Background: Chronic obstructive pulmonary disease (COPD) is a common lung disease causing restricted airflow and breathing problems. It is sometimes called emphysema or chronic bronchitis. The damage results in swelling and irritation, also called inflammation, inside the airways that limit airflow into and out of the lungs. BFR Rehabilitation is effective in improving functional mobility and balance among COPD patients.
Objective: To find out the effects of Blood Flow Restriction (BFR) Rehabilitation on functional mobility and balance among COPD (Chronic Obstructive Pulmonary Disease) patients.
Methods: A Randomized Controlled Trial Study was conducted at Gulab Devi Hospital, Hameed Latif Hospital and Arif Memorial Teaching Hospital Lahore. Fifty patients of age 45-60 years with COPD were randomized into two groups. Allocation of patients in two equal groups by lottery method will be through random assignment. Group A was treated with controlled physical therapy while Group B was treated with BFR rehabilitation. Controlled treatment includes low intensity resistance exercises while BFR Rehabilitation includes use of a tourniquet with low intensity resistance exercises. All this information will be collected through a pulse oximeter. Berg Balance Scale will be used for balance and timed up and go test for functional mobility.
Subjects who are clinically stable before study
Forced expiratory volume in 1s (FEV1)/forced vital capacity (FVC)<70% and FEV1 ≥30% but <80% respectively
Subjects who will be willing to take part in this study
Upper abdominal surgery
Lung cancer
Open fracture
Mental disorder
Parallel
Resistance Exercise without tourniquet
Other interventionThe control group performed the same above-mentioned resistance training without the pressure cuff under the supervision of physiotherapist.
Blood flow restriction resistance exercise
Other interventionBlood flow restriction resistance exercise (BFR-RE), or Kaatsu training, was developed by Dr. Yoshiaki Sato over 40 years ago. It uses a low load (15-30% 1-RM) to induce gains in muscle strength and mass. External pressure (\~80% limb occlusion pressure, LOP) is applied via a tourniquet cuff to the proximal limb, restricting venous return while allowing partial arterial inflow, creating blood pooling in distal muscles. Training was supervised by BFR-certified physiotherapists using medium-sized cuffs, placed at the proximal thigh for a maximum of 10 minutes. Pressure was auto-adjusted to personalized LOP, inflated before the first set, maintained during rests, and deflated post-session. Each session trained a single limb, alternated on different days, 2-3 times/week. Exercises included isotonic knee extensions from 150° to 180°: 1 set of 30 reps, then 3 sets of 15 reps, with 30-second rests, at 1-2 sec/repetition, using sandbag resistance (15-30% 1-RM).
Balance
Balance was assessed using the Berg Balance Scale (BBS), a widely used clinical tool that evaluated functional balance through 14 tasks of varying difficulty. Each task was scored from 0-4, with a maximum score of 56. Higher scores indicated better balance, while lower scores reflected greater fall risk.
Oxygen Saturation
Oxygen saturation reflects the percentage of haemoglobin carrying oxygen, normally ranging between 95-100% in healthy individuals.
Respiratory rate
Respiratory rate will be measured using a pulse oximeter and recorded as the number of breaths taken per minute.
Heart Rate
Heart rate will be measured using a pulse oximeter and recorded as the number of heartbeats per minute.
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