Low Load Blood Flow Restriction Resistance Training in Colorectal Cancer Related Sarcopenia

PURPOSE: To investigate the effects of low-load resistance training combined with blood flow restriction on muscle strength, functional performance, and cancer-related fatigue in colorectal cancer survivors with probable sarcopenia. BACKGROUND: Muscle weakness and cancer-related fatigue are prevalent in colorectal cancer survivors with probable sarcopenia and are associated with adverse outcomes (Brown et al., 2022; Caan et al., 2018). High-load resistance training is often poorly tolerated in this population (Schmitz et al., 2019). Although low-load resistance training with blood flow restriction shows promise, CRC-specific randomized evidence remains limited (Patterson et al., 2019; Arnold et al., 2017). HYPOTHESES: It is hypothesized that low-load blood flow restriction resistance training will lead to significant improvements in muscle strength and functional performance, and a significant reduction in cancer-related fatigue in colorectal cancer survivors with probable sarcopenia. RESEARCH QUESTION: Does low-load blood flow restriction resistance training will lead to significant improvements in muscle strength and functional performance, and a significant reduction in cancer-related fatigue in colorectal cancer survivors with probable sarcopenia?

Inclusion Criteria: 1. Colorectal cancer with probable sarcopenia. 2. Age 40-59 years. 3. Low muscle strength defined by EWGSOP2 criteria using the five-times sit-to-stand test (\>15 seconds without upper limb support). 4. Current chemotherapy/radiotherapy or postoperative status with confirmed medical stability. 5. Medical clearance for supervised exercise. 6. Ability to follow instructions and complete assessments. Exclusion Criteria: 1. Any contraindication to resistance or blood flow restriction training. 2. Uncontrolled cardiovascular disease or hypertension. 3. Recent thromboembolic events. 4. Severe peripheral vascular disease. 5. Uncontrolled treatment-related complications, such as severe anemia or infection. 6. Metastatic bone disease in the lower limbs. 7. Neurological or musculoskeletal disorders limiting safe participation.