Name: vascular occlusion training for inclusion body myositis: a novel therapeutic approach
Uploaded: 2010-06-05T17:00:00
Description: Watch this Scientific Journal Video about Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach at JoVE.com

<p class="jove_content">We would like to thank Mr. Julio Maia for participating in this video and Mr. Joel S. Torres for reviewing the manuscript. Bruno Gualano is supported by Conselho Nacional de Pesquisa e Tecnologia.</p>

<p class="jove_title">1. Determination of full vascular occlusion pressure</p>
<ol>
    <li>In order to determine the blood pressure of vascular occlusion, in mmHg, a vascular Doppler is used</li>
    <li>The patient lies in a supine position while a customized blood pressure cuff (180mm length x 80mm width) is fixed on his thigh.</li>
    <li>After detection of the tibial artery location, the Doppler's probe is then placed over the determined spot in the patient's leg.</li>
    <li>A sound signal is generated by the Doppler machine as it ...

<ol>
	<li>Needha, M., Mastaglia, F. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inclusion+body+myositis:+current+pathogenetic+concepts+and+diagnostic+and+therapeutic+approaches.">Inclusion body myositis: current pathogenetic concepts and diagnostic and therapeutic approaches.</a> <em style='font-style: italic'>Lancet Neurol</em>. <b>6</b>, 620-631 (2007).</li><li>de Salles Painelli, V., Gualano, B., Artioli, G. G., de Sa Pinto, A. L., Bonfa, E., Lancha Junior, A. H., Lima, F. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+possible+role+of+physical+exercise+on+the+treatment+of+idiopathic+inflammatory+myopathies.">The possible role of physical exercise on the treatment of idiopathic inflammatory myopathies.</a> <em style='font-style: italic'>Autoimmun. Rev</em>. <b>8</b>, 355-359 (2009).</li><li>Spector, S. A., Lemmer, J. T., Koffman, B. M., Fleisher, T. A., Feuerstein, I. M., Hurley, B. F., Dalakas, M. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+and+efficacy+of+strength+training+in+patients+with+sporadic+inclusion+body+myositis.">Safety and efficacy of strength training in patients with sporadic inclusion body myositis.</a> <em style='font-style: italic'>Muscle Nerve</em>. <b>20</b>, 1242-1248 (1997).</li><li>Gualano, B., Neves, M., Lima, F. R., de S&#225; Pinto, A. L., Laurentino, G., Borges, C., Baptista, L., Artioli, G. G., Aoki, M. S., Moriscot, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Training+with+Vascular+Occlusion+in+Inclusion+BodyMyositis:+A+Case+Study.">Training with Vascular Occlusion in Inclusion BodyMyositis: A Case Study.</a> <em style='font-style: italic'>Med. Sci. Sports Exerc</em>. , .</li><li>Takarada, Y., Takazawa, H., Sato, Y., Takebayashi, S., Tanaka, Y., Ishii, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+resistance+exercise+combined+with+moderate+vascular+occlusion+on+muscular+function+in+humans.">Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans.</a> <em style='font-style: italic'>J. Appl. Physiol</em>. <b>88</b>, 2097-2106 (2000).</li></ol>

<p class="jove_content">We presented a novel, and likely the first, non pharmacological therapeutic tool able to counteract the muscle atrophy and decline of strength that usually occurs in patients with IBM under conventional treatment. Resistance training with vascular occlusion is a relatively novel training method, but results are very encouraging. We have found that after a 12-wk training program, an IBM patient's leg press one-repetition maximum, balance and mobility function, and thigh cross-sectional area increased 15.9%, 60%, and 4.7%,...

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<td>Vascular Doppler</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
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<td>Treadmill (optional)</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Two customized tourniquets cuffs with pressure manometers</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Conventional blood pressure cuff</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Leg extension machine</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Leg press machine</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
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<td>Ankle weights</td>
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vascular occlusion training for inclusion body myositis: a novel therapeutic approach

Inclusion body myositis (IBM) is a rare idiopathic inflammatory myopathy. It is known to produces remarkable muscle weakness and to greatly compromise function and quality of life. Moreover, clinical practice suggests that, unlike other inflammatory myopathies, the majority of IBM patients are not responsive to treatment with immunosuppressive or immunomodulatory drugs to counteract disease progression<sup>1</sup>. Additionally, conventional resistance training programs have been proven ineffective in restoring muscle function and muscle mass in these patients<sup>2,3</sup>. Nevertheless, we have recently observed that restricting muscle blood flow using tourniquet cuffs in association with moderate intensity resistance training in an IBM patient produced a significant gain in muscle mass and function, along with substantial benefits in quality of life<sup>4</sup>. Thus, a new non-pharmacological approach for IBM patients has been proposed. Herein, we describe the details of a proposed protocol for vascular occlusion associated with a resistance training program for this population.

Watch this Scientific Journal Video about Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach at JoVE.com

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

<p class="jove_content">The present article presents the details pertaining to the application of resistance training associated to vascular occlusion in IBM patients.</p>

Inclusion body myositis (IBM) is a rare idiopathic inflammatory myopathy. It is known to produces remarkable muscle weakness and to greatly compromise ...

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