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de Castro FMP, Oliveira LDP, Aquino R, Tourinho Filho H, Puggina EF. Impact of Complete Intermittent Blood Flow Restriction in Upper Limbs Strength and Neural Function. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:635-645. [PMID: 38306672 DOI: 10.1080/02701367.2023.2294092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Abstract
Purpose: We aimed to investigate the chronic effects of low-load strength training (LT) with complete intermittent blood flow restriction (IBFR) on neural adaptations and strength in biceps brachii. Methods: Nineteen volunteers were randomly assigned into two different 9-week training protocols consisting of three assessment weeks and six training weeks: (a) LT with complete IBFR (LT-IBFR; n = 10) and (b) LT without complete IBFR (LT; n = 9). Strength was evaluated by predicted 1 repetition maximum (1RM) at weeks 1, 5, and 9 and neural function by root mean square (RMS) and median frequency (MDF) at sessions 1, 7, and 12 during the first three and last three repetitions. Both groups performed three sets of Scott curl with 20% of predicted 1RM interspersed with 90s rest twice a week. Results: No changes were found in predicted 1RM throughout the training protocols nor between groups. LT-IBFR group showed lower RMS in the first set than LT for the first three repetitions and higher RMS in all sets for the last three repetitions with decreases in this value across the sets with no longitudinal changes for both groups. MDF in the first three repetitions did not differentiate between groups, however, in the last three repetitions, MDF were lower for LTIBFR group in all sets and it increased across the sets for this condition with no chronical changes for both groups in both repetitions zones. These results suggest that LT-IBFR may be ineffective for increasing Q5 strength and it did not promote chronic neural adaptations.
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Ma F, He J, Wang Y. Blood flow restriction combined with resistance training on muscle strength and thickness improvement in young adults: a systematic review, meta-analysis, and meta-regression. Front Physiol 2024; 15:1379605. [PMID: 39189029 PMCID: PMC11345148 DOI: 10.3389/fphys.2024.1379605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024] Open
Abstract
Background High-intensity resistance training is known to be the most effective method for enhancing muscle strength and thickness, but it carries potential injury risks. Blood flow restriction (BFR) combined with resistance training has been proposed as a safer alternative method for improving muscle strength and thickness. Methods A meta-analysis was conducted, including 20 studies from five databases that met the inclusion criteria, to assess the efficacy of BFR combined with resistance training compared to traditional resistance training (NOBFR). The analysis focused on changes in muscle strength and thickness. Subgroup analysis and meta-regression were performed to explore the effects of tourniquet width and pressure. Results The findings showed that BFR combined with resistance training is comparable to traditional resistance training in enhancing muscle strength [0.11, 95%CI: (-0.08 to 0.29), I 2 = 0%] and muscle thickness [-0.07, 95% CI: (-0.25 to 0.12), I 2 = 0%]. Subgroup analysis indicated no significant differences in muscle strength (P = 0.66) and thickness (P = 0.87) between low-intensity BFR training and other intensity levels. Meta-regression suggested that tourniquet width and pressure might affect intervention outcomes, although the effects were not statistically significant (P > 0.05). Conclusion BFR combined with resistance training offers a viable alternative to high-intensity resistance training with reduced injury risks. We recommend interventions of 2-3 sessions per week at 20%-40% of 1 RM, using a wider cuff and applying an arterial occlusion pressure of 50%-80% to potentially enhance muscle strength and thickness. It is also recommended to release tourniquet pressure during rest intervals to alleviate discomfort. This protocol effectively improves muscle strength with minimal cardiac workload and reduced risk of adverse events. Systematic Review Registration [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023495465], identifier [CRD42023495465].
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Affiliation(s)
| | | | - Yan Wang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Clarkson MJ, McMahon B, Warmington SA. Comparing adaptations from blood flow restriction exercise training using regulated or unregulated pressure systems: A systematic review and meta-analysis. Clin Rehabil 2024:2692155241271040. [PMID: 39105331 DOI: 10.1177/02692155241271040] [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: 08/07/2024]
Abstract
OBJECTIVE No study has examined outcomes derived from blood flow restriction exercise training interventions using regulated compared with unregulated blood flow restriction pressure systems. Therefore, we used a systematic review and meta-analyses to compare the chronic adaptations to blood flow restriction exercise training achieved with regulated and unregulated blood flow restriction pressure systems. DATA SOURCES The electronic database search included using the tool EBSCOhost and other online database search engines. The search included Medline, SPORTDiscus, CINAHL, Embase and SpringerLink. METHODS Included studies utilised chronic blood flow restriction exercise training interventions greater than two weeks duration, where blood flow restriction was applied using a regulated or unregulated blood flow restriction pressure system, and where outcome measures such as muscle strength, muscle size or physical function were measured both pre- and post-training. Studies included in the meta-analyses used an equivalent non-blood flow restriction exercise comparison group. RESULTS Eighty-one studies were included in the systematic review. Data showed that regulated (n = 47) and unregulated (n = 34) blood flow restriction pressure systems yield similar training adaptations for all outcome measures post-intervention. For muscle strength and muscle size, this was reaffirmed in the included meta-analyses. CONCLUSION This review indicates that practitioners may achieve comparable training adaptations with blood flow restriction exercise training using either regulated or unregulated blood flow restriction pressure systems. Therefore, additional factors such as device quality, participant comfort and safety, cost and convenience are important factors to consider when deciding on appropriate equipment to use when prescribing blood flow restriction exercise training.
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Affiliation(s)
- Matthew J Clarkson
- Institute for Health & Sport (IHES), Victoria University, Melbourne, Victoria, Australia
| | - Breanna McMahon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Stuart A Warmington
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Hammert WB, Kataoka R, Yamada Y, Song JS, Loenneke JP. Blood flow restriction training attenuates changes in local muscle endurance: At odds with previous work? Exp Physiol 2024; 109:1395-1398. [PMID: 39030974 PMCID: PMC11291865 DOI: 10.1113/ep091924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/23/2024] [Indexed: 07/22/2024]
Affiliation(s)
- William B. Hammert
- Kevser Ermin Applied Physiology LaboratoryDepartment of Health, Exercise Science, and Recreation ManagementUniversity of MississippiUniversityMississippiUSA
| | - Ryo Kataoka
- Kevser Ermin Applied Physiology LaboratoryDepartment of Health, Exercise Science, and Recreation ManagementUniversity of MississippiUniversityMississippiUSA
| | - Yujiro Yamada
- Kevser Ermin Applied Physiology LaboratoryDepartment of Health, Exercise Science, and Recreation ManagementUniversity of MississippiUniversityMississippiUSA
| | - Jun Seob Song
- Kevser Ermin Applied Physiology LaboratoryDepartment of Health, Exercise Science, and Recreation ManagementUniversity of MississippiUniversityMississippiUSA
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology LaboratoryDepartment of Health, Exercise Science, and Recreation ManagementUniversity of MississippiUniversityMississippiUSA
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Ida A, Sasaki K. Response to 'Letter to the Editor': Blood flow restriction training attenuates changes in local muscle endurance: At odds with previous work? Exp Physiol 2024; 109:1399-1400. [PMID: 38941357 PMCID: PMC11291850 DOI: 10.1113/ep092002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 06/11/2024] [Indexed: 06/30/2024]
Affiliation(s)
- Akito Ida
- Department of Life Sciences, Graduate School of Arts and SciencesThe University of TokyoTokyoJapan
| | - Kazushige Sasaki
- Department of Life Sciences, Graduate School of Arts and SciencesThe University of TokyoTokyoJapan
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Montgomery TR, Olmos A, Sears KN, Succi PJ, Hammer SM, Bergstrom HC, Hill EC, Trevino MA, Dinyer-McNeely TK. Influence of Blood Flow Restriction on Neuromuscular Function and Fatigue During Forearm Flexion in Men. J Strength Cond Res 2024; 38:e349-e358. [PMID: 38900183 DOI: 10.1519/jsc.0000000000004762] [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: 06/21/2024]
Abstract
ABSTRACT Montgomery, TR Jr, Olmos, A, Sears, KN, Succi, PJ, Hammer, SM, Bergstrom, HC, Hill, EC, Trevino, MA, and Dinyer-McNeely, TK. Influence of blood flow restriction on neuromuscular function and fatigue during forearm flexion in men. J Strength Cond Res 38(7): e349-e358, 2024-To determine the effects of blood flow restriction (BFR) on the mean firing rate (MFR) and motor unit action potential amplitude (MUAPAMP) vs. recruitment threshold (RT) relationships during fatiguing isometric elbow flexions. Ten men (24.5 ± 4.0 years) performed isometric trapezoidal contractions at 50% maximum voluntary contraction to task failure with or without BFR, on 2 separate days. For BFR, a cuff was inflated to 60% of the pressure required for full brachial artery occlusion at rest. During both visits, surface electromyography was recorded from the biceps brachii of the dominant limb and the signal was decomposed. A paired-samples t test was used to determine the number of repetitions completed between BFR and CON. ANOVAs (repetition [first, last] × condition [BFR, CON]) were used to determine differences in MFR vs. RT and MUAPAMP vs. RT relationships. Subjects completed more repetitions during CON (12 ± 4) than BFR (9 ± 2; p = 0.012). There was no significant interaction (p > 0.05) between the slopes and y-intercepts during the repetition × condition interaction for MUAPAMP vs. MFR. However, there was a main effect of repetition for the slopes of the MUAPAMP vs. RT (p = 0.041) but not the y-intercept (p = 0.964). Post hoc analysis (collapsed across condition) indicated that the slopes of the MUAPAMP vs. RT during the first repetition was less than the last repetition (first: 0.022 ± 0.003 mv/%MVC; last: 0.028 ± 0.004 mv/%MVC; p = 0.041). Blood flow restriction resulted in the same amount of higher threshold MU recruitment in approximately 75% of the repetitions. Furthermore, there was no change in MFR for either condition, even when taken to task failure. Thus, BFR training may create similar MU responses with less total work completed than training without BFR.
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Affiliation(s)
- Tony R Montgomery
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Alex Olmos
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Kylie N Sears
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Pasquale J Succi
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky; and
| | - Shane M Hammer
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Haley C Bergstrom
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky; and
| | - Ethan C Hill
- Division of Kinesiology, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida
| | - Michael A Trevino
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Taylor K Dinyer-McNeely
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
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Su Y, Wang F, Wang M, He S, Yang X, Luan Z. Effects of blood flow restriction training on muscle fitness and cardiovascular risk of obese college students. Front Physiol 2024; 14:1252052. [PMID: 38235388 PMCID: PMC10791898 DOI: 10.3389/fphys.2023.1252052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose: The aim of this study was to investigate the effect of blood flow restriction (BFR) combined with low-intensity resistance training (RT) on cardiovascular risk factors in obese individuals. Methods: Twenty-six male obese college students were recruited and randomly assigned to a control group (CON, n = 8), a low-intensity RT group (RT, n = 9), and a combined BFR training and low-intensity RT group (BFRT, n = 9). Results: The subjects in BFRT group showed significant reductions in body fat percentage and waist-to-hip ratio and a significant increase in lean mass and muscle mass; the peak torque, peak power, and endurance ratio of knee extensors and elbow flexors were significantly upregulated; the root mean square (RMS) for the medial femoral muscle, lateral femoral muscle and biceps significantly increased; the diastolic blood pressure (DBP) showed a significant decrease. The BFRT group also showed significant up-regulations in RMS of the difference between the adjacent R-R intervals (RMSSD), high-frequency power (HF) of parasympathetic modulatory capacity, the standard deviation of R-R intervals (SDNN) of overall heart rate variability (HRV) changes and low-frequency power (LF) of predominantly sympathetic activity. In addition, glycated hemoglobin (HbA1C), insulin resistance index (HOMA-IR) and fasting blood glucose (FBG) were all significantly downregulated in BFRT group. In parallel, low-density lipoprotein (LDL-C) significantly reduced while high-density lipoprotein (HDL-C) significantly increased in BFRT group. Conclusion: BFR combined with low-intensity RT training effectively improved body composition index, increased muscle mass, improved neuromuscular activation, enhanced muscle strength and endurance, which in turn improved abnormal glucolipid metabolism and enhanced cardiac autonomic regulation.
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Affiliation(s)
- Yanhong Su
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Fuqing Wang
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Meng Wang
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Shiyong He
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Xiaolei Yang
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Zhilin Luan
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, China
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Cintineo HP, Chandler AJ, Mastrofini GF, Lints BS, McFadden BA, Arent SM. Effects of Minimal-Equipment Resistance Training and Blood Flow Restriction on Military-Relevant Performance Outcomes. J Strength Cond Res 2024; 38:55-65. [PMID: 38085621 DOI: 10.1519/jsc.0000000000004596] [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: 12/18/2023]
Abstract
ABSTRACT Cintineo, HP, Chandler, AJ, Mastrofini, GF, Lints, BS, McFadden, BA, and Arent, SM. Effects of minimal-equipment resistance training and blood flow restriction on military-relevant performance outcomes. J Strength Cond Res 38(1): 55-65, 2024-This study compared minimal-equipment resistance training (RT) with and without blood flow restriction (BFR) to traditional-equipment RT on performance and body composition changes over 6 weeks. Reserve officers' training corps cadets and midshipmen (N = 54, 40.7% female) were randomized into traditional-equipment RT (TRAD), minimal-equipment RT (MIN), or minimal-equipment RT with BFR (MIN + BFR). Performance and body composition were assessed pretraining and post-training, and measures of intensity and workload were evaluated throughout. Performance assessments included the army combat fitness test (ACFT), countermovement vertical jump, 3RM bench press, and V̇O2max; body composition measures included body fat percentage, fat-free mass, and muscle and tendon thickness. All groups trained 4 days per week after a full-body routine. Data were analyzed by mixed-effects models (α = 0.05). Group-by-time interactions for 3RM deadlift and 3RM bench press (p < 0.004) showed larger improvements for TRAD compared with MIN and MIN + BFR. Time main effects for all other performance variables, body fat percentage, fat-free mass, and muscle thickness (p ≤ 0.035) indicated improvements in all groups. A group-by-time interaction for blood lactate (p < 0.001) and group main effects for heart rate (p < 0.001) and workload variables (p < 0.008) indicated higher intensity and workload for MIN and MIN + BFR compared with TRAD. A sex-by-time interaction for 3RM deadlift (p = 0.008) and sex-by-group-by-time interaction for 3RM bench press (p = 0.018) were also found. Minimal-equipment RT improved performance and body composition, although strength improvements were greater with traditional equipment. Minimal-equipment RT and minimal-equipment RT with BFR exhibited higher exertion levels than TRAD, although adaptations were similar. Overall, individuals can improve performance and body composition using portable, field-expedient RT equipment.
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Affiliation(s)
- Harry P Cintineo
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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Yang J, Ma F, Wang Q, Cui Y, Zheng J. Effect of blood flow restriction with low-load exercise on muscle damage in healthy adults: A systematic review of randomized controlled trials. Clin Physiol Funct Imaging 2024; 44:1-13. [PMID: 37577825 DOI: 10.1111/cpf.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Blood flow restriction (BFR) is a relatively new rehabilitative technique and low-load exercise combined with BFR (LL-BFR) can increase muscle strength and muscle mass. However, it is currently unknown whether LL-BFR causes muscle damage. Therefore, the aim of this study is to investigate the effects of LL-BFR on muscle damage and provide recommendations for sports training and physical exercise. MATERIALS AND METHODS A systematic search was conducted using PubMed, Web of Science, Medline, Cochrane Library and Physiotherapy Evidence Database (PEDro) with a cut-off of March 2022. Randomized controlled trials (RCTs) and English-language studies were selected. Two independent assessors used the PEDro scoring scale to evaluate the methodological quality and risk of bias of the included studies. RESULTS Of the 2935 articles identified, 15 RCTs were included in this systematic review. Two studies demonstrated that LL-BFR could induce muscle damage in healthy individuals; however, two studies presented contrasting findings in the short term. Four studies found that no muscle damage occurred after LL-BFR in the long term. The remaining seven articles showed that it was unclear if LL-BFR could cause muscle damage, regardless of whether these participants were trained or not. CONCLUSION Although LL-BFR may induce muscle damage within 1 week, it will help gain long-term muscle strength and muscle hypertrophy. However, the lack of sufficient evidence on the effect of LL-BFR on muscle damage in clinical practice warrants additional RCTs with large sample sizes in the future.
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Affiliation(s)
- Jinchao Yang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fenghao Ma
- Department of Therapy, Shanghai Yangzhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qian Wang
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuanfen Cui
- Department of Pain Management, Wuhan No. 1 Hospital, Wuhan, China
| | - Jun Zheng
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
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Parkington T, Broom D, Maden-Wilkinson T, Nawaz S, Klonizakis M. Low-intensity resistance exercise with blood flow restriction for patients with claudication: A randomized controlled feasibility trial. Vasc Med 2023; 28:554-563. [PMID: 37819259 PMCID: PMC10693738 DOI: 10.1177/1358863x231200250] [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] [Indexed: 10/13/2023]
Abstract
BACKGROUND Claudication is a common and debilitating symptom of peripheral artery disease, resulting in poor exercise performance and quality of life (QoL). Supervised exercise programs are an effective rehabilitation for patients with claudication, but they are poorly adhered to, in part due to the high pain and effort associated with walking, aerobic, and resistance exercise. Low-intensity resistance exercise with blood flow restriction (BFR) represents an alternative exercise method for individuals who are intolerant to high-intensity protocols. The aim of this study was to evaluate the feasibility of a supervised BFR program in patients with claudication. METHODS Thirty patients with stable claudication completed an 8-week supervised exercise program and were randomized to either BFR (n = 15) or a control of matched exercise without BFR (control; n = 15). Feasibility, safety, and efficacy were assessed. RESULTS All success criteria of the feasibility trial were met. Exercise adherence was high (BFR = 78.3%, control = 83.8%), loss to follow up was 10%, and there were no adverse events. Clinical improvement in walking was achieved in 86% of patients in the BFR group but in only 46% of patients in the control group. Time to claudication pain during walking increased by 35% for BFR but was unchanged for the control. QoL for the BFR group showed improved mobility, ability to do usual activities, pain, depression, and overall health at follow up. CONCLUSION A supervised blood flow restriction program is feasible in patients with claudication and has the potential to increase exercise performance, reduce pain, and improve QoL. (Clinicaltrials.gov Identifier: NCT04890275).
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Affiliation(s)
- Thomas Parkington
- Department of Nursing and Midwifery, Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, UK
- Department of Sport and Physical Activity, Physical Activity, Wellness and Public Health Research Group, Sheffield Hallam University, Sheffield, UK
| | - David Broom
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Thomas Maden-Wilkinson
- Department of Sport and Physical Activity, Physical Activity, Wellness and Public Health Research Group, Sheffield Hallam University, Sheffield, UK
| | - Shah Nawaz
- Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Markos Klonizakis
- Department of Nursing and Midwifery, Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, UK
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Wang Y, Li Z, Tongtong C, Zhang W, Li X. Effect of continuous and intermittent blood flow restriction deep-squat training on thigh muscle activation and fatigue levels in male handball players. Sci Rep 2023; 13:19152. [PMID: 37932313 PMCID: PMC10628241 DOI: 10.1038/s41598-023-44523-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023] Open
Abstract
We aimed to investigate acute changes before and after low-intensity continuous and intermittent blood flow restriction (BFR) deep-squat training on thigh muscle activation characteristics and fatigue level under suitable individual arterial occlusion pressure (AOP). Twelve elite male handball players were recruited. Continuous (Program 1) and intermittent (Program 2) BFR deep-squat training was performed with 30% one-repetition maximum load. Program 1 did not include decompression during the intervals, while Program 2 contained decompression during each interval. Electromyography (EMG) was performed before and after two BFR training programs in each period. EMG signals of the quadriceps femoris, posterior femoral muscles, and gluteus maximus, including the root mean square (RMS) and normalized RMS and median frequency (MF) values of each muscle group under maximum voluntary contraction (MVC), before and after training were calculated. The RMS value under MVC (RMSMVC) of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and gluteus maximus (GM) decreased after continuous and intermittent BFR training programs, and those of the biceps femoris (BF) and semitendinosus (SEM) increased; The RMS standard values of the VL, BF, and SEM were significantly increased after continuous and intermittent BFR training (P < 0.05), The RMS value of GM significantly decreased after cuff inflating (P < 0.05). The MF values of RF, VM, VL, and GM decreased significantly after continuous BFR training (P < 0.05). Continuous BFR deep-squat training applied at 50% AOP was more effective than the intermittent BFR training program. Continuous application of BFR induces greater levels of acute fatigue than intermittent BFR that may translate into greater muscular training adaptations over time.
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Affiliation(s)
- Yan Wang
- Department of Physical Education Teaching and Research, Fuzhou University, Fuzhou, 350108, Fujian, China
| | - Zhiyuan Li
- Department of Public Physical and Art Education, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
| | - Che Tongtong
- School of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Wenjuan Zhang
- Department of Military Theory, Fuzhou University, Fuzhou, 350108, Fujian, China.
| | - Xiaoxiao Li
- Department of Military Theory, Fuzhou University, Fuzhou, 350108, Fujian, China
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Davids CJ, Roberts LA, Bjørnsen T, Peake JM, Coombes JS, Raastad T. Where Does Blood Flow Restriction Fit in the Toolbox of Athletic Development? A Narrative Review of the Proposed Mechanisms and Potential Applications. Sports Med 2023; 53:2077-2093. [PMID: 37578669 PMCID: PMC10587223 DOI: 10.1007/s40279-023-01900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
Blood flow-restricted exercise is currently used as a low-intensity time-efficient approach to reap many of the benefits of typical high-intensity training. Evidence continues to lend support to the notion that even highly trained individuals, such as athletes, still benefit from this mode of training. Both resistance and endurance exercise may be combined with blood flow restriction to provide a spectrum of adaptations in skeletal muscle, spanning from myofibrillar to mitochondrial adjustments. Such diverse adaptations would benefit both muscular strength and endurance qualities concurrently, which are demanded in athletic performance, most notably in team sports. Moreover, recent work indicates that when traditional high-load resistance training is supplemented with low-load, blood flow-restricted exercise, either in the same session or as a separate training block in a periodised programme, a synergistic and complementary effect on training adaptations may occur. Transient reductions in mechanical loading of tissues afforded by low-load, blood flow-restricted exercise may also serve a purpose during de-loading, tapering or rehabilitation of musculoskeletal injury. This narrative review aims to expand on the current scientific and practical understanding of how blood flow restriction methods may be applied by coaches and practitioners to enhance current athletic development models.
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Affiliation(s)
- Charlie J Davids
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia.
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Thomas Bjørnsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Jonathan M Peake
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Truls Raastad
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
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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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Mannozzi J, Al-Hassan MH, Kaur J, Lessanework B, Alvarez A, Massoud L, Aoun K, Spranger M, O'Leary DS. Blood flow restriction training activates the muscle metaboreflex during low-intensity sustained exercise. J Appl Physiol (1985) 2023; 135:260-270. [PMID: 37348015 PMCID: PMC10393340 DOI: 10.1152/japplphysiol.00274.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
Blood flow restriction training (BFRT) employs partial vascular occlusion of exercising muscle and has been shown to increase muscle performance while using reduced workload and training time. Numerous studies have demonstrated that BFRT increases muscle hypertrophy, mitochondrial function, and beneficial vascular adaptations. However, changes in cardiovascular hemodynamics during the exercise protocol remain unknown, as most studies measured blood pressure before the onset and after the cessation of exercise. With reduced perfusion to the exercising muscle during BFRT, the resultant accumulation of metabolites within the ischemic muscle could potentially trigger a large reflex increase in blood pressure, termed the muscle metaboreflex. At low workloads, this pressor response occurs primarily via increases in cardiac output. However, when increases in cardiac output are limited (e.g., heart failure or during severe exercise), the reflex shifts to peripheral vasoconstriction as the primary mechanism to increase blood pressure, potentially increasing the risk of a cardiovascular event. Using our chronically instrumented conscious canine model, we utilized a 60% reduction in femoral blood pressure applied to the hindlimbs during steady-state treadmill exercise (3.2 km/h) to reproduce the ischemic environment observed during BFRT. We observed significant increases in heart rate (+19 ± 3 beats/min), stroke volume (+2.52 ± 1.2 mL), cardiac output (+1.21 ± 0.2 L/min), mean arterial pressure (+18.2 ± 2.4 mmHg), stroke work (+1.93 ± 0.2 L/mmHg), and nonischemic vascular conductance (+3.62 ± 1.7 mL/mmHg), indicating activation of the muscle metaboreflex.NEW & NOTEWORTHY Blood flow restriction training (BFRT) increases muscle mass, strength, and endurance. There has been minimal consideration of the reflex cardiovascular responses that could be elicited during BFRT sessions. We showed that during low-intensity exercise BFRT may trigger large reflex increases in blood pressure and sympathetic activity due to muscle metaboreflex activation. Thus, we urge caution when employing BFRT, especially in patients in whom exaggerated cardiovascular responses may occur that could cause sudden, adverse cardiovascular events.
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Affiliation(s)
- Joseph Mannozzi
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Mohamed-Hussein Al-Hassan
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Jasdeep Kaur
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, United States
| | - Beruk Lessanework
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Alberto Alvarez
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Louis Massoud
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Kamel Aoun
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Marty Spranger
- Department of Physiology, Michigan State University, East Lansing, Michigan, United States
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
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15
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Nakao S, Ikezoe T, Motomura Y, Hirono T, Ichihashi N. Acute Effects of Low-intensity Isometric Exercise at Long and Short Muscle-tendon Unit Lengths. Int J Sports Med 2023. [PMID: 36539199 DOI: 10.1055/a-2002-4352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low-intensity training at long muscle-tendon unit lengths with a greater passive force may cause muscle swelling, which may be related to hypertrophy, even if the active force production is lower than that at short muscle-tendon unit lengths. This study compared muscle swelling after low-intensity torque-matched isometric exercises at long and short muscle-tendon unit lengths. Twenty-six volunteers performed isometric knee flexion exercises (30% of maximal voluntary contraction× 5 seconds×10 repetitions×9 sets) either at long or short lengths of the hamstrings (90° hip flexion and 30° knee flexion, or 90° hip and knee flexion, respectively). Active torque was calculated by subtracting passive torque from the total torque generated during exercise. Swelling-induced changes in cross-sectional area was assessed before and after exercise using ultrasonography. There was no between-group difference in the total torque during exercise; however, the active torque was significantly lower in the group trained at long than in the group trained at short muscle-tendon unit lengths. Muscle swelling occurred in both groups. The results suggest that exercise at long muscle-tendon unit lengths can cause similar muscle swelling as exercise at short muscle-tendon unit lengths, even in cases where active torque production is lower than that at short lengths.
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Affiliation(s)
- Sayaka Nakao
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan.,Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tome Ikezoe
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan.,Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshiki Motomura
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kobayashi Orthopaedic Clinic, Kyoto, Japan
| | - Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Research Fellow of Japan Society for the Promotion of Science, Chiyoda-ku, Japan.,School of Health and Sport Science, Chukyo University, Nagoya, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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16
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Rivera PM, Proppe CE, Gonzalez-Rojas D, Wizenberg A, Hill EC. Effects Of Load Matched Isokinetic Versus Isotonic Blood Flow Restricted Exercise on Neuromuscular and Muscle Function. Eur J Sport Sci 2023:1-9. [PMID: 36825621 DOI: 10.1080/17461391.2023.2184724] [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: 02/25/2023]
Abstract
ABSTRACTPURPOSE: The purpose of this investigation was to examine neuromuscular function, muscle fatigue, rating of perceived exertion (RPE), and muscle swelling between isokinetic and isotonic leg extensions with blood flow restriction (BFR). METHODS: Fourteen (21±2years; 160cm±3.8; 61kg±9.1) trained women performed 75 (1×30,3×15) submaximal (30% of maximal strength), unilateral, isokinetic and isotonic leg extensions with BFR (60% of total arterial occlusion pressure). Before and after exercise, subjects performed maximal voluntary isometric contractions (MVIC) and muscle thickness (MT) was assessed with ultrasound. RPE was recorded across all sets and surface electromyography (EMG) was assessed during the MVIC muscle actions. Separate repeated measures ANOVAs were used to examine MVIC, MT, RPE and neuromuscular function. RESULTS: There were greater reductions in MVIC torque and EMG mean power frequency following isotonic (46.2±17.1%; 16.4±7.9%) than isokinetic (17.9±10.9%;6.5±6.3%). RPE was also higher during isotonic (7.5±2.2), than isokinetic (5.7±1.9). There were no differences in EMG amplitude or MT increases (20±2.1%) between conditions. CONCLUSIONS: Isotonic BFR elicited greater fatigue-induced decreases in muscular strength and greater RPE than isokinetic BFR, but similar MT and muscle excitation responses for both conditions. Therefore, both isokinetic and isotonic may induce similar acute physiological responses, but isotonic BFR was associated with greater muscle fatigue and perceived effort.
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Affiliation(s)
- Paola M Rivera
- Exercise Physiology Intervention & Collaboration Laboratory, School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florid, Orlando, Florida 32816
| | - Christopher E Proppe
- Exercise Physiology Intervention & Collaboration Laboratory, School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florid, Orlando, Florida 32816
| | - David Gonzalez-Rojas
- Exercise Physiology Intervention & Collaboration Laboratory, School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florid, Orlando, Florida 32816
| | - Aaron Wizenberg
- Exercise Physiology Intervention & Collaboration Laboratory, School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florid, Orlando, Florida 32816
| | - Ethan C Hill
- Exercise Physiology Intervention & Collaboration Laboratory, School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florid, Orlando, Florida 32816.,Florida Space Institute, Partnership I, Research Parkway, University of Central Florida, Orlando, FL 32826
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17
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Escaloni J, Mazloomdoost D, Young I. Novel Orthobiologic Preparation and Regenerative Rehabilitation of a Complex Shoulder Injury in a Competitive Adolescent Female Athlete. Int J Sports Phys Ther 2023; 18:240-252. [PMID: 36793563 PMCID: PMC9897030 DOI: 10.26603/001c.68143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/23/2022] [Indexed: 02/05/2023] Open
Abstract
Background Platelet-rich plasma (PRP) and prolotherapy have resulted in promising outcomes in patients with various types of shoulder injuries. However, there is a lack of preliminary evidence supporting preparation of PRP production, timely application of these therapies and regenerative rehabilitation protocols. The purpose of this case report is to describe the distinct method including orthobiologic preparation, tissue-specific treatment and regenerative rehabilitation of an athlete with a complex shoulder injury. Case Presentation A 15y/o competitive female wrestler with a complex shoulder injury presented to the clinic after unsuccessful conservative rehabilitation. Unique methods were incorporated to optimize PRP production, specific tissue healing and regenerative rehabilitation. Multiple injuries required different orthobiologic interventions at different time frames, in order to promote optimal healing and stability of the shoulder. Outcomes The described interventions resulted in successful outcomes including pain, disability, full return to sport, and regenerative tissue healing confirmed with diagnostic imaging. Level of Evidence 5.
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Affiliation(s)
- James Escaloni
- American Academy of Manipulative Therapy
- Wellward Regenerative Medicine
| | | | - Ian Young
- American Academy of Manipulative Therapy
- Tybee Wellness & Osteopractic
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18
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Kataoka R, Song JS, Bell ZW, Wong V, Spitz RW, Yamada Y, Loenneke JP. Effect of Increased Pressure Pain Threshold on Resistance Exercise Performance With Blood Flow Restriction. J Strength Cond Res 2023; 37:1204-1210. [PMID: 36727998 DOI: 10.1519/jsc.0000000000004397] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT Kataoka, R, Song, JS, Bell, ZW, Wong, V, Spitz, RW, Yamada, Y, and Loenneke, JP. Effect of increased pressure pain threshold on resistance exercise performance with blood flow restriction. J Strength Cond Res XX(X): 000-000, 2022-This study aimed to examine whether increasing pressure pain threshold (PPT) through isometric handgrip exercise (HG) affects the number of repetitions completed and discomfort with knee extension exercise (KE) with blood flow restriction (BFR), and examine whether performing additional exercise leads to a further increase in PPT. Forty-one participants completed 2 trials: rest followed by low-load KE with BFR at 80% of resting arterial occlusion pressure (Rest + KE BFR) and low-intensity (30% of maximal strength) HG exercise followed by KE with BFR (HG + KE BFR). Pressure pain threshold was measured before and after exercise at the forearm and tibialis anterior. Results are presented as median difference (95% credible interval). Pressure pain threshold increased at the forearm (Bayes factor [BF10]: 5.2 × 107) and tibialis anterior (BF10: 1.5 × 106) after HG exercise. However, this did not lead to greater repetitions being completed with BFR exercise (0.2 [-0.1, 0.6] repetitions, BF10: 0.07). Pressure pain threshold after BFR exercise was not augmented over that observed with HG exercise (0.02 [-0.15, 0.2] kg·cm-2, BF10: 0.175) at the forearm. More data are needed in the lower body to determine which model best fits the data (BF10: 0.84). Discomfort with BFR exercise was not different between conditions (1.0 [-2.3, 4.4] arbitrary units, BF10: 0.10). The pain-reducing effect of prior exercise did not change the repetitions completed with BFR exercise, suggesting that the change in PPT may not have been great enough to alter performance. Performing additional exercise did not elicit further increases in PPT nor was perceived discomfort to BFR exercise altered by changes in PPT.
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Affiliation(s)
- Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
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19
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Rolnick N, Kimbrell K, de Queiros V. Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice-A review of the current state of the research. Front Physiol 2023; 14:1089065. [PMID: 37064884 PMCID: PMC10099250 DOI: 10.3389/fphys.2023.1089065] [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: 11/03/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Training with blood flow restriction (BFR) has been shown to be a useful technique to improve muscle hypertrophy, muscle strength and a host of other physiological benefits in both healthy and clinical populations using low intensities [20%-30% 1-repetition maximum (1RM) or <50% maximum oxygen uptake (VO2max)]. However, as BFR training is gaining popularity in both practice and research, there is a lack of awareness for potentially important design characteristics and features associated with BFR cuff application that may impact the acute and longitudinal responses to training as well as the safety profile of BFR exercise. While cuff width and cuff material have been somewhat addressed in the literature, other cuff design and features have received less attention. This manuscript highlights additional cuff design and features and hypothesizes on their potential to impact the response and safety profile of BFR. Features including the presence of autoregulation during exercise, the type of bladder system used, the shape of the cuff, the set pressure versus the interface pressure, and the bladder length will be addressed as these variables have the potential to alter the responses to BFR training. As more devices enter the marketplace for consumer purchase, investigations specifically looking at their impact is warranted. We propose numerous avenues for future research to help shape the practice of BFR that may ultimately enhance efficacy and safety using a variety of BFR technologies.
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Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, NY, United States
- *Correspondence: Nicholas Rolnick,
| | - Kyle Kimbrell
- Owens Recovery Science, San Antonio, TX, United States
| | - Victor de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), NatalRN, Brazil
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20
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Fan Y, Bai D, Cheng C, Tian G. The effectiveness and safety of blood flow restriction training for the post-operation treatment of distal radius fracture. Ann Med 2023; 55:2240329. [PMID: 37505919 PMCID: PMC10392265 DOI: 10.1080/07853890.2023.2240329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load training, which is suitable for post-op rehabilitation. We explored the effectiveness and safety of BFR therapy in DRF patients who underwent surgery. MATERIALS AND METHODS Thirty-five patients were randomly assigned to either the BFR or the regular training (RT; no BFR therapy) groups. All patients completed the same 4-week postoperative rehabilitation program, including anti-inflammatory treatments, strengthening and range of motion (ROM) training. In the BFR group, the pressure was 120 mmHg in strengthening training course. Pain, circumferences of wrists and forearms, ROM, muscle strength, and D-dimer levels were evaluated at weeks 0, 2, and 4. Radius union scoring system (RUSS) was measured at weeks 4 and 12. Finally, wrist functionality (Cooney modification) was evaluated at week 12. RESULTS The BFR group had significantly decreased pain levels compared with the RT group (p < 0.01, effect size= 2.33, -2.44 at weeks 2 and 4). Swelling was effectively relieved in both groups. The wrist swelling was less in the BFR group (p < 0.01, effect size = -2.17 at week 4). The isometric strength of wrist extension (p < 0.01, effect size = 1.5, 3.02 at weeks 2 and 4), flexion (p < 0.01, effect size = 1.33, 2.53 at weeks 2 and 4), and functionality significantly increased in the BFR group (p < 0.01, effect size = 2.80 at week 12). No risk of VT in the BFR group was found. BFR did not threaten bone healing. CONCLUSIONS In patients with DRF who underwent corrective surgery, BFR therapy effectively relieved pain and swelling, increased muscle strength and wrist function, and had no additional risks for bone healing and VT.
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Affiliation(s)
- Yi Fan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chongyuan Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guihua Tian
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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21
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Yang Q, He XJ, Li YD, Zhang YZ, Ding CS, Li GX, Sun J. Dose-response relationship of blood flow restriction training on isometric muscle strength, maximum strength and lower limb extensor strength: A meta-analysis. Front Physiol 2022; 13:1046625. [PMID: 36589415 PMCID: PMC9800008 DOI: 10.3389/fphys.2022.1046625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
Objective: To perform a meta-analysis on the efficacy and dose-response relationship of blood flow restriction training on muscle strength reported worldwide. Methods: Thirty-four eligible articles with a total sample size of 549 participants were included in the meta-analysis. This study was performed using the method recommended by the Cochrane Handbook (https://training.cochrane.org/handbook), and the effect size was estimated using the standardized mean difference (SMD) and using RevMan 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014). Results: The meta-analysis showed that blood flow restriction training increased the lower limb extensor muscle strength [SMD = 0.72, 95%; confidence interval (CI): 0.43 to 1.00, p < 0.01], knee extensor isokinetic torque SMD = 0.48 [95% CI: 0.24 to 0.73, p < 0.01], knee flexor isokinetic torque SMD = 0.39 [95% CI: 0.11 to 0.67, p < 0.01], and squat one-repetition maximum [SMD = 0.28, 95% CI: 0.01 to 0.55, p < 0.01]. There was no publication bias. Evaluation of dose-response relationship showed that the training load, mode, frequency, duration, and maximum cuff pressure affected the muscle function. Conclusion: blood flow restriction training. 16 significantly improved lower limb muscle strength, and the optimal training conditions consisted of a weight load smaller or equal to 30% of one-repetition maximum, training duration longer than 4 weeks, frequency of more than 3 times/week, and maximum cuff pressure lower than 200 mmHg. Systematic Review Registration: website, identifier registration number.
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Affiliation(s)
| | | | | | | | | | | | - Jian Sun
- *Correspondence: Guo Xing Li, ; Jian Sun,
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22
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Effects of Blood Flow Restriction Therapy for Muscular Strength, Hypertrophy, and Endurance in Healthy and Special Populations: A Systematic Review and Meta-Analysis. Clin J Sport Med 2022; 32:531-545. [PMID: 36083329 DOI: 10.1097/jsm.0000000000000991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Blood flow restriction (BFR) training is an increasingly applied tool with potential benefits in muscular hypertrophy, strength, and endurance. This study investigates the effectiveness of BFR training relative to other forms of training on muscle strength, hypertrophy, and endurance. DATA SOURCES We performed systematic searches of MEDLINE, Embase, and PubMed and assessed the methodological quality of included studies using the Cochrane risk of bias tool. MAIN RESULTS We included 53 randomized controlled trials with 31 included in meta-analyses. For muscular strength comparing low-intensity BFR (LI-BFR) training with high-intensity resistance training (HIRT), the pooled mean difference (MD) for 1 repetition maximum was 5.34 kg (95% CI, 2.58-8.09; P < 0.01) favoring HIRT. When comparing LI-BFR training with HIRT for torque, the MD was 6.35 N·m (95% CI, 0.5-12.3; P = 0.04) also favoring HIRT. However, comparing LI-BFR with low-intensity resistance training (LIRT) for torque, there was a MD of 9.94 N·m (95% CI, 5.43-14.45; P < 0.01) favoring BFR training. Assessing muscle hypertrophy, the MD in cross-sectional area was 0.96 cm2 (95% CI, 0.21-1.7; P = 0.01) favoring pooled BFR training compared with nonocclusive training. Assessing endurance, V̇o2 maximum demonstrated a greater mean increase of 0.37 mL/kg/min (95% CI, -0.97 to 3.17; P = 0.64) in BFR endurance training compared with endurance training alone. CONCLUSION Blood flow restriction training produced increases in muscular strength, hypertrophy, and endurance. Comparing LI-BFR training with HIRT, HIRT was a significantly better training modality for increasing muscle hypertrophy and strength. However, LI-BFR was superior when compared with a similar low-intensity protocol. Blood flow restriction training is potentially beneficial to those unable to tolerate the high loads of HIRT; however, better understanding of its risk to benefit ratio is needed before clinical application. LEVEL OF EVIDENCE Level 1.
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23
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Stanford DM, Mouser JG, Chatlaong MA, Jessee MB. A narrative review of the effects of blood flow restriction on vascular structure and function. Physiol Int 2022; 109:186-203. [PMID: 35587387 DOI: 10.1556/2060.2022.00223] [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: 12/18/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/19/2022]
Abstract
Blood flow restriction is growing in popularity as a tool for increasing muscular size and strength. Currently, guidelines exist for using blood flow restriction alone and in combination with endurance and resistance exercise. However, only about 1.3% of practitioners familiar with blood flow restriction applications have utilized it for vascular changes, suggesting many of the guidelines are based on skeletal muscle outcomes. Thus, this narrative review is intended to explore the literature available in which blood flow restriction, or a similar application, assess the changes in vascular structure or function. Based on the literature, there is a knowledge gap in how applying blood flow restriction with relative pressures may alter the vasculature when applied alone, with endurance exercise, and with resistance exercise. In many instances, the application of blood flow restriction was not in accordance with the current guidelines, making it difficult to draw definitive conclusions as to how the vascular system would be affected. Additionally, several studies report no change in vascular structure or function, but few studies look at variables for both outcomes. By examining outcomes for both structure and function, investigators would be able to generate recommendations for the use of blood flow restriction to improve vascular structure and/or function in the future.
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Affiliation(s)
- Daphney M Stanford
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - J Grant Mouser
- 2 Department of Kinesiology and Health Promotion, Applied Physiology Laboratory, Troy University, Troy, AL, USA
| | - Matthew A Chatlaong
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - Matthew B Jessee
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
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Tangchaisuriya P, Chuensiri N, Tanaka H, Suksom D. Physiological Adaptations to High-Intensity Interval Training Combined with Blood Flow Restriction in Masters Road Cyclists. Med Sci Sports Exerc 2022; 54:830-840. [PMID: 34967801 DOI: 10.1249/mss.0000000000002857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE High-intensity interval training (HIIT) and blood flow restriction (BFR) training have been used to enhance athletic performance and cardiovascular health. Combining these training modalities might be an effective training modality for masters athletes who seek to enhance athletic performance and to reduce cardiovascular risks. METHODS Fifty masters road cyclists age 35-49 yr were randomly assigned to the continuous exercise training (n = 16), continuous plus HIIT (n = 17), and continuous plus BFR training combined with HIIT (BFRIT; n = 17) for 12 wk. Both HIIT and BFRIT were performed on a cycle ergometer twice a week. RESULTS Maximal oxygen consumption (V̇O2max) increased in the HIIT and BFRIT groups (P < 0.05). This was accompanied by significant improvements in maximal cardiac output and stroke volume (P < 0.05). Forty-kilometer time trial performance improved in all three groups (P < 0.05). Peak power output increased in both HIIT and BFRIT groups (P < 0.05). Flow-mediated dilation in both brachial and popliteal arteries increased in all three groups (all P < 0.05). There were no significant changes in carotid intima-media thickness and arterial stiffness in any of the groups. Total lean mass, muscle cross-sectional area and thickness in rectus femoris and vastus lateralis, and peak torque of isokinetic knee extension increased only in the BFRIT group (all P < 0.05). Tissue saturation index decreased only in the BFRIT group (P < 0.05). Changes in 40-km time trial performance were associated with corresponding changes in V̇O2max (r = -0.312, P = 0.029) and peak isokinetic extensor torque (r = -0.432, P = 0.002). CONCLUSIONS Including HIIT particularly with BFR in the routine continuous training may be more effective in enhancing performance and physiological functions in masters road cyclists.
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Affiliation(s)
| | | | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX
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25
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Das A, Paton B. Is There a Minimum Effective Dose for Vascular Occlusion During Blood Flow Restriction Training? Front Physiol 2022; 13:838115. [PMID: 35464074 PMCID: PMC9024204 DOI: 10.3389/fphys.2022.838115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background Blood flow restriction (BFR) training at lower exercise intensities has a range of applications, allowing subjects to achieve strength and hypertrophy gains matching those training at high intensity. However, there is no clear consensus on the percentage of limb occlusion pressure [%LOP, expressed as a % of the pressure required to occlude systolic blood pressure (SBP)] and percentage of one repetition max weight (%1RM) required to achieve these results. This review aims to explore what the optimal and minimal combination of LOP and 1RM is for significant results using BFR. Method A literature search using PubMed, Scopus, Wiley Online, Springer Link, and relevant citations from review papers was performed, and articles assessed for suitability. Original studies using BFR with a resistance training exercise intervention, who chose a set %LOP and %1RM and compared to a non-BFR control were included in this review. Result Twenty-one studies met the inclusion criteria. %LOP ranged from 40 to 150%. %1RM used ranged from 15 to 80%. Training at 1RM ≤20%, or ≥ 80% did not produce significant strength results compared to controls. Applying %LOP of ≤50% and ≥ 80% did not produce significant strength improvement compared to controls. This may be due to a mechanism mediated by lactate accumulation, which is facilitated by increased training volume and a moderate exercise intensity. Conclusion Training at a minimum of 30 %1RM with BFR is required for strength gains matching non-BFR high intensity training. Moderate intensity training (40-60%1RM) with BFR may produce results exceeding non-BFR high intensity however the literature is sparse. A %LOP of 50-80% is optimal for BFR training.
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Affiliation(s)
- Arpan Das
- Institute of Sports, Exercise and Health, Department of Medical Sciences, University College of London, London, United Kingdom
| | - Bruce Paton
- Institute of Sports, Exercise and Health, Department of Medical Sciences, University College of London, London, United Kingdom
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26
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Constantinou A, Mamais I, Papathanasiou G, Lamnisos D, Stasinopoulos D. Comparing hip and knee focused exercises versus hip and knee focused exercises with the use of blood flow restriction training in adults with patellofemoral pain. Eur J Phys Rehabil Med 2022; 58:225-235. [PMID: 34985237 PMCID: PMC9980495 DOI: 10.23736/s1973-9087.22.06691-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hip and knee strengthening exercises are implemented in rehabilitation of patellofemoral pain patients, but typically use high loads (70% of 1 repetition maximum). This may lead to increased patellofemoral joint stress. Low load training (20-30% of 1 repetition maximum) with blood flow restriction could allow for exercise strength benefits to proximal and distal muscles with reduced joint stress and by promoting hypoalgesia. AIM The aim of this study was to compare hip and knee focused exercises with and without blood flow restriction in adults with patellofemoral pain for short term effectiveness. DESIGN A randomized observed-blind controlled trial. SETTING Musculoskeletal laboratories of the European University Cyprus, Nicosia, Cyprus. POPULATION 60 volunteer patients, 18-40 years of age with patellofemoral pain. METHODS Participants were randomly assigned to (1 reference group) hip and knee strengthening at (70% of 1 repetition maximum) or (2 experimental group) Strengthening with blood flow restriction at (30% of 1 repetition maximum at 70% of limb occlution pressure). Treatments took place 3 times per week for 4weeks and outcomes were assessed at baseline, end of treatment and at 2-month follow-up. The primary outcome was the Kujala Anterior Knee Pain Scale and secondary outcomes were worst and usual pain, pain with Single leg Squats, the maximum pain free flexion angle, the Tampa Scale of kinesiophobia, the Pain Catastrophizing Scale and isometric strength of knee extensors, hip extensors and hip abductors. RESULTS No difference were found for the main outcome of this study between groups. There was a significant effect of time for all outcome measures in both groups. Between group differences showed a significant difference for isometric strength of Knee extensor values at 2 month follow-up F(1,58)=5.56, P=0.02, partial η2=0.09, 459.4 (412.13, 506.64) vs. 380.68 (333.42, 427.93) and in worst pain post-treatment F(1,58)=5.27, P=0.02, partial η2=0.08, 0.76 (0.48, 1.04) vs. reference group 1.30 (0.91, 1.68) with significantly better scores in the blood flow restriction group. CONCLUSIONS Blood flow restriction exercises of the hip and knee musculature used in this study were as effective as usual exercises of Hip and knee musculature in reducing symptoms in the short term. They also indicated greater increases in strength and reduction of worst pain post-treatment. CLINICAL REHABILITATION IMPACT Further research is needed to investigate the dose response relationship with longer follow-ups.
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Affiliation(s)
| | - Ioannis Mamais
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia Cyprus
| | - Giorgos Papathanasiou
- Department of Physiotherapy, Director of Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), Faculty of Health and Caring Sciences, University of West Attica, Athens, Greece
| | - Demetris Lamnisos
- Department of Health Sciences, Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC) Physiotherapy Program, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Dimitrios Stasinopoulos
- Department of Physiotherapy, Faculty of Health and Caring Sciences, University of West Attica, Athens, Greece
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Kolind MI, Gam S, Phillip JG, Pareja-Blanco F, Olsen HB, Gao Y, Søgaard K, Nielsen JL. Effects of low load exercise with and without blood-flow restriction on microvascular oxygenation, muscle excitability and perceived pain. Eur J Sport Sci 2022; 23:542-551. [PMID: 35125067 DOI: 10.1080/17461391.2022.2039781] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This paper aimed to examine the acute effect of low-load (LL) exercise with blood-flow restriction (LL-BFR) on microvascular oxygenation and muscle excitability of the vastus medialis (VM) and vastus lateralis (VL) muscles during a single bout of unilateral knee extension exercise performed to task failure. Seventeen healthy recreationally resistance-trained males were enrolled in a within-group randomized cross-over study design. Participants performed one set of unilateral knee extensions at 20% of one-repetition maximum (1RM) to task failure, using a LL-BFR or LL free-flow (LL-FF) protocol in a randomized order on separate days. Changes in microvascular oxygenation and muscle excitability in VL and VM were assessed using near-infrared spectroscopy (NIRS) and surface electromyography (sEMG), respectively. Pain measures were collected using the visual analog scale (VAS) before and following set completion. Within- and between- protocol comparisons were performed at multiple time points of set completion for each muscle. During LL-BFR, participants performed 43% fewer repetitions and reported feeling more pain compared to LL-FF (p<0.05). Normalized to time to task failure, LL-BFR and LL-FF generally demonstrated similar progression in microvascular oxygenation and muscle excitability during exercise to task failure. The present results demonstrate that LL-BFR accelerates time to task failure, compared with LL-FF, resulting in a lower dose of mechanical work to elicit similar levels of oxygenation, blood-pooling, and muscle excitability. LL-BFR may be preferable to LL-FF in clinical settings where high workloads are contraindicated, although increased pain experienced during BFR may limit its application.HighlightsCompared to free flow (FF), neuromuscular fatigue mechanisms are accelerated during blood flow restricted (BFR) training. This can be observed as changes in microvascular oxygenation and muscle excitability occurring at a ∼43% faster mean rate during BFR compared to FF.BFR exercise seems to elicit the same level of neuromuscular fatigue as FF training within a shorter timeframe. This reduces total joint load and may be especially helpful in cases where high training volumes may be contraindicated (e.g. recovering from a sports injury or orthopedic surgery).
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Affiliation(s)
- Mikkel I. Kolind
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
| | - Søren Gam
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
| | - Jeppe G. Phillip
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
| | - Fernando Pareja-Blanco
- Physical Performance & Sports Research Center, Universidad Pablo de Olavide, Ctra. de Utrera, 1, 41013 Sevilla, Spain
| | - Henrik B. Olsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
| | - Ying Gao
- Department of Sports Science, College of Education, Zhejiang University, 310028 Hangzhou, China
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014 Jyväskylä, Finland
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense, Denmark
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Hirono T, Ikezoe T, Taniguchi M, Tanaka H, Saeki J, Yagi M, Umehara J, Ichihashi N. Relationship Between Muscle Swelling and Hypertrophy Induced by Resistance Training. J Strength Cond Res 2022; 36:359-364. [PMID: 31904714 DOI: 10.1519/jsc.0000000000003478] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Hirono, T, Ikezoe, T, Taniguchi, M, Tanaka, H, Saeki, J, Yagi, M, Umehara, J, and Ichihashi, N. Relationship between muscle swelling and hypertrophy induced by resistance training. J Strength Cond Res 36(2): 359-364, 2022-Muscle swelling immediately after resistance exercise may be induced by metabolic stress. The accumulation of metabolic stress is considered to promote muscle hypertrophy after several weeks of resistance training (RT). The purpose of this study was to determine the relationship between muscle swelling immediately after the first session of RT and muscle hypertrophy after a 6-week RT using ultrasonography. Twenty-two untrained young men performed knee extension resistance exercise consisting of 3 sets with 8 repetitions at a load of 80% of one repetition maximum for 6 weeks (3 d·wk-1). Muscle thickness of the quadriceps femoris was measured using ultrasonography device at 3 anatomical sites (proximal, medial, and distal sites) of the middle, lateral, and medial part of the anterior thigh. The sum of the muscle thickness at 9 measurement sites was used for analysis. Acute change in muscle thickness immediately after the first session of RT was used as an indicator of muscle swelling. Chronic change in muscle thickness after the 6-week RT was used as an indicator of muscle hypertrophy. A significant increase in muscle thickness was observed immediately after the first session of RT (8.3 ± 3.2%, p < 0.001). After the 6-week RT, muscle thickness increased significantly (2.9 ± 2.6%, p < 0.001). A significant positive correlation was found between muscle swelling and muscle hypertrophy (ρ = 0.443, p = 0.039). This study suggests that the greater the muscle swelling immediately after the first session of RT, the greater the muscle hypertrophy after RT.
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Affiliation(s)
- Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tome Ikezoe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Tanaka
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan ; and
| | - Junya Saeki
- Japan Society for the Promotion of Science, Tokyo, Japan.,Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Umehara
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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29
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Muscle growth adaptations to high-load training and low-load training with blood flow restriction in calf muscles. Eur J Appl Physiol 2022; 122:623-634. [PMID: 34981201 DOI: 10.1007/s00421-021-04862-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare muscle growth adaptations between traditional high-load training and low-load training with blood flow restriction (BFR) in the calf muscles over 6 weeks. METHODS 27 trained individuals performed calf exercise in both legs for 6 weeks. Each leg was randomly assigned to one of the two conditions: (1) Traditional (70% of 1RM) training (TRAD); and (2) Low-load (30% of 1RM) training with BFR. In addition, subjects performed standing calf raises with or without BFR. Measures were taken pre- and post-intervention. RESULTS For the posterior muscle site, there was no condition (BFR vs. TRAD) × time (pre vs. post) interaction (p = 0.15). In addition, there was no main effect for condition (p = 0.83) or time (p = 0.20). For the lateral muscle site, there was no condition × time interaction (p = 0.47). In addition, there was no main effect for condition (p = 0.10) or time (p = 0.57). For the medial muscle site, there was no condition × time interaction (p = 0.60). In addition, there was no main effect for condition (p = 0.44) or time (p = 0.72). For RPE, there was no condition × time interaction. However, there was a main effect for condition (p < 0.05) with BFR having higher RPE. For discomfort, there was no condition × time interaction. However, there was a main effect for condition (p < 0.001) with the BFR condition displaying higher discomfort. CONCLUSION No muscle growth was detected in the calf musculature. BFR was not more effective at eliciting muscle hypertrophy compared to traditional training. However, it was accompanied with higher exertion and discomfort.
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30
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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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31
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Hill EC, Housh TJ, Smith CM, Keller JL, Anders JPV, Schmidt RJ, Johnson GO. Acute changes in muscle thickness, edema, and blood flow are not different between low-load blood flow restriction and non-blood flow restriction. Clin Physiol Funct Imaging 2021; 41:452-460. [PMID: 34192417 DOI: 10.1111/cpf.12720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/05/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
The purpose of the present study was to examine the acute changes in muscle swelling (as assessed by muscle thickness and echo intensity) and muscle blood flow associated with an acute bout of low-load blood flow restriction (LLBFR) and low-load non-blood flow restriction (LL) exercise. Twenty women (mean ± SD; 22 ± 2years) volunteered to perform an acute exercise bout that consisted of 75 (1 × 30, 3 × 15) isokinetic, reciprocal, concentric-only, submaximal (30% of peak torque), forearm flexion and extension muscle actions. Pretest, immediately after (posttest), and 5-min after (recovery) completing the 75 repetitions, muscle thickness and echo intensity were assessed from the biceps brachii and triceps brachii muscles and muscle blood flow was assessed from the brachial artery. There were no between group differences for any of the dependent variables, but there were significant simple and main effects for muscle and time. Biceps and triceps brachii muscle thickness increased from pretest (2.13 ± 0.39 cm and 1.88 ± 0.40 cm, respectively) to posttest (2.58 ± 0.49 cm and 2.17 ± 0.43 cm, respectively) for both muscles and remained elevated for the biceps brachii (2.53 ± 0.43 cm), but partially returned to pretest levels for the triceps brachii (2.06 ± 0.41 cm). Echo intensity and muscle blood flow increased from pretest (98.0 ± 13.6 Au and 94.5 ± 31.6 ml min-1 , respectively) to posttest (109.2 ± 16.9 Au and 312.2 ± 106.5 ml min-1 , respectively) and pretest to recovery (110.1 ± 18.3 Au and 206.7 ± 92.9 ml min-1 , respectively) and remained elevated for echo intensity, but partially returned to pretest levels for muscle blood flow. The findings of the present study indicated that LLBFR and LL elicited comparable acute responses as a result of reciprocal, concentric-only, forearm flexion and extension muscle actions.
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Affiliation(s)
- Ethan C Hill
- School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florida, Orlando, FL, USA.,Florida Space Institute, University of Central Florida, Orlando, FL, USA
| | - Terry J Housh
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Cory M Smith
- College of Health Sciences, Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA
| | - Joshua L Keller
- College of Education and Professional Studies, Department of Health, Kinesiology and Sport, University of South Alabama, Mobile, AL, USA
| | - John Paul V Anders
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Richard J Schmidt
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Glen O Johnson
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE, USA
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32
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Rolnick N, Kimbrell K, Cerqueira MS, Weatherford B, Brandner C. Perceived Barriers to Blood Flow Restriction Training. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:697082. [PMID: 36188864 PMCID: PMC9397924 DOI: 10.3389/fresc.2021.697082] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/11/2021] [Indexed: 12/13/2022]
Abstract
Blood flow restriction (BFR) training is increasing in popularity in the fitness and rehabilitation settings due to its role in optimizing muscle mass and strength as well as cardiovascular capacity, function, and a host of other benefits. However, despite the interest in this area of research, there are likely some perceived barriers that practitioners must overcome to effectively implement this modality into practice. These barriers include determining BFR training pressures, access to appropriate BFR training technologies for relevant demographics based on the current evidence, a comprehensive and systematic approach to medical screening for safe practice and strategies to mitigate excessive perceptual demands of BFR training to foster long-term compliance. This manuscript attempts to discuss each of these barriers and provides evidence-based strategies and direction to guide clinical practice and future research.
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Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States
- *Correspondence: Nicholas Rolnick
| | - Kyle Kimbrell
- Owens Recovery Science, San Antonio, TX, United States
| | - Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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33
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Davids CJ, Raastad T, James LP, Gajanand T, Smith E, Connick M, McGorm H, Keating S, Coombes JS, Peake JM, Roberts LA. Similar Morphological and Functional Training Adaptations Occur Between Continuous and Intermittent Blood Flow Restriction. J Strength Cond Res 2021; 35:1784-1793. [PMID: 34027913 DOI: 10.1519/jsc.0000000000004034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Davids, CJ, Raastad, T, James, L, Gajanand, T, Smith, E, Connick, M, McGorm, H, Keating, S, Coombes, JS, Peake, JM, and Roberts, LA. Similar morphological and functional training adaptations occur between continuous and intermittent blood flow restriction. J Strength Cond Res 35(7): 1784-1793, 2021-The aim of the study was to compare skeletal muscle morphological and functional outcomes after low-load resistance training using 2 differing blood flow restriction (BFR) protocols. Recreationally active men and women (n = 42 [f = 21], 24.4 ± 4.4 years) completed 21 sessions over 7 weeks of load-matched and volume-matched low-load resistance training (30% 1 repetition maximum [1RM]) with either (a) no BFR (CON), (b) continuous BFR (BFR-C, 60% arterial occlusion pressure [AOP]), or (c) intermittent BFR (BFR-I, 60% AOP). Muscle mass was assessed using peripheral quantitative computed tomography before and after training. Muscular strength, endurance, and power were determined before and after training by assessing isokinetic dynamometry, 1RM, and jump performance. Ratings of pain and effort were taken in the first and final training session. An alpha level of p < 0.05 was used to determine significance. There were no between-group differences for any of the morphological or functional variables. The muscle cross sectional area (CSA) increased pre-post training (p = 0.009; CON: 1.6%, BFR-C: 1.1%, BFR-I: 2.2%). Maximal isometric strength increased pre-post training (p < 0.001; CON: 9.6%, BFR-C: 14.3%, BFR-I: 19.3%). Total work performed during an isokinetic endurance task increased pre-post training (p < 0.001, CON: 3.6%, BFR-C: 9.6%, BFR-I: 11.3%). Perceptions of pain (p = 0.026) and effort (p = 0.033) during exercise were higher with BFR-C; however, these reduced with training (p = 0.005-0.034). Overall, these data suggest that when 30% 1RM loads are used with a frequency of 3 times per week, the addition of BFR does not confer superior morphological or functional adaptations in recreationally active individuals. Furthermore, the additional metabolic stress that is proposed to occur with a continuous BFR protocol does not seem to translate into proportionally greater training adaptations. The current findings promote the use of both intermittent BFR and low-load resistance training without BFR as suitable alternative training methods to continuous BFR. These approaches may be practically applicable for those less tolerable to pain and discomfort associated with ischemia during exercise.
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Affiliation(s)
- Charlie J Davids
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lachlan P James
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Trishan Gajanand
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Emily Smith
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Mark Connick
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Hamish McGorm
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia
| | - Shelley Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jonathan M Peake
- Queensland Academy of Sport, Nathan, Australia.,School of Biomedical Sciences and Institute of Health and Biomedical Sciences, Queensland University of Technology, Brisbane, Australia; and
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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34
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Cerqueira MS, Maciel DG, Barboza JAM, Centner C, Lira M, Pereira R, De Brito Vieira WH. Effects of low-load blood flow restriction exercise to failure and non-failure on myoelectric activity: a meta-analysis. J Athl Train 2021; 57:402-417. [PMID: 34038945 DOI: 10.4085/1062-6050-0603.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To compare the short- and long-term effects of low load blood flow restriction (LL-BFR) versus low- (LL-RT) or high-load (HL-RT) resistance training with free blood flow on myoelectric activity, and investigate the differences between failure and non-failure protocols. DATA SOURCE We identified sources by searching the MEDLINE/PUBMED, CINAHL, WEB OF SCIENCE, CENTRAL, SCOPUS, SPORTDiscus, and PEDro electronic databases. STUDY SELECTION We screened titles and abstracts of 1048 articles using our inclusion criteria. A total of 39 articles were selected for further analysis. DATA EXTRACTION Two reviewers independently assessed the methodological quality of each study and extracted data from studies. A meta-analytic approach was used to compute standardized mean differences (SMD ± 95% confidence intervals (CI)). Subgroup analyses were conducted for both failure or non-failure protocols. DATA SYNTHESIS The search identified n = 39 articles that met the inclusion criteria. Regarding the short-term effects, LL-BFR increased muscle excitability compared with LL-RT during non-failure exercises (SMD 0.61, 95% CI 0.34 to 0.88), whereas HL-RT increased muscle excitability compared with LL-BFR regardless of voluntary failure (SMD -0.61, 95% CI -1.01 to 0.21) or not (SMD -1.13, CI -1.94 to -0.33). Concerning the long-term effects, LL-BFR increased muscle excitability compared with LL-RT during exercises performed to failure (SMD 1.09, CI 0.39 to 1.79). CONCLUSIONS Greater short-term muscle excitability levels are observed in LL-BFR than LL-RT during non-failure protocols. Conversely, greater muscle excitability is present during HL-RT compared with LL-BFR, regardless of volitional failure. Furthermore, LL-BFR performed to failure increases muscle excitability in the long-term compared with LL-RT.
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Affiliation(s)
- Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Daniel Germano Maciel
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Jean Artur Mendonça Barboza
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany; Praxisklinik Rennbahn, Muttenz, Switzerland,
| | - Maria Lira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil,
| | - Wouber Hérickson De Brito Vieira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
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Schwiete C, Franz A, Roth C, Behringer M. Effects of Resting vs. Continuous Blood-Flow Restriction-Training on Strength, Fatigue Resistance, Muscle Thickness, and Perceived Discomfort. Front Physiol 2021; 12:663665. [PMID: 33859576 PMCID: PMC8042206 DOI: 10.3389/fphys.2021.663665] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The purpose of this study was to clarify whether blood-flow restriction during resting intervals [resting blood-flow restriction (rBFR)] is comparable to a continuous BFR (cBFR) training regarding its effects on maximum strength, hypertrophy, fatigue resistance, and perceived discomfort. Materials and Methods: Nineteen recreationally trained participants performed four sets (30-15-15-15 repetitions) with 20% 1RM on a 45° leg press twice a week for 6 weeks (cBFR, n = 10; rBFR, n = 9). Maximum strength, fatigue resistance, muscle thickness, and girth were assessed at three timepoints (pre, mid, and post). Subjective pain and perceived exertion were determined immediately after training at two timepoints (mid and post). Results: Maximum strength (p < 0.001), fatigue resistance (p < 0.001), muscle thickness (p < 0.001), and girth (p = 0.008) increased in both groups over time with no differences between groups (p > 0.05). During the intervention, the rBFR group exposed significantly lower perceived pain and exertion values compared to cBFR (p < 0.05). Discussion: Resting blood-flow restriction training led to similar gains in strength, fatigue resistance, and muscle hypertrophy as cBFR training while provoking less discomfort and perceived exertion in participants. In summary, rBFR training could provide a meaningful alternative to cBFR as this study showed similar functional and structural changes as well as less discomfort.
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Affiliation(s)
- Carsten Schwiete
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Alexander Franz
- Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Christian Roth
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michael Behringer
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
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Sumi D, Yamaguchi K, Goto K. Impact of Three Consecutive Days of Endurance Training Under Hypoxia on Muscle Damage and Inflammatory Responses. Front Sports Act Living 2021; 3:663095. [PMID: 33937753 PMCID: PMC8082451 DOI: 10.3389/fspor.2021.663095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/08/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: The purpose of this study was to determine the effect of 3 consecutive days of endurance training under hypoxia on muscle damage, inflammation, and performance responses. Methods: Nine active healthy males completed two trials in different periods, consisting of either 3 consecutive days of endurance training under hypoxia [fraction of inspired oxygen (Fio2): 14.5%, HYP] or normoxia (Fio2: 20.9%, NOR). They performed daily 90-min sessions of endurance training consisting of high-intensity endurance interval pedaling [10 × 4-min pedaling at 80% of maximal oxygen uptake (V˙o2max) with 2 min of active rest at 30% of V˙o2max] followed by 30-min continuous pedaling at 60% of V˙o2max during 3 consecutive days (days 1–3). Venous blood sample, muscular performance of lower limb, and score of subjective feelings were determined every morning (days 1–4) to evaluate muscle damage and inflammation. On day 4, subjects performed an incremental exercise test (IET) to evaluate the performance response. Results: Pedaling workload during daily endurance training was significantly lower in the HYP trial (interval exercise: 166 ± 4 W) than in the NOR trial (194 ± 8 W; P < 0.0001). Serum creatine kinase (CK) and high-sensitivity C-reactive protein (hsCRP) concentrations did not significantly change during days 1–4 in either trial. Maximal voluntary contraction (MVC) of knee extension (P < 0.0001) and drop jump (DJ) index (P = 0.004) were significantly decreased with training in both trials, with no significant difference between trials. The muscle soreness and fatigue scores significantly increased in both trials (P < 0.0001). However, the HYP trial showed a significantly lower score of fatigue on day 4 compared with the NOR trial (P = 0.004). Maximal aerobic power output during IET on day 4 did not significantly differ between trials. Conclusion: Three consecutive days of endurance training under hypoxia induced comparable levels of muscle damage, inflammation, and performance responses compared with the same training under normoxia.
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Affiliation(s)
- Daichi Sumi
- Research Center for Urban Health and Sports, Osaka City University, Osaka, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.,Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Japan
| | - Keiichi Yamaguchi
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Kazushige Goto
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Japan
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Hirono T, Ikezoe T, Taniguchi M, Nojiri S, Tanaka H, Ichihashi N. Acute effects of repetitive peripheral magnetic stimulation following low-intensity isometric exercise on muscle swelling for selective muscle in healthy young men. Electromagn Biol Med 2021; 40:420-427. [PMID: 33764250 DOI: 10.1080/15368378.2021.1907402] [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: 10/21/2022]
Abstract
Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive stimulator that can induce strong muscle contraction in selective regions. This study aimed to measure acute changes in skeletal muscle thickness induced by rPMS following a low-intensity exercise. Fifteen healthy young men performed an isometric knee extensor exercise at 30% of maximum strength consisting of three sets of 10 contractions on their dominant leg. rPMS was then applied on the vastus lateralis (VL) at the maximum intensity of the rPMS device. Muscle thicknesses of the rectus femoris (RF) and VL were measured using an ultrasound device and were compared among baseline, post-exercise, and post-rPMS. There were significant increases in muscle thickness of both the RF and VL post-exercise compared with baseline values (RF: baseline; 24.7 ± 2.4, post-exercise; 25.3 ± 2.4 mm, p = .034, VL: baseline; 27.0 ± 2.8, post-exercise; 27.4 ± 2.8 mm, p = .006). Compared with post-exercise, there was a significant increase post-rPMS in only the VL (VL: post-rPMS; 28.3 ± 2.9 mm, p = .002). These findings suggest that low-intensity isometric exercise can induce acute increases in muscle thickness (muscle swelling) in synergist muscles, and rPMS following exercise can induce further acute muscle swelling via repetitive muscle contraction.
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Affiliation(s)
- Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tome Ikezoe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shusuke Nojiri
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Tanaka
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Keller JL, Hill EC, Housh TJ, Smith CM, Anders JPV, Schmidt RJ, Johnson GO. The acute and early phase effects of blood flow restriction training on ratings of perceived exertion, performance fatigability, and muscular strength in women. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-204198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Blood flow restriction (BFR) resistance training (RT) has garnered recent interest, but female-specific data remains scarce. OBJECTIVE: The purpose was to examine the effects of 2-wks of low-load concentric, isokinetic, reciprocal forearm flexion and extension training, with and without BFR on perceptual responses, performance fatigability, and muscular strength. METHODS: Twenty women were assigned to a BFRT or a non-BFRT group. Each group trained at 30% of concentric peak moment. Each session consisted of 75 concentric, isokinetic, reciprocal forearm flexion extension muscle actions. RPEs were recorded following each set. Pretest and posttest maximal voluntary isometric contraction (MVIC) force was measured, and percent decline was defined as performance fatigability. RESULTS: The RPE values (p< 0.05) increased across sets. Strength (collapsed across muscle action) increased (p< 0.05) from 0-wk (23.7 ± 3.2 Nm) to 2-wk (26.8 ± 2.7 Nm). Independent of group and muscle action, performance fatigability (p< 0.05) increased from 0-wk (10.9 ± 5.0%) to 2-wk (14.1 ± 4.4%). CONCLUSIONS: 2-wks of low-load concentric, reciprocal forearm flexion and extension training resulted in similar training-induced changes in perceptual responses, performance fatigability, and muscular strength between BFRT and non-BFRT. These findings may reduce concerns of increased perceptual responses following BFRRT compared to non-BFRRT.
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Affiliation(s)
- Joshua L. Keller
- Department of Health, Kinesiology and Sport, College of Education, University of South Alabama, AL, USA
| | - Ethan C. Hill
- Division of Kinesiology, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, USA
| | - Terry J. Housh
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
| | - Cory M. Smith
- Human and Environmental Physiology Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA
| | - John Paul V. Anders
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
| | - Richard J. Schmidt
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
| | - Glen O. Johnson
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
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EFFECTS OF BLOOD FLOW RESTRICTION TRAINING ON HANDGRIP STRENGTH AND MUSCULAR VOLUME OF YOUNG WOMEN. Int J Sports Phys Ther 2020; 15:901-909. [PMID: 33344006 DOI: 10.26603/ijspt20200901] [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: 11/18/2022] Open
Abstract
Background High-intensity training methods are generally recommended to increase muscle mass and strength, with training loads of 60-70% 1RM for novice and 80-100% 1RM for advanced individuals. Blood flow restriction training, despite using lower intensities (30-50% 1RM), can provide similar improvements in muscle mass and strength. However, studies commonly investigate the effects of blood flow restriction training in large muscular groups, whereas there are few studies that investigated those effects in smaller muscle groups, such as the muscles involved in grasping (e.g, wrist flexors; finger flexors). Clinically, smaller muscular groups should also be considered in intervention programs, given that repetitive stress, such as repeated strain injuries, affects upper limbs and may lead to chronic pain and incapacity for work. The purpose of the present study was to examine the effects of blood flow restriction training in strength and anthropometric indicators of muscular volume in young women. Hypothesis The effect of blood flow restriction training in handgrip strength (HGS) and muscular volume of young women can be similar to traditional training, even with lower loads. Methods Twenty-eight university students, 18 to 25 years of age, were randomly assigned into two groups, blood flow restriction training (BFR, n = 14) and traditional training (TRAD, n = 14). The anthropometric measures and maximum handgrip strength (MHGS) test were performed before and after the intervention. The participants did three weekly sessions of dynamic concentric contraction exercises on a dynamometer for four weeks (12 sessions). Each session had a time length of five minutes and the intensity was established from a percentage of MHGS at 30-35% in the first week, 40-45% in the second and 50-55% in third/fourth weeks. Three sets of 15-25 handgrip repetitions were performed until a failure with a 30 seconds rest for BFR training and three sets of 8-12 repetitions with one-minute rest for TRAD training. Results A significant increase was found in the arm muscle circumference (20.6 ± 2.2 vs 21.6 ± 1.7cm) and right MHGS (32.7 ± 4.5 vs 34.3 ± 4.1 kgf) and left MHGS (28.0 ± 5.5 vs 30.9 ± 4.1 kgf) for the BFR training, and the left MHGS (27.6 ± 5.0 vs 31.0 ± 6.1 kgf) for the TRAD training. Conclusion Dynamometer training with blood flow restriction, performed with low to moderate loads, was more effective than the traditional training in increasing HGS and muscle volume in young women. Level of evidence 2b.
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Acute Effects of Tissue Flossing Around the Upper Thigh on Neuromuscular Performance: A Study Using Different Degrees of Wrapping Pressure. J Sport Rehabil 2020; 30:601-608. [PMID: 33238242 DOI: 10.1123/jsr.2020-0105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/27/2020] [Accepted: 09/05/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT It has been recently demonstrated that tissue flossing around the ankle joint can be effectively used to improve ankle range of motion, jump, and sprint ability. However, there is a lack of studies investigating the acute effects of tissue flossing applied using different wrapping pressures. OBJECTIVE To investigate the acute effects of tissue flossing and the degree of floss band pressure, around the upper thigh on knee range of motion, strength, and muscle contractile characteristics. DESIGN Crossover design in 3 distinct sessions. SETTING University laboratory. PARTICIPANTS A total of 19 recreationally trained volunteers (age 23.8[4.8] y) participated in this study. INTERVENTION Active knee extension and flexion performed for 3 sets of 2 minutes (2-min rest between sets with wrapped upper thigh). Individualized wrapping pressures were applied to create conditions of high and moderate vascular occlusion, while a loose band application served as a control condition. MAIN OUTCOME MEASURES Participants were assessed for active straight leg raise test; tensiomyography displacement and contraction time for rectus femoris, vastus medialis, and biceps femoris muscles; and maximum voluntary contractions for knee extensors and flexors for pre, after, and 30 minutes after applying the floss band. RESULTS There was a statistically significant increase in maximum voluntary contractions for knee extensors and a significant shortening in rectus femoris contraction time for the moderate condition, which was associated with small to medium effects in favor of the moderate condition. There were no statistically significant changes observed between control and high conditions. The active straight leg raise test was unaffected regardless of intervention. CONCLUSIONS The results of this study suggest that tissue flossing around the upper thigh might have a localized as well as pressure-sensitive response, thereby improving neuromuscular function of the knee extensors.
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Ramme AJ, Darcy R, Rourke BJ, Davis C, Markworth JF, Junginger L, Maerz T, Brooks SV, Bedi A. Local and Systemic Effects of Blood Flow Restriction Therapy in an Animal Model. Am J Sports Med 2020; 48:3245-3254. [PMID: 33136456 DOI: 10.1177/0363546520962058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Blood flow restriction therapy (BFRT) has been increasingly applied to improve athletic performance and injury recovery. Validation of BFRT has lagged behind commercialization, and currently the mechanism by which this therapy acts is unknown. BFRT is one type of ischemic therapy, which involves exercising with blood flow restriction. Repetitive restriction of muscle blood flow (RRMBF) is another ischemic therapy type, which does not include exercise. HYPOTHESIS/PURPOSE The purpose was to develop a rat model of ischemic therapy, characterize changes to muscle contractility, and evaluate local and systemic biochemical and histologic responses of 2 ischemic therapy types. We hypothesized that ischemic therapy would improve muscle mass and strength as compared with the control group. STUDY DESIGN Controlled laboratory study. METHODS Four groups of 10 Sprague-Dawley rats were established: control, stimulation, RRMBF, and BFRT. One hindlimb of each subject underwent 8 treatment sessions over 4 weeks. To simulate exercise, the stimulation group underwent peroneal nerve stimulation for 2 minutes. The RRMBF group used a pneumatic cuff inflated to 100 mm Hg with a 48-minute protocol. The BFRT group involved 100-mm Hg pneumatic cuff inflation and peroneal nerve stimulation for a 5-minute protocol. Four methods of evaluation were performed: in vivo contractility testing, histology, immunohistochemistry, and ELISA. Analysis of variance with post hoc Tukey test and linear mixed effects modeling were used to compare the treatment groups. RESULTS There was no difference in muscle mass among groups (P = .40) or between hindlimbs (P = .73). In vivo contractility testing showed no difference in maximum contractile force among groups (P = .64) or between hindlimbs (P = .30). On histology, myocyte cross-sectional area was not different among groups (P = .55) or between hindlimbs (P = .44). Pax7 immunohistochemistry demonstrated no difference in muscle satellite cell density among groups (P = .06) or between hindlimbs (P = .046). ELISA demonstrated the RRMBF group as eliciting elevated GH levels as compared with the other groups (P < .001). CONCLUSION Ischemic therapy did not induce gains in muscle mass, contractility strength, fiber cross-sectional area, or satellite cell density locally or systemically in this model, although the RRMBF group did have elevated GH levels on ELISA. CLINICAL RELEVANCE This animal model does not support ischemic therapy as a method to improve muscle mass, function, or satellite cell density.
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Affiliation(s)
- Austin J Ramme
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.,Steindler Orthopedic Clinic, Iowa City, Iowa, USA
| | - Rose Darcy
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Brennan J Rourke
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol Davis
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - James F Markworth
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Lucas Junginger
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Tristan Maerz
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan V Brooks
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Rolnick N, Schoenfeld BJ. Can Blood Flow Restriction Used During Aerobic Training Enhance Body Composition in Physique Athletes? Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rolnick N, Schoenfeld BJ. Blood Flow Restriction Training and the Physique Athlete: A Practical Research-Based Guide to Maximizing Muscle Size. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
BACKGROUND The competitive environment of athletics has promoted the exploration of any technology application that may offer an edge with performance and recovery from injury. Ischemic therapy is one such technology that has rapidly been incorporated into training rooms and physical therapy clinics worldwide. This therapy modality is reported to increase an athlete's ability to improve muscle mass, strength, and endurance. PURPOSE To provide the sports medicine physician with an understanding of the current state of ischemic therapy technology, including treatment specifications, known physiological effects, hypothesized mechanisms, biochemical effects, athletic applications, medical applications, animal models, and future research recommendations. STUDY DESIGN Literature review. METHODS A computer-based search of the PubMed database was used to perform a comprehensive literature review on musculoskeletal ischemic therapy. RESULTS The current research on ischemic therapy is largely composed of case series with varying equipment, methods, and therapy specifications. The publication of case series has value in identifying this technology for future research, but the results of these studies should not be justification for application to athletes without validation of safety and effectiveness. CONCLUSION To date, ischemic therapy remains unvalidated, and the mechanism by which it improves muscle performance is not clear.
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Affiliation(s)
- Austin J Ramme
- Department of Orthopaedic Surgery, The University of Michigan, Ann Arbor, Michigan, USA.,Steindler Orthopedic Clinic, Iowa City, Iowa, USA
| | - Brennan J Rourke
- Department of Orthopaedic Surgery, The University of Michigan, Ann Arbor, Michigan, USA
| | | | - Asheesh Bedi
- Department of Orthopaedic Surgery, The University of Michigan, Ann Arbor, Michigan, USA
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Pignanelli C, Burr JF. Greater discomfort with blood flow restriction training compared to standard low‐load resistance exercise when both are performed to task failure. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christopher Pignanelli
- Department of Human Health and Nutritional Sciences University of Guelph Guelph ON Canada
| | - Jamie F. Burr
- Department of Human Health and Nutritional Sciences University of Guelph Guelph ON Canada
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Da Silva-Grigoletto ME, Neto EP, Behm DG, Loenneke JP, La Scala Teixeira CV. Functional Training and Blood Flow Restriction: A Perspective View on the Integration of Techniques. Front Physiol 2020; 11:817. [PMID: 32848818 PMCID: PMC7412632 DOI: 10.3389/fphys.2020.00817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/18/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marzo E. Da Silva-Grigoletto
- Functional Training Group, Federal University of Sergipe, Aracajú, Brazil
- *Correspondence: Marzo E. Da Silva-Grigoletto
| | | | - David George Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jeremy P. Loenneke
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, United States
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Vissing K, Groennebaek T, Wernbom M, Aagaard P, Raastad T. Myocellular Adaptations to Low-Load Blood Flow Restricted Resistance Training. Exerc Sport Sci Rev 2020; 48:180-187. [DOI: 10.1249/jes.0000000000000231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Low-intensity blood flow restriction calf muscle training leads to similar functional and structural adaptations than conventional low-load strength training: A randomized controlled trial. PLoS One 2020; 15:e0235377. [PMID: 32603351 PMCID: PMC7326162 DOI: 10.1371/journal.pone.0235377] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/12/2020] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to investigate whether a six-week, twice weekly resistance training (4 sets at 30% 1-RM until failure) with practical blood flow restriction (BFR) using 7cm wide cuffs with a twist lock placed below the patella is superior to training without BFR (NoBFR) concerning muscle mass and strength gains in calf muscles. A two-group (BFR n = 12, mean age 27.33 (7.0) years, training experience 7.3 (7.0) years; NoBFR n = 9, mean age 28.9 (7.4) years, training experience 7.1 (6.6) years) randomized matched pair design based on initial 1-RM was used to assess the effects on structural and functional adaptations in healthy males (Perometer calf volume [CV], gastrocnemius muscle thickness using ultrasound [MT], 7-maximal hopping test for leg stiffness [LS], 1-RM smith machine calf raise [1-RM], and visual analogue scale as a measure of pain intensity [VAS]). The mean number of repetitions completed per training session across the intervention period was higher in the NoBFR group compared to the BFR group (70 (16) vs. 52 (9), p = 0.002). VAS measured during the first session increased similarly in both groups from first to fourth set (p<0.001). No group effects or time×group interactions were found for CV, MT, LS, and 1-RM. However, there were significant time effects for MT (BFR +0.07 cm; NoBFR +0.04; p = 0.008), and 1-RM (BFR +40 kg; NoBFR +34 kg; p<0.001). LS and CV remained unchanged through training. VAS in both groups were similar, and BFR and NoBFR were equally effective for increasing 1-RM and MT in trained males. However, BFR was more time efficient, due to lesser repetition per training session.
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Acute cardiovascular response to unilateral, bilateral, and alternating resistance exercise with blood flow restriction. Eur J Appl Physiol 2020; 120:1921-1930. [PMID: 32588194 DOI: 10.1007/s00421-020-04401-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
AIM Blood flow restriction (BFR) exercise is a common alternative to traditional high-load resistance exercise used to increase muscle size and strength. Some populations utilizing BFR at a low load may wish to limit their cardiovascular response to exercise. Different contraction patterns may attenuate the cardiovascular response, but this has not been compared using BFR. PURPOSE To compare the cardiovascular response to unilateral (UNI), bilateral (BIL), and alternating (ALT) BFR exercise contraction patterns. METHODS Twenty healthy participants performed four sets (30 s rest) of knee extensions to failure, using 30% one-repetition maximum, 40% arterial occlusion pressure, and each of the three contraction patterns (on different days, at the same time of day, separated by 2-10 days, randomized). Cardiovascular responses, presented as pre- to post-exercise mean changes (SD), were measured using pulse wave analysis and analyzed with Bayesian RMANOVA. RESULTS ALT caused greater changes in: aortic systolic [ΔmmHg: ALT = 21(8); UNI = 13(11); BIL = 15(8); BF10 = 29.599], diastolic [ΔmmHg: ALT = 13(8); UNI = 7(11); BIL = 8(8); BF10 = 5.175], and mean arterial [ΔmmHg: ALT = 19(8); UNI = 11(11); BIL = 13(7); BF10 = 48.637] blood pressures. Aortic [ΔmmHg bpm: ALT = 4945(2340); UNI = 3294(1408); BIL = 3428 (1461); BF10 = 113.659] and brachial [ΔmmHg bpm: ALT = 6134(2761); UNI = 4300(1709); BIL = 4487(1701); BF10 = 31.845] rate pressure products, as well as heart rate [Δbpm: ALT = 26(14); UNI = 19(8); BIL = 19(11); BF10 = 5.829] were greatest with ALT. Augmentation index [Δ%: UNI = -6(13); BIL = - 7(11); ALT = - 5(16); BF10 = 0.155] and wave reflection magnitude [Δ%: UNI = - 5(9); BIL = - 4(7); ALT = - 4(7); BF10 = 0.150] were not different. CONCLUSION Those at risk of a cardiovascular event may choose unilateral or bilateral BFR exercise over alternating until further work determines the degree to which it can be tolerated.
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Korkmaz E, Dönmez G, Uzuner K, Babayeva N, Torgutalp ŞŞ, Özçakar L. Effects of Blood Flow Restriction Training on Muscle Strength and Architecture. J Strength Cond Res 2020; 36:1396-1403. [PMID: 32287091 DOI: 10.1519/jsc.0000000000003612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Korkmaz, E, Dönmez, G, Uzuner, K, BabayevaŞerife Şeyma Torgutalp, N, and Özçakar, L. Effects of blood flow restriction training on muscle strength and architecture. J Strength Cond Res XX(X): 000-000, 2020-The aim of this study was to compare the effect of the traditional resistance (RES) training and low-intensity resistance training with blood flow restriction (BFR) protocols on quadriceps and hamstring muscle strength, and rectus femoris (RF) and vastus lateralis architecture, in youth team soccer players. Twenty-three young trained soccer team players were divided into 2 groups: the RES group that practiced traditional high-intensity resistance training (80% 1 repetition maximum [1RM], 4 sets, 12 rep.) (n = 12) and the BFR group that performed low-intensity resistance exercise with BFR (30% 1RM, 4 sets, 30-15-15-15 rep) (n = 11)-unilateral knee extension exercise-twice a week for 6 weeks. Muscle strength (isokinetic concentric peak torque of the quadriceps and hamstring muscles) and ultrasonographic parameters (muscle thickness, pennation angle, and fascicle length) were assessed. Bilateral knee flexor and extensor strength was increased in both groups compared with pre-exercise. The increase in dominant side extensor muscle strength (60°·s p = 0.02, ηp = 0.256, 180°·s p = 0.019, ηp = 0.271) and RF thickness (p = 0.002, ηp = 0.361) was statistically higher in the BFR group than in the RES group. These findings support that occlusion training can provide better benefits than traditional strength training to improve muscle hypertrophy. In addition, the novelty of our study is that BFR training may affect the muscle structure measured by ultrasonography.
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Affiliation(s)
| | - Gürhan Dönmez
- Gençlerbirliği Sports Club, Ankara, Turkey.,Department of Sports Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Kubilay Uzuner
- Department of Physiology, Eskişehir Osmangazi University, School of Medicine, Eskişehir, Turkey
| | - Naila Babayeva
- Department of Sports Medicine, Hacettepe University Medical School, Ankara, Turkey
| | | | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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