation (by surface electromyography) during resistance exercise with BFR taken until. Article 3 indicated that muscle excitation during low load exercise with BFR was greater than low-load exercise without BFR only when muscle failure is not achieved. Additionally, low-load exercise with BFR showed less muscle excitation than high-load exercise, regardless of whether muscle failure was achieved or not. The second manuscript of chapter 4 (article 4) is a systematic review with meta-analysis that investigated whether the BFR pressure level influences the time to achieve voluntary muscle failure during a fatiguing task. In article 4 we showed that muscle failure is anticipated during low-load exercises with high-, but not low-BFR pressures. The third manuscript of chapter 4 (article 5) is a narrative review that discusses the possible need to adjust the BFR pressure over weeks of training. In article 5 we observed that the literature is contradictory and makes it difficult to recommend whether such adjustments in the BFR pressure are necessary. The last four articles of chapter 4 deal with resistance training combined with BFR in the chronic knee pain treatment. Articles 6 and 7 are letters to the editor about recent systematic reviews with meta-analysis and point out the need for greater methodological rigor in systematic reviews on BFR to treat chronic knee pain. Article 8 is a protocol for a randomized clinical trial proposed to investigate the effects of low-load and reduced total volume exercise with BFR versus high-load training without BFR in the treatment of knee osteoarthritis. Article 9 is the randomized clinical trial that presents the results of article 8 and shows that low-load training with reduced total volume and with BFR had an effect similar to high-load training without BFR on knee pain, muscle performance, physical function and quality of life of patients with knee osteoarthritis, although the magnitude of strength gains was greater after high-load training. CONCLUSIONS: Overall, with the exception of IPC to protect against muscle damage induced by exercise, blood flow restriction modalities are potentially useful in the management of musculoskeletal disorders studied herein. Additionally, we conclude that it is necessary to advance in the understanding of the physiological mechanisms and in the study of the prescription methods of the different modalities of blood flow restriction.

BANKING MEMBERS:
Externo à Instituição - CLEITON AUGUSTO LIBARDI - UFSCAR
Externo à Instituição - GABRIEL PEIXOTO LEÃO ALMEIDA - UFC
Externo à Instituição - HAMILTON AUGUSTO ROSCHEL DA SILVA - USP
Interno - 2316237 - RODRIGO SCATTONE DA SILVA
Presidente - 2566849 - WOUBER HÉRICKSON DE BRITO VIEIRA