gms | German Medical Science

10th Munich Vascular Conference

01.-03.12.2021, online

The KAATSU training as an innovative method in post-interventional rehabilitation of peripheral arterial disease patients

Meeting Abstract

  • corresponding author presenting/speaker Aleksandra Wlodarczyk - Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
  • author Agnieszka Wachsmann-Maga - Department of Angiology, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
  • author Martyna Schonborn - Department of Angiology, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
  • author Agnieszka Trynkiewicz - Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
  • author Malgorzata Cebenko - Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
  • author Paweł Maga - Department of Angiology, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
  • author Roman Nowobilski - Department of Rehabilitation in Internal Medicine, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
  • author Mikolaj Maga - Department of Rehabilitation in Internal Medicine, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland

10th Munich Vascular Conference. sine loco [digital], 01.-03.12.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc26

doi: 10.3205/21mac26, urn:nbn:de:0183-21mac269

Published: December 22, 2021

© 2021 Wlodarczyk et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: Peripheral artery disease (PAD) is a non-cardiac atherosclerosis manifestation affecting over 20% of Europeans aged 55 and above. Best treatment option of non-critical lower limbs ischemia remains the open case. Among many treatment forms, the most non-invasive, but still effective is rehabilitation by physical training. Recently, innovative solutions have been introduced concerning this form of treatment by combining anaerobic interval exercises with venous blood flow restriction (BFR) and cooling. The aim of the research is to evaluate the endothelial and angiogenic response to the KAATSU training.

Methods: Study was divided into 2 stages: with healthy volunteers and non-CLI patients. 35 healthy volunteers were enrolled into the 1st stage. They performed a 21-minute interval training using a cross trainer with cooling liquid pressure cuffs (arms: 40 mmHg; legs: 65 mmHg) providing vein occlusion and cooling seat. Angiogenic processes and endothelial functions were monitored by laboratory parameters – vascular endothelial growth factor (VEGF), clusters of differentiation (CD31, CD34) as well as imaging examinations – flow mediated dilatation (FMD), stiffness index (SI), reflexion index (RI), reactive hyperaemia index (RHI) and augmentation index (AI). All measurements were performed before, as well as 20 to 30 minutes after the training.

Results: All of the laboratory parameters were significantly elevated after the BFRT – CD34 (ΔCD34: 0.13 vs 0.01 p<0,001), CD31 (ΔCD31: 1.11 vs 0.37 p<0,001) and VEGFR (ΔVEGFR: 6.35 vs 2.86 p<0.001). Only FMD and RI of all endothelial imaging parametrs significantly changed after BFRT compared to regular training (FMD: 8.9% vs 7.41 p<0,001 ΔFMD: 2.89 vs 1.33 p<0,01; RI: 63.43 vs 69.49 p<0,001, ΔRI: 4.0 vs 2.0, p>0,001). RHI and AI weren’t significantly influenced by any exercise type.

Conclusion: KAATSU training successfully stimulates acute angiogenic response and moderately influences certain endothelial functions. This 1st stage results are being now implemented into the 2nd part of project involving PAD patients.


References

1.
Morcos R, Louka B, Tseng A, Misra S, McBane R, Esser H, Shamoun F. The Evolving Treatment of Peripheral Arterial Disease through Guideline-Directed Recommendations. J Clin Med. 2018;7(1): 9.
2.
Stray-Gundersen S, Wooten S, Tanaka H. Walking With Leg Blood Flow Restriction: Wide-Rigid Cuffs vs. Narrow-Elastic Bands. Front Physiol. 2020;29(11):568.