Role of blood flow restriction strength training in chronic obstructive pulmonary disease

Blood flow restriction (BFR) training is a method partially restricting arterial inflow and fully restricting venous outflow in working musculature during exercise.1 The method uses a pneumatic tourniquet system and involves applying an external pressure, typically using a tourniquet cuff, to the most proximal region of the upper and/or lower limbs. When the cuff is inflated, there is gradual mechanical compression of the vasculature underneath the cuff, resulting in partial restriction of arterial blood flow to structures distal to the cuff, while more profoundly affecting venous outflow from under the cuff. The reduction in blood flow and subsequent localised hypoxia within exercising skeletal muscles during BFR training stimulates anaerobic metabolism and metabolite accumulation, upregulates muscle protein synthesis, induces systemic anabolic hormone release and possibly angiogenesis.