[Rehabilitation with the aid of blood flow restriction training]. / Rehabilitation mithilfe des "blood flow restriction training".

BACKGROUND: For various reasons many patient groups are unable to perform high-intensity strength training. OBJECTIVE: Is the application of low-intensity strength training under blood flow restriction (BFR) an alternative to high-intensity training for patients? MATERIAL AND METHODS: Overview and summary of possible applications of BFR training in patients with osteoarthritis of the knee joint, after surgery and in patients with reduced performance. Possible contraindications and application recommendations for clinical practice based on the currently available literature are shown. RESULTS: In patients with arthritic joint complaints, muscular hypertrophy and strength improvement were achieved by low-intensity exercise with the aid of BFR. In the postoperative treatment after knee arthroscopy and anterior cruciate ligament reconstruction, BFR can be used to reduce atrophy. CONCLUSION: The effectiveness of low-intensity BFR training is lower than for classical high-resistance training; however, it may be used as additional training method in rehabilitation programs.

The best from East and West? Acupuncture and medical training therapy as monotherapies or in combination for adult patients with episodic and chronic tension-type headache: study protocol for a randomized controlled trial.

BACKGROUND: This study aims to evaluate the feasibility and efficacy of a complex health intervention, based on the combination of conventional Western medicine and traditional Chinese medicine (TCM), in an outpatient department of a university hospital for patients with frequent episodic or chronic tension-type headaches. METHODS/DESIGN: This is a prospective randomized controlled pilot study with four balanced treatment arms (usual care, acupuncture, training, and training plus acupuncture). Each arm will have 24 patients. After the initial screening examination and randomization, a 6-week treatment period follows, with treatment frequencies decreasing at 2-week intervals. After completion of the intervention, two follow-up evaluations will be performed 3 and 6 months after the start of treatment. At predefined times, the various outcomes (pain intensity, health-related quality of life, pain duration, autonomic regulation, and heart rate variability) as well as the participants' acceptance of the complex treatment will be evaluated with valid assessment instruments (Migraine Disability Assessment, PHQ-D, GAD-7, and SF-12) and a headache diary. The acupuncture treatment will be based on the rules of TCM, comprising a standardized combination of acupuncture points and additional points selected according to individual pain localization. The training therapy comprises a combination of strength training, endurance training, and training to improve flexibility and coordination. Besides descriptive analyses of the samples, their comparability will be assessed using an analysis of variance (ANOVA) or chi-squared tests. Analyses will be performed on an intention-to-treat basis. Potential interaction effects will be calculated using a repeated-measures ANOVA to test the primary and secondary hypotheses. In supplementary analyses, the proportion of treatment responders (those with a 50% reduction in the frequency of pain episodes) will be determined for each treatment arm. DISCUSSION: This trial may provide evidence for the additive effects of acupuncture and medical training therapy as a combination treatment and may scientifically support the implementation of this complex health intervention. TRIAL REGISTRATION: Registered on 11 Feburary 2019. German Clinical Trials Register, DRKS00016723.