Effects of Low Load Blood-Flow-Restriction Training on Body Composition and Strength in Cancer Cachexia: A Case Study.

Purpose: A common side effect from cancer and anti-cancer treatment is cancer-associated cachexia (CAC), a multifactorial syndrome characterized by the loss of bodyweight, skeletal muscle and adipose tissue. Recommended therapeutic options are multidimensional, including nutritional, pharmacological and exercise interventions. A novel therapeutic approach is the use of low-load resistance training combined with blood-flow-restriction to the trained limbs (LL-BFR). It has been shown to induce adaptations in muscle mass and strength despite low training load in various clinical populations and might be a suitable training modality for cancer patients suffering from CAC.

Methods: A 56-year-old female patient diagnosed with stage IV gallbladder cancer, suffering from CAC performed LL-BFR training twice weekly for twelve weeks and received a guideline-based nutritional intervention. All outcome measures (maximal strength (8-RM), handgrip strength, body mass, lean body mass, body cell mass, quality of life and symptom burden) were evaluated before and directly after the training period.

Results: Adherence was moderate (67% of all training sessions completed) and no adverse events were noted. All measures of physical capacity and body composition improved between 19-55% and 9-11%, respectively. Quality of life decreased in 5/6 subscales while symptom burden increased in 2/4 subscales.

Conclusions: Treatment of CAC requires a multitargeted and interdisciplinary approach. This is the first case study using LL-BFR training in an oncological patient during active therapy. Our results show that LL-BFR was feasible and, despite no positive effect on quality of life and symptom burden, could induce relevant changes of muscle strength and muscle mass in a relatively short training period. Further research is necessary to confirm the results of this case study in randomised controlled trials.