Blood Flow Restricted Training as the Last-Opportunity, Non-Invasive Treatment for a Patient Suffering from Peripheral Arterial Disease Without Possibility for Implementing Conventional Walking Exercise Rehabilitation a Case Report

Abstract

Introduction and Objectives: We report a non-invasive and innovative treatment method with blood flow restricted training (BFR) in a 62-year-old man with short-distance claudication of the right calf (Rutherford 3), and post-thrombotic deep vein syndrome of the same limb. This is the first described case of BFR training used in the rehabilitation of a patient with lower limb ischaemia.Material and Methods: The patient, undertaking frequent physical activity, a previous cigarette smoker, with a history of deep vein thrombosis, was diagnosed with occlusion of the popliteal and anterior tibial arteries causing intermittent, short-distance claudication. An invasive approach was not possible, as the patient refused any vascular surgery interventions, open or endovascular. Due to recently diagnosed hip joint degeneration, accompanied by degeneration and dyscopathy of the lumbosacral vertebral column, regular supervised walking training could not be implemented. Experimental blood flow restricted low-intensity training, with the use of a cross-trainer tool accompanied by cooling, was introduced. The 21-minute training, 3 times per week for 3 months, was performed in a seated position with a special low-pressure cuff placed on the arms and legs.Results: The patients limb symptoms were promptly reduced and the vascular parameters significantly improved, allowing surgical treatment of the right hip joint. The patient continued the non-invasive treatment for peripheral arterial disease in the form of walking training.Conclusions: Blood flow restriction training may be individually considered for patients with peripheral arterial disease having limited possibilities of classic walking training and revascularization, but this should be done with great caution and after detailed consultation with a vascular medicine specialist.