Monday, April 2, 2018

KAATSU Training: Application to Metabolic Syndrome

Courtesy of the International Journal of KAATSU Training Research, 2011; 7: 7-12

Dr. Satoh of the Satoh Clinic in Ube City, Japan presented a clinical study entitled Kaatsu Training: Application to Metabolic Syndrome where he applied KAATSU to patients with metabolic syndrome.

His goal was to evaluate the effect of KAATSU on patients with hypertension, diabetes mellitus, dyslipidemia, and obesity with metabolic syndrome.

Dr. Satoh asked 18 patients to do the standard KAATSU 3-Point Exercises for 6-12 minutes, once or twice a week with a Borg scale at level 13. The usefulness of KAATSU was evaluated after 3-4 months. The patients were instructed not to change their lifestyles (e.g., food, medicine and exercise).

Dr. Satoh (note: no relation to KAATSU inventor Dr. Yoshiaki Sato of Tokyo) reported the following results: The effectiveness of KAATSU was shown in 31 out of 51 patients (61%). In 12 out of 18 patients (67%) with hypertension, systolic blood pressure dropped from an average of 166 mmHg to 146 mmHg and diastolic blood pressure also dropped from an average of 96 mmHg to 86 mmHg.

In 6 out of 10 patients (60%) with diabetes mellitus, HbA1c dropped from an average of 6.8% to 6.12%.

In 8 out of 14 patients (57%) with dyslipidemia, LDL-c decreased from an average of 158 mg/dl to 136 mg/dl. In 5 out of 9 patients (56%) with obesity, there was a reduction in weight from an average of 67 kg to 59 kg.

The doctor concluded that KAATSU improves physical conditions including hypertension, diabetes mellitus, dyslipidemia and obesity with metabolic syndrome.

INTRODUCTION

Metabolic syndrome is defined as a condition of visceral fat accumulation with a combination of two or more of hyperglycemia, hypertension or dyslipidemia. These closely resemble the symptoms of somatopause which is the condition of decreasing growth hormone (hereafter GH) secretion with aging.

On the other hand, KAATSU has brought about a variety of good effects in muscle strength (Takarada et al., 2000; Abe et al., 2005), lipolysis (Satoh, 2011) and health promotion. KAATSU has also been applied in the field of medical care (Nakajima et al., 2007). In my clinic, exercise therapy, especially walking, has become valued for the treatment and prevention of metabolic syndrome (Satoh, 1990). Nevertheless, in cases of patients with a walking disturbance or patients who cannot spare one hour or more for walking, KAATSU has been proactively introduced and good results were obtained (Satoh, 2006). This method can be performed in a short period of time, without placing a burden on the knees and the lower back. Furthermore, it is believed that there is a good effect even with metabolic syndrome because of the secretion of GH. Therefore, the effectiveness of KAATSU on metabolic syndrome was evaluated in this study.

METHODS

The subjects of this study were 51 patients with metabolic syndrome (14 males and 37 females) out of 96 patients treated with KAATSU so far at my clinic.

The ages of these subjects were as follows: 3 in their 30’s, 5 in their 40’s, 9 in their 50’s, 12 in their 60’s, 10 in their 70’s, 10 in their 80’s and 2 in their 90’s. The diseases of subjects were as follows: 18 patients with hypertension (7 males and 11 females), 10 patients with diabetes mellitus (3 males and 7 females), 14 patients with dyslipidemia (4 males and 10 females), and 9 patients with obesity (1 male and 8 females).

The criteria of indication for KAATSU were as follows:

Hypertension: Systolic blood pressure, 150 mmHg - 170 mmHg, Diastolic blood pressure, 90 mmHg - 100 mmHg
Diabetes mellitus: HbA1c levels of 6.5% or above
Dyslipidemia: LDL cholesterol levels of 140 mg/dl or above
Obesity: BMI levels of 28 or above

However, patients with a resting blood pressure of 170 / 100 mmHg or above were excluded from the subjects because they could be considered at danger of a rise in pressure during KAATSU training. Fasting blood samples were taken early in the morning and body weight was measured with the Body Composition Analyzer MC190 (TANITA Corporation, Tokyo). The kinetics of GH secretion before and after KAATSU was examined in one elderly patient to confirm the results reported before, since the levels of GH in previous studies were checked only in young athletes (Takarada et al., 2000) or healthy males (Takano et al., 2006).

KAATSU training protocols

Before KAATSU was applied, there was first a 10-minute period of stretching of the entire body. Then, the KAATSU belts (Sato Sports Plaza, Tokyo) were coiled around the proximal end of either the arms or the legs. After this, the pneumatic control type KAATSU Training Device (the KAATSU-Master or the KAATSU-Mini, Sato Sports Plaza, Tokyo) was connected to those belts, and KAATSU was performed for a period of 6-12 minutes under an appropriate pressure (60 to 160 mmHg for the arms and 80 to 200 mmHg for the legs respectively). The appropriate pressure was set so as the patients didn’t feel pain in the distal portion to the KAATSU belt during the exercise. The content of KAATSU was a 3-exercise set of training (Sato Y, 2007a); that is, (1) an opening and shutting movement of both the fingers and the toes at the same time, (2) an extension and a flexion of the arms (arm curl) and the feet (toes raise) at the same time, and (3) a pushing the both fists which are placed in front of the chest down obliquely to behind, with stretching the elbows (push down) and the heels up (calf raise) at the same time. Each 3-exercise set was performed 30 times with 20 second resting intervals.

This exercise intensity was equivalent to the Borg scale of level 13 (somewhat hard). KAATSU was performed once or twice a week.

Evaluation of the effectiveness

For the exact evaluation, the purpose of this study was sufficiently explained to the patients and they were instructed not to change their lifestyle (food, exercise, and medicine). Nevertheless, some patients changed their lifestyle during this study and they were therefore excluded from the assessment. The evaluation of the effect was done 3 to 4 months later.

The criteria of effectiveness were as follows:

Hypertension: Drop in systolic and diastolic pressure of 10% or above
Diabetes mellitus: Drop in HbA1c of 10% or above
Dyslipidemia: Decrease in LDL cholesterol of 8% or above
Obesity: Weight loss of 10% or above

Statistical methods

All values are expressed as means ± S.D.

RESULTS

There were no accidents in this study.

KAATSU was effective against metabolic syndrome in 31 patients (61%), and ineffective in 11 patients (22%). A total of 9 patients (17%) were excluded.

Among the excluded cases, 6 patients changed their lifestyles during this study; 5 patients added diet or exercise therapy by themselves, seeking further improvement because they had seen the effectiveness of KAATSU before the evaluation, and a patient had his medical treatment changed by another clinic during the study. Furthermore, 3 patients withdrew themselves from the study because no effects had appeared; 2 patients had diabetes mellitus and the other one had dyslipidemia.

KAATSU decreased blood pressure in 12 out of 18 patients with hypertension (67%). In systolic blood pressure, there was an average drop from 166 ± 5.98 mmHg to 146 ± 1.15 mmHg and the average drop rate was -12 ± 2.87%. In diastolic blood pressure, there was an average drop from 96 ± 2.68 mmHg to 86 ± 2.88 mmHg and the average drop rate was -10 ± 2.24%. Among the 2 excluded cases, one patient added walking to his lifestyle by himself and the other patient who attended a different clinic had his medication reduced by the attending physician.

KAATSU was effective in 6 out of 10 patients with diabetes mellitus (60%): HbA1c dropped by an average of 6.8 ± 0.31% to 6.12 ± 0.29% and the average of drop rate was -10 ± 0.56%. There were 3 excluded patients in this group. A patient restricted her eating habits (snacks between meals) by herself and the other 2 patients discontinued KAATSU 2 months after starting without seeing a drop in HbA1c.

KAATSU was effective in 8 out of 14 patients with dyslipidemia (57%): LDL-c decreased by an average of -14 ± 2.62% in 158 ± 12.60 mg/dl to 136 ± 6.99 mg/dl. Among the 2 excluded patients, one patient restricted her eating habits (snacks between meals) by herself, and the other patient discontinued KAATSU treatment because LDL-c didn’t drop. KAATSU was also effective in 5 out of 9 patients with obesity (56%): There was an average reduction in body weight from 67 ± 4.26 kg (BMI 28.7±1.82) to 59 ± 3.30 kg (BMI 25.2±1.41) and by an average of -12 ± 1.91 (BMI -12 ± 0.48)%. There were 2 patients excluded because they restricted their eating habits (snacks between meals).

For additional details on this study, visit the Research Page on the KAATSU Global website here.

KAATSU Arm 3-point Exercises [refer to illustrations above]

The KAATSU 3-point Exercises for the arms involves hand clenches, bicep curls and tricep extensions. Each set of exercises should be done 3-4 times each with a maximum of 20 seconds rest between each set. Ideally, the number of repetitions for each exercise decreases before the user reaches muscular or technical failure* (or fatigues).

That is, an ideal set would be 25-30 repetitions on set #1, 10-15 repetitions on set #2, and 5-10 repetitions on set #3. Even if only 1-2 repetitions are completed on the last set, this failure signal sent to the central nervous system is one of the goals of KAATSU.

KAATSU Leg 3-point Exercises [refer to illustrations above]

The KAATSU 3-point Exercises for the legs are either defined as Standard or Advanced.

The Standard KAATSU 3-point Exercises for the legs involves toe curls, toe raises, and heel raises. These are all performed while the user is seated comfortably with good posture on a chair. In general, these are preferred for older or less fit individuals or those just starting an exercise program or KAATSU.

The Advanced KAATSU 3-point Exercises for the legs are alternatively used by more fit or active individuals or for those individuals with more experience in KAATSU. These 3 basic exercises includes heel raises, leg curls and squats. The heel raises can be done while sitting or standing. The leg curls can be performed while standing and holding onto a chair or balancing against a wall. The squats (or "chair touches") can be performed while bending the knees to touch a chair and then popping back up.

Ideally, the squats are "non-lock" (partial extension) so that the muscles are constantly engaged and there is no rest while the knees are "locked" straight (in a full extension). This will build up fatigue and lactic acid more quickly.

Each set of exercises should be done 3-4 times each with a maximum of 20 seconds between each set. Ideally, the number of repetitions for each exercise decreases before the user reaches muscular or technical failure (or fatigues).

That is, an ideal set would be 25-30 repetitions on set #1, 10-15 repetitions on set #2, and 5-10 repetitions on set #3. Even if only 1-2 repetitions are completed on the last set, this failure signal sent to the central nervous system is one of the goals of KAATSU.

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