Is blood flow-restricted training effective for rehabilitation of a pianist with residual neurological symptoms in the upper limbs? A case study.
Tomohiro Yasuda, Yumi Sato, Toshiaki Nakajima
PMID 34393373WHAT IT FOUND
In one pianist with neck and upper-limb neurological symptoms, playing a piece with arm blood-flow restriction caused more forearm and upper-arm swelling and more right-hand grip fatigue than playing without it.
This was a single case and did not show that the training improves rehabilitation.
Key findings
01During a 3-minute piano performance with blood-flow restriction, forearm circumference rose immediately afterwards by 3.6% on the left and 5.4% on the right from pre-performance values, versus 0.4% and 0.0% without restriction.
02Upper arm circumference rose immediately afterwards by 2.0% on the left and 3.4% on the right from pre-performance values, versus −0.3% and −0.5% without restriction.
03Right-hand grip strength fell immediately afterwards: −13.4% from pre-performance values with restriction versus 1.3% without restriction; left-hand grip strength did not change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only one participant was studied, so the results cannot show what would happen in other pianists or patients with similar symptoms. The study measured immediate arm circumference and grip strength, not daily function, pain, or long-term rehabilitation outcomes. The blood-flow restriction pressure was set at 130-170 mmHg for this participant, and the authors said this arbitrary pressure led to large differences compared with other studies. The authors noted that laterality of the participant's neurological symptoms could not be completely ruled out as an influence on the arm differences. The authors called the work a preliminary experiment and said further clinical studies are needed to confirm acute and chronic effects.
Declared interests
The study was supported in part by JSPS KAKENHI Grant Number 18K10906. One author belongs to a donation course supported by KAATSU JAPAN Co., Ltd., the company listed for the pressure cuff, but the paper states the company had no role in the design and analysis of the data. The other authors declared no competing interests.
The easy way to misread this
Do not conclude that blood-flow-restricted piano training is effective rehabilitation. This was one person, and the measured changes were immediate arm swelling and right-hand grip fatigue, not improved function or long-term strength.