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Hill EC, Schmidt JT, Reedy KR, Lubiak SM, Proppe CE, Rivera PM, Gonzalez-Rojas DH, Lawson JE, Prajapati AJ, Shah NM, Patel NN, Guirgis AM, Silverio AA, Howard MA, Choi H, Keller JL. Progression and perceptual responses to blood flow restriction resistance training among people with multiple sclerosis. Eur J Appl Physiol 2024:10.1007/s00421-024-05584-2. [PMID: 39162881 DOI: 10.1007/s00421-024-05584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/10/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE Resistance exercise can attenuate muscular impairments associated with multiple sclerosis (MS), and blood flow restriction (BFR) may provide a viable alternative to prescribing heavy training loads. The purpose of this investigation was to examine the progression of upper and lower body low-load (30% of one-repetition maximum [1RM]) resistance training (RT) with BFR applied intermittently during the exercise intervals (RT + BFR) versus volume-matched heavy-load (65% of 1RM) RT. METHODS Men and women with MS (n = 16) were randomly assigned to low-load RT + BFR (applied intermittently) or heavy-load RT and completed 12 weeks (2 × /week) of RT that consisted of bilateral chest press, seated row, shoulder press, leg press, leg extension, and leg curl exercises. Exercise load, tonnage, and rating of perceived exertion were assessed at baseline and every 6 weeks. RESULTS Training load increased to a greater extent and sometimes earlier for RT + BFR (57.7-106.3%) than heavy-load RT (42.3-54.3%) during chest press, seated row, and leg curl exercises, while there were similar increases (63.5-101.1%) for shoulder press, leg extension, and leg press exercises. Exercise tonnage was greater across all exercises for RT + BFR than heavy-load RT, although tonnage only increased during the chest press (70.7-80.0%) and leg extension (89.1%) exercises. Perceptions of exertion (4.8-7.2 au) and compliance (97.9-99.0%) were similar for both interventions. CONCLUSION The training-induced increases in load, high compliance, and moderate levels of exertion suggested that RT + BFR and heavy-load RT are viable interventions among people with MS. RT + BFR may be a preferred modality if heavy loads are not well tolerated and/or to promote early-phase training responses.
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Affiliation(s)
- Ethan C Hill
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA.
- Florida Space Institute, University of Central Florida, Partnership I, Research Parkway, Orlando, FL, 32826, USA.
- College of Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA.
| | - Jeffrey T Schmidt
- AdventHealth Sports Med and Rehab, 265 E Rollins St. Suite 9100, Orlando, FL, 32804, USA
| | - Kyle R Reedy
- AdventHealth Sports Med and Rehab, 265 E Rollins St. Suite 9100, Orlando, FL, 32804, USA
| | - Sean M Lubiak
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Chris E Proppe
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Paola M Rivera
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - David H Gonzalez-Rojas
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - John E Lawson
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Anuj J Prajapati
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Niriham M Shah
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Nihar N Patel
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Andrew M Guirgis
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Abner-Alexander Silverio
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Mason A Howard
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Hwan Choi
- College of Engineering, Mechanical and Aerospace, University of Central Florida, 4328 Scorpius St, Orlando, FL, 32816, USA
| | - Joshua L Keller
- College of Education and Professional Studies, University of South Alabama, 75 S University Blvd #3600, Mobile, AL, 36618, USA
- College of Medicine, Department of Physiology and Cell Biology, University of South Alabama, 5851 USA Dr. N, Mobile, AL, 36618, USA
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Bechan Vergara I, Puig-Diví A, Amestoy Alonso B, Milà-Villarroel R. Effects of low-load blood flow restriction training in healthy adult tendons: A systematic review and meta-analysis. J Bodyw Mov Ther 2024; 39:13-23. [PMID: 38876617 DOI: 10.1016/j.jbmt.2023.11.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/18/2023] [Accepted: 11/24/2023] [Indexed: 06/16/2024]
Abstract
OBJECTIVE To systematically review the effects of low-load blood flow restriction training (LL-BFR) on healthy adult tendons. DESIGN A systematic review with meta-analysis. LITERATURE SEARCH Six electronic databases were searched by two researchers. STUDY SELECTION CRITERIA Clinical trials comparing the effects of LL-BFR to high-load resistance training (HL-RT) or low-load resistance training (LL-RT) in healthy adult tendons. DATA SYNTHESIS Two reviewers selected the eligible clinical trials, and one reviewer exported the data. Two reviewers evaluated the study quality and risk of bias using the PEDro scale and the ROB2 scale. We performed meta-analysis where appropriate using a random-effects model. We rated the quality of evidence using GRADE. RESULTS Six studies were eligible. We analyzed tendon cross-sectional area (CSA) and tendon stiffness as the outcomes. Across all comparisons, there was low-to moderate-quality evidence of a difference between LL-BFR and LL-RT immediately after exercise. There was high-quality evidence of no difference between LL-BFR and HL-RT in the long term. CONCLUSION The effects of LL-BFR on the tendons depends on the time and dose of the intervention. LL-BFR could be useful to increase the CSA of the tendons in a similar or superior way to HL-RT after 8 weeks of intervention.
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Affiliation(s)
- Ilan Bechan Vergara
- Blanquerna School of Health Sciences - Ramon Llull University, c/ Padilla, 326, 08025, Barcelona, Spain.
| | - Albert Puig-Diví
- Blanquerna School of Health Sciences - Ramon Llull University, c/ Padilla, 326, 08025, Barcelona, Spain.
| | - Beñat Amestoy Alonso
- Neuroscience Lab (part of IDIBAPS, Barcelona), Calle Marina 312 3-4, 08025, Barcelona, Spain.
| | - Raimon Milà-Villarroel
- Blanquerna School of Health Sciences - Ramon Llull University, c/ Padilla, 326, 08025, Barcelona, Spain.
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Burton I, McCormack A. Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes. Front Sports Act Living 2022; 4:879860. [PMID: 35548459 PMCID: PMC9083008 DOI: 10.3389/fspor.2022.879860] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To identify current evidence on blood flow restriction training (BFRT) in tendon injuries and healthy tendons, evaluating physiological tendon effects, intervention parameters, and outcomes. Methods This scoping review was reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Databases searched included MEDLINE, CINAHL, AMED, EMBase, SPORTDiscus, Cochrane library (Controlled trials, Systematic reviews), and five trial registries. Two independent reviewers screened studies at title/abstract and full text. Following screening, data was extracted and charted, and presented as figures and tables alongside a narrative synthesis. Any study design conducted on adults, investigating the effects of BFRT on healthy tendons or tendon pathology were included. Data were extracted on physiological tendon effects, intervention parameters and outcomes with BFRT. Results Thirteen studies were included, three on tendinopathy, two on tendon ruptures, and eight on healthy Achilles, patellar, and supraspinatus tendons. A variety of outcomes were assessed, including pain, function, strength, and tendon morphological and mechanical properties, particularly changes in tendon thickness. BFRT intervention parameters were heterogeneously prescribed. Conclusion Despite a dearth of studies to date on the effects of BFRT on healthy tendons and in tendon pathologies, preliminary evidence for beneficial effects of BFRT on tendons and clinical outcomes is encouraging. As BFRT is a relatively novel method, definitive conclusions, and recommendations on BFRT in tendon rehabilitation cannot be made at present, which should be addressed in future research, due to the potential therapeutic benefits highlighted in this review.
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Affiliation(s)
- Ian Burton
- Musculoskeletal (MSK) Service, Fraserburgh Physiotherapy Department, Fraserburgh Hospital, National Health Service (NHS) Grampian, Aberdeen, United Kingdom
- *Correspondence: Ian Burton
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