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Chen YC, Lo IP, Tsai YY, Zhao CG, Hwang IS. Dual-task improvement of older adults after treadmill walking combined with blood flow restriction of low occlusion pressure: the effect on the heart-brain axis. J Neuroeng Rehabil 2024; 21:116. [PMID: 38997727 PMCID: PMC11241870 DOI: 10.1186/s12984-024-01412-y] [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: 11/02/2023] [Accepted: 06/23/2024] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVE This study explored the impact of one session of low-pressure leg blood flow restriction (BFR) during treadmill walking on dual-task performance in older adults using the neurovisceral integration model framework. METHODS Twenty-seven older adults participated in 20-min treadmill sessions, either with BFR (100 mmHg cuff pressure on both thighs) or without it (NBFR). Dual-task performance, measured through light-pod tapping while standing on foam, and heart rate variability during treadmill walking were compared. RESULTS Following BFR treadmill walking, the reaction time (p = 0.002) and sway area (p = 0.012) of the posture dual-task were significantly reduced. Participants exhibited a lower mean heart rate (p < 0.001) and higher heart rate variability (p = 0.038) during BFR treadmill walking. Notably, BFR also led to band-specific reductions in regional brain activities (theta, alpha, and beta bands, p < 0.05). The topology of the EEG network in the theta and alpha bands became more star-like in the post-test after BFR treadmill walking (p < 0.005). CONCLUSION BFR treadmill walking improves dual-task performance in older adults via vagally-mediated network integration with superior neural economy. This approach has the potential to prevent age-related falls by promoting cognitive reserves.
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Affiliation(s)
- Yi-Ching Chen
- Department of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung City, Taiwan
- Physical Therapy Room, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - I-Ping Lo
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Yi-Ying Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Chen-Guang Zhao
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Ing-Shiou Hwang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan.
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
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Suggitt JO, Eaves BE, Spranger MD. What are the cardiovascular responses during blood flow-restricted resistance exercise? Front Physiol 2024; 15:1417855. [PMID: 38966227 PMCID: PMC11222610 DOI: 10.3389/fphys.2024.1417855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Affiliation(s)
| | | | - Marty D. Spranger
- Department of Physiology, Michigan State University, East Lansing, MI, United States
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Jia B, Lv C, Li D, Lv W. Cerebral cortex activation and functional connectivity during low-load resistance training with blood flow restriction: An fNIRS study. PLoS One 2024; 19:e0303983. [PMID: 38781264 PMCID: PMC11115316 DOI: 10.1371/journal.pone.0303983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Despite accumulating evidence that blood flow restriction (BFR) training promotes muscle hypertrophy and strength gain, the underlying neurophysiological mechanisms have rarely been explored. The primary goal of this study is to investigate characteristics of cerebral cortex activity during BFR training under different pressure intensities. 24 males participated in 30% 1RM squat exercise, changes in oxygenated hemoglobin concentration (HbO) in the primary motor cortex (M1), pre-motor cortex (PMC), supplementary motor area (SMA), and dorsolateral prefrontal cortex (DLPFC), were measured by fNIRS. The results showed that HbO increased from 0 mmHg (non-BFR) to 250 mmHg but dropped sharply under 350 mmHg pressure intensity. In addition, HbO and functional connectivity were higher in M1 and PMC-SMA than in DLPFC. Moreover, the significant interaction effect between pressure intensity and ROI for HbO revealed that the regulation of cerebral cortex during BFR training was more pronounced in M1 and PMC-SMA than in DLPFC. In conclusion, low-load resistance training with BFR triggers acute responses in the cerebral cortex, and moderate pressure intensity achieves optimal neural benefits in enhancing cortical activation. M1 and PMC-SMA play crucial roles during BFR training through activation and functional connectivity regulation.
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Affiliation(s)
- Binbin Jia
- School of Sports Training, Wuhan Sports University, Wuhan, China
- School of Physical Education, Wuhan Sports University, Wuhan, China
| | - Chennan Lv
- Center of Strength and Conditioning, Wuhan Sports University, Wuhan, China
| | - Danyang Li
- School of Sports Training, Wuhan Sports University, Wuhan, China
- School of Physical Education, Wuhan Sports University, Wuhan, China
| | - Wangang Lv
- Center of Strength and Conditioning, Wuhan Sports University, Wuhan, China
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Wong V, Spitz RW, Song JS, Yamada Y, Kataoka R, Hammert WB, Kang A, Seffrin A, Bell ZW, Loenneke JP. Blood flow restriction augments the cross-education effect of isometric handgrip training. Eur J Appl Physiol 2024; 124:1575-1585. [PMID: 38168713 DOI: 10.1007/s00421-023-05386-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION The application of blood flow restriction (BFR) to low-intensity exercise may be able to increase strength not only in the trained limb but also in the homologous untrained limb. Whether this effect is repeatable and how that change compares to that observed with higher intensity exercise is unknown. PURPOSE Examine whether low-intensity training with BFR enhances the cross-education of strength compared to exercise without BFR and maximal efforts. METHODS A total of 179 participants completed the 6-week study, with 135 individuals performing isometric handgrip training over 18 sessions. Participants were randomly assigned to one of four groups: 1) low-intensity (4 × 2 min of 30% MVC; LI, n = 47), 2) low-intensity with blood flow restriction (LI + 50% arterial occlusion pressure; LI-BFR, n = 41), 3) maximal effort (4 × 5 s of 100% MVC; MAX, n = 47), and 4) non-exercise control (CON, n = 44). RESULTS LI-BFR was the only group that observed a cross-education in strength (CON: 0.64 SD 2.9 kg, LI: 0.95 SD 3.6 kg, BFR-LI: 2.7 SD 3.3 kg, MAX: 0.80 SD 3.1 kg). In the trained hand, MAX observed the greatest change in strength (4.8 SD 3.3 kg) followed by LI-BFR (2.8 SD 4.0 kg). LI was not different from CON. Muscle thickness did not change in the untrained arm, but ulna muscle thickness was increased within the trained arm of the LI-BFR group (0.06 SD 0.11 cm). CONCLUSION Incorporating BFR into low-intensity isometric training led to a cross-education effect on strength that was greater than all other groups (including high-intensity training).
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Affiliation(s)
- Vickie Wong
- Department of Sport and Health, Solent University, Southampton, Hampshire, SO14 0YN, UK
| | - Robert W Spitz
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - William B Hammert
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Anna Kang
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Aldo Seffrin
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Zachary W Bell
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA.
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Vehrs PR, Richards S, Blazzard C, Hart H, Kasper N, Lacey R, Lopez D, Baker L. Use of a handheld Doppler to measure brachial and femoral artery occlusion pressure. Front Physiol 2023; 14:1239582. [PMID: 37664423 PMCID: PMC10470651 DOI: 10.3389/fphys.2023.1239582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Objective: Measurement of arterial occlusion pressure (AOP) is essential to the safe and effective use of blood flow restriction during exercise. Use of a Doppler ultrasound (US) is the "gold standard" method to measure AOP. Validation of a handheld Doppler (HHDOP) device to measure AOP could make the measurement of AOP more accessible to practitioners in the field. The purpose of this study was to determine the accuracy of AOP measurements of the brachial and femoral arteries using an HHDOP. Methods: We simultaneously measured AOP using a "gold standard" US and a HHDOP in the dominant and non-dominant arms (15 males; 15 females) and legs (15 males; 15 females). Results: There were no differences in limb circumference or limb volume in the dominant and non-dominant arms and legs between males and females or between the dominant and non-dominant arms and legs of males and females. The differences between US and HHDOP measures of AOP in the dominant and non-dominant arms and legs were either not significant or small (<10 mmHg) and of little practical importance. There were no sex differences in AOP measurements of the femoral artery (p > 0.60). Bland-Altman analysis yielded an average bias (-0.65 mmHg; -2.93 mmHg) and reasonable limits of agreement (±5.56 mmHg; ±5.58 mmHg) between US and HHDOP measures of brachial and femoral artery AOP, respectively. Conclusion: HHDOP yielded acceptable measures of AOP of the brachial and femoral arteries and can be used to measure AOP by practitioners for the safe and effective use of blood flow restriction. Due to the potential differences in AOP between dominant and non-dominant limbs, AOP should be measured in each limb.
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Affiliation(s)
- Pat R. Vehrs
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Shay Richards
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Chase Blazzard
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Hannah Hart
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Nicole Kasper
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Ryan Lacey
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Daniela Lopez
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Luke Baker
- Department of Statistics, Ohio State University, Columbus, OH, United States
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Wedig IJ, Durocher JJ, McDaniel J, Elmer SJ. Blood flow restriction as a potential therapy to restore physical function following COVID-19 infection. Front Physiol 2023; 14:1235172. [PMID: 37546539 PMCID: PMC10400776 DOI: 10.3389/fphys.2023.1235172] [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: 06/05/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
Accumulating evidence indicates that some COVID-19 survivors display reduced muscle mass, muscle strength, and aerobic capacity, which contribute to impairments in physical function that can persist for months after the acute phase of illness. Accordingly, strategies to restore muscle mass, muscle strength, and aerobic capacity following infection are critical to mitigate the long-term consequences of COVID-19. Blood flow restriction (BFR), which involves the application of mechanical compression to the limbs, presents a promising therapy that could be utilized throughout different phases of COVID-19 illness. Specifically, we hypothesize that: 1) use of passive BFR modalities can mitigate losses of muscle mass and muscle strength that occur during acute infection and 2) exercise with BFR can serve as an effective alternative to high-intensity exercise without BFR for regaining muscle mass, muscle strength, and aerobic capacity during convalescence. The various applications of BFR may also serve as a targeted therapy to address the underlying pathophysiology of COVID-19 and provide benefits to the musculoskeletal system as well as other organ systems affected by the disease. Consequently, we present a theoretical framework with which BFR could be implemented throughout the progression from acute illness to outpatient rehabilitation with the goal of improving short- and long-term outcomes in COVID-19 survivors. We envision that this paper will encourage discussion and consideration among researchers and clinicians of the potential therapeutic benefits of BFR to treat not only COVID-19 but similar pathologies and cases of acute critical illness.
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Affiliation(s)
- Isaac J. Wedig
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
- Health Research Institute, Michigan Technological University, Houghton, MI, United States
| | - John J. Durocher
- Department of Biological Sciences and Integrative Physiology and Health Sciences Center, Purdue University Northwest, Hammond, IN, United States
| | - John McDaniel
- Department of Exercise Physiology, Kent State University, Kent, OH, United States
| | - Steven J. Elmer
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
- Health Research Institute, Michigan Technological University, Houghton, MI, United States
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Wang Z, Atakan MM, Acar B, Xiong R, Peng L. Effects of 4-Week Low-Load Resistance Training with Blood Flow Restriction on Muscle Strength and Left Ventricular Function in Young Swimmers: A Pilot Randomized Trial. J Hum Kinet 2023; 87:63-76. [PMID: 37559761 PMCID: PMC10407315 DOI: 10.5114/jhk/163013] [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: 07/28/2022] [Accepted: 01/27/2023] [Indexed: 08/11/2023] Open
Abstract
Low-load resistance training combined with blood flow restriction (BFR) is known to result in muscle hypertrophy and strength similar to that observed with higher loads. However, the effects of resistance training with BFR on cardiac structure and cardiac function remain largely unknown. Therefore, the purpose of this randomized study was to compare the effects of conventional high-load resistance training (HL-RT) with the effects of low-load resistance training with BFR (LL-BFR) on muscle strength and left ventricular function. Sixteen young swimmers (mean ± standard deviation: age = 19.7 ± 1.6 years, body mass = 78.9 ± 9.7 kg, body height = 180.8 ± 5.8 cm) were randomly allocated to a conventional HL-RT group (n = 8) or a LL-BFR group (n = 8) with a pressure band (200 mmHg) placed on both thighs of participants for 4 weeks (3 days•week-1). Outcome measures were taken at baseline and after 4 weeks of training, and included body composition, one-repetition maximum (1RM) back squat, and echocardiography measures. The 1RM back squat significantly improved (partial eta squared (Ƞ2) = 0.365; p = 0.013) in HL-RT (mean difference (Δ) = 6.6 kg; [95% confidence interval (CI) -7.09 to 20.27]) and LL-BFR groups (Δ = 14.7 kg; [95% CI 3.39 to 26.10]), with no main effect of group or group × time interaction (p > 0.05). Interventricular septum end-systolic thickness showed a slight but statistically significant increase in LL-BFR and HL-RT groups (Ƞ2 = 0.253; p = 0.047), yet there was no main effect of group or group × time interaction (p > 0.05). There were no statistically significant changes (p > 0.05) in other cardiac structure or function parameters (e.g., left ventricular (LV) mass, LV cardiac output, LV ejection fraction, LV stroke volume) after the training programs. Results suggest that 4 weeks of HL-RT and LL-BFR improve muscle strength similarly with limited effects on left ventricular function in young swimmers.
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Affiliation(s)
- Zhenhuan Wang
- Key Lab of General Administration of Sport, Southwest University, Chongqing, China
- Institute for Health and Sport, Victoria University, Footscray, Melbourne, Australia
| | - Muhammed M. Atakan
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Burak Acar
- Department of Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Rui Xiong
- Key Lab of General Administration of Sport, Southwest University, Chongqing, China
| | - Li Peng
- Key Lab of General Administration of Sport, Southwest University, Chongqing, China
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Zheng X, Headley SA, Maris SA, Smith DM. Acute cardiovascular responses to unilateral bicep curls with blood flow restriction. J Exerc Sci Fit 2023; 21:179-185. [PMID: 36816779 PMCID: PMC9906011 DOI: 10.1016/j.jesf.2023.01.001] [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: 10/20/2022] [Revised: 12/27/2022] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
A consensus on the acute cardiovascular responses to low intensity (LI) resistance exercise (RE) combined with blood flow restriction (BFR) has not yet been reached. This study was designed to compare acute cardiovascular responses to a single bout of LIRE, high intensity (HI) RE, and LIRE with BFR in physically active young males. Participants completed 3 RE sessions in random order, where each session consists of 4 sets of unilateral dumbbell bicep curls. Cardiovascular hemodynamics were measured at baseline and right after each set of RE. Aortic augmentation index (AIx) was significantly higher after set 2,3,4 of RE in LI + BFR session compared to LI session (P < 0.05). Brachial systolic blood pressure (SBP), heart rate (HR), brachial rate pressure product (RPP), and central RPP responses did not differ between LI and LI + BFR sessions (P > 0.05). HI session had a higher central SBP, brachial RPP, central RPP, and aortic AIx compared to LI session after each set of RE (P < 0.05), but not brachial SBP (P > 0.05). Taken together, this study showed that LIRE combined with BFR acutely augmented aortic stiffness, as also observed in HI session, but myocardial oxygen consumption was only higher in HI session when compared to LI session. Thus, although BFR did not exaggerate cardiovascular responses nor cause extra myocardial oxygen consumption, it should be prescribed with caution when control of acute aortic stiffening is necessary during RE.
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Affiliation(s)
- Xiangyu Zheng
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA,Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA,Corresponding author. Springfield College, 263 Alden Street, Athletic Training and Exercise Science Facilities, Rm 214, Springfield, MA, 01109, USA.
| | - Samuel A.E. Headley
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA
| | - Stephen A. Maris
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA
| | - Daniel M. Smith
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA
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Moreno EN, Hammert WB, Martin CC, Buckner SL. Acute muscular and cardiovascular responses to high load training with pre-exercise blood flow restriction. Clin Physiol Funct Imaging 2023; 43:109-119. [PMID: 36401343 DOI: 10.1111/cpf.12799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study is to examine the acute muscular and cardiovascular responses to applying blood flow restriction (BFR) before high-load training. METHODS Forty trained individuals visited the lab on three occasions. On Visit 1, participants completed paperwork and performed strength assessments. During Visits 2 and 3, participants completed four exercise conditions (one in each arm during each visit) as follows: (1) traditional resistance training (TRAD), (2) low load training with BFR (LLBFR), (3) low repetition high load training with pre-exercise BFR (PreBFR), and (4) low repetition traditional training (LRTRAD). Blood pressure, muscle thickness (MT), and isometric strength (ISO) were measured before and after exercise. RESULTS Data are displayed as means (SD). Immediately following exercise, MT in TRAD was greater compared with PreBFR (mean difference = 0.18[0.30] cm, p < 0.001) and LRTRAD (mean difference = 0.28[0.30] cm, p < 0.001). In addition, LLBFR demonstrated greater MT compared with PreBFR (mean difference = 0.24[0.30] cm, p < 0.001]. Immediately following exercise, ISO was lower in TRAD compared with PreBFR (mean difference = 33.8[46.9]N, p < 0.001) and the LRTRAD condition (mean difference = 32.8[50.4]N, p < 0.001). In addition, ISO was lower in LLBFR compared with PreBFR (mean difference = 43.9 [47.4]N, p < 0.001) and LRTRAD (mean difference = 42.9 [43.8]N, p < 0.001). Immediately following exercise, systolic blood pressure was greater in TRAD compared with PreBFR and LRTRAD. CONCLUSION The application of BFR before engaging in high-load training does not seem to augment the muscular responses to exercise when compared with traditional high loads alone; however, it may pose less demand on the cardiovascular system.
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Affiliation(s)
- Enrique N Moreno
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - William B Hammert
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - Cole C Martin
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - Samuel L Buckner
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
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Lemos LK, Toledo Teixeira Filho CA, Biral TM, de Souza Cavina AP, Junior EP, Oliveira Damasceno SD, Vanderlei FM. Acute effects of resistance exercise with blood flow restriction on cardiovascular response: a meta-analysis. J Comp Eff Res 2022; 11:829-842. [PMID: 35712965 DOI: 10.2217/cer-2021-0272] [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: 11/21/2022] Open
Abstract
Aim: To compare the acute effects of low-load resistance training associated with blood flow restriction (LLRT-BFR) with low-load resistance training (LLRT) and high-load resistance training (HLRT) on cardiovascular outcomes in healthy individuals. Methods: This review was registered and the studies were selected using seven databases. Randomized controlled clinical trials were included that evaluated LLRT-BFR compared with LLRT and HLRT in young individuals for the cardiovascular outcomes. Results: 19 studies were included. In the comparison of LLRT-BFR with HLRT, there were significant differences for cardiac output and heart rate - with reduced values and in favor of LLRT-BFR. Conclusion: There are no greater acute effects of the addition of blood flow restriction, with the exception of the reduction in cardiac output and heart rate for LLRT-BFR compared with HLRT.
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Affiliation(s)
- Leonardo Kesrouani Lemos
- Postgraduate Program in Physiotherapy, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | | | - Taíse Mendes Biral
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | | | - Eduardo Pizzo Junior
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | - Silas de Oliveira Damasceno
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | - Franciele Marques Vanderlei
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil.,Department of Physiotherapy, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
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11
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Blood flow restriction training on resting blood pressure and heart rate: a meta-analysis of the available literature. J Hum Hypertens 2022; 36:738-743. [PMID: 34140637 DOI: 10.1038/s41371-021-00561-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 11/08/2022]
Abstract
The purpose of this meta-analysis was to examine the effects of blood flow restriction training on resting blood pressure and heart rate. A meta-analysis was completed in May 2020 including all previously published papers on blood flow restriction and was analyzed using a random effects model. To be included, studies needed to implement a blood flow restriction protocol compared to the same exercise protocol without restriction. A total of four studies met the inclusion criteria for quantitative analysis including four effect sizes for resting systolic blood pressure, four effect sizes for resting diastolic blood pressure, and three effect sizes for resting heart rate. There was evidence of a difference [mean difference (95 CI)] in resting systolic blood pressure between training with and without blood flow restriction [4.2 (0.3, 8.0) mmHg, p = 0.031]. No significant differences were observed when comparing resting diastolic blood pressure [1.2 (-1, 3.5) mmHg p = 0.274] and resting heart rate [-0.2 (-4.7, 4.1) bpm, p = 0.902] between chronic exercise with and without blood flow restriction. These results indicate that training with blood flow restriction may elicit an increase in resting systolic blood pressure. However, lack of data addressing this topic makes any conclusion speculative. Based on the results of the present study along with the overall lack of long-term data, it is suggested that future research on this topic is warranted. Recommendations include making changes in resting blood pressure a primary outcome and increasing the sample size of the interventions.
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Pedon WR, Lima FV, Cipriano G, da Silva WA, Fernandes MVS, Gomes NS, Chiappa AMG, Pena de Sousa R, Pereira da Silva ME, Chiappa GR. Acute hemodynamic responses from Low- load resistance exercise with blood flow restriction in young and older individuals: A Systematic Review and Meta-Analysis of Cross-Over Trials. Clin Physiol Funct Imaging 2022; 42:396-412. [PMID: 35808940 DOI: 10.1111/cpf.12779] [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] [Received: 04/22/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To summarize the existing evidence on the acute response of low-load (LL) resistance exercise (RE) with blood flow restriction (BFR) on hemodynamic parameters. DATA SOURCES MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, and MedRxiv databases were searched from inception to February 2022. REVIEW METHODS Cross-over trials investigating the acute effect of LLRE+BFR vs. passive (no exercise) and active control methods (LLRE or HLRE) on heart rate (HR), systolic (SBP), diastolic (DBP), and mean (MBP) blood pressure responses. RESULTS The quality of the studies was assessed using the PEDro scale, risk of bias using the RoB 2.0 tool for cross-over trials, and certainty of the evidence using the GRADE method. A total of 15 randomized cross-over studies with 466 participants were eligible for analyses. Our data showed that LLRE+BFR increases all hemodynamic parameters compared to passive control, but not compared to conventional resistance exercise. Subgroup analysis did not demonstrate any differences between LLRE+BFR and low- (LL) or high-load (HL) resistance exercise protocols. Studies including younger volunteers presented higher chronotropic responses (HR) than those with older volunteers. CONCLUSIONS Despite causing notable hemodynamic responses compared to no exercise, the short-term low-load resistance exercise with BFR modulates all hemodynamic parameters HR, SBP, DBP, and MBP, similarly to a conventional resistance exercise protocol, whether at low or high-intensity. The chronotropic response is slightly higher in younger healthy individuals despite the similarity regarding pressure parameters. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- William R Pedon
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | | | | | - Weder A da Silva
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | - Marcos V S Fernandes
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | - Natalia S Gomes
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | | | - Rafael Pena de Sousa
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | | | - Gaspar R Chiappa
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
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13
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Reina-Ruiz ÁJ, Galán-Mercant A, Molina-Torres G, Merchán-Baeza JA, Romero-Galisteo RP, González-Sánchez M. Effect of Blood Flow Restriction on Functional, Physiological and Structural Variables of Muscle in Patients with Chronic Pathologies: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031160. [PMID: 35162182 PMCID: PMC8835162 DOI: 10.3390/ijerph19031160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 02/01/2023]
Abstract
The main objective of this systematic review of the current literature is to analyze the changes that blood flow restriction (BFR) causes in subjects with neuro-musculoskeletal and/or systemic pathologies focusing on the following variables: strength, physiological changes, structural changes and cardiocirculatory variables. The search was carried out in seven databases, including randomized clinical trials in which therapeutic exercise was combined with the blood flow restriction tool in populations with musculoskeletal pathologies. Outcome variables are strength, structural changes, physiological changes and cardiocirculatory variables. Twenty studies were included in the present study. Although there is a lot of heterogeneity between the interventions and evaluation instruments, we observed how the restriction of blood flow presents significant differences in the vast majority of the variables analyzed. In addition, we observed how BFR can become a supplement that provides benefits when performed with low intensity, similar to those obtained through high-intensity muscular efforts. The application of the BFR technique can provide benefits in the short and medium term to increase strength, muscle thickness and cardiovascular endurance, even improving the physiological level of the cardiovascular system. In addition, BFR combined with low-load exercises also achieves benefits comparable to high-intensity exercises without the application of BFR, benefiting patients who are unable to lift high loads.
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Affiliation(s)
- Álvaro Jesús Reina-Ruiz
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain; (Á.J.R.-R.); (R.P.R.-G.); (M.G.-S.)
| | - Alejandro Galán-Mercant
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education, Sciences University of Cádiz, 11002 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11002 Cádiz, Spain
- Correspondence: (A.G.-M.); (G.M.-T.)
| | - Guadalupe Molina-Torres
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Nursing and Physiotherapy, University of Almeria, 04120 Almeria, Spain
- Correspondence: (A.G.-M.); (G.M.-T.)
| | - Jose Antonio Merchán-Baeza
- Centre for Health and Social Care Research (CESS), Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain;
| | - Rita Pilar Romero-Galisteo
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain; (Á.J.R.-R.); (R.P.R.-G.); (M.G.-S.)
- Instituto de Investigación Biomédica de Málaga, IBIMA, Calle Doctor Miguel Díaz Recio, 28, 29010 Málaga, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain; (Á.J.R.-R.); (R.P.R.-G.); (M.G.-S.)
- Instituto de Investigación Biomédica de Málaga, IBIMA, Calle Doctor Miguel Díaz Recio, 28, 29010 Málaga, Spain
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14
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Freitas EDS, Karabulut M, Bemben MG. The Evolution of Blood Flow Restricted Exercise. Front Physiol 2021; 12:747759. [PMID: 34925056 PMCID: PMC8674694 DOI: 10.3389/fphys.2021.747759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022] Open
Abstract
The use of blood flow restricted (BFR) exercise has become an accepted alternative approach to improve skeletal muscle mass and function and improve cardiovascular function in individuals that are not able to or do not wish to use traditional exercise protocols that rely on heavy loads and high training volumes. BFR exercise involves the reduction of blood flow to working skeletal muscle by applying a flexible cuff to the most proximal portions of a person’s arms or legs that results in decreased arterial flow to the exercising muscle and occluded venous return back to the central circulation. Safety concerns, especially related to the cardiovascular system, have not been consistently reported with a few exceptions; however, most researchers agree that BFR exercise can be a relatively safe technique for most people that are free from serious cardiovascular disease, as well as those with coronary artery disease, and also for people suffering from chronic conditions, such as multiple sclerosis, Parkinson’s, and osteoarthritis. Potential mechanisms to explain the benefits of BFR exercise are still mostly speculative and may require more invasive studies or the use of animal models to fully explore mechanisms of adaptation. The setting of absolute resistive pressures has evolved, from being based on an individual’s systolic blood pressure to a relative measure that is based on various percentages of the pressures needed to totally occlude blood flow in the exercising limb. However, since several other issues remain unresolved, such as the actual external loads used in combination with BFR, the type of cuff used to induce the blood flow restriction, and whether the restriction is continuous or intermittent, this paper will attempt to address these additional concerns.
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Affiliation(s)
- Eduardo D S Freitas
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Murat Karabulut
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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15
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Tai YL, Marshall EM, Parks JC, Kingsley JD. Hemodynamic response and pulse wave analysis after upper- and lower-body resistance exercise with and without blood flow restriction. Eur J Sport Sci 2021; 22:1695-1704. [PMID: 34529554 DOI: 10.1080/17461391.2021.1982018] [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] [Indexed: 10/20/2022]
Abstract
Resistance exercise (RE) has been shown to elevate hemodynamics and pulse wave reflection. However, the effects of acute RE with blood flow restriction (BFR) on hemodynamics and pulse wave reflection are unclear. The purpose of this study was to evaluate the differences between upper- and lower-body RE with and without BFR on hemodynamics and pulse wave reflection. Twenty-three young resistance-trained individuals volunteered for the study. Hemodynamics and pulse wave reflection were assessed at rest, 10, 25, 40, and 55 min after either upper- or lower-body with or without BFR. The upper-body RE (URE) consisted of the latissimus dorsi pulldown and chest press; the lower-body RE (LRE) consisted of knee extension and knee flexion. The BFR condition consisted of four sets of 30, 15, 15, and 15 repetitions at 30% 1-repetition maximum (1RM) while the without BFR condition consisted of four sets of 8 repetitions at 70% 1RM. Heart rate, rate pressure product, and subendocardial viability ratio significantly (p < 0.05) increased after all exercises. Brachial and aortic systolic blood pressure (BP) significantly (p < 0.05) elevated after LRE while brachial and aortic diastolic BP significantly (p < 0.05) reduced after URE. Augmentation pressure, augmentation index (AIx), AIx normalized at 75 bpm, and wasted left ventricular pressure energy significantly (p < 0.05) increased after URE while transit time of reflected wave significantly (p < 0.05) decreased after LRE. URE places greater stress on pulse wave reflection while LRE results in greater responses in BP. Regardless of URE or LRE, the cardiovascular responses between BFR and without BFR are similar.HIGHLIGHTS High-load resistance exercise and low-load resistance exercise with blood flow restriction may produce similar cardiovascular responses.Upper-body resistance exercise generates greater changes on pulse wave reflections while lower-body resistance exercise induces greater elevations in systolic blood pressure.
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Affiliation(s)
- Yu Lun Tai
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, USA.,Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
| | - Erica M Marshall
- Exercise Science, Florida Southern College, Lakeland, FL, USA.,Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
| | - Jason C Parks
- State University of New York Cortland, Cortland, NY, USA.,Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
| | - J Derek Kingsley
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
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16
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Zhao Y, Lin A, Jiao L. Eight weeks of resistance training with blood flow restriction improve cardiac function and vascular endothelial function in healthy young Asian males. Int Health 2021; 13:471-479. [PMID: 33175117 PMCID: PMC8417084 DOI: 10.1093/inthealth/ihaa089] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/22/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background Resistance training with blood flow restriction (BFR) is a physiological ischaemic training method. Before it is applied to patients with coronary artery disease, it must be proven safe and effective. Methods Twenty-four healthy adult males were randomly assigned to three groups: the resistance training (RT) group, low-pressure BFR and resistance training (LP-RT) group and high-pressure BFR and resistance training (HP-RT) group. The training protocol was 20 times/min/set, with a 2-min break, five sets/day and 5 d/week for 8 weeks. Cardiac function, haemodynamics and vascular endothelial function were evaluated before and after the first training and the last training. Results There were no significant differences among groups before and after training. After 8 weeks of training, the resting heart rate (p<0.05) of the three groups significantly decreased (p<0.05). The rate–pressure product in the LP-RT group significantly decreased (p<0.05) compared with before training. Just after the last training, heart rate (p<0.05) and cardiac output (p<0.05) in the LP-RT and HP-RT groups significantly decreased compared with those just after the first training. At the end of the experiment, vascular endothelial growth factor (VEGF; p<0.01), soluble VEGF receptor (VEGFR) (p<0.05) and interleukin-6 (p<0.01) significantly increased, except for soluble VEGFR in the RT group. Conclusions Low-intensity resistance training with BFR moderately alters cardiac function. The expression levels of proteins related to vascular endothelial function have significantly changed. Both findings suggest that low-intensity resistance training with BFR may be safely and effectively applied to patients with coronary artery disease.
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Affiliation(s)
- Yan Zhao
- School of Sports and Health, Nanjing Sport Institute, 8 Linggusi Road, Nanjing, PA 210014, China
| | - Aicui Lin
- Department of Science and Technology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, PA 210006, China
| | - Long Jiao
- Department of Rehabilitation, Kunshan Rehabilitation Hospital, 888 Yingbin Road, Kunshan, PA 215300, China
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Sinclair P, Kadhum M, Paton B. Tolerance to Intermittent vs. Continuous Blood Flow Restriction Training: A meta-Analysis. Int J Sports Med 2021; 43:3-10. [PMID: 34535020 DOI: 10.1055/a-1537-9886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The proven beneficial effects of low-load blood flow restriction training on strength gain has led to further exploration into its application during rehabilitation, where the traditional use of heavy loads may not be feasible. With current evidence showing that low-load blood flow restriction training may be less well tolerated than heavy-load resistance training, this review was conducted to decipher whether intermittently deflating the pressure cuff during rest intervals of a training session improves tolerance to exercise, without compromising strength. Four databases were searched for randomized controlled trials that compared the effect of intermittent versus continuous blood flow restriction training on outcomes of exercise tolerance or strength in adults. Nine studies were identified, with six included in the meta-analysis. No significant difference in rate of perceived exertion was found (SMD-0.06, 95% CI-0.41 to 0.29, p=0.73, I 2=80%). Subgroup analysis excluding studies that introduced bias showed a shift towards favoring the use of intermittent blood flow restriction training (SMD-0.42, 95% CI-0.87 to 0.03, p=0.07, I 2=0%). There was no significant difference in strength gain. Intermittent cuff deflations during training intervals does not improve tolerance to exercise during blood flow restriction training.
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Affiliation(s)
- Pierre Sinclair
- Department of Institute of Sports and Exercise Health (ISEH), University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Murtaza Kadhum
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Bruce Paton
- Department of Institute of Sports and Exercise Health (ISEH), University College London, London, United Kingdom of Great Britain and Northern Ireland
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18
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Differences in Femoral Artery Occlusion Pressure between Sexes and Dominant and Non-Dominant Legs. ACTA ACUST UNITED AC 2021; 57:medicina57090863. [PMID: 34577785 PMCID: PMC8471356 DOI: 10.3390/medicina57090863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/21/2021] [Accepted: 08/21/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Blood flow restriction during low-load exercise stimulates similar muscle adaptations to those normally observed with higher loads. Differences in the arterial occlusion pressure (AOP) between limbs and between sexes are unclear. We compared the AOP of the superficial femoral artery in the dominant and non-dominant legs, and the relationship between blood flow and occlusion pressure in 35 (16 males, 19 females) young adults. Materials and Methods: Using ultrasound, we measured the AOP of the superficial femoral artery in both legs. Blood flow at occlusion pressures ranging from 0% to 100% of the AOP was measured in the dominant leg. Results: There was a significant difference in the AOP between males and females in the dominant (230 ± 41 vs. 191 ± 27 mmHg; p = 0.002) and non-dominant (209 ± 37 vs. 178 ± 21 mmHg; p = 0.004) legs, and between the dominant and non-dominant legs in males (230 ± 41 vs. 209 ± 37 mmHg; p = 0.009) but not females (191 ± 27 vs. 178 ± 21 mmHg; p = 0.053), respectively. Leg circumference was the most influential independent predictor of the AOP. There was a linear relationship between blood flow (expressed as a percentage of unoccluded blood flow) and occlusion pressure (expressed as a percentage of AOP). Conclusions: Arterial occlusion pressure is not always greater in the dominant leg or the larger leg. Practitioners should measure AOP in both limbs to determine if occlusion pressures used during exercise should be limb specific. Occlusion pressures used during blood flow restriction exercise should be chosen carefully.
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19
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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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20
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de Queiros VS, Dantas M, Neto GR, da Silva LF, Assis MG, Almeida-Neto PF, Dantas PMS, Cabral BGDAT. Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals. Medicine (Baltimore) 2021; 100:e25794. [PMID: 33950976 PMCID: PMC8104249 DOI: 10.1097/md.0000000000025794] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/15/2021] [Indexed: 01/04/2023] Open
Abstract
The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings.To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique.This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique.Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60-80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively).Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.
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Affiliation(s)
- Victor Sabino de Queiros
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Matheus Dantas
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Gabriel Rodrigues Neto
- Professional Master's in Family Health/Physical Education Coordination/Physiotherapy Coordination, Faculties of Nursing and Medicine Nova Esperança (FACENE/FAMENE), João Pessoa
| | - Luiz Felipe da Silva
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Marina Gonçalves Assis
- Bachelor of Science in Physical Education, Unifacisa University Center (UNIFACISA), Campina Grande, Paraíba, Brazil
| | - Paulo Francisco Almeida-Neto
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Paulo Moreira Silva Dantas
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
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21
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Song JS, Spitz RW, Yamada Y, Bell ZW, Wong V, Abe T, Loenneke JP. Exercise-induced hypoalgesia and pain reduction following blood flow restriction: A brief review. Phys Ther Sport 2021; 50:89-96. [PMID: 33940556 DOI: 10.1016/j.ptsp.2021.04.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To review past literature regarding exercise-induced hypoalgesia and pain reduction following blood flow restriction interventions, and to discuss potential mechanisms as well as future considerations towards the efficacy of blood flow restriction in pain reduction following exercise. METHODS To be eligible for inclusion, studies had to include acute exercise, or long-term training interventions, with blood flow restriction, along with including pre and post intervention pain measurements. RESULTS A total of 13 studies met the inclusion criteria. Among these 13 studies, 3 studies examined exercise-induced hypoalgesia after an acute bout of resistance exercise with blood flow restriction, and 10 studies investigated pain reduction following long-term blood flow restriction training. CONCLUSIONS Existing literature suggests that low load resistance exercise with blood flow restriction may serve as an effective pain management method for those who are unable or unwilling to train with high loads. Several potential mechanisms have been suggested, however, the roles of these mechanisms are still unclear and require further clarification. Future research should consider implementing different methods of blood flow restriction application, and research study design to clarify the utility and efficacy of blood flow restriction as a pain management tool, by itself or in combination with exercise.
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Affiliation(s)
- Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States.
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22
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Saatmann N, Zaharia OP, Loenneke JP, Roden M, Pesta DH. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab 2021; 32:106-117. [PMID: 33358931 DOI: 10.1016/j.tem.2020.11.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/15/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
Blood flow restriction resistance training (BFRT) employs partial vascular occlusion of exercising muscles via inflation cuffs. Compared with high-load resistance training, mechanical load is markedly reduced with BFRT, but induces similar gains in muscle mass and strength. BFRT is thus an effective training strategy for people with physical limitations. Recent research indicates that BFRT has beneficial effects on glucose and mitochondrial metabolism. BFRT may therefore qualify as a valuable exercise alternative for individuals with type 2 diabetes (T2D), a disorder characterized by impaired glucose metabolism, musculoskeletal decline, and exacerbated progression of sarcopenia. This review covers the effects of BFRT in healthy populations and in persons with impaired physical fitness, the mechanisms of action of this novel training modality, and possible applications for individuals with T2D.
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Affiliation(s)
- Nina Saatmann
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Michael Roden
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | - Dominik H Pesta
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany; Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Centre for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, Cologne, Germany.
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Franz A, Berndt F, Raabe J, Harmsen JF, Zilkens C, Behringer M. Invasive Assessment of Hemodynamic, Metabolic and Ionic Consequences During Blood Flow Restriction Training. Front Physiol 2021; 11:617668. [PMID: 33391036 PMCID: PMC7772195 DOI: 10.3389/fphys.2020.617668] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/27/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose: Medically recommended training often faces the dilemma that necessary mechanical intensities for muscle adaptations exceed patients' physical capacity. In this regard, blood flow restriction (BFR) training is becoming increasingly popular because it enables gains in muscle mass and strength despite using low-mechanical loads combined with external venous occlusion. Since the underlying mechanisms are still unknown, we applied invasive measurements during exercise with and without BFR to promote physiological understanding and safety of this popular training technique. Methods: In a randomized cross-over design, ten healthy men (28.1 ± 6.5 years) underwent two trials of unilateral biceps curls either with (BFR) and without BFR (CON). For analysis of changes in intravascular pressures, blood gases, oximetry and electrolytes, an arterial and a venous catheter were placed at the exercising arm before exercise. Arterial and venous blood gases and intravascular pressures were analyzed before, during and 5 min after exercise. Results: Intravascular pressures in the arterial and venous system were more increased during exercise with BFR compared to CON (p < 0.001). Furthermore, arterial and venous blood gas analyses revealed a BFR-induced metabolic acidosis (p < 0.05) with increased lactate production (p < 0.05) and associated elevations in [K+], [Ca2+] and [Na+] (p < 0.001). Conclusion: The present study describes for the first time the local physiological changes during BFR training. While BFR causes greater hypertension in the arterial and venous system of the exercising extremity, observed electrolyte shifts corroborate a local metabolic acidosis with concurrent rises in [K+] and [Na+]. Although BFR could be a promising new training concept for medical application, its execution is associated with comprehensive physiological challenges.
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Affiliation(s)
- Alexander Franz
- Department of Orthopedics, University Hospital Duesseldorf, Düsseldorf, Germany.,Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Felix Berndt
- Department of Orthopedics, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Joachim Raabe
- Department of Anesthesiology, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Jan-Frieder Harmsen
- Department of Nutrition and Movement Sciences, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Christoph Zilkens
- Department of Orthopedics, University Hospital Duesseldorf, Düsseldorf, Germany.,Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Michael Behringer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt, Germany
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24
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Silva HGD, Rodrigues Neto G, Vasconcelos WKV, Pereira-Neto EA, Silva JCGD, Bittar ST, Cirilo-Sousa MS. EFFECT OF EXERCISE WITH CONTINUOUS AND INTERMITTENT BLOOD FLOW RESTRICTION ON HEMODYNAMICS. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202606222490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Strength training with blood flow restriction (BFR) involves the use of low loads (20-30% of 1RM) with restriction of blood flow to promote gains in physical fitness. The restriction can be applied continuously or intermittently; however, it is unclear how it affects the hemodynamics of hypertensive women. Objective: To analyze the acute effect of resistance exercise (RE) on the upper and lower limbs with continuous and intermittent blood flow restriction (BFR) on the hemodynamic variables of women with hypertension. Methods: Thirteen women with controlled hypertension (40 to 65 years) underwent eight experimental protocols, with a randomized, counter balanced, crossover design; four exercise sessions for the right upper limb (elbow flexion) and four for the right lower limb (knee extension). The systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate (HR) were measured before, during, immediately after and 15, 30, 45 and 60 minutes after the exercises. Results: There were no significant interactions between the protocols vs. segments vs. time, protocols vs. segments, protocols vs. time, segments vs. time, protocol, segment and time, on the variables SAP, DAP, and HR during and after the RE (p>0.05). Although all these protocols had significantly elevated SAP, DAP and HR, the values remained within the normal range. The protocols of this study did not cause hypotensive effect. Conclusion: Low-load RE combined with continuous and intermittent BFR, on the upper and lower limbs, appears to promote similar variations in the hemodynamic variables of women with hypertension. Level of evidence II; Randomized clinical trial.
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Affiliation(s)
| | | | | | | | - Julio Cesar Gomes da Silva
- Universidade de Pernambuco/Universidade Federal da Paraíba, Brazil; Universidade Federal da Paraíba, Brazil; Faculdades Nova Esperança, Brazil
| | | | - Maria Socorro Cirilo-Sousa
- Universidade de Pernambuco/Universidade Federal da Paraíba, Brazil; Universidade Federal da Paraíba, Brazil
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25
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Murray J, Bennett H, Boyle T, Williams M, Davison K. Approaches to determining occlusion pressure for blood flow restricted exercise training: Systematic review. J Sports Sci 2020; 39:663-672. [PMID: 33135570 DOI: 10.1080/02640414.2020.1840734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Low-intensity exercise with blood flow restriction (BFR) is an increasingly common method of improving muscular strength and hypertrophy, and improving aerobic fitness, in clinical and athletic populations. The aim of this systematic review was to describe common approaches to determining occlusion pressures for BFR exercise. A comprehensive literature search yielded 1389 results, of which 129 were included. Studies were predominantly randomised control trials (86.7%) with modest sample sizes (average number of 11.4 ± 6.2 participants per BFR group/s) of young adults (average age of 34.6 ± 17.9). Five different approaches for determining occlusion pressure were identified: arbitrary pressures (56.6%), percentage of limb occlusion pressure (25.6%), brachial systolic blood pressure (10.9%), perceived tightness (3.9%) and other (3%). From 2016 to 2018, the number of published papers using a percentage of limb occlusion pressure increased yearly, paralleling a decrease use of arbitrary pressures. Of the studies included in this review, the most common approach to determining occlusion pressure was using a non-individualised, arbitrary pressure. Given the safety concerns associated with arbitrary pressures, continual dissemination regarding the optimal applications of BFR for safety and efficacy is required.
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Affiliation(s)
- James Murray
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Hunter Bennett
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, Australia
| | - Marie Williams
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Innovation, Implementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, Australia
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
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26
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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: 2] [Impact Index Per Article: 0.5] [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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27
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Minniti MC, Statkevich AP, Kelly RL, Rigsby VP, Exline MM, Rhon DI, Clewley D. The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review. Am J Sports Med 2020; 48:1773-1785. [PMID: 31710505 DOI: 10.1177/0363546519882652] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The effectiveness of blood flow restriction training (BFRT) as compared with other forms of training, such as resistance training, has been evaluated in the literature in clinical and nonclinical populations. However, the safety of this intervention has been summarized only in healthy populations and not in clinical populations with musculoskeletal disorders. PURPOSE To evaluate the safety and adverse events associated with BFRT in patients with musculoskeletal disorders. STUDY DESIGN Systematic review. METHODS A literature search was conducted with 3 online databases (MEDLINE, CINAHL, and Embase). Eligibility criteria for selecting studies were as follows: (1) BFRT was used as a clinical intervention, (2) study participants had a disorder of the musculoskeletal system, (3) authors addressed adverse events, (4) studies were published in English, and (5) the intervention was performed with human participants. RESULTS Nineteen studies met eligibility criteria, with a pooled sample size of 322. Diagnoses included various knee-related disorders, inclusion body myositis, polymyositis or dermatomyositis, thoracic outlet syndrome, Achilles tendon rupture, and bony fractures. Nine studies reported no adverse events, while 3 reported rare adverse events, including an upper extremity deep vein thrombosis and rhabdomyolysis. Three case studies reported common adverse events, including acute muscle pain and acute muscle fatigue. In the randomized controlled trials, individuals exposed to BFRT were not more likely to have an adverse event than individuals exposed to exercise alone. Of the 19 studies, the adverse events were as follows: overall, 14 of 322; rare overall, 3 of 322; rare BFRT, 3 of 168; rare control, 0 of 154; any adverse BFRT, 10 of 168; any adverse control, 4 of 154. A majority of studies were excluded because they did not address safety. CONCLUSION BFRT appears to be a safe strengthening approach for knee-related musculoskeletal disorders, but further research is needed to make definitive conclusions and to evaluate the safety in other musculoskeletal conditions. Improved definitions of adverse events related to BFRT are needed to include clear criteria for differentiating among common, uncommon, and rare adverse events. Finally, further research is needed to effectively screen who might be at risk for rare adverse events.
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Affiliation(s)
- Melissa C Minniti
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Andrew P Statkevich
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Ryan L Kelly
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Victoria P Rigsby
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Meghan M Exline
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Daniel I Rhon
- Physical Performance Service Line, Office of the Army Surgeon General, Falls Church, Virginia, USA.,Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Derek Clewley
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
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28
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Alves TC, Santos AP, Abdalla PP, Venturini ACR, Angelotti PS, Borges FG, Reis HDO, Bollela VR, Mota J, Machado DRL. Resistance training with blood flow restriction: Impact on the muscle strength and body composition in people living with HIV/AIDS. Eur J Sport Sci 2020; 21:450-459. [PMID: 32349629 DOI: 10.1080/17461391.2020.1757765] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of the study was to compare the impact of 12-week resistance training with blood flow restriction (GRTBFR) versus, traditional resistance training (GTRT) and non-training on the muscle strength and body composition HIV/AIDS participants. Muscle strength was tested at baseline, and on the 6th, 21st and 36th training sessions, using maximal repetition test. Pre- and post-intervention body composition changes were measured by dual-energy X-ray absorptiometry. Resistance training was undertaken three times a week comprising bilateral elbow extension and flexion exercises, unilateral flexion and bilateral knee extension. Changes in strength and body composition (pre- and post-intervention) between groups were evaluated by mixed models of repeated measures, and by paired and unpaired comparisons, considering the Effect Size. All groups were similar at baseline for muscle strength and body composition. Post-intervention, the training groups showed similar, statistically significant increases in muscle strength (GRTBFR=25.7-57.4%; GTRT=24.5-52.3%) and skeletal muscle tissue (GRTBFR=8.4%; GTRT=8.3%). There was also a significant change in body fat (p=0.023-0.043), with significant effect sizes for strength and skeletal muscle tissue (0.41-2.27), respectively. These results suggest that both resistance training interventions promoted muscle hypertrophy, body fat reduction and positive impact on muscle strength in people living with HIV/AIDS. Resistance training with blood flow restriction proved to be an effective alternative to include patients with marked physical weakness, unable to engage in regular strength training programme.ClinicalTrials.gov identifier: NCT02783417.
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Affiliation(s)
- Thiago Cândido Alves
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group.,Minas Gerais State University
| | - André P Santos
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Pedro P Abdalla
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Ana Cláudia R Venturini
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | | | - Franciane Góes Borges
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Henrique D O Reis
- Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Valdes R Bollela
- Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Dalmo R L Machado
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group.,Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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29
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Clarkson MJ, May AK, Warmington SA. Is there rationale for the cuff pressures prescribed for blood flow restriction exercise? A systematic review. Scand J Med Sci Sports 2020; 30:1318-1336. [PMID: 32279391 DOI: 10.1111/sms.13676] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/12/2020] [Accepted: 03/27/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Blood flow restriction exercise has increasingly broad applications among healthy and clinical populations. Ensuring the technique is applied in a safe, controlled, and beneficial way for target populations is essential. Individualized cuff pressures are a favored method for achieving this. However, there remains marked inconsistency in how individualized cuff pressures are applied. OBJECTIVES To quantify the cuff pressures used in the broader blood flow restriction exercise literature, and determine whether there is clear justification for the choice of pressure prescribed. METHODS Studies were included in this review from database searches if they employed an experimental design using original data, involved either acute or chronic exercise using blood flow restriction, and they assessed limb or arterial occlusion pressure to determine an individualized cuff pressure. Methodologies of the studies were evaluated using a bespoke quality assessment tool. RESULTS Fifty-one studies met the inclusion criteria. Individualized cuff pressures ranged from 30% to 100% arterial occlusion pressure. Only 7 out of 52 studies attempted to justify the individualized cuff pressure applied during exercise. The mean quality rating for all studies was 11.1 ± 1.2 out of 13. CONCLUSIONS The broader blood flow restriction exercise literature uses markedly heterogeneous prescription variables despite using individualized cuff pressures. This is problematic in the absence of any clear justification for the individualized cuff pressures selected. Systematically measuring and reporting all relevant acute responses and training adaptations to the full spectrum of BFR pressures alongside increased clarity around the methodology used during blood flow restriction exercise is paramount.
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Affiliation(s)
- Matthew J Clarkson
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Anthony K May
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Stuart A Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
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30
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Cristina-Oliveira M, Meireles K, Spranger MD, O'Leary DS, Roschel H, Peçanha T. Clinical safety of blood flow-restricted training? A comprehensive review of altered muscle metaboreflex in cardiovascular disease during ischemic exercise. Am J Physiol Heart Circ Physiol 2019; 318:H90-H109. [PMID: 31702969 DOI: 10.1152/ajpheart.00468.2019] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Blood flow restriction training (BFRT) is an increasingly widespread method of exercise that involves imposed restriction of blood flow to the exercising muscle. Blood flow restriction is achieved by inflating a pneumatic pressure cuff (or a tourniquet) positioned proximal to the exercising muscle before, and during, the bout of exercise (i.e., ischemic exercise). Low-intensity BFRT with resistance training promotes comparable increases in muscle mass and strength observed during high-intensity exercise without blood flow restriction. BFRT has expanded into the clinical research setting as a potential therapeutic approach to treat functionally impaired individuals, such as the elderly, and patients with orthopedic and cardiovascular disease/conditions. However, questions regarding the safety of BFRT must be fully examined and addressed before the implementation of this exercise methodology in the clinical setting. In this respect, there is a general concern that BFRT may generate abnormal reflex-mediated cardiovascular responses. Indeed, the muscle metaboreflex is an ischemia-induced, sympathoexcitatory pressor reflex originating in skeletal muscle, and the present review synthesizes evidence that BFRT may elicit abnormal cardiovascular responses resulting from increased metaboreflex activation. Importantly, abnormal cardiovascular responses are more clearly evidenced in populations with increased cardiovascular risk (e.g., elderly and individuals with cardiovascular disease). The evidence provided in the present review draws into question the cardiovascular safety of BFRT, which clearly needs to be further investigated in future studies. This information will be paramount for the consideration of BFRT exercise implementation in clinical populations.
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Affiliation(s)
- Michelle Cristina-Oliveira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Marty D Spranger
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
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31
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Kjeldsen SS, Næss-Schmidt ET, Hansen GM, Nielsen JF, Stubbs PW. Neuromuscular effects of dorsiflexor training with and without blood flow restriction. Heliyon 2019; 5:e02341. [PMID: 31467996 PMCID: PMC6710534 DOI: 10.1016/j.heliyon.2019.e02341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/26/2019] [Accepted: 08/15/2019] [Indexed: 10/27/2022] Open
Abstract
Blood flow restriction training (BFRT) has been proposed for elderly and clinical populations with weakness. Before being used in these populations it is important to understand the neurological effects of, and subject perceptions to, BFRT. Seventeen healthy subjects were recruited and performed 2 experimental sessions, BFRT and training without blood flow restriction (TR-only), on separate days. Four sets of concentric/eccentric dorsiflexion contractions against theraband resistance were performed. Surface electromyography of the tibialis anterior was recorded during exercise and for the electrophysiological measures. At baseline, immediately-post, 10-min-post and 20-min-post exercise, motor evoked potentials (MEPs) from single pulse transcranial magnetic stimulation (TMS), paired-pulse TMS with interstimulus intervals of 2-ms (SICI) and 15-ms (ICF), and the M-max amplitude were recorded in the resting TA. Following training, subjects provided a numerical rating of the levels of pain, discomfort, fatigue, focus and difficulty during training. Muscle activation was higher in the last 20 contractions during BFRT compared to TR. There was no difference (time × condition interaction) between BFRT and TR for single-pulse MEP, SICI, ICF or M-max amplitude. There was a significant main effect of timepoint for single-pulse MEP and M-max amplitudes with both significantly reduced for 20-min-post exercise. No reductions were observed for SICI and ICF amplitudes. Taken together, BFRT and TR-only were only different during exercise and both regimes induced similar significant reductions in M-Max and MEP-amplitude post-training. Due to the lack of changes in SICI and ICF, it is unlikely that changes occurred in cortical sites related to these pathways. The increased surface electromyography activity in the last 20 contractions, indicate that the training regimes are different and that BFRT possibly induces more fatigue than TR. As such, BFRT could be used as an adjunct to conventional training. However, as subjects perceived BFRT as more painful, difficult and uncomfortable than TR-only, people should be selected carefully to undertake BFRT.
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Affiliation(s)
- Simon Svanborg Kjeldsen
- Research Department, Hammel Neurorehabilitation and Research Center, Aarhus University, Hammel, Denmark
| | | | - Gunhild Mo Hansen
- Research Department, Hammel Neurorehabilitation and Research Center, Aarhus University, Hammel, Denmark
| | - Jørgen Feldbæk Nielsen
- Research Department, Hammel Neurorehabilitation and Research Center, Aarhus University, Hammel, Denmark
| | - Peter William Stubbs
- Research Department, Hammel Neurorehabilitation and Research Center, Aarhus University, Hammel, Denmark.,University of Technology Sydney, Graduate School of Health, Discipline of Physiotherapy, Sydney, Australia
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32
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Ilett MJ, Rantalainen T, Keske MA, May AK, Warmington SA. The Effects of Restriction Pressures on the Acute Responses to Blood Flow Restriction Exercise. Front Physiol 2019; 10:1018. [PMID: 31456694 PMCID: PMC6700307 DOI: 10.3389/fphys.2019.01018] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 07/23/2019] [Indexed: 12/02/2022] Open
Abstract
Purpose No current guidelines or recommendations exist informing the selection of restriction pressure during blood flow restriction exercise (BFRE). Moreover, the effects of specific relative restriction pressures on the acute muscle, metabolic and cardiopulmonary responses to BFRE are unclear. The purpose of this study was to characterize these acute responses at different levels of restriction pressure. Methods Participants (n = 10) completed rhythmic isometric knee extension exercise across five experimental trials in a balanced randomized order. Three were BFRE trials {B-40 [restriction pressure set to 40% LOP (total limb occlusion pressure)]; B-60 (60% LOP); and B-80 (80% LOP)} with a workload equivalent to 20% maximal voluntary force (MVC), one was non-BFRE at 20% MVC (LL) and one was non-BFRE at 80% MVC (HL). Measurements recorded were torque, muscle activity via electromyography (EMG), tissue oxygenation via near infrared spectroscopy, whole body oxygen consumption, blood lactate and heart rate. Results For the LL and B-40 trials, most measures remained constant. However, for the B-60 and B-80 trials, significant fatigue was demonstrated by a reduction in MVC torque across the trial (p < 0.05). Blood lactate increased from baseline in HL, B-60, and B-80 (p < 0.05). Submaximal EMG was greater in B-60 and B-80 than LL, but lower compared with HL (p < 0.05). Tissue oxygenation decreased in HL, B-40, B-60, and B-80 (p < 0.05), which was lower in the B-80 trial compared to all other trials (p < 0.01). Whole body oxygen consumption was not different between the BFRE trials (p > 0.05). Conclusion We demonstrate graded/progressive acute responses with increasing applied pressure during BFRE, from which we speculate that an effective minimum “threshold” around 60% LOP may be necessary for BFRE to be effective with training. While these data provide some insight on the possible mechanisms by which BFRE develops skeletal muscle size and strength when undertaken chronically across a training program, the outcomes of chronic training programs using different levels of applied restriction pressures remain to be tested. Overall, the present study recommends 60–80% LOP as a suitable “minimum” BFRE pressure.
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Affiliation(s)
- Michael J Ilett
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Timo Rantalainen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Michelle A Keske
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Anthony K May
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Stuart A Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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33
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Chen YT, Hsieh YY, Ho JY, Lin JC. Effects of Running Exercise Combined With Blood Flow Restriction on Strength and Sprint Performance. J Strength Cond Res 2019; 35:3090-3096. [PMID: 31453935 DOI: 10.1519/jsc.0000000000003313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chen, YT, Hsieh, YY, Ho, JY, and Lin, JC. Effects of running exercise combined with blood flow restriction on strength and sprint performance. J Strength Cond Res XX(X): 000-000, 2019-We investigated muscle strength and sprint performance after combining running exercise (RE) with blood flow restriction (BFR). Twelve male sprinters received 2 experimental warm-ups: (a) RE (50% heart rate reserve, 2 minutes × 5 sets, 1-minute rest interval) with BFR (occlusion pressure: 1.3 × resting systolic blood pressure) warm-up, namely RE-BFR; and (b) RE without BFR warm-up, namely RE. Isokinetic strength or 60-m sprint performance was assessed after a 5-minute recovery from each experimental warm-up. All subjects completed 4 exercise trials in a counterbalanced order: (a) RE-BFR-strength; (b) RE-strength; (c) RE-BFR-sprint; and (d) RE-sprint. Muscle activation (during RE), blood lactate (BLa) (pre- and post-REs), heart rate (HR), and rating of perceived exertion (RPE) (pre- and post-REs and at a 5-minute recovery) were determined during each experimental warm-up. The isokinetic knee flexor strength and the hamstring-quadriceps (H:Q) ratio observed for the RE-BFR warm-up were significantly higher than those observed for the RE warm-up (p < 0.05). However, no differences (p > 0.05) in the isokinetic knee extensor strength and 60-m sprint performance were observed between the 2 warm-ups. Running exercise-BFR warm-up induced a higher level of vastus lateralis and biceps femoris muscle activation than did RE warm-up (p < 0.05). Furthermore, RE-BFR warm-up induced higher HR, RPE, and BLa values than did RE warm-up after RE and at a 5-minute recovery (p < 0.05). These results suggest that RE-BFR warm-up may augment physiological responses and improve the H:Q ratio and isokinetic knee flexor strength. Thus, RE-BFR warm-up may be considered a practical warm-up strategy for promoting muscle strength and reducing the risk of hamstring injury in male sprinters.
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Affiliation(s)
- Yun-Tsung Chen
- Department of Physical Education, Dongguan University of Technology, Guangdong, China
| | - Yao-Yi Hsieh
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Jen-Yu Ho
- Department of Athletic Performance, National Taiwan Normal University, Taipei, Taiwan
| | - Jung-Charng Lin
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
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Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2019; 10:533. [PMID: 31156448 PMCID: PMC6530612 DOI: 10.3389/fphys.2019.00533] [Citation(s) in RCA: 303] [Impact Index Per Article: 60.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
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Affiliation(s)
- Stephen D. Patterson
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Luke Hughes
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jamie Burr
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada
| | - Brendan R. Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Cleiton Augusto Libardi
- MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gabriel Rodrigues Neto
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, Brazil
| | | | - Juan Martin-Hernandez
- I+HeALTH Research Group, Department of Health Sciences, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
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Son H, Kim J, Hong G, Park W, Yoon S, Lim K, Park J. Analyses of physiological wrist tremor with increased muscle activity during bench press exercise. J Exerc Nutrition Biochem 2019; 23:1-6. [PMID: 31010268 PMCID: PMC6477828 DOI: 10.20463/jenb.2019.0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/09/2019] [Indexed: 11/27/2022] Open
Abstract
[Purpose] To date, there have been no studies on the response of wrist tremor to increased muscle activity during exercise. This study aimed to evaluate the wrist tremor response with increasing muscle activity during bench press exercise. [Methods] Triceps muscle activity and wrist tremor response were measured by electromyography and an accelerometer, respectively, during bench press exercise in 11 healthy men without weight-training experience. Subjects performed bench press at 30% repetition maximum (RM), and the rating of perceived exertion (RPE) and lactate concentration were measured before and after exercise. One week later, an equivalent number of bench presses at 30% RM was performed without weight load as a control trial (CT). [Results] RPEs and lactate concentrations significantly increased after resistance exercise (30% RM) from 7.4 to 14.3 and 1.7 to 4.9, respectively (P<.01), but no such difference was observed in the CT. Muscle activity linearly increased during the 30% RM exercise, and wrist tremors were shown to linearly decrease. A strong negative correlation was observed between the two variables (r=−0.88, P<.001). [Conclusion] We found that wrist tremors during resistance exercise, as measured using an accelerometer, can be used to predict muscle activity.
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Stavres J, Singer TJ, Brochetti A, Kilbane MJ, Brose SW, McDaniel J. The Feasibility of Blood Flow Restriction Exercise in Patients With Incomplete Spinal Cord Injury. PM R 2018; 10:1368-1379. [DOI: 10.1016/j.pmrj.2018.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/07/2018] [Accepted: 05/12/2018] [Indexed: 01/09/2023]
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Jessee MB, Mouser JG, Buckner SL, Dankel SJ, Mattocks KT, Abe T, Loenneke JP. Effects of load on the acute response of muscles proximal and distal to blood flow restriction. J Physiol Sci 2018; 68:769-779. [PMID: 29349721 PMCID: PMC10717311 DOI: 10.1007/s12576-018-0593-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 01/10/2018] [Indexed: 01/10/2023]
Abstract
To determine the effects of load and blood flow restriction (BFR) on muscular responses, we asked 12 participants to perform chest presses under four different conditions [30/0, 30/40, 50/0, and 50/40, presented as percentage one-repetition maximum (1RM)/percentage arterial occlusion pressure (AOP)]. Muscle thickness increased pre- to post-exercise [chest: mean 0.29, 95% confidence interval (CI) 0.21, 0.37 cm; triceps: mean 0.44, 95% CI 0.34, 0.54 cm], remaining elevated for 15 min post-exercise. Electromyography amplitude was greater with 50% 1RM and increased over time for the first three repetitions of each set of chest presses. The last three repetitions differed across time only. AOP increased from pre- to post-exercise, augmented by BFR [30/0: mean 31, 95% CI 18, 44 mmHg; 30/40: mean 39, 95% CI 28, 50 mmHg; 50/0: mean 32, 95% CI 23, 41 mmHg; 50/40: mean 46, 95% CI 32, 59 mmHg). Tranquility decreased and physical exhaustion increased from the pre- to post-condition, with both parameters returning to the baseline 15 min post-exercise level. In conclusion, load and BFR do not elicit meaningful differences in the acute response of chest press exercise taken to failure.
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Affiliation(s)
- Matthew B Jessee
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - J Grant Mouser
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Samuel L Buckner
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Scott J Dankel
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Kevin T Mattocks
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, 38677, USA.
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Törpel A, Herold F, Hamacher D, Müller NG, Schega L. Strengthening the Brain-Is Resistance Training with Blood Flow Restriction an Effective Strategy for Cognitive Improvement? J Clin Med 2018; 7:E337. [PMID: 30304785 PMCID: PMC6210989 DOI: 10.3390/jcm7100337] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 02/07/2023] Open
Abstract
Aging is accompanied by a decrease in physical capabilities (e.g., strength loss) and cognitive decline. The observed bidirectional relationship between physical activity and brain health suggests that physical activities could be beneficial to maintain and improve brain functioning (e.g., cognitive performance). However, the exercise type (e.g., resistance training, endurance training) and their exercise variables (e.g., load, duration, frequency) for an effective physical activity that optimally enhance cognitive performance are still unknown. There is growing evidence that resistance training induces substantial brain changes which contribute to improved cognitive functions. A relative new method in the field of resistance training is blood flow restriction training (BFR). While resistance training with BFR is widely studied in the context of muscular performance, this training strategy also induces an activation of signaling pathways associated with neuroplasticity and cognitive functions. Based on this, it seems reasonable to hypothesize that resistance training with BFR is a promising new strategy to boost the effectiveness of resistance training interventions regarding cognitive performance. To support our hypothesis, we provide rationales of possible adaptation processes induced by resistance training with BFR. Furthermore, we outline recommendations for future studies planning to investigate the effects of resistance training with BFR on cognition.
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Affiliation(s)
- Alexander Törpel
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - Dennis Hamacher
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Notger G Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany.
- Center for Behavioral Brain Sciences (CBBS), Universitätsplatz 2, 39106 Magdeburg, Germany.
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - Lutz Schega
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
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Tai YL, Marshall EM, Glasgow A, Parks JC, Sensibello L, Kingsley JD. Pulse wave reflection responses to bench press with and without practical blood flow restriction. Appl Physiol Nutr Metab 2018; 44:341-347. [PMID: 30205017 DOI: 10.1139/apnm-2018-0265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resistance exercise is recommended to increase muscular strength but may also increase pulse wave reflection. The effect of resistance exercise combined with practical blood flow restriction (pBFR) on pulse wave reflection is unknown. The purpose of this study was to evaluate the differences in pulse wave reflection characteristics between bench press with pBFR and traditional high-load bench press in resistance-trained men. Sixteen resistance-trained men participated in the study. Pulse wave reflection characteristics were assessed before and after low-load bench press with pBFR (LL-pBFR), traditional high-load bench press (HL), and a control (CON). A repeated-measures ANOVA was used to evaluate differences in pulse wave reflection characteristics among the conditions across time. There were significant (p ≤ 0.05) interactions for heart rate, augmentation index, augmentation index normalized at 75 bpm, augmentation pressure, time-tension index, and wasted left ventricular energy such that they were increased after LL-pBFR and HL compared with rest and CON, with no differences between LL-pBFR and HL. Aortic pulse pressure (p < 0.001) was elevated only after LL-pBFR compared with rest. In addition, there was a significant (p ≤ 0.05) interaction for aortic diastolic blood pressure (BP) such that it was decreased after LL-pBFR compared with rest and CON but not HL. The subendocardial viability ratio and diastolic pressure-time index were significantly different between LL-pBFR and HL compared with rest and CON. There were no significant interactions for brachial systolic or diastolic BP, aortic systolic BP, or time of the reflected wave. In conclusion, acute bench press resistance exercise significantly altered pulse wave reflection characteristics without differences between LL-pBFR and HL.
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Affiliation(s)
- Yu Lun Tai
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Erica M Marshall
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Alaina Glasgow
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Jason C Parks
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Leslie Sensibello
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
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Hughes L, Paton B, Haddad F, Rosenblatt B, Gissane C, Patterson SD. Comparison of the acute perceptual and blood pressure response to heavy load and light load blood flow restriction resistance exercise in anterior cruciate ligament reconstruction patients and non-injured populations. Phys Ther Sport 2018; 33:54-61. [DOI: 10.1016/j.ptsp.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/07/2018] [Accepted: 07/07/2018] [Indexed: 01/20/2023]
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Mouser JG, Mattocks KT, Dankel SJ, Buckner SL, Jessee MB, Bell ZW, Abe T, Loenneke JP. Very-low-load resistance exercise in the upper body with and without blood flow restriction: cardiovascular outcomes. Appl Physiol Nutr Metab 2018; 44:288-292. [PMID: 30148969 DOI: 10.1139/apnm-2018-0325] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is proposed that, at very low loads, greater blood flow restriction (BFR) pressures might be required for muscular adaptation to occur. The cardiovascular and hyperemic response to very low loads combined with relative levels of BFR is unknown. Ninety-seven participants were recruited and assigned to 1 of 4 exercise conditions: 15% of 1-repetition maximum (1RM) without BFR (15/00), 15% 1RM with BFR at 40% of arterial occlusion pressure (AOP) (15/40), 15% of 1RM with BFR at 80% of AOP (15/80), and 70% of 1RM without BFR (70/00). Participants performed 4 sets of unilateral biceps curls. Blood pressure was measured before and after exercise; brachial artery blood flow was measured before exercise, following the second set, and 1 min following exercise. Systolic blood pressure increased following exercise in all conditions (+10 (11) mm Hg, P < 0.0005). Diastolic pressure increased in all but 70/00 (+2 (11) mm Hg, P = 0.107). Brachial artery blood flow increased following the second set of exercise in all but 15/80 (+43.4 (76.8) mL·min-1, P = 0.348). One minute following exercise and cuff deflation, there were no differences in blood flow between conditions (P > 0.05). Similarly, artery diameter was increased in all conditions except 15/80 (+0.002 (0.041) cm, P = 0.853) following the second set, and increased in all conditions by 1 min following exercise (P < 0.05). In conclusion, exercise-induced hyperemia is blunted with increasing pressures of BFR. There is a modest increase in blood pressure at very low loads of resistance exercise in the upper body.
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Affiliation(s)
- J Grant Mouser
- a Department of Kinesiology and Health Promotion, Troy University, Troy, AL 36082, USA
| | - Kevin T Mattocks
- b Department of Exercise Science, Lindenwood Belleville, Belleville, IL 62226, USA
| | - Scott J Dankel
- c Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Samuel L Buckner
- d Exercise Science Program, University of South Florida, Tampa, FL 33620, USA
| | - Matthew B Jessee
- e School of Kinesiology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Zachary W Bell
- c Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Takashi Abe
- c Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Jeremy P Loenneke
- c Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS 38677, USA
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Domingos E, Polito MD. Blood pressure response between resistance exercise with and without blood flow restriction: A systematic review and meta-analysis. Life Sci 2018; 209:122-131. [PMID: 30086274 DOI: 10.1016/j.lfs.2018.08.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/31/2018] [Accepted: 08/03/2018] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to compare, by means of a systematic review and meta-analysis, the effects of resistance training with and without blood flow restriction (BFR) on blood pressure (BP). MATERIALS AND METHODS This review was composed according to the preferred Reporting items for Systematic Reviews and Meta-Analyses guidelines. Searches were carried out in the databases PubMed, SPORTDiscus, and Web of Science. BP was the main outcome for the analysis of the acute, post-exercise, and chronic effect of resistance exercise with and without BFR. Search results were limited to studies investigating the effect of resistance training with and without BFR on acute or chronic BP, published in a scientific peer-reviewed journal in English. KEY FINDINGS Seventeen references were eligible. During exercise, the diastolic BP (DBP) was higher in exercise with BFR (ES = 17.84) in comparison to traditional exercise with loads ≥60% 1RM (ES = 5.53; P < 0.01); and the systolic BP (SBP) and DBP were higher during exercise with BFR in hypertensive individuals (ES = 69.83 and 43.66) in comparison to traditional exercise with loads <60% 1RM (ES = 48.05 and 28.37; P < 0.05). In the post-exercise analysis, exercise with BFR presented lower values for SBP (ES = -5.13; P = 0.02) and DBP (ES = -4.70; P < 0.01). SIGNIFICANCE Although resistance exercise with BFR resulted in greater post-exercise hypotension than traditional exercise, higher SBP and/or DBP values were observed during exercise with BFR compared to traditional exercise, especially in hypertensive individuals. Thus, exercise with BFR should be prescribed with caution when BP control is necessary during exercise.
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Affiliation(s)
- Everton Domingos
- Research Group of Cardiovascular Response and Exercise, Londrina State University, Londrina, Paraná, PR, Brazil
| | - Marcos D Polito
- Research Group of Cardiovascular Response and Exercise, Londrina State University, Londrina, Paraná, PR, Brazil.
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May AK, Brandner CR, Warmington SA. Hemodynamic responses are reduced with aerobic compared with resistance blood flow restriction exercise. Physiol Rep 2018; 5:5/3/e13142. [PMID: 28183863 PMCID: PMC5309582 DOI: 10.14814/phy2.13142] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/28/2016] [Indexed: 12/31/2022] Open
Abstract
The hemodynamics of light‐load exercise with an applied blood‐flow restriction (BFR) have not been extensively compared between light‐intensity, BFR, and high‐intensity forms of both resistance and aerobic exercise in the same participant population. Therefore, the purpose of this study was to use a randomized crossover design to examine the hemodynamic responses to resistance and aerobic BFR exercise in comparison with a common high‐intensity and light‐intensity non‐BFR exercise. On separate occasions participants completed a leg‐press (resistance) or treadmill (aerobic) trial. Each trial comprised a light‐intensity bout (LI) followed by a light‐intensity bout with BFR (80% resting systolic blood pressure (LI+BFR)), then a high‐intensity bout (HI). To characterize the hemodynamic response, measures of cardiac output, stroke volume, heart rate and blood pressure were taken at baseline and exercise for each bout. Exercising hemodynamics for leg‐press LI+BFR most often resembled those for HI and were greater than LI (e.g. for systolic blood pressure LI+BFR = 152 ± 3 mmHg; HI = 153 ± 3; LI = 143 ± 3 P < 0.05). However, exercising hemodynamics for treadmill LI+BFR most often resembled those for LI and were lower than HI (e.g. for systolic pressure LI+BFR = 124 ± 2 mmHg; LI = 123 ± 2; HI = 140 ± 3 P < 0.05). In conclusion, the hemodynamic response for light aerobic (walking) BFR exercise suggests this mode of BFR exercise may be preferential for chronic use to develop muscle size and strength, and other health benefits in certain clinical populations that are contraindicated to heavy‐load resistance exercise.
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Affiliation(s)
- Anthony K May
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences Deakin University, Burwood, Victoria, Australia
| | | | - Stuart A Warmington
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences Deakin University, Burwood, Victoria, Australia
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Reported Side-effects and Safety Considerations for the Use of Blood Flow Restriction During Exercise in Practice and Research. Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000259] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bell ZW, Buckner SL, Jessee MB, Mouser JG, Mattocks KT, Dankel SJ, Abe T, Loenneke JP. Moderately heavy exercise produces lower cardiovascular, RPE, and discomfort compared to lower load exercise with and without blood flow restriction. Eur J Appl Physiol 2018; 118:1473-1480. [DOI: 10.1007/s00421-018-3877-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/26/2018] [Indexed: 11/29/2022]
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46
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Hughes L, Rosenblatt B, Gissane C, Paton B, Patterson SD. Interface pressure, perceptual, and mean arterial pressure responses to different blood flow restriction systems. Scand J Med Sci Sports 2018; 28:1757-1765. [DOI: 10.1111/sms.13092] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 12/16/2022]
Affiliation(s)
- L. Hughes
- School of Sport, Health and Applied Science; St Mary's University; London UK
- Institute of Sport, Exercise and Health; London UK
| | | | - C. Gissane
- School of Sport, Health and Applied Science; St Mary's University; London UK
| | - B. Paton
- Institute of Sport, Exercise and Health; London UK
| | - S. D. Patterson
- School of Sport, Health and Applied Science; St Mary's University; London UK
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Brandner CR, Warmington SA. Delayed Onset Muscle Soreness and Perceived Exertion After Blood Flow Restriction Exercise. J Strength Cond Res 2018; 31:3101-3108. [PMID: 28118308 DOI: 10.1519/jsc.0000000000001779] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Brandner, CR, and Warmington, SA. Delayed onset muscle soreness and perceived exertion after blood flow restriction exercise. J Strength Cond Res 31(11): 3101-3108, 2017-The purpose of this study was to determine the perceptual responses to resistance exercise with heavy loads (80% 1 repetition maximum [1RM]), light loads (20% 1RM), or light loads in combination with blood flow restriction (BFR). Despite the use of light loads, it has been suggested that the adoption of BFR resistance exercise may be limited because of increases in delayed onset muscle soreness (DOMS) and perceived exertion. Seventeen healthy untrained males participated in this balanced, randomized cross-over study. After 4 sets of elbow-flexion exercise, participants reported ratings of perceived exertion (RPE), with DOMS also recorded for 7 days after each trial. Delayed onset muscle soreness was significantly greater for low-pressure continuous BFR (until 48 hours postexercise) and high-pressure intermittent BFR (until 72 hours postexercise) than for traditional heavy-load resistance exercise and light-load resistance exercise. In addition, RPE was higher for heavy-load resistance exercise and high-pressure intermittent BFR than for low-pressure continuous BFR, with all trials greater than light-load resistance exercise. For practitioners working with untrained participants, this study provides evidence to suggest that to minimize the perception of effort and postexercise muscle soreness associated with BFR resistance exercise, continuous low-pressure application may be more preferential than intermittent high-pressure application. Importantly, these perceptual responses are relatively short-lived (∼2 days) and have previously been shown to subside after a few exercise sessions. Combined with smaller initial training volumes (set × repetitions), this may limit RPE and DOMS to strengthen uptake and adherence and assist in program progression for muscle hypertrophy and gains in strength.
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Affiliation(s)
- Christopher R Brandner
- 1Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Campus at Burwood, Victoria, Australia; and 2Sport Science Department, Aspire Academy for Sports Excellence, Doha, Qatar
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Mouser JG, Dankel SJ, Mattocks KT, Jessee MB, Buckner SL, Abe T, Loenneke JP. Blood flow restriction and cuff width: effect on blood flow in the legs. Clin Physiol Funct Imaging 2018; 38:944-948. [PMID: 29356291 DOI: 10.1111/cpf.12504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 12/19/2017] [Indexed: 11/29/2022]
Abstract
Much of the literature examining blood flow restriction in the lower body uses cuffs of differing widths. It is currently unknown whether similar relative pressures using cuffs of differing widths elicit the same blood flow response. PURPOSE To examine the hemodynamic responses to relative pressures using two commonly used cuffs (10 and 12 cm). METHODS In a random order over two laboratory visits, one cuff was applied to the right proximal thigh of the participant (men = 17, women = 14), and arterial occlusion pressure (AOP) was measured. Ultrasound measures of blood flow, mean blood velocity, peak blood velocity and artery diameter were taken from the posterior tibial artery at rest and during the application of 10% increments of the AOP. RESULTS There was no significant difference between the 10- and 12-cm cuff relating to blood flow (-0·501 ml min-1 , SD 7·9, P = 0·728), mean blood velocity (-0·168 cm s-1 , SD 1·7, P = 0·590), peak blood velocity (0·586 cm s-1 , SD 11·7, P = 0·783) or artery diameter (0·003 cm, SD 0·02, P = 0·476). There was a main effect of pressure for blood flow (P<0·0005), mean blood velocity (P<0·0005), peak blood velocity (P<0·0005) and artery diameter (P = 0·005), with each decreasing with increasing pressures. Peak blood velocity increased to 60% of AOP before decreasing with increased pressure. CONCLUSION As long as relative pressures are applied, cuff width appears to have little to no effect on the blood flow stimulus during blood flow restriction at rest.
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Affiliation(s)
- J Grant Mouser
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Scott J Dankel
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Kevin T Mattocks
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Matthew B Jessee
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Samuel L Buckner
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
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Lower body blood flow restriction training may induce remote muscle strength adaptations in an active unrestricted arm. Eur J Appl Physiol 2018; 118:617-627. [PMID: 29350278 DOI: 10.1007/s00421-018-3806-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/14/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE We examined the concurrent characteristics of the remote development of strength and cross-sectional area (CSA) of upper body skeletal muscle in response to lower body resistance training performed with an applied blood flow restriction (BFR). METHODS Males allocated to an experimental BFR group (EXP; n = 12) or a non-BFR control group (CON; n = 12) completed 7-weeks of resistance training comprising three sets of unilateral bicep curls [50% 1-repetition maximum (1-RM)], then four sets of bilateral knee extension and flexion exercises (30% 1-RM). EXP performed leg exercises with an applied BFR (60% limb occlusion pressure). 1-RM strength was measured using bilateral leg exercises and unilateral bicep curls in both trained and untrained arms. Muscle CSA was measured via peripheral quantitative computed tomography in the dominant leg and both arms. RESULTS 1-RM in the trained arm increased more in EXP (2.5 ± 0.4 kg; mean ± SEM) than the contralateral untrained arm (0.8 ± 0.4 kg), and the trained arm of CON (0.6 ± 0.3 kg, P < 0.05). The increase in knee extension 1-RM was twofold that of CON (P < 0.01). Knee flexion 1-RM, leg CSA, and trained arm CSA increased similarly between groups (P > 0.05), while untrained arm CSA did not change (P > 0.05). CONCLUSION Lower limb BFR training increased trained arm strength more than the contralateral untrained arm, and the trained arm of controls. However, there was no additional effect on muscle CSA. These findings support evidence for a BFR training-derived remote strength transfer that may be relevant to populations with localised movement disorders.
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Mattocks KT, Jessee MB, Counts BR, Buckner SL, Grant Mouser J, Dankel SJ, Laurentino GC, Loenneke JP. The effects of upper body exercise across different levels of blood flow restriction on arterial occlusion pressure and perceptual responses. Physiol Behav 2017; 171:181-186. [DOI: 10.1016/j.physbeh.2017.01.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/28/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
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