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Hammert WB, Kataoka R, Yamada Y, Song JS, Kang A, Spitz RW, Loenneke JP. Progression of total training volume in resistance training studies and its application to skeletal muscle growth. Physiol Meas 2024; 45:08TR03. [PMID: 39178897 DOI: 10.1088/1361-6579/ad7348] [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: 09/21/2023] [Accepted: 08/23/2024] [Indexed: 08/26/2024]
Abstract
Progressive overload describes the gradual increase of stress placed on the body during exercise training, and is often quantified (i.e. in resistance training studies) through increases in total training volume (i.e. sets × repetitions × load) from the first to final week of the exercise training intervention. Within the literature, it has become increasingly common for authors to discuss skeletal muscle growth adaptations in the context of increases in total training volume (i.e. the magnitude progression in total training volume). The present manuscript discusses a physiological rationale for progressive overload and then explains why, in our opinion, quantifying the progression of total training volume within research investigations tells very little about muscle growth adaptations to resistance training. Our opinion is based on the following research findings: (1) a noncausal connection between increases in total training volume (i.e. progressively overloading the resistance exercise stimulus) and increases in skeletal muscle size; (2) similar changes in total training volume may not always produce similar increases in muscle size; and (3) the ability to exercise more and consequently amass larger increases in total training volume may not inherently produce more skeletal muscle growth. The methodology of quantifying changes in total training volume may therefore provide a means through which researchers can mathematically determine the total amount of external 'work' performed within a resistance training study. It may not, however, always explain muscle growth adaptations.
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Affiliation(s)
- William B Hammert
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, United States of America
| | - Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, United States of America
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, United States of America
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, United States of America
| | - Anna Kang
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, United States of America
| | - Robert W Spitz
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, United States of America
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, United States of America
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Franz A, Ji S, Luckmann S, Boemer T, Fröschen F, Wahl P, Behringer M. Comparison of Metabolic, Ionic, and Electrolyte Responses to Exhaustive Low-Load Strength Training With and Without Blood Flow Restriction and High-Load Resistance Training. Scand J Med Sci Sports 2024; 34:e14721. [PMID: 39219240 DOI: 10.1111/sms.14721] [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: 03/06/2024] [Revised: 08/13/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
Low-load blood-flow-restriction resistance training (LL-BFR-RT) is gaining popularity, but its physiological effects remain unclear. This study aimed to compare LL-BFR-RT with low-load resistance exercise (LL-RT) and high-load resistance exercise (HL-RT) on metabolism, electrolytes, and ions in the lower extremities by invasive catheter measurements, which are crucial for risk assessment. Ten healthy men (27.6 ± 6.4 years) completed three trials of knee-extensor exercises with LL-RT (30% 1RM), LL-BFR-RT (30% 1RM, 50% limb occlusion pressure), and HL-RT (75% 1RM). The exercise protocol consisted of four sets to voluntary muscle failure with 1 min of rest between sets. Blood gas analysis was collected before, during, and after each trial through intravenous catheters at the exercising leg. LL-BFR-RT had lower total workload (1274 ± 237 kg, mean ± SD) compared to LL-RT (1745 ± 604 kg), and HL-RT (1847 ± 367 kg, p < 0.01), with no difference between LL-RT and HL-RT. Pain perception did not differ significantly. Exercise-induced drop in oxygen partial pressure, lactate accumulation and electrolyte shifts (with increased [K+]) occurred during under all conditions (p < 0.001). Creatine kinase and lactate dehydrogenase increased significantly 24- and 48-h postexercise under all three conditions (p < 0.001). This study, using invasive catheter measurements, found no significant differences in metabolic, ionic, and electrolyte responses among LL-BFR-RT, LL-RT, and HL-RT when exercised to voluntary muscular failure. LL-BFR-RT reduced time to failure without specific physiological responses.
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Affiliation(s)
- Alexander Franz
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany
- Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Sanghyeon Ji
- Section Exercise Physiology, German Sports University Cologne, Cologne, Germany
- The German Research Center of Elite Sports, German Sports University Cologne, Cologne, Germany
| | - Stefan Luckmann
- Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Tobias Boemer
- Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
- Section Exercise Physiology, German Sports University Cologne, Cologne, Germany
| | - Frank Fröschen
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany
| | - Patrick Wahl
- Section Exercise Physiology, German Sports University Cologne, Cologne, Germany
- The German Research Center of Elite Sports, German Sports University Cologne, Cologne, Germany
| | - Michael Behringer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt, Germany
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Moreno EN, Figueroa EC, Heath AW, Buckner SL. An examination of acute physiological and perceptual responses following blood flow restriction exercise using a traditional research device or novel, automated system. Physiol Meas 2024; 45:065007. [PMID: 38838705 DOI: 10.1088/1361-6579/ad548c] [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: 09/22/2023] [Accepted: 06/05/2024] [Indexed: 06/07/2024]
Abstract
Objective. To compare the acute physiological and perceptual responses to blood flow restriction (BFR) exercise using a traditional research device or novel, automated system.Methods. Forty-four resistance trained individuals performed four sets of unilateral elbow flexion exercise (30% one-repetition maximum) to volitional failure using two distinct restrictive devices [SmartCuffs PRO BFR Model (SMARTCUFF), Hokanson E20 Rapid Inflation device (HOKANSON)] and with two levels of BFR [40% limb occlusion pressure (LOP), 80% LOP]. Blood pressure (BP), muscle thickness (MT), and isometric strength (ISO) were assessed prior to and following exercise. Perceptual responses [ratings of perceived exertion (RPE), discomfort] were assessed prior to exercise and following each exercise set.Main results. Data are displayed as means (SD). Immediately following exercise with 40% LOP, there were no statistical differences between devices for BP, MT, and ISO. However, only following Set 1 of exercise, RPE was greater with SMARTCUFF compared to HOKANSON (p< 0.05). In addition, only following Set 2 of exercise, discomfort was greater with HOKANSON compared to SMARTCUFF (p< 0.001). Immediately following exercise with 80% LOP, there were no statistical differences between devices for BP, MT, and ISO. However, only following Set 4 of exercise, RPE was greater with HOKANSON compared to SMARTCUFF (p< 0.05). In addition, following all exercise sets, discomfort was greater with HOKANSON compared to SMARTCUFF (p< 0.001). For repetitions completed with 40% LOP there were no statistical differences between SMARTCUFF and HOKANSON across any exercise sets. For repetitions completed with 80% LOP there were no statistical differences between SMARTCUFF and HOKANSON across Set 1 of exercise (p= 0.34), however, for Sets 2-4 of exercise, significantly greater number of repetitions were completed during SMARTCUFF than HOKANSON.Significance. The present study provides valuable insight into the efficacy of a novel, automated BFR system (SMARTCUFF) eliciting comparable acute physiological responses to BFR exercise and in some cases favorable perceptual responses when compared to a traditional research device (HOKANSON).
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Affiliation(s)
- Enrique N Moreno
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
| | - Elias C Figueroa
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
| | - Andrew W Heath
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
| | - Samuel L Buckner
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
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de Queiros VS, Rolnick N, dos Santos ÍK, de França IM, Lima RJ, Vieira JG, Aniceto RR, Neto GR, de Medeiros JA, Vianna JM, de Araújo Tinôco Cabral BG, Silva Dantas PM. Acute Effect of Resistance Training With Blood Flow Restriction on Perceptual Responses: A Systematic Review and Meta-Analysis. Sports Health 2023; 15:673-688. [PMID: 36415041 PMCID: PMC10467469 DOI: 10.1177/19417381221131533] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory. OBJECTIVES To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses. DATA SOURCES CINAHL, Cochrane Library, PubMed®, Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022. STUDY SELECTION Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 2. DATA EXTRACTION All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer. RESULTS Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar. CONCLUSION In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.
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Affiliation(s)
- Victor Sabino de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, Bronx, New York, USA
| | - Ísis Kelly dos Santos
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil; Graduate Program in Physical Education, State University of Rio Grande do Norte (UERN), Mossoró-RN, Brazil
| | - Ingrid Martins de França
- Graduate Program in Physiotherapy, Federal University of Rio Grande do Rio Grande Norte (UFRN), Natal-RN, Brazil
| | - Rony Jerônimo Lima
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - João Guilherme Vieira
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil; Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil
| | - Rodrigo Ramalho Aniceto
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Currais Novos-RN, Brazil
| | - Gabriel Rodrigues Neto
- Faculty Nova Esperança (FAMENE/FACENE), Coordination of Physical Education, Nursing and Medical Schools, João Pessoa, Brazil; Coordination of Physical Education, University Center for Higher Education and Development (CESED/UNIFACISA/FCM/ESAC), Campina Grande, Brazil
| | - Jason Azevedo de Medeiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - Jeferson Macedo Vianna
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil; Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil
| | - Breno Guilherme de Araújo Tinôco Cabral
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil)
| | - Paulo Moreira Silva Dantas
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil)
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Chang H, Yan J, Lu G, Chen B, Zhang J. Muscle strength adaptation between high-load resistance training versus low-load blood flow restriction training with different cuff pressure characteristics: a systematic review and meta-analysis. Front Physiol 2023; 14:1244292. [PMID: 37693006 PMCID: PMC10485702 DOI: 10.3389/fphys.2023.1244292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose: In this systematic review and meta-analysis, blood flow restriction (BFR) with low-load resistance training (BFR-RT) was compared with high-load resistance training (HL-RT) on muscle strength in healthy adults. The characteristics of cuff pressure suitable for muscle strength gain were also investigated by analyzing the effects of applying different occlusion pressure prescriptions and cuff inflation patterns on muscle strength gain. Methods: Literature search was conducted using PubMed, Ovid Medline, ProQuest, Cochrane Library, Embase, and Scopus databases to identify literature published until May 2023. Studies reporting the effects of BFR-RT interventions on muscle strength gain were compared with those of HL-RT. The risk of bias in the included trials was assessed using the Cochrane tool, followed by a meta-analysis to calculate the combined effect. Subgroup analysis was performed to explore the beneficial variables. Results: Nineteen articles (42 outcomes), with a total of 458 healthy adults, were included in the meta-analysis. The combined effect showed higher muscle strength gain with HL-RT than with BFR-RT (p = 0.03, SMD = -0.16, 95% CI: -0.30 to -0.01). The results of the subgroup analysis showed that the BFR-RT applied with incremental and individualized pressure achieved muscle strength gain similar to the HL-RT (p = 0.8, SMD = -0.05, 95% CI: -0.44 to 0.34; p = 0.68, SMD = -0.04, 95% CI: -0.23 to 0.15), but muscle strength gain obtained via BFR-RT applied with absolute pressure was lower than that of HL-RT (p < 0.05, SMD = -0.45, 95% CI: -0.71 to -0.19). Furthermore, muscle strength gain obtained by BFR-RT applied with intermittent pressure was similar to that obtained by HL-RT (p = 0.88, SMD = -0.02, 95% CI: -0.27 to 0.23), but muscle strength gain for BFR-RT applied with continuous pressure showed a less prominent increase than that for HL-RT (p < 0.05, SMD = -0.3, 95% CI: -0.48 to -0.11). Conclusion: In general, HL-RT produces superior muscle strength gains than BFR-RT. However, the application of individualized, incremental, and intermittent pressure exercise protocols in BFR-RT elicits comparable muscle strength gains to HL-RT. Our findings indicate that cuff pressure characteristics play a significant role in establishing a BFR-RT intervention program for enhancing muscle strength in healthy adults. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails; Identifier: PROSPERO (CRD42022364934).
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Affiliation(s)
- Hualong Chang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jing Yan
- College of Education, Anyang Normal University, Anyang, China
| | - Guiwei Lu
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Biao Chen
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jianli Zhang
- Exercise and Metabolism Research Center, College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Duarte de Oliveira JL, Vieira JG, Sabino de Queiros V, Mourão Júnior CA, Panza PS, Krzysztofik M, Bichowska M, Guilherme de Araújo Tinôco Cabral B, Rolnick N, Wilk M, Vianna JM. Cardiovascular and Perceptual Responses to Resistance Training with Practical Blood Flow Restriction Induced by a Non-Elastic Band vs. Pneumatic Cuff: A Crossover Randomized Study. Percept Mot Skills 2023; 130:1152-1167. [PMID: 36914166 DOI: 10.1177/00315125231162732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Our purpose in this study was to analyze perceptual and cardiovascular responses in low-load resistance training (RT) sessions associated with a fixed non-elastic band compressed to the proximal region of the arms (p-BFR) versus a pneumatic cuff inflated to a pressure of 150 mmHg (t-BFR). Participants (16 healthy trained men) were randomly assigned to two conditions of low-load RT (20% one repetition maximum [1RM]) with BFR (p-BFR or t-BFR). In both conditions, the participants performed five exercises (4 sets/30-15-15-15) for the upper-limbs, but in one of the conditions, the exercises were performed with a p-BFR induced by a non-elastic band, while in the other, the exercises were performed with a t-BFR using a device with similar width. The devices used to generate the BFR had similar widths (5 cm). Brachial blood pressure (bBP) and heart rate (HR) were measured before, after each exercise and after the experimental session (5-, 10-, 15-, and 20 min post-session). Rating of perceived exertion (RPE) and rating of pain perception (RPP) were reported after each exercise and 15 minutes post-session. HR increased during the training session in both conditions, with no differences between p-BFR and t-BFR. Neither intervention increased diastolic BP (DBP) during training, but there was a significant post-session reduction in DBP in the p-BFR, with no differences observed between conditions. There were no significant differences in RPE and RPP in the two training conditions, with both conditions associated with higher RPE and RPP at the end versus beginning of the experimental session. We conclude that when BFR device width and material are similar, low-load training with t-BFR and p-BFR promotes similar acute perceptual and cardiovascular responses in healthy trained men.
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Affiliation(s)
- Jorge Luiz Duarte de Oliveira
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - João Guilherme Vieira
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Victor Sabino de Queiros
- Postgraduate Program in Health Sciences, 28123Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Patrícia Silva Panza
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Michał Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Marta Bichowska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | | | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, New York, USA
| | - Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Jeferson Macedo Vianna
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
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Moreno EN, Hammert WB, Martin CC, Buckner SL. Acute muscular and cardiovascular responses to high load training with pre-exercise blood flow restriction. Clin Physiol Funct Imaging 2023; 43:109-119. [PMID: 36401343 DOI: 10.1111/cpf.12799] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study is to examine the acute muscular and cardiovascular responses to applying blood flow restriction (BFR) before high-load training. METHODS Forty trained individuals visited the lab on three occasions. On Visit 1, participants completed paperwork and performed strength assessments. During Visits 2 and 3, participants completed four exercise conditions (one in each arm during each visit) as follows: (1) traditional resistance training (TRAD), (2) low load training with BFR (LLBFR), (3) low repetition high load training with pre-exercise BFR (PreBFR), and (4) low repetition traditional training (LRTRAD). Blood pressure, muscle thickness (MT), and isometric strength (ISO) were measured before and after exercise. RESULTS Data are displayed as means (SD). Immediately following exercise, MT in TRAD was greater compared with PreBFR (mean difference = 0.18[0.30] cm, p < 0.001) and LRTRAD (mean difference = 0.28[0.30] cm, p < 0.001). In addition, LLBFR demonstrated greater MT compared with PreBFR (mean difference = 0.24[0.30] cm, p < 0.001]. Immediately following exercise, ISO was lower in TRAD compared with PreBFR (mean difference = 33.8[46.9]N, p < 0.001) and the LRTRAD condition (mean difference = 32.8[50.4]N, p < 0.001). In addition, ISO was lower in LLBFR compared with PreBFR (mean difference = 43.9 [47.4]N, p < 0.001) and LRTRAD (mean difference = 42.9 [43.8]N, p < 0.001). Immediately following exercise, systolic blood pressure was greater in TRAD compared with PreBFR and LRTRAD. CONCLUSION The application of BFR before engaging in high-load training does not seem to augment the muscular responses to exercise when compared with traditional high loads alone; however, it may pose less demand on the cardiovascular system.
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Affiliation(s)
- Enrique N Moreno
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - William B Hammert
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - Cole C Martin
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - Samuel L Buckner
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
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Sandbach PJ, Carvajal MS, Uygur M, Dankel SJ. The impact of post-exercise blood flow restriction on local muscle endurance of a remote limb. Clin Physiol Funct Imaging 2022; 42:356-361. [PMID: 35778804 DOI: 10.1111/cpf.12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies have examined the influence of post-exercise blood flow restriction as a mechanism to activate muscle afferents and assess non-local muscle fatigue. While these studies have assessed fatigue during maximal contractions, less is known on how these afferents may impact submaximal local muscle endurance which was the purpose of the present study. METHODS Individuals completed two testing visits which involved completing a set of elbow flexion exercises to volitional failure on the non-dominant followed by the dominant arm. During both trials, a pneumatic cuff was placed at the top of the non-dominant arm prior to exercise. This cuff was inflated to either 0% (control) or 70% (experimental) of the individual's arterial occlusion pressure immediately after the set was completed. We then evaluated how this impacted local muscle endurance of the dominant arm using a Bayesian paired samples t-test with an uninformed prior width of 0.707 centered on 0. RESULTS A total of 36 individuals completed the study (18 females). There was a greater discomfort present in the experimental trial when compared to the control trial [control: 4.5 (SD: 2.4), experimental: 5.8 (SD: 1.9); BF10 =61.46], but there were no differences in repetitions completed on the dominant arm [control: 43 (SD: 9), experimental: 43 (SD: 10); BF10 = 0.179]. CONCLUSION Applying blood flow restriction post-exercise induced sensations of discomfort but did not alter local muscle endurance of the contralateral limb. These results suggest that increasing the activation of muscle afferents does not appear to alter submaximal muscle endurance of a remote limb. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Paul J Sandbach
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Marlon S Carvajal
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Mehmet Uygur
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
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Aniceto RR, da Silva Leandro L. Practical Blood Flow Restriction Training: New Methodological Directions for Practice and Research. SPORTS MEDICINE - OPEN 2022; 8:87. [PMID: 35763185 PMCID: PMC9240154 DOI: 10.1186/s40798-022-00475-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/08/2022] [Indexed: 01/23/2023]
Abstract
Most studies with blood flow restriction (BFR) training have been conducted using devices capable of regulating the restriction pressure, such as pneumatic cuffs. However, this may not be a viable option for the general population who exercise in gyms, squares and sports centers. Thinking about this logic, practical blood flow restriction (pBFR) training was created in 2009, suggesting the use of elastic knee wraps as an alternative to the traditional BFR, as it is low cost, affordable and practical. However, unlike traditional BFR training which seems to present a consensus regarding the prescription of BFR pressure based on arterial occlusion pressure (AOP), studies on pBFR training have used different techniques to apply the pressure/tension exerted by the elastic wrap. Therefore, this Current Opinion article aims to critically and chronologically examine the techniques used to prescribe the pressure exerted by the elastic wrap during pBFR training. In summary, several techniques were found to apply the elastic wrap during pBFR training, using the following as criteria: application by a single researcher; stretching of the elastic (absolute and relative overlap of the elastic); the perceived tightness scale; and relative overlap of the elastic based on the circumference of the limbs. Several studies have shown that limb circumference seems to be the greatest predictor of AOP. Therefore, we reinforce that applying the pressure exerted by the elastic for pBFR training based on the circumference of the limbs is an excellent, valid and safe technique.
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Affiliation(s)
- Rodrigo Ramalho Aniceto
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Department of Physical Education and Sport, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Rua Manoel Lopes Filho, nº 773. Valfredo Galvão, Currais Novos, RN, CEP: 59380-000, Brazil.
| | - Leonardo da Silva Leandro
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Department of Physical Education and Sport, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Rua Manoel Lopes Filho, nº 773. Valfredo Galvão, Currais Novos, RN, CEP: 59380-000, Brazil
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10
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The Effect of Increasing Blood Flow Restriction Pressure When the Contractions Are Already Occlusive. J Sport Rehabil 2021; 31:152-157. [PMID: 34697249 DOI: 10.1123/jsr.2020-0402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/25/2021] [Accepted: 08/08/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Blood flow restricted exercise involves the use of external pressure to enhance fatigue and augment exercise adaptations. The mechanisms by which blood flow restricted exercise limits muscular endurance are not well understood. OBJECTIVE To determine how increasing blood flow restriction pressure impacts local muscular endurance, discomfort, and force steadiness when the contractions are already occlusive. DESIGN Within-participant, repeated-measures crossover design. SETTING University laboratory. PATIENTS A total of 22 individuals (13 males and 9 females). INTERVENTION Individuals performed a contraction at 30% of maximal isometric elbow flexion force for as long as possible. One arm completed the contraction with 100% of arterial occlusion pressure applied, while the other arm had 150% of arterial occlusion pressure applied. At the end of the protocol, individuals were asked to rate their perceived discomfort. MAIN OUTCOME MEASURES Time to task failure, discomfort, and force steadiness. RESULTS Individuals had a longer time to task failure when performing the 100% arterial occlusion condition compared with the 150% arterial occlusion pressure condition (time to task failure = 82.4 vs 70.8 s; Bayes factors = 5.77). There were no differences in discomfort between the 100% and 150% conditions (median discomfort = 5.5 vs 6; Bayes factors = 0.375) nor were there differences in force steadiness (SD of force output 3.16 vs 3.31 N; Bayes factors = 0.282). CONCLUSION The results of the present study suggest that, even when contractions are already occlusive, increasing the restriction pressure reduces local muscle endurance but does not impact discomfort or force steadiness. This provides an indication that mechanisms other than the direct alteration of blood flow are contributing to the increased fatigue with added restrictive pressure. Future studies are needed to examine neural mechanisms that may explain this finding.
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11
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Bielitzki R, Behrendt T, Behrens M, Schega L. Current Techniques Used for Practical Blood Flow Restriction Training: A Systematic Review. J Strength Cond Res 2021; 35:2936-2951. [PMID: 34319939 DOI: 10.1519/jsc.0000000000004104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Bielitzki, R, Behrendt, T, Behrens, M, and Schega, L. Current techniques used for practical blood flow restriction training: a systematic review. J Strength Cond Res 35(10): 2936-2951, 2021-The purpose of this article was to systematically review the available scientific evidence on current methods used for practical blood flow restriction (pBFR) training together with application characteristics as well as advantages and disadvantages of each technique. A literature search was conducted in different databases (PubMed, Web of Science, Scopus, and Cochrane Library) for the period from January 2000 to December 2020. Inclusion criteria for this review were (a) original research involving humans, (b) the use of elastic wraps or nonpneumatic cuffs, and (c) articles written in English. Of 26 studies included and reviewed, 15 were conducted using an acute intervention (11 in the lower body and 4 in the upper body), and 11 were performed with a chronic intervention (8 in the lower body, 1 in the upper body, and 2 in both the upper and the lower body). Three pBFR techniques could be identified: (a) based on the perceptual response (perceived pressure technique), (b) based on the overlap of the cuff (absolute and relative overlap technique), and (c) based on the cuffs' maximal tensile strength (maximal cuff elasticity technique). In conclusion, the perceived pressure technique is simple, valid for the first application, and can be used independently of the cuffs' material properties, but is less reliable within a person over time. The absolute and relative overlap technique as well as the maximal cuff elasticity technique might be applied more reliably due to markings, but require a cuff with constant material properties over time.
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Affiliation(s)
- Robert Bielitzki
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
| | - Tom Behrendt
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
- Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
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12
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Wilk M, Trybulski R, Krzysztofik M, Wojdala G, Campos Y, Zajac A, Lulińska E, Stastny P. Acute Effects of Different Blood Flow Restriction Protocols on Bar Velocity During the Squat Exercise. Front Physiol 2021; 12:652896. [PMID: 34234686 PMCID: PMC8255669 DOI: 10.3389/fphys.2021.652896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
The main goal of the present study was to evaluate the effects of different blood flow restriction (BFR) protocols (continuous and intermittent) on peak bar velocity (PV) and mean bar velocity (MV) during the squat exercise at progressive loads, from 40 to 90% 1RM. Eleven healthy men (age = 23.4 ± 3.1 years; body mass = 88.5 ± 12.1 kg; squat 1RM = 183.2 ± 30.7 kg; resistance training experience, 5.7 ± 3.6 years) performed experimental sessions once a week for 3 weeks in random and counterbalanced order: without BFR (NO-BFR), with intermittent BFR (I-BFR), and with continuous BFR (C-BFR). During the experimental session, the participants performed six sets of the barbell squat exercise with loads from 40 to 90% 1RM. In each set, they performed two repetitions. During the C-BFR session, the cuffs were maintained throughout the training session. During the I-BFR, the cuffs were used only during the exercise and released for each rest interval. The BFR pressure was set to ∼80% arterial occlusion pressure (AOP). Analyses of variance showed a statistically significant interaction for MV (p < 0.02; η2 = 0.18). However, the post hoc analysis did not show significant differences between particular conditions for particular loads. There was no significant condition × load interaction for PV (p = 0.16; η2 = 0.13). Furthermore, there were no main effects for conditions in MV (p = 0.38; η2 = 0.09) as well as in PV (p = 0.94; η2 = 0.01). The results indicate that the different BFR protocols used during lower body resistance exercises did not reduce peak bar velocity and mean bar velocity during the squat exercise performed with various loads.
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Affiliation(s)
- Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Robert Trybulski
- Department of Medical Sciences, The Wojciech Korfanty School of Economics, Katowice, Poland.,Provita Zory Medical Center, Zory, Poland
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Grzegorz Wojdala
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Yuri Campos
- Postgraduate Program, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, Brazil.,Study Group and Research in Neuromuscular Responses, Federal University of Lavras, Lavras, Brazil
| | - Adam Zajac
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Ewelina Lulińska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Petr Stastny
- Department of Sport Games, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
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13
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Wilk M, Gepfert M, Krzysztofik M, Stastny P, Zajac A, Bogdanis GC. Acute Effects of Continuous and Intermittent Blood Flow Restriction on Movement Velocity During Bench Press Exercise Against Different Loads. Front Physiol 2020; 11:569915. [PMID: 33329020 PMCID: PMC7728989 DOI: 10.3389/fphys.2020.569915] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/20/2020] [Indexed: 01/02/2023] Open
Abstract
This study evaluated the effects of continuous and intermittent blood flow restriction (BFR) with 70% of full arterial occlusion pressure on bar velocity during the bench press exercise against a wide range of resistive loads. Eleven strength-trained males (age: 23.5 ± 1.4 years; resistance training experience: 2.8 ± 0.8 years, maximal bench press strength - 1RM = 101.8 ± 13.9 kg; body mass = 79.8 ± 10.4 kg), performed three different testing protocols in random and counterbalanced order: without BFR (NO-BFR); intermittent BFR (I-BFR) and continuous BFR (C-BFR). During each experimental session, subjects performed eight sets of two repetitions each, with increasing loads from 20 to 90% 1RM (10% steps), and 3 min rest between each set. In the C-BFR condition occlusion was kept throughout the trial, while in the I-BFR, occlusion was released during each 3 min rest interval. Peak bar velocity (PV) during the bench press exercise was higher by 12-17% in both I-BFR and C-BFR compared with NO-BFR only at the loads of 20, 30, 40, and 50% 1RM (p < 0.001), while performance at higher loads remained unchanged. Mean bar velocity (MV) was unaffected by occlusion (p = 0.342). These results indicate that BFR during bench press exercise increases PV and this may be used as an enhanced stimulus during explosive resistance training. At higher workloads, bench press performance was not negatively affected by BFR, indicating that the benefits of exercise under occlusion can be obtained while explosive performance is not impaired.
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Affiliation(s)
- Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Mariola Gepfert
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Petr Stastny
- Department of Sport Games, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Adam Zajac
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Gregory C. Bogdanis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
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14
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Freitas EDS, Galletti BRA, Koziol KJ, Miller RM, Heishman AD, Black CD, Bemben D, Bemben MG. The Acute Physiological Responses to Traditional vs. Practical Blood Flow Restriction Resistance Exercise in Untrained Men and Women. Front Physiol 2020; 11:577224. [PMID: 33117195 PMCID: PMC7552431 DOI: 10.3389/fphys.2020.577224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/09/2020] [Indexed: 11/13/2022] Open
Abstract
This study compared the acute physiological responses of traditional and practical blood flow restriction resistance exercise (tBFR and pBFR, respectively) and high- and low-load resistance exercise without BFR (HL and LL, respectively), as well as the potential sex differences within the aforementioned exercise methods. Fourteen men and fifteen women randomly completed the following experimental conditions: (1) tBFR, consisting of four sets of 30-15-15-15 repetitions of the bilateral horizontal leg press and knee extension exercises, at 30% of one-repetition maximum (1-RM), with a 13.5 cm wide pneumatic cuff placed at the most proximal portion of each thigh and inflated to a pressure equivalent to 50% of the participant’s total occlusion pressure; (2) pBFR, which was the same as the tBFR condition, except that an elastic band wrapped around the proximal portion of each thigh at a tightness of 7 on a 0 to 10 perceived pressure scale was used to reduce blood flow; (3) LL, same as the tBFR and pBFR protocols, except that no BFR was applied; and (4) HL, consisting of 3 sets of 10 repetitions at 80% of 1-RM, with the same 1-min rest interval between sets and a 3-min rest period between exercises. At baseline, immediately post-, 5 min post-, and 15 min post-exercise, whole-blood lactate (WBL), indices of muscle swelling (muscle thickness and thigh circumference), hematocrit and plasma volume changes, were measured as well as superficial electromyography (sEMG) amplitude during exercise. There were no significant (p > 0.05) differences between the tBFR and pBFR exercise protocols for any of the physiological parameters assessed. However, significantly greater (p < 0.05) WBL and sEMG values were observed for HL compared to the remaining exercise conditions. Finally, males displayed greater WBL levels than females at 15 min post-exercise. Interestingly, males also displayed significantly (p < 0.05) greater sEMG amplitude than females within the low-load trials during leg press, but no significant (p < 0.05) sex differences were observed during knee extension. In conclusion, tBFR and pBFR seemed to be capable of inducing the same acute physiological responses. Furthermore, males displayed greater responses than females for some of the physiological parameters measured.
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Affiliation(s)
- Eduardo D S Freitas
- Neuromuscular Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Bianca R A Galletti
- Neuromuscular Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Karolina J Koziol
- Neuromuscular Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Ryan M Miller
- Neuromuscular Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Aaron D Heishman
- Neuromuscular Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Christopher D Black
- Sensory and Muscle Function Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Debra Bemben
- Bone Density Research Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
| | - Michael G Bemben
- Neuromuscular Laboratory, Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, United States
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15
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Miller RM, Galletti BAR, Koziol KJ, Freitas EDS, Heishman AD, Black CD, Larson DJ, Bemben DA, Bemben MG. Perceptual responses: Clinical versus practical blood flow restriction resistance exercise. Physiol Behav 2020; 227:113137. [PMID: 32798570 DOI: 10.1016/j.physbeh.2020.113137] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/25/2022]
Abstract
The purpose of the current investigation was to compare the acute perceptual responses during low-load resistance exercise (RE) with clinical blood flow restriction (cBFR-RE) and practical blood flow restriction (pBFR-RE), and during conventional low- (LL-RE) and high-load resistance exercise (HL-RE), to determine if these responses differed between young males and females. Twenty-nine participants (14 males: 23.6±2.7years, 25.3±3.1kg/m2 and 15 females: 20.3±1.6years, 23.4±1.9kg/m2) completed the following exercise conditions in a randomized design: 1) cBFR-RE, 2) pBFR-RE, 3) HL-RE, and 4) LL-RE. Low-load conditions consisted of 30-15-15-15 repetitions of two-leg press (LP) and knee extension (KE) exercises with 30% one-repetition maximum (1-RM), and HL-RE consisted of 3 sets of 10 repetitions at 80% 1-RM, all with 60s rest intervals. Ratings of perceived exertion (RPE) and discomfort were assessed before exercise and immediately following each set. RPE was significantly higher in HL-RE compared to all low-load conditions for both exercises after each set (all p<0.05). cBFR-RE resulted in significantly greater RPE than pBFR-RE and LL-RE for both exercises for sets 1-4 for LP and sets 2-3 for KE (all p<0.05). Levels of discomfort were similar between cBFR-RE and HL-RE, which tended to be significantly higher than pBFR-RE and LL-RE (p<0.05). Men reported significantly greater RPE than women following sets 2-4 during KE with cBFR-RE and sets 2 and 3 during KE for HL-RE (all p<0.05). Males also reported significantly greater discomfort than women following sets 2-4 for KE LL-RE (p<0.05). Altogether, these data suggest that pBFR-RE may provide a more favorable BFR condition based on perceptual responses and that perceptual responses may differ between sexes across varying resistance exercise conditions.
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Affiliation(s)
- Ryan M Miller
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA.
| | - Bianca A R Galletti
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA
| | - Karolina J Koziol
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA
| | - Eduardo D S Freitas
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA
| | - Aaron D Heishman
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA; Department of Athletics, Basketball Strength and Performance, University of Oklahoma, Norman, Oklahoma, USA
| | - Christopher D Black
- Department of Health and Exercise Science, Sensory and Muscle Function Research Laboratory, University of Oklahoma, USA
| | - Daniel J Larson
- Departmeny of Health and Exercise Science, Sport, Health, and Exercise Data Analytics Laboratory, University of Oklahoma, Norman, Oklahoma, USA
| | - Debra A Bemben
- Departmeny of Health and Exercise Science, Bone Density Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA
| | - Michael G Bemben
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, University of Oklahoma, Norman, Oklahoma, USA
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16
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Wilk M, Krzysztofik M, Filip A, Lockie RG, Zajac A. The Acute Effects of External Compression With Blood Flow Restriction on Maximal Strength and Strength-Endurance Performance of the Upper Limbs. Front Physiol 2020; 11:567. [PMID: 32587525 PMCID: PMC7298135 DOI: 10.3389/fphys.2020.00567] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022] Open
Abstract
The main goal of the present study was to evaluate the acute effects external compression with blood flow restriction (BFR) at 100 and 150% of full arterial occlusion pressure (AOP) on maximal strength and strength-endurance performance during the bench press (BP) exercise. The study included 12 strength-trained male subjects (age = 23.2 ± 2.66 years; body mass = 75.3 ± 6.33 kg; height = 179.1 ± 3.82 cm), experienced in resistance training (5.7 ± 2.93 years). During the experimental sessions in a randomized crossover design, the subjects performed a 1 repetition maximum (1RM) test and three sets of the BP using 60% 1RM to failure with three different conditions: without BFR (NO-BFR); BFR with a pressure of 100% AOP (BFR100); and BFR with a pressure of 150% AOP (BFR150). The differences between the NO-BFR, BFR100, and BFR150 conditions were examined using repeated measures ANOVA. The ANOVA indicated significant main effect for condition in 1RM, number of performed repetitions (REP), and time under tension (TUT) (p < 0.01). Post hoc analyses for the main effect indicated significant increases in 1RM (p < 0.01; 95.00 ± 15.37 vs 91.87 ± 15.99), REP (p < 0.01; 17.56 ± 3.36 vs 15.67 ± 5.24), and TUT (p < 0.01; 32.89 ± 6.40 vs 28.72 ± 6.18) for the BFR150 condition compared to NO-BFR. Furthermore, significant increases in REP (p = 0.03; 17.56 ± 3.36 vs 16.47 ± 4.01) and TUT (p = 0.03; 32.89 ± 6.40 vs 30.00 ± 6.45) were observed for the BFR150 condition compared to the BFR100. The results of the present study indicate that high external compression increases maximal strength evaluated by the 1RM test, as well as endurance performance during three sets of the BP exercise.
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Affiliation(s)
- Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Aleksandra Filip
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Robert G Lockie
- Center for Sports Performance, Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States
| | - Adam Zajac
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
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17
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Bowman EN, Elshaar R, Milligan H, Jue G, Mohr K, Brown P, Watanabe DM, Limpisvasti O. Upper-extremity blood flow restriction: the proximal, distal, and contralateral effects-a randomized controlled trial. J Shoulder Elbow Surg 2020; 29:1267-1274. [PMID: 32423577 DOI: 10.1016/j.jse.2020.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/28/2020] [Accepted: 02/02/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Blood flow restriction (BFR) training with low weight is purported to induce similar physiological changes to high-weight regimens with the benefit of less tissue stress. We hypothesized that low-weight training with BFR would produce increased gains in strength and hypertrophy for muscle groups proximal, distal, and contralateral to tourniquet placement compared with low-weight training alone. METHODS In this prospective, randomized controlled trial, healthy subjects were randomized into a 6-week low-weight training program either with or without BFR on 1 extremity. Outcome measures included limb circumference and strength. Comparisons were made between the BFR and non-BFR extremities, BFR and control groups, and non-BFR extremity and control groups. RESULTS A total of 24 subjects (14 BFR and 10 control subjects) completed the protocol. Significantly greater gains were observed in dynamometric strength both proximal (shoulder scaption [30% greater], flexion [23%], and abduction [22%]) and distal (grip strength [13%]) to the tourniquet in the BFR limb compared with both the non-BFR extremity and the control group (P < .05). Arm and forearm circumferences significantly increased in the BFR limb compared with the non-BFR limb and control group (P = .01). The non-BFR extremity demonstrated greater grip strength than the control group (9%, P < .01). No adverse events were reported. CONCLUSION Low-weight BFR training provided a greater increase in strength and hypertrophy in the upper-extremity proximal and distal muscle groups compared with the control group. The non-BFR extremity showed a significant increase in grip strength compared with the control group, indicating a potential systemic effect.
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Affiliation(s)
- Eric N Bowman
- Department of Orthopaedics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Rami Elshaar
- Rochester Regional Health Orthopaedics, Pittsford, NY, USA
| | | | - Gregory Jue
- Select Physical Therapy, Los Angeles, CA, USA
| | - Karen Mohr
- Kerlan Jobe Institute, Los Angeles, CA, USA
| | - Patty Brown
- Patty Brown Physical Therapy & Associates, El Segundo, CA, USA
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18
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Wilk M, Krzysztofik M, Filip A, Zajac A, Bogdanis GC, Lockie RG. Short-Term Blood Flow Restriction Increases Power Output and Bar Velocity During the Bench Press. J Strength Cond Res 2020; 36:2082-2088. [PMID: 32379236 DOI: 10.1519/jsc.0000000000003649] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Wilk, M, Krzysztofik, M, Filip, A, Zajac, A, Bogdanis, GC, and Lockie, RG. Short-term blood flow restriction increases power output and bar velocity during the bench press. J Strength Cond Res XX(X): 000-000, 2020-This study examined the effect of blood flow restriction (BFR) with 2 different types of cuffs on peak power output (PP), mean power output (MP), peak bar velocity (PV), and mean bar velocity (MV) in the bench press exercise (BP). Fourteen healthy strength-trained male athletes (age = 27.6 ± 3.5 years; body mass = 84.1 ± 8.0 kg; height = 175.8 ± 6.7 cm; BP 1 repetition maximum [RM] = 138.6 ± 17.8 kg) performed 3 different testing protocols as follows: without BFR (NO-BFR), BFR with a narrow cuff (BFRNARROW), and BFR with a wide cuff (BFRWIDE) in a randomized crossover design. During all sessions, subjects performed one set of 3 repetitions of the BP exercise using 70% 1RM. Cuff pressure was set to approximately 90% full arterial occlusion pressure of the upper limb at rest. Analyses of variance showed an increase in PP (by 21%, p < 0.01; effect size [ES] = 1.67), MP (by 16%, p < 0.01; ES = 0.93), PV (by 22%, p < 0.01; ES = 1.79), and MV (by 21%, p < 0.01; ES = 1.36) during BFRWIDE compared with NO-BFR and a significant increase in PP (by 15%, p < 0.01; ES = 1.07), MP (by 17%, p < 0.01; ES = 0.78), PV (by 18%, p < 0.01; ES = 1.65), and MV (by 13% p < 0.01; ES = 1.00) during BFRWIDE compared with BFRNARROW. There were no significant differences in any of the variable between NO-BFR and BFRNARROW. The results of the study indicate that short-term BFR training increases power output and bar velocity during the BP exercise. However, only BFRWIDE significantly influenced bar velocity and power output, which indicates that the width of the cuff is a critical factor determining acute exercise adaptation during BFR resistance training.
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Affiliation(s)
- Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Aleksandra Filip
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Adam Zajac
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Gregory C Bogdanis
- School of P.E. and Sport Science, National & Kapodistrian University of Athens, Athens, Greece
| | - Robert G Lockie
- Center for Sports Performance, Department of Kinesiology, California State University, Fullerton, Fullerton, California
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19
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Acute Muscular Responses to Practical Low-Load Blood Flow Restriction Exercise Versus Traditional Low-Load Blood Flow Restriction and High-/Low-Load Exercise. J Sport Rehabil 2019; 29:984-992. [PMID: 31821993 DOI: 10.1123/jsr.2019-0217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/19/2019] [Accepted: 10/15/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Blood flow restriction (BFR) increases muscle size and strength when combined with low loads, but various methods are used to produce this stimulus. It is unclear how using elastic knee wraps can impact acute muscular responses compared with using nylon cuffs, where the pressure can be standardized. OBJECTIVE Investigate how elastic knee wraps compare with nylon cuffs and high-load (HL)/low-load (LL) resistance exercise. DESIGN A randomized cross-over experimental design using 6 conditions combined with unilateral knee extension. SETTING Human Performance Laboratory. PARTICIPANTS A total of 9 healthy participants (males = 7 and females = 2) and had an average age of 22 (4) years. INTERVENTION LL (30% of 1-repetition maximum [1-RM]), HL (70% 1-RM), BFR at 40% of arterial occlusion pressure (BFR-LOW), BFR at 80% of arterial occlusion pressure (BFR-HIGH), elastic knee wraps stretched by 2 in (PRACTICAL-LOW), and elastic knee wraps stretched to a new length equivalent to 85% of thigh circumference (PRACTICAL-HIGH). BFR and practical conditions used 30% 1-RM. MAIN OUTCOME MEASURES Muscle thickness, maximum voluntary isometric contraction, and electromyography amplitude. Bayesian statistics evaluated differences in changes between conditions using the Bayes factor (BF10), and median and 95% credible intervals were reported from the posterior distribution. RESULTS Total repetitions completed were greater for BFR-LOW versus PRACTICAL-HIGH (BF10 = 3.2, 48.6 vs 44 repetitions) and greater for PRACTICAL-LOW versus BFR-HIGH (BF10 = 717, 51.8 vs 36.3 repetitions). Greater decreases in changes in maximum voluntary isometric contraction were found in PRACTICAL-HIGH versus HL (BF10 = 1035, ∼103 N) and LL (BF10 = 45, ∼66 N). No differences in changes in muscle thickness were found between LL versus PRACTICAL-LOW/PRACTICAL-HIGH conditions (BF10 = 0.32). Greater changes in electromyography amplitude were also found for BFR-LOW versus PRACTICAL-HIGH condition (BF10 = 6.13, ∼12%), but no differences were noted between the other BFR conditions. CONCLUSIONS Overall, elastic knee wraps produce a more fatiguing stimulus than LL or HL conditions and might be used as an alternative to pneumatic cuffs that are traditionally used for BFR exercise.
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Krzysztofik M, Wilk M, Wojdała G, Gołaś A. Maximizing Muscle Hypertrophy: A Systematic Review of Advanced Resistance Training Techniques and Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4897. [PMID: 31817252 PMCID: PMC6950543 DOI: 10.3390/ijerph16244897] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/29/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Effective hypertrophy-oriented resistance training (RT) should comprise a combination of mechanical tension and metabolic stress. Regarding training variables, the most effective values are widely described in the literature. However, there is still a lack of consensus regarding the efficiency of advanced RT techniques and methods in comparison to traditional approaches. METHODS MEDLINE and SPORTDiscus databases were searched from 1996 to September 2019 for all studies investigating the effects of advanced RT techniques and methods on muscle hypertrophy and training variables. Thirty articles met the inclusion criteria and were consequently included for the quality assessment and data extraction. RESULTS Concerning the time-efficiency of training, the use of agonist-antagonist, upper-lower body supersets, drop and cluster sets, sarcoplasma stimulating training, employment of fast, but controlled duration of eccentric contractions (~2s), and high-load RT supplemented with low-load RT under blood flow restriction may provide an additional stimulus and an advantage to traditional training protocols. With regard to the higher degree of mechanical tension, the use of accentuated eccentric loading in RT should be considered. Implementation of drop sets, sarcoplasma stimulating training, low-load RT in conjunction with low-load RT under blood flow restriction could provide time-efficient solutions to increased metabolic stress. CONCLUSIONS Due to insufficient evidence, it is difficult to provide specific guidelines for volume, intensity of effort, and frequency of previously mentioned RT techniques and methods. However, well-trained athletes may integrate advanced RT techniques and methods into their routines as an additional stimulus to break through plateaus and to prevent training monotony.
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Affiliation(s)
- Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, ul. Mikolowska 72a, 40-065 Katowice, Poland; (M.W.); (G.W.); (A.G.)
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Hwang PS, Willoughby DS. Mechanisms Behind Blood Flow-Restricted Training and its Effect Toward Muscle Growth. J Strength Cond Res 2019; 33 Suppl 1:S167-S179. [PMID: 30011262 DOI: 10.1519/jsc.0000000000002384] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hwang, P and Willoughby, DS. Mechanisms behind blood flow-restricted training and its effect toward muscle growth. J Strength Cond Res 33(7S): S167-S179, 2019-It is widely established throughout the literature that skeletal muscle can induce hypertrophic adaptations after progressive overload of moderate-to-high-intensity resistance training. However, there has recently been a growing body of research that shows that the combination of blood flow-restricted (BFR) training with low-intensity resistance exercise can induce similar gains in muscular strength and hypertrophic adaptations. The implementation of external pressure cuffs over the most proximal position of the limb extremities with the occlusion of venous outflow of blood distal to the occlusion site defines the BFR training protocol. There are various mechanisms through which BFR training may cause the stimulations for skeletal muscle hypertrophy and increases in strength. These may include increases in hormonal concentrations, increases within the components of the intracellular signaling pathways for muscle protein synthesis such as the mTOR pathway, increases within biomarkers denoting satellite cell activity and apparent patterns in fiber type recruitment. There have also been scientific findings demonstrating hypertrophic effects within both BFR limbs and non-BFR muscles during BFR training programs. The purpose behind this critical review will be to provide a comprehensive discussion on relevant literature that can help elucidate the potential underlying mechanisms leading to hypertrophic adaptations after BFR training programs. This review will also explicate the various findings within the literature that focalizes on both BFR limb and non-BFR muscle hypertrophy after bouts of BFR training. Furthermore, this critical review will also address the various needs for future research in the many components underlying the novel modality of BFR training.
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Affiliation(s)
- Paul S Hwang
- Department of Health, Human Performance, and Recreation, Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
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Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2019; 10:533. [PMID: 31156448 PMCID: PMC6530612 DOI: 10.3389/fphys.2019.00533] [Citation(s) in RCA: 330] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
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Affiliation(s)
- Stephen D. Patterson
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Luke Hughes
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jamie Burr
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada
| | - Brendan R. Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Cleiton Augusto Libardi
- MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gabriel Rodrigues Neto
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, Brazil
| | | | - Juan Martin-Hernandez
- I+HeALTH Research Group, Department of Health Sciences, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
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Technical and Training Related Aspects of Resistance Training Using Blood Flow Restriction in Competitive Sport - A Review. J Hum Kinet 2018; 65:249-260. [PMID: 30687436 PMCID: PMC6341949 DOI: 10.2478/hukin-2018-0101] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Blood flow restriction (BFR) combined with resistance training (RT-BFR) shows significant benefits in terms of muscle strength and hypertrophy. Such effects have been observed in clinical populations, in groups of physically active people, and among competitive athletes. These effects are comparable or, in some cases, even more efficient compared to conventional resistance training (CRT). RT-BFR stimulates muscle hypertrophy and improves muscle strength even at low external loads. Since no extensive scientific research has been done in relation to groups of athletes, the aim of the present study was to identify technical, physiological and methodological aspects related to the use of RT-BFR in competitive athletes from various sport disciplines. RT-BFR in groups of athletes has an effect not only on the improvement of muscle strength or muscle hypertrophy, but also on specific motor abilities related to a particular sport discipline. The literature review reveals that most experts do not recommend the use RT-BFR as the only training method, but rather as a complementary method to CRT. It is likely that optimal muscle adaptive changes can be induced by a combination of CRT and RT-BFR. Some research has confirmed benefits of using CRT followed by RT-BFR during a training session. The use of BFR in training also requires adequate progression or modifications in the duration of occlusion in a training session, the ratio of exercises performed with BFR to conventional exercises, the value of pressure or the cuff width.
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Abe T, Mouser JG, Dankel SJ, Bell ZW, Buckner SL, Mattocks KT, Jessee MB, Loenneke JP. A method to standardize the blood flow restriction pressure by an elastic cuff. Scand J Med Sci Sports 2018; 29:329-335. [PMID: 30468528 DOI: 10.1111/sms.13340] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/22/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Abstract
Blood flow restriction training using a practical (non-pneumatic) elastic cuff has recently increased in popularity. However, a criticism of this method is that the pressure applied and the amount of blood flow restriction induced is unknown. The aim was to quantify blood flow following the application of an elastic cuff and compare that to what is observed using a more traditional pressurized nylon cuff. Thirty-five young participants (16 men and 19 women) visited the laboratory once for testing. In a randomized order (one condition per arm), an elastic cuff (5 cm wide) was applied to one arm and blood flow was measured following the cuff being pulled to two distinct lengths; 10% and 20% of the resting length based on arm circumference. The other arm would follow a similar protocol but use a pressurized nylon cuff (5 cm wide) and be inflated to 40% and 80% of the individuals resting arterial occlusion pressure. There was a main effect of pressure for blood flow with it decreasing in a pressure-dependent manner (High < Low, P < 0.001). The mean difference (95% CI) in blood flow between cuffs was -5.9 (-18.9, 7.0) % for the lower pressure and -4.0 (-13.2, 5.1) % for the higher pressure. When the relative changes for each cuff were separated by sex, there were no differences in the changes from Pre (P ≥ 0.509). The application of a pressure relative to the initial belt length, which is largely dependent upon arm circumference, appears to provide one method to standardize the practical blood flow restriction pressure for future research.
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Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - J Grant Mouser
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Scott J Dankel
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Zachary W Bell
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Samuel L Buckner
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Kevin T Mattocks
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Matthew B Jessee
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
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Buckner SL, Jessee MB, Dankel SJ, Mattocks KT, Mouser JG, Bell ZW, Abe T, Loenneke JP. Acute skeletal muscle responses to very low-load resistance exercise with and without the application of blood flow restriction in the upper body. Clin Physiol Funct Imaging 2018; 39:201-208. [PMID: 30506882 DOI: 10.1111/cpf.12557] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
Abstract
The purpose was to examine the acute skeletal muscle response to high load exercise and low-load exercise with and without different levels of applied pressure (BFR). A total of 22 participants completed the following four conditions: elbow flexion exercise to failure using a traditional high load [70% 1RM, (7000)], low load [15% 1RM,(1500)], low load with moderate BFR [15%1RM+40%BFR(1540)] or low load with greater BFR [15% 1RM+80%BFR(1580)]. Torque and muscle thickness were measured prior to, immediately post, and 15 min postexercise. Muscle electromyography (EMG) amplitude was measured throughout. Immediately following exercise, the 7000 condition had lower muscle thickness [4·2(1·0)cm] compared to the 1500 [4·4 (1·1)cm], 1540 [4·4(1·1)cm] and 1580 [4·5(1·0)cm] conditions. This continued 15 min post. Immediately following exercise, torque was lower in the 1500 [31·8 (20) Nm], 1540 [28·3(16·9) Nm, P<0·001] and 1580 [29·5 (17) Nm] conditions compared to the 7000 condition [40 (19) Nm]. Fifteen minutes post, 1500 and 1540 conditions demonstrated lower torque compared to the 7000 condition. For the last three repetitions percentage EMG was greater in the 7000 compared to the 1580 condition. Very low-load exercise (with or without BFR) appears to result in greater acute muscle swelling and greater muscular fatigue compared to high load exercise.
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Affiliation(s)
- Samuel L Buckner
- USF Muscle Laboratory, Division of Exercise Science, University of South Florida, Tampa, FL, USA
| | - Matthew B Jessee
- School of Kinesiology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Scott J Dankel
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Kevin T Mattocks
- Department of Exercise Science, Lindenwood Belleville, Belleville, IL, USA
| | - J Grant Mouser
- Department of Kinesiology and Health Promotion, Troy University, Troy, AL, USA
| | - Zachary W Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
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Törpel A, Herold F, Hamacher D, Müller NG, Schega L. Strengthening the Brain-Is Resistance Training with Blood Flow Restriction an Effective Strategy for Cognitive Improvement? J Clin Med 2018; 7:E337. [PMID: 30304785 PMCID: PMC6210989 DOI: 10.3390/jcm7100337] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 02/07/2023] Open
Abstract
Aging is accompanied by a decrease in physical capabilities (e.g., strength loss) and cognitive decline. The observed bidirectional relationship between physical activity and brain health suggests that physical activities could be beneficial to maintain and improve brain functioning (e.g., cognitive performance). However, the exercise type (e.g., resistance training, endurance training) and their exercise variables (e.g., load, duration, frequency) for an effective physical activity that optimally enhance cognitive performance are still unknown. There is growing evidence that resistance training induces substantial brain changes which contribute to improved cognitive functions. A relative new method in the field of resistance training is blood flow restriction training (BFR). While resistance training with BFR is widely studied in the context of muscular performance, this training strategy also induces an activation of signaling pathways associated with neuroplasticity and cognitive functions. Based on this, it seems reasonable to hypothesize that resistance training with BFR is a promising new strategy to boost the effectiveness of resistance training interventions regarding cognitive performance. To support our hypothesis, we provide rationales of possible adaptation processes induced by resistance training with BFR. Furthermore, we outline recommendations for future studies planning to investigate the effects of resistance training with BFR on cognition.
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Affiliation(s)
- Alexander Törpel
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - Dennis Hamacher
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Notger G Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany.
- Center for Behavioral Brain Sciences (CBBS), Universitätsplatz 2, 39106 Magdeburg, Germany.
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - Lutz Schega
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
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Hughes L, Paton B, Haddad F, Rosenblatt B, Gissane C, Patterson SD. Comparison of the acute perceptual and blood pressure response to heavy load and light load blood flow restriction resistance exercise in anterior cruciate ligament reconstruction patients and non-injured populations. Phys Ther Sport 2018; 33:54-61. [DOI: 10.1016/j.ptsp.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/07/2018] [Accepted: 07/07/2018] [Indexed: 01/20/2023]
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Dankel SJ, Jessee MB, Mattocks KT, Buckner SL, Mouser JG, Bell ZW, Abe T, Loenneke JP. Perceptual and arterial occlusion responses to very low load blood flow restricted exercise performed to volitional failure. Clin Physiol Funct Imaging 2018; 39:29-34. [PMID: 29938892 DOI: 10.1111/cpf.12535] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/06/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Studies examining perceptual and arterial occlusion responses between blood flow restricted exercise and high load exercise often prescribe an arbitrary number of repetitions, making it difficult for direct comparisons. Therefore, the purpose of this study was to compare these protocols when performed to volitional failure. METHODS Individuals completed four exercise conditions varying in load and pressure: (i) 15% 1RM; no restrictive pressure, (ii) 15% 1RM; 40% arterial occlusion pressure, (iii) 15% 1RM; 80% arterial occlusion pressure, and (iv) 70% 1RM; no pressure. Four sets of knee extension exercises were performed until volitional failure (or until 90 repetitions per set) was completed. RESULTS A total of 23 individuals completed the study. While all conditions increased arterial occlusion pressure, the greatest increases (~30%) were observed in the blood flow restriction conditions. All lower load conditions resulted in greater RPE and discomfort than that of the high load condition, but only discomfort was increased further when adding blood flow restriction. CONCLUSION High load exercise will likely be perceived more favourably than lower load exercise to volitional failure; however, those who are incapable or unwilling to lift heavier loads may use blood flow restriction to help reduce the volume needed to reach volitional failure, although this will likely increase discomfort.
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Affiliation(s)
- Scott J Dankel
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Matthew B Jessee
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Kevin T Mattocks
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Samuel L Buckner
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - J Grant Mouser
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Zachary W Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
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Mattocks KT, Jessee MB, Mouser JG, Dankel SJ, Buckner SL, Bell ZW, Owens JG, Abe T, Loenneke JP. The Application of Blood Flow Restriction. Curr Sports Med Rep 2018; 17:129-134. [DOI: 10.1249/jsr.0000000000000473] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Bunevicius K, Grunovas A, Venckunas T, Poderiene K, Trinkunas E, Poderys J. Blood flow restriction late in recovery after heavy resistance exercise hampers muscle recuperation. Eur J Appl Physiol 2017; 118:313-320. [PMID: 29214460 DOI: 10.1007/s00421-017-3771-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 11/23/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to examine the effect of acute blood flow restriction during the late recovery phase between two resistance exercise bouts on muscular endurance and oxygenation. METHODS Amateur male middle- and long-distance runners performed two bouts of one-leg dynamic plantar flexion exercise to failure with the load equivalent to 75% of maximum. Subjects were randomly assigned into two experimental groups with thigh occlusion pressure between bouts at either 120 or 200 mmHg with 20 min of passive rest in between, and two control groups without any blood flow restriction separated by either 5 or 20 min of rest. Blood flow restriction in the experimental groups was implemented during the last 15 min of recovery. Calf arterial blood flow and muscle oxygenation were measured by venous occlusion plethysmography and near-infrared spectroscopy, respectively. RESULTS Decrease of muscular oxygenation and blood flow during recovery between exercise bouts depended on the applied occlusion pressure. When compared with bout 1, work capacity in the experimental groups during bout 2 was reduced by 9.3 ± 2.2% with 120 mmHg and by 10.5 ± 3.1% (p < 0.05) with 200 mmHg occlusion pressure. In the control groups, work capacity was restored after 20 min (- 3.9 ± 3.2%, p > 0.05) but not after 5-min recovery (- 20.0 ± 1.8%, p < 0.05). CONCLUSIONS Blood flow restriction late in recovery after a heavy resistance exercise bout decreased muscle oxygenation and work capacity during the subsequent heavy resistance exercise bout.
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Affiliation(s)
- Kestutis Bunevicius
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania.
| | - Albinas Grunovas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
| | - Tomas Venckunas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
| | - Kristina Poderiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
| | - Eugenijus Trinkunas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
| | - Jonas Poderys
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
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Dankel SJ, Mattocks KT, Jessee MB, Buckner SL, Mouser JG, Loenneke JP. Do metabolites that are produced during resistance exercise enhance muscle hypertrophy? Eur J Appl Physiol 2017; 117:2125-2135. [PMID: 28776271 DOI: 10.1007/s00421-017-3690-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022]
Abstract
Many reviews conclude that metabolites play an important role with respect to muscle hypertrophy during resistance exercise, but their actual physiologic contribution remains unknown. Some have suggested that metabolites may work independently of muscle contraction, while others have suggested that metabolites may play a secondary role in their ability to augment muscle activation via inducing fatigue. Interestingly, the studies used as support for an anabolic role of metabolites use protocols that are not actually designed to test the importance of metabolites independent of muscle contraction. While there is some evidence in vitro that metabolites may induce muscle hypertrophy, the only study attempting to answer this question in humans found no added benefit of pooling metabolites within the muscle post-exercise. As load-induced muscle hypertrophy is thought to work via mechanotransduction (as opposed to being metabolically driven), it seems likely that metabolites simply augment muscle activation and cause the mechanotransduction cascade in a larger proportion of muscle fibers, thereby producing greater muscle growth. A sufficient time under tension also appears necessary, as measurable muscle growth is not observed after repeated maximal testing. Based on current evidence, it is our opinion that metabolites produced during resistance exercise do not have anabolic properties per se, but may be anabolic in their ability to augment muscle activation. Future studies are needed to compare protocols which produce similar levels of muscle activation, but differ in the magnitude of metabolites produced, or duration in which the exercised muscles are exposed to metabolites.
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Affiliation(s)
- Scott J Dankel
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Kevin T Mattocks
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Matthew B Jessee
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Samuel L Buckner
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - J Grant Mouser
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA.
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Dankel SJ, Buckner SL, Counts BR, Jessee MB, Mouser JG, Mattocks KT, Laurentino GC, Abe T, Loenneke JP. The acute muscular response to two distinct blood flow restriction protocols. Physiol Int 2017; 104:64-76. [PMID: 28361570 DOI: 10.1556/2060.104.2017.1.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to determine acute physiological and perceptual responses to two commonly implemented blood flow restriction protocols. Using a within-subject design, 15 participants (age ∼25) performed four sets of unilateral elbow flexion with each arm. One arm exercised using a 3-cm elastic cuff inflated to 160 mmHg, whereas the other arm exercised using a 5-cm nylon cuff inflated to 40% of the individual's arterial occlusion pressure. While both protocols elicited increases in acute muscle thickness [pre: 4.5 (0.2) cm, post: 5.0 (0.2) cm; p < 0.001] and electromyography amplitude [first 3 reps: 55 ( 5 ) %MVC; last 3 reps: 87 ( 10 ) %MVC], there were no differences between conditions. Both protocols produced decreases in post-exercise strength (pre: 70 Nm, post: 51 Nm; p < 0.001) with no difference between conditions. The nylon protocol resulted in more repetitions during sets 2 [13 ( 2 ) vs. 9 ( 4 ); p = 0.001] and 3 [10 ( 2 ) vs. 7 ( 4 ); p = 0.05], while producing lower levels of discomfort following each set (average 3 vs. 4; p < 0.05). In conclusion, both protocols produced similar acute responses thought to be important for promoting muscle growth. However, the use of arbitrary pressures may place some individuals under complete arterial occlusion which may increase the potential risk of an adverse event.
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Affiliation(s)
- S J Dankel
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - S L Buckner
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - B R Counts
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - M B Jessee
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - J G Mouser
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - K T Mattocks
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - G C Laurentino
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
| | - T Abe
- 2 Department of Sport and Life Sciences, National Institute of Fitness and Sports in Kanoya , Kanoya, Kagoshima, Japan
| | - J P Loenneke
- 1 Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi , University, MS, USA
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Dankel SJ, Buckner SL, Jessee MB, Mattocks KT, Mouser JG, Counts BR, Laurentino GC, Loenneke JP. Can blood flow restriction augment muscle activation during high-load training? Clin Physiol Funct Imaging 2017; 38:291-295. [DOI: 10.1111/cpf.12414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Scott J. Dankel
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Samuel L. Buckner
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Matthew B. Jessee
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Kevin T. Mattocks
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - J. Grant Mouser
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Brittany R. Counts
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Gilberto C. Laurentino
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
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Dankel SJ, Buckner SL, Jessee MB, Mattocks KT, Mouser JG, Counts BR, Laurentino GC, Abe T, Loenneke JP. Post-exercise blood flow restriction attenuates muscle hypertrophy. Eur J Appl Physiol 2016; 116:1955-63. [DOI: 10.1007/s00421-016-3447-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/26/2016] [Indexed: 11/29/2022]
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The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure. Sports Med 2015; 46:23-33. [DOI: 10.1007/s40279-015-0407-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Scott BR, Loenneke JP, Slattery KM, Dascombe BJ. Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development. Sports Med 2014; 45:313-25. [DOI: 10.1007/s40279-014-0288-1] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Loenneke JP, Thiebaud RS, Abe T. Does blood flow restriction result in skeletal muscle damage? A critical review of available evidence. Scand J Med Sci Sports 2014; 24:e415-422. [PMID: 24650102 DOI: 10.1111/sms.12210] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 01/06/2023]
Abstract
Blood flow restriction (BFR) alone or in combination with exercise has been shown to result in muscle hypertrophy and strength gain across a variety of populations. Although there are numerous studies in the literature showing beneficial muscular effects following the application of BFR, questions have been raised over whether BFR may lead to or even increase the incidence of muscle damage. The purpose of this review is to examine the proposed mechanisms behind muscle damage and critically review the available BFR literature. The available evidence does not support the hypothesis that BFR in combination with low-intensity exercise increases the incidence of muscle damage. Instead, the available literature suggests that minimal to no muscle damage is occurring with this type of exercise. This conclusion is drawn from the following observations: (a) no prolonged decrements in muscle function; (b) no prolonged muscle swelling; (c) muscle soreness ratings similar to a submaximal low load control; and (d) no elevation in blood biomarkers of muscle damage.
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Affiliation(s)
- J P Loenneke
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, The University of Oklahoma, Norman, Oklahoma, USA
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Loenneke JP, Thiebaud RS, Abe T, Bemben MG. Blood flow restriction pressure recommendations: the hormesis hypothesis. Med Hypotheses 2014; 82:623-6. [PMID: 24636784 DOI: 10.1016/j.mehy.2014.02.023] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 02/23/2014] [Indexed: 11/28/2022]
Abstract
Blood flow restriction (BFR) alone or in combination with exercise has been shown to result in favorable effects on skeletal muscle form and function. The pressure applied should be high enough to occlude venous return from the muscle but low enough to maintain arterial inflow into the muscle. The optimal pressure for beneficial effects on skeletal muscle are currently unknown; however, preliminary data from our laboratory suggests that there may be a point where greater pressure may not augment the response (e.g. metabolic accumulation, cell swelling) but may actually result in decrements (e.g. muscle activation). This led us to wonder if BFR elicits somewhat of a hormesis effect. The purpose of this manuscript is to discuss whether pressure may be modulated to maximize skeletal muscle adaptation with resistance training in combination with BFR. Furthermore, the potential safety issues that could arise from increasing pressure too high are also briefly reviewed. We hypothesize that with BFR there is likely a moderate (∼ 50% estimated arterial occlusion pressure) pressure that maximizes the anabolic response to skeletal muscle without producing the potential negative consequences of higher pressures. Thus, BFR may follow the hormesis theory to some degree, in that a low/moderate dose of BFR produces beneficial effects while higher pressures (at or near arterial occlusion) may decrease the benefits of exercise and increase the health risk. This hypothesis requires long term studies investigating chronic training adaptations to differential pressures. In addition, how differences in load interact with differences in pressure should also be investigated.
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Affiliation(s)
- J P Loenneke
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, USA.
| | - R S Thiebaud
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, USA
| | - T Abe
- Department of Kinesiology, Indiana University, USA
| | - M G Bemben
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK, USA
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Fitschen PJ, Kistler BM, Jeong JH, Chung HR, Wu PT, Walsh MJ, Wilund KR. Perceptual effects and efficacy of intermittent or continuous blood flow restriction resistance training. Clin Physiol Funct Imaging 2013; 34:356-63. [DOI: 10.1111/cpf.12100] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/11/2013] [Indexed: 11/30/2022]
Affiliation(s)
- P. J. Fitschen
- Division of Nutritional Sciences; University of Illinois; Urbana IL USA
| | - B. M. Kistler
- Department of Kinesiology and Community Health; University of Illinois; Urbana IL USA
| | - J. H. Jeong
- Department of Kinesiology and Community Health; University of Illinois; Urbana IL USA
| | - H. R. Chung
- Department of Kinesiology and Community Health; University of Illinois; Urbana IL USA
| | - P. T. Wu
- Department of Kinesiology and Community Health; University of Illinois; Urbana IL USA
| | - M. J. Walsh
- Department of Kinesiology and Community Health; University of Illinois; Urbana IL USA
| | - K. R. Wilund
- Division of Nutritional Sciences; University of Illinois; Urbana IL USA
- Department of Kinesiology and Community Health; University of Illinois; Urbana IL USA
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Loenneke J, Abe T, Wilson J, Thiebaud R, Fahs C, Rossow L, Bemben M. Blood flow restriction: An evidence based progressive model (Review). ACTA ACUST UNITED AC 2012; 99:235-50. [DOI: 10.1556/aphysiol.99.2012.3.1] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Loenneke JP, Fahs CA, Rossow LM, Sherk VD, Thiebaud RS, Abe T, Bemben DA, Bemben MG. Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise. Eur J Appl Physiol 2011; 112:2903-12. [PMID: 22143843 DOI: 10.1007/s00421-011-2266-8] [Citation(s) in RCA: 257] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 11/23/2011] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to determine the difference in cuff pressure which occludes arterial blood flow for two different types of cuffs which are commonly used in blood flow restriction (BFR) research. Another purpose of the study was to determine what factors (i.e., leg size, blood pressure, and limb composition) should be accounted for when prescribing the restriction cuff pressure for this technique. One hundred and sixteen (53 males, 63 females) subjects visited the laboratory for one session of testing. Mid-thigh muscle (mCSA) and fat (fCSA) cross-sectional area of the right thigh were assessed using peripheral quantitative computed tomography. Following the mid-thigh scan, measurements of leg circumference, ankle brachial index, and brachial blood pressure were obtained. Finally, in a randomized order, arterial occlusion pressure was determined using both narrow and wide restriction cuffs applied to the most proximal portion of each leg. Significant differences were observed between cuff type and arterial occlusion (narrow: 235 (42) mmHg vs. wide: 144 (17) mmHg; p = 0.001, Cohen's D = 2.52). Thigh circumference or mCSA/fCSA with ankle blood pressure, and diastolic blood pressure, explained the most variance in the cuff pressure required to occlude arterial flow. Wide BFR cuffs restrict arterial blood flow at a lower pressure than narrow BFR cuffs, suggesting that future studies account for the width of the cuff used. In addition, we have outlined models which indicate that restrictive cuff pressures should be largely based on thigh circumference and not on pressures previously used in the literature.
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Affiliation(s)
- Jeremy P Loenneke
- Department of Health and Exercise Science, Neuromuscular Research Laboratory, The University of Oklahoma, 1401 Asp Avenue, Room 104, Norman, OK 73019-0615, USA.
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