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Fleming AR, MacDonald HV, Buckner SL, Winchester LJ. Lower limb blood flow occlusion increases systemic pressor response without increasing brachial arterial blood flow redistribution in women. Clin Physiol Funct Imaging 2024; 44:285-296. [PMID: 38402408 DOI: 10.1111/cpf.12873] [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: 05/11/2023] [Revised: 01/16/2024] [Accepted: 02/08/2024] [Indexed: 02/26/2024]
Abstract
This study was conducted to investigate the systemic hemodynamic and vascular changes in women during and after two commonly used clinical blood flow restriction (BFR) pressures at rest. There are minimal data regarding the independent effects of BFR on hemodynamic and systemic vascular changes due to pressor response, particularly among women. Therefore, this study investigated BFR-induced alterations in pressor response and systemic flow redistribution at rest during two commonly used pressures (50% and 80% limb occlusion pressure [LOP]). Fifteen women (22.1 ± 4.2 years) completed two randomised sessions involving 8-min of bilateral, lower limb restriction at 50% or 80% LOP followed by 8-min of recovery post-deflation. Changes in vascular (arterial diameter [DIA], time-averaged mean velocity [TAMV], volume flow [VF], and area) and hemodynamic (heart rate [HR] and blood pressure) measures over time (pre-, during, post-occlusion) and by session (50% vs. 80% LOP) were tested using repeated measures analysis of variance. Repeated measures correlations (rrm) quantified common intraindividual associations between BFR-induced hemodynamic and vascular responses. HR increased from baseline during 50% LOP and remained elevated during recovery (p < 0.05). HR increased from baseline during 80% LOP, while tibial VF and TAMV decreased (p < 0.03 for all). HR and TAMV values returned to baseline during recovery, while brachial artery VF decreased (p < 0.05). Changes in HR, brachial VF, and brachial TAMV were similar between 50% and 80% LOP (rrm = 0.32-0.70, p < 0.05 for all). At 80% LOP, changes in HR were positively correlated with brachial VF (rrm = 0.38) and TAMV (rrm = 0.43) and negatively correlated with tibial VF (rrm = -0.36) and TAMV (rrm = -0.30) (p < 0.05 for all). Results suggest that BFR at 80% LOP elicits an acute systemic pressor reflex without concomitant increases in brachial arterial flow, while 50% LOP elicits a subdued response.
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Affiliation(s)
- Abby R Fleming
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama, USA
| | - Hayley V MacDonald
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama, USA
| | - Samuel L Buckner
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, USA
| | - Lee J Winchester
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama, USA
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Moreno EN, Figueroa EC, Heath AW, Buckner SL. An examination of acute physiological and perceptual responses following blood flow restriction exercise using a traditional research device or novel, automated system. Physiol Meas 2024; 45:065007. [PMID: 38838705 DOI: 10.1088/1361-6579/ad548c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 06/05/2024] [Indexed: 06/07/2024]
Abstract
Objective. To compare the acute physiological and perceptual responses to blood flow restriction (BFR) exercise using a traditional research device or novel, automated system.Methods. Forty-four resistance trained individuals performed four sets of unilateral elbow flexion exercise (30% one-repetition maximum) to volitional failure using two distinct restrictive devices [SmartCuffs PRO BFR Model (SMARTCUFF), Hokanson E20 Rapid Inflation device (HOKANSON)] and with two levels of BFR [40% limb occlusion pressure (LOP), 80% LOP]. Blood pressure (BP), muscle thickness (MT), and isometric strength (ISO) were assessed prior to and following exercise. Perceptual responses [ratings of perceived exertion (RPE), discomfort] were assessed prior to exercise and following each exercise set.Main results. Data are displayed as means (SD). Immediately following exercise with 40% LOP, there were no statistical differences between devices for BP, MT, and ISO. However, only following Set 1 of exercise, RPE was greater with SMARTCUFF compared to HOKANSON (p< 0.05). In addition, only following Set 2 of exercise, discomfort was greater with HOKANSON compared to SMARTCUFF (p< 0.001). Immediately following exercise with 80% LOP, there were no statistical differences between devices for BP, MT, and ISO. However, only following Set 4 of exercise, RPE was greater with HOKANSON compared to SMARTCUFF (p< 0.05). In addition, following all exercise sets, discomfort was greater with HOKANSON compared to SMARTCUFF (p< 0.001). For repetitions completed with 40% LOP there were no statistical differences between SMARTCUFF and HOKANSON across any exercise sets. For repetitions completed with 80% LOP there were no statistical differences between SMARTCUFF and HOKANSON across Set 1 of exercise (p= 0.34), however, for Sets 2-4 of exercise, significantly greater number of repetitions were completed during SMARTCUFF than HOKANSON.Significance. The present study provides valuable insight into the efficacy of a novel, automated BFR system (SMARTCUFF) eliciting comparable acute physiological responses to BFR exercise and in some cases favorable perceptual responses when compared to a traditional research device (HOKANSON).
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Affiliation(s)
- Enrique N Moreno
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
| | - Elias C Figueroa
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
| | - Andrew W Heath
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
| | - Samuel L Buckner
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL, United States of America
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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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Okada K, Shimatani K. Effect of olfactory stimulation from aromatherapy on the autonomic nervous activity during aerobic exercises. Sci Rep 2024; 14:11198. [PMID: 38755393 PMCID: PMC11099183 DOI: 10.1038/s41598-024-61732-w] [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: 11/30/2023] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
Variations in the autonomic nervous system activity during exercise therapy in patients with cardiovascular diseases may lead to adverse events. Aromatherapy may reduce these adverse events by enhancing parasympathetic nervous activity (PNA). However, the effects of aromatherapy during exercise remain relatively unknown. This study aimed to evaluate the effect of aromatherapy on autonomic nervous activity during exercise and recovery. This randomized crossover study included 20 healthy men subjected to both aroma and placebo conditions which involved rest and moderate-intensity aerobic exercise on a cycle ergometer, followed by recovery. Blood pressure, heart rate variability indices, and SpO2 were measured during the rest, exercise, and recovery phases. Moreover, aroma preferences and emotional changes in response to the aroma were assessed. Under the placebo condition, high frequency (HF), root mean square of successive differences indices, and heart rate showed delayed recovery (P < 0.05). Furthermore, a moderate positive correlation was identified between aroma preference, pleasant emotions induced by aromatherapy, and the HF index (P < 0.05). These results indicate that aromatherapy facilitates the recovery of PNA after exercise. Furthermore, these effects were more pronounced among individuals who exhibited a stronger preference for and more positive emotions toward aromas.
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Affiliation(s)
- Katsuki Okada
- Ehime Prefectural Imabari Hospital, Imabari, Ehime, 794-0006, Japan
| | - Koji Shimatani
- Prefectural University of Hiroshima, Mihara, Hiroshima, 723-0053, Japan.
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Miura M, Kohzuki M, Saito C, Sakai S, Sugaya H, Koyama S, Matsui Y, Sakuma T, Ito O, Yamagata K. Systemic Capillary Responses to Acute Exercise in Hypertensive Seniors: Insights from a Single-Center Pilot Study. J Clin Med 2024; 13:2818. [PMID: 38792358 PMCID: PMC11122561 DOI: 10.3390/jcm13102818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Objective: The aim of this study was to investigate nailfold capillary parameters in community-dwelling individuals aged over 60 years who have hypertension and do not exercise regularly. Furthermore, the study examined the correlations between capillary function and other health-related indicators. DESIGN This study was a single- center pilot trial. SETTING The study took place in the Faculty of Health, Tsukuba University of Technology, Japan. PARTICIPANTS Hypertensive community-dwelling elderly people took part in the study. INTERVENTION Microcirculation was observed before and 1 min after an arm-curl exercise by means of capillary microscopy of the non-exercised limb. Additionally, we examined other health-related indicators. Methods: We measured the acute effects of reperfusion on nailfold density, flow, and diameters. Secondary outcomes included the correlations between microvascular parameters and other health-related indicators. We hypothesized that brief exercise could enhance microcirculation reperfusion and correlate with other health-related parameters. Results: There were 20 participants with a mean (SD) age of 67.1 (5.8) years. The capillary flow rate changed from 2.3 ± 6.7 to 2.7 ± 0.2 log µm/s (p < 0.01), and the capillary density changed from 0.8 ± 0.2 to 0.9 ± 0.1 log/mm (p < 0.01), which included a significant increase in the non-exercising limb. Significant correlations were observed between the nailfold capillary diameter and body fat mass, the capillary diameter and physical activity, and the capillary density and bone mineral density. Conclusions: The acute effects of exercise on high-risk elderly individuals can be safe, and even 1 of min exercise can potentially improve their nailfold capillary function, despite the brief time, compared to no exercise. The results indicate that capillaries have an impact on the function of the whole body. Thus, they may be a useful diagnostic tool for assessing nailfold capillaries.
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Affiliation(s)
- Misa Miura
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Masahiro Kohzuki
- Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan;
| | - Chie Saito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan; (C.S.); (K.Y.)
| | - Satoshi Sakai
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Hisashi Sugaya
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Shingo Koyama
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Yasushi Matsui
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Tohru Sakuma
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Osamu Ito
- Division of General Medicine and Rehabilitation, Faculty of Medicine, Tohoku Medical Pharmaceutical University, Sendai 981-8558, Japan;
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan; (C.S.); (K.Y.)
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Cockfield BA, Wedig IJ, Vinckier AL, McDaniel J, Elmer SJ. Physiological and perceptual responses to acute arm cranking with blood flow restriction. Eur J Appl Physiol 2024; 124:1509-1521. [PMID: 38142449 DOI: 10.1007/s00421-023-05384-0] [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: 06/08/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Lower-body aerobic exercise with blood flow restriction (BFR) offers a unique approach for stimulating improvements in muscular function and aerobic capacity. While there are more than 40 reports documenting acute and chronic responses to lower-body aerobic exercise with BFR, responses to upper-body aerobic exercise with BFR are not clearly established. PURPOSE We evaluated acute physiological and perceptual responses to arm cranking with and without BFR. METHODS Participants (N = 10) completed 4 arm cranking (6 × 2 min exercise, 1 min recovery) conditions: low-intensity at 40%VO2peak (LI), low-intensity at 40%VO2peak with BFR at 50% of arterial occlusion pressure (BFR50), low-intensity at 40%VO2peak with BFR at 70% of arterial occlusion pressure (BFR70), and high-intensity at 80%VO2peak (HI) while tissue oxygenation, cardiorespiratory, and perceptual responses were assessed. RESULTS During exercise, tissue saturation for BFR50 (54 ± 6%), BFR70 (55 ± 6%), and HI (54 ± 8%) decreased compared to LI (61 ± 5%, all P < 0.01) and changes in deoxyhemoglobin for BFR50 (11 ± 4), BFR70 (15 ± 6), and HI (16 ± 10) increased compared to LI (4 ± 2, all P < 0.01). During recovery intervals, tissue saturation for BFR50 and BFR70 decreased further and deoxyhemoglobin for BFR50 and BFR70 increased further (all P < 0.04). Heart rate for BFR70 and HI increased by 9 ± 9 and 50 ± 15b/min, respectively, compared to LI (both P < 0.02). BFR50 (8 ± 2, 1.0 ± 1.0) and BFR70 (10 ± 2, 2.1 ± 1.4) elicited greater arm-specific perceived exertion (6-20 scale) and pain (0-10 scale) compared to LI (7 ± 1, 0.2 ± 0.5, all P < 0.05) and pain for BFR70 did not differ from HI (1.7 ± 1.9). CONCLUSION Arm cranking with BFR decreased tissue saturation and increased deoxyhemoglobin without causing excessive cardiorespiratory strain and pain.
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Affiliation(s)
- Benjamin A Cockfield
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
- Department of Physical Therapy, Central Michigan University, Mount Pleasant, MI, USA
| | - Isaac J Wedig
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
- Health Research Institute, Michigan Technological University, Houghton, MI, USA
- School of Health and Human Performance, Marquette, MI, USA
| | - Alyssa L Vinckier
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
- Department of Physical Therapy, Central Michigan University, Mount Pleasant, MI, USA
| | - John McDaniel
- Exercise Physiology Program, Kent State University, Kent, OH, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
| | - Steven J Elmer
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA.
- Health Research Institute, Michigan Technological University, Houghton, MI, USA.
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Nishikawa T, Hirono T, Takeda R, Okudaira M, Ohya T, Watanabe K. Effects of 7-day quercetin intervention on motor unit activity and muscle contractile properties before and after resistance exercise in young adults randomized controlled trials. Appl Physiol Nutr Metab 2024; 49:447-458. [PMID: 38033306 DOI: 10.1139/apnm-2023-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
We investigated whether the alteration of the motor unit recruitment threshold (MURT) caused by quercetin ingestion intervention for 7 days modifies motor unit activation patterns before and after a single session of resistance exercise. Twenty young male and female adults were divided into two groups: ingestion of placebo (PLA) or quercetin glycosides at 200 mg/day (QUE). High-density surface electromyography during submaximal contractions was measured to assess the motor unit firing rate (MUFR) and MURT of the vastus lateralis muscle before (PRE) and after (POST) resistance exercise (DAY1). The same measurements were repeated after 7 days of placebo or quercetin glycoside ingestion (DAY8). In QUE, MURT decreased more from DAY1-PRE to DAY8-PRE (29.1 ± 9.1 to 27.1 ± 9.5% MVC, p < 0.001) but not in PLA (29.8 ± 10.4 to 28.9 ± 9.7% MVC, p < 0.167). For percentage change in MUFR following resistance exercise, there was a significant interaction (day × group, p < 0.001). The degree of changes in MURT from DAY1-PRE to DAY8-PRE was significantly correlated with the percentage change of MUFR from DAY8-PRE to DAY8-POST in QUE (p = 0.014, r = -0.363) but not in PLA (p = 0.518). The study suggests that 7-day quercetin ingestion alters the motor unit recruitment pattern, and this may induce changes in motor unit firing patterns during a single session of resistance training (Trial registration: UMIN000052255, R000059650).
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Affiliation(s)
- Taichi Nishikawa
- Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Japan
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Toyota, Japan
| | - Tetsuya Hirono
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Toyota, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Ryosuke Takeda
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Toyota, Japan
| | - Masamichi Okudaira
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Toyota, Japan
| | - Toshiyuki Ohya
- School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Toyota, Japan
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Scott BR, Marston KJ, Owens J, Rolnick N, Patterson SD. Current Implementation and Barriers to Using Blood Flow Restriction Training: Insights From a Survey of Allied Health Practitioners. J Strength Cond Res 2024; 38:481-490. [PMID: 38088873 DOI: 10.1519/jsc.0000000000004656] [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] [Indexed: 02/29/2024]
Abstract
ABSTRACT Scott, BR, Marston, KJ, Owens, J, Rolnick, N, and Patterson, SD. Current implementation and barriers to using blood flow restriction training: Insights from a survey of allied health practitioners. J Strength Cond Res 38(3): 481-490, 2024-This study investigated the use of blood flow restriction (BFR) exercise by practitioners working specifically with clinical or older populations, and the barriers preventing some practitioners from prescribing BFR. An online survey was disseminated globally to allied health practitioners, with data from 397 responders included in analyses. Responders who had prescribed BFR exercise ( n = 308) completed questions about how they implement this technique. Those who had not prescribed BFR exercise ( n = 89) provided information on barriers to using this technique, and a subset of these responders ( n = 22) completed a follow-up survey to investigate how these barriers could be alleviated. Most practitioners prescribe BFR exercise for musculoskeletal rehabilitation clients (91.6%), with the BFR cuff pressure typically relative to arterial occlusion pressure (81.1%) and implemented with resistance (96.8%) or aerobic exercise (42.9%). Most practitioners screen for contraindications (68.2%), although minor side effects, including muscle soreness (65.8%), are common. The main barriers preventing some practitioners from using BFR are lack of equipment (60.2%), insufficient education (55.7%), and safety concerns (31.8%). Suggestions to alleviate these barriers included developing educational resources about the safe application and benefits of BFR exercise ( n = 20) that are affordable ( n = 3) and convenient ( n = 4). These results indicate that BFR prescription for clinical and older cohorts mainly conforms with current guidelines, which is important considering the potentially increased risk for adverse events in these cohorts. However, barriers still prevent broader utility of BFR training, although some may be alleviated through well-developed educational offerings to train practitioners in using BFR exercise.
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Affiliation(s)
- Brendan R Scott
- Centre for Healthy Ageing, Murdoch University, Perth, Australia
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Australia
| | - Kieran J Marston
- Centre for Healthy Ageing, Murdoch University, Perth, Australia
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Australia
| | | | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, New York, NY; and
| | - Stephen D Patterson
- Faculty of Sport, Allied Health & Performance Sciences, St Mary's University, London, United Kingdom
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Hu C, Zhu B, Wang Y, Yang F, Zhang J, Zhong W, Lu S, Luo C. Effectiveness of blood flow restriction versus traditional weight-bearing training in rehabilitation of knee osteoarthritis patients with MASLD: a multicenter randomized controlled trial. Front Endocrinol (Lausanne) 2023; 14:1220758. [PMID: 38155949 PMCID: PMC10753484 DOI: 10.3389/fendo.2023.1220758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
To compare the reliability and effectiveness of blood blow restriction resistance training (BFR) versus traditional weight-bearing training (WB) in knee osteoarthritis (KOA) patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Methods This multicenter randomized controlled trial was conducted from January 2021 to June 2022 at Shanghai Jiao Tong University affiliated Sixth People's Hospital and The People's Hospital of Mengla County. A total of 120 outpatients were recruited and randomized to perform WB (n=60) or BFR (n=60) resistance training protocols in accordance with standard recommended protocols for 12 weeks. Demographic data and Kellgren and Lawrence grading system scores were collected. Pain, range of motion (ROM), scaled maximal isotonic strength (10RM), self-reported function (KOOS), and 30-s chair sit-to-stand test results were assessed at weeks 1, 4, and 12. Results 112 patients (57 in the WB group, 55 in the BFR group) completed the training programs and assessments. No significant intergroup demographic differences were noted. ROM and scaled 10RM significantly increased at the 4- and 12-week assessments and differed significantly between groups. The pain, ability of daily living and quality of life subscale in KOOS increased significantly at the 12-week assessment and differed significantly between groups, adjusted for baseline value. Significant and comparable increases in 30-s chair sit-to-stand test results were observed within and between study groups. Conclusion BFR training enhanced muscle strength, reduced pain, and improved daily living and sports activities in patients with KOA, compared to WB training alone. BFR should be recommended for rehabilitation in KOA individuals with MASLD. Clinical trial registration number ChiCTR2100042872.
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Affiliation(s)
- Chengfang Hu
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zhu
- Department of Orthopedics, The People’s Hospital of Mengla County, Mengla, China
| | - Yanmao Wang
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Yang
- Department of Orthopedics, The People’s Hospital of Mengla County, Mengla, China
| | - Jun Zhang
- Department of Orthopedics, The People’s Hospital of Mengla County, Mengla, China
| | - Wanrun Zhong
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengdi Lu
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congfeng Luo
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wang J, Liu H, Jiang L. The effects of blood flow restriction training on PAP and lower limb muscle activation: a meta-analysis. Front Physiol 2023; 14:1243302. [PMID: 38028795 PMCID: PMC10666059 DOI: 10.3389/fphys.2023.1243302] [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: 06/20/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Objective: This study aims to systematically evaluate the effects of blood flow restriction (BFR) training on lower limb muscle activation and post-activation potentiation (PAP) in athletes through a meta-analysis and discuss methods to improve instant muscle strength so as to provide a reference for training in this field. Methods: Randomized controlled trials (RCTs) that examined the impact of BFR training on muscle activation and PAP were gathered through database searches, such as CNKI, Wanfang, Web of Science, PubMed, and others. The Cochrane risk of bias tool was used to include and exclude literature. Quality evaluation and statistical analysis were conducted using ReviewManager 5.3 software, STATA 16.0, and other software programs. The sensitivity analysis and funnel plots were employed to assess result stability and publication bias. Results: In total, 18 literature studies were included with a total of 267 subjects. The meta-analysis showed that BFR could significantly improve the RMS value of lower limb muscles [SMD = 0.98, 95% CI (0.71, 1.24), and p < 0.00001]. BFR had a significant effect on the immediate explosive power of the lower limbs [SMD = 0.28, 95% CI (0.02, 0.53), and p = 0.03], but the heterogeneity was obvious (I 2 = 51%). The subgroup analysis showed that different training methods may be influencing factors that lead to the heterogeneity between studies. The measurement indexes were the counter movement jump (CMJ) [SMD = 0.45, 95% CI (0.20, 0.69), and p = 0.0004], training mode to overcome body weight [SMD = 0.57, 95% CI (0.33, 0.82), and p < 0.00001], and compressive strength of 40%-60% arterial occlusion pressure (AOP) [SMD = 0.57, 95% CI (0.31, 0.83), and p < 0.0001], which reached the maximum effect and was statistically significant. Conclusion: BFR training can induce lower extremity muscle activation and PAP. Combining self-weight training with BFR exercises set at 40%-60% AOP appears to be particularly effective in inducing PAP, especially for enhancing CMJ. Furthermore, combining body-weight training with BFR is considered an effective warm-up method to improve CMJ. Systematic Review Registration: http://inplasy.com, identifier INPLASY2023100087.
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Affiliation(s)
- Jian Wang
- Department of Physical Education, Ningbo University of Technology, Ningbo, China
| | - Haiyang Liu
- Department of Physical Education, Ningbo University of Technology, Ningbo, China
| | - Lizhu Jiang
- Ningde Vocational and Technical College, Ningde, China
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11
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Hoshida S. Due Diligence of a Diastolic Index as a Prognostic Factor in Heart Failure with Preserved Ejection Fraction. J Clin Med 2023; 12:6692. [PMID: 37892830 PMCID: PMC10607873 DOI: 10.3390/jcm12206692] [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: 09/15/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Of the existing non-invasive diastolic indices, none consider arterial load. This article reveals points of caution for determining the diastolic prognostic index using a novel index of vascular resistance-integrated diastolic function in old, real-world patients with heart failure with preserved ejection fraction (HFpEF) in Japan. This index represents the ratio of left ventricular diastolic elastance (Ed) to arterial elastance (Ea), where Ed/Ea = (E/e')/(0.9 × systolic blood pressure), showing a relative ratio of left atrial filling pressure to left ventricular end-systolic pressure. The role of hemodynamic prognostic factors related to diastolic function, such as Ed/Ea, may differ according to the clinical endpoint, follow-up duration, and sex. In HFpEF patients with heterogenous cardiac structure and function, an assessment using a serial echocardiographic diastolic index in clinical care can provide an accurate prognosis.
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Affiliation(s)
- Shiro Hoshida
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Osaka 581-0069, Japan
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12
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Mannozzi J, Al-Hassan MH, Kaur J, Lessanework B, Alvarez A, Massoud L, Aoun K, Spranger M, O'Leary DS. Blood flow restriction training activates the muscle metaboreflex during low-intensity sustained exercise. J Appl Physiol (1985) 2023; 135:260-270. [PMID: 37348015 PMCID: PMC10393340 DOI: 10.1152/japplphysiol.00274.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
Blood flow restriction training (BFRT) employs partial vascular occlusion of exercising muscle and has been shown to increase muscle performance while using reduced workload and training time. Numerous studies have demonstrated that BFRT increases muscle hypertrophy, mitochondrial function, and beneficial vascular adaptations. However, changes in cardiovascular hemodynamics during the exercise protocol remain unknown, as most studies measured blood pressure before the onset and after the cessation of exercise. With reduced perfusion to the exercising muscle during BFRT, the resultant accumulation of metabolites within the ischemic muscle could potentially trigger a large reflex increase in blood pressure, termed the muscle metaboreflex. At low workloads, this pressor response occurs primarily via increases in cardiac output. However, when increases in cardiac output are limited (e.g., heart failure or during severe exercise), the reflex shifts to peripheral vasoconstriction as the primary mechanism to increase blood pressure, potentially increasing the risk of a cardiovascular event. Using our chronically instrumented conscious canine model, we utilized a 60% reduction in femoral blood pressure applied to the hindlimbs during steady-state treadmill exercise (3.2 km/h) to reproduce the ischemic environment observed during BFRT. We observed significant increases in heart rate (+19 ± 3 beats/min), stroke volume (+2.52 ± 1.2 mL), cardiac output (+1.21 ± 0.2 L/min), mean arterial pressure (+18.2 ± 2.4 mmHg), stroke work (+1.93 ± 0.2 L/mmHg), and nonischemic vascular conductance (+3.62 ± 1.7 mL/mmHg), indicating activation of the muscle metaboreflex.NEW & NOTEWORTHY Blood flow restriction training (BFRT) increases muscle mass, strength, and endurance. There has been minimal consideration of the reflex cardiovascular responses that could be elicited during BFRT sessions. We showed that during low-intensity exercise BFRT may trigger large reflex increases in blood pressure and sympathetic activity due to muscle metaboreflex activation. Thus, we urge caution when employing BFRT, especially in patients in whom exaggerated cardiovascular responses may occur that could cause sudden, adverse cardiovascular events.
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Affiliation(s)
- Joseph Mannozzi
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Mohamed-Hussein Al-Hassan
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Jasdeep Kaur
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, United States
| | - Beruk Lessanework
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Alberto Alvarez
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Louis Massoud
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Kamel Aoun
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Marty Spranger
- Department of Physiology, Michigan State University, East Lansing, Michigan, United States
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
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13
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Sarfabadi P, Rizvi MR, Sharma A, Sami W, Sajid MR, Arora S, Anand A, bin Ab Hamid MR. Elevating athletic performance: Maximizing strength and power in long jumpers through combined low-intensity blood flow restriction and high-intensity resistance training. Heliyon 2023; 9:e19068. [PMID: 37636460 PMCID: PMC10457511 DOI: 10.1016/j.heliyon.2023.e19068] [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: 05/22/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose This study aimed to evaluate the effects of low-intensity blood flow restriction (BFR) training and high-intensity resistance training (HI-RT) on the leaping performance of long-jumpers. Materials and methods Long jump players were divided into two groups; one group (group A) receiving HI-RT (n = 8) and the other group (group B) receiving combined low-intensity BFR training plus HI-RT (n = 8). Muscle power and knee muscle strength was assessed at baseline, 3 weeks and 6 weeks of intervention. Results 1-RM was found to be significantly different between Group A and Group B at 3 and 6 weeks. Further, IKDQR, IKDHR and IKDQL was significantly improved in group B as compared to group A both at 3 and 6 weeks. There was significant time effect, group effect and time-group interaction in the strength of quadriceps and hamstring of both left and right leg measured through isokinetic device. Post-hoc analysis for 1-RM in group B showed a significant improvement at baseline and 6 weeks and the broad jump was significant at baseline and 3 weeks and at baseline and 6 weeks. Conclusion The combined effects of low-intensity BFR training and HI-RT is effective in improving the muscle strength and power of lower limbs in long jumpers.
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Affiliation(s)
- Pehzaan Sarfabadi
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad, 121001, India
| | - Moattar Raza Rizvi
- Faculty of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad, 121001, India
| | - Ankita Sharma
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad, 121001, India
| | - Waqas Sami
- Department of Pre-Clinical Affairs, College of Nursing, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | | | - Sumit Arora
- Manav Rachna Sport Science Centre, Manav Rachna International Institute and Studies (MRIIRS), Faridabad, 121001 India
| | - Akshay Anand
- Sultan Qaboos Comprehensive Cancer Care and Research Centre, Al Khoud, Muscat, Oman
| | - Mohd Rashid bin Ab Hamid
- Centre for Mathematical Sciences, Universiti Malaysia Pahang Al-Sultan Abdullah, Lebuh Persiaran Tun Khalil Yaakob, 26300, Kuantan, Pahang, Malaysia
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14
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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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15
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Maga M, Wachsmann-Maga A, Batko K, Włodarczyk A, Kłapacz P, Krężel J, Szopa N, Sliwka A. Impact of Blood-Flow-Restricted Training on Arterial Functions and Angiogenesis-A Systematic Review with Meta-Analysis. Biomedicines 2023; 11:1601. [PMID: 37371696 DOI: 10.3390/biomedicines11061601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Despite growing evidence of the significant influence of blood-flow-restricted (BFR) training on different body functions, its impact on the vascular system, especially the arteries, is controversial. Therefore, the objective of our study was to analyze how BFR exercise, compared to other types of exercise without the restriction of blood flow, influences arterial functions and angiogenesis in adults. Studies comparing the effect of BFR versus non-BFR training on arterial parameters were divided into three categories: endothelial function, angiogenesis, and other vasculature functions. The search was based on Cochrane Library, PubMed®, and Embase, and 38 studies were included. The meta-analysis revealed a more significant improvement in flow-mediated dilatation (FMD) (p = 0.002) and the production of the primary angiogenesis biomarker vascular endothelial growth factor (VEGF) (p = 0.009) after BFR compared to non-BFR training (p = 0.002). The analysis of the pulse wave velocity, ankle-brachial index, systolic blood pressure, and heart rate did not show significant differences in changes between BFR and non-BFR training. The other parameters examined did not have sufficient data to be included in the meta-analysis. The results obtained present trends that suggest significant impacts of BFR training on endothelial functions and angiogenesis. There is still a lack of multicenter randomized clinical trials including many participants, and such studies are necessary to confirm the advantage of BFR over non-BFR activity.
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Affiliation(s)
- Mikołaj Maga
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Agnieszka Wachsmann-Maga
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Krzysztof Batko
- Department of Research and Design, Medicine Economy Law Society (MELS) Foundation, 30-040 Krakow, Poland
| | - Aleksandra Włodarczyk
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Paulina Kłapacz
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Jakub Krężel
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Natalia Szopa
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Agnieszka Sliwka
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
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16
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Yamada Y, Kang A, Seffrin A, Song JS, Kataoka R, Hammert WB, Spitz RW, Wong V, Loenneke JP. Potential considerations with estimating blood flow restriction pressure in the lower body using a narrower cuff. Eur J Appl Physiol 2023; 123:937-943. [PMID: 36580110 DOI: 10.1007/s00421-022-05122-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: 10/26/2022] [Accepted: 12/21/2022] [Indexed: 12/30/2022]
Abstract
Blood flow restriction pressures are typically set as a percentage of the arterial occlusion pressure. For those who do not have the ability to measure the arterial occlusion pressure, estimation equations are available. However, notable considerations are needed when estimating pressure with a narrow cuff (5 cm) in the lower body. A previously published equation in this journal was developed but was created only using 55% of the sample because the arterial occlusion of the others could not be obtained within the manufacturer's pressure limit. The purpose of this article was twofold: (1) to investigate how previous studies have implemented the equation and (2) to highlight potential concerns of using this equation. Two databases were used to locate articles that used the equation from Loenneke et al. (2015). We found that this equation had been cited 10 times to estimate arterial occlusion pressure with some notable concerns. Some did not use a 5 cm wide cuff, while others used it for participants who had arterial occlusion pressures exceeding 300 mmHg. To highlight the latter, we also applied the Loenneke et al. (2015) lower body equation to participants with arterial occlusion pressures known to exceed 300 mmHg to demonstrate potential concerns. This retrospective analysis found that 52% of the sample with known pressures over 300 mmHg (40 out of 77) would be estimated below 300 mmHg. This paper highlighted important considerations for those trying to estimate arterial occlusion pressure in the lower body with a narrow cuff (5 cm).
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Affiliation(s)
- Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Anna Kang
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Aldo Seffrin
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - William B Hammert
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Vickie Wong
- 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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17
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Vanwye WR, Weatherholt AM, Winchester LJ, Owens JG, Spears M. Cardiovascular Responses During Light-intensity Aerobic Exercise with Varying Levels of Limb Occlusion Pressures. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:676-687. [PMID: 37622157 PMCID: PMC10446952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
The study aimed to assess cardiovascular responses to low-intensity aerobic exercise with varying levels of limb occlusion pressures (LOP) in a healthy population of men and women 30 to 60 years. The study was a single-session repeated measures design. Thirty individuals completed the study. All subjects participated in a single bout of low-intensity cycling (30-39% HRR) with bilateral lower extremity (LE) BFR for four 5-minute stages [0% (No BFR), 40%, 60%, and 80% LOP] with a 2-minute active rest between stages (BFR pressure released). The subjects' systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2), and ratings of perceived exertion (RPE) were measured at rest, peak, immediately post, post-15 minutes, and post-30 minutes. Peak SBP (no BFR 160.7 ±19.1 mmHg; 40% LOP 173.6 ± 18.7 mmHg; 60 % LOP; 182.5 ± 21.1 mmHg; 80% LOP 193.5± 23.3 mmHg ; p<0.001; η P 2 = .747 ), DBP (no BFR 74.9 ± 8.5 mmHg; 40% LOP (83.0 ± 9.0 mmHg;60 % LOP 90.4 ± 8.7 mmHg; 80% LOP 97.7 ± 9.5 mmHg ;p<0.001; η P 2 = .924 ), MAP (no BFR 103.5 ± 10.1 mmHg; 40% LOP 113.2 ± 10.5 mmHg; 60% LOP 121.1 ± 11.7 mmHg; 80% LOP 129.7 ± 12.9 mmHg; p<0.001; η P 2 = .960 ), and RPE (No BFR 10.0 ± 2.0; 40 % LOP 11.5 ± 2.3; 60% LOP 13.2 ± 2.6; 80% LOP 14.5 ± 3.; p<0.001; η P 2 = .826 ) were significantly higher with each progressing stage. The results indicate that low-intensity cycling with bilateral LE BFR for each LOP stage resulted in elevated SBP, DBP, MAP, and RPE despite maintaining a fixed HR.
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Affiliation(s)
- William R Vanwye
- School of Physical Therapy, Florida Southern College, Lakeland, FL, USA
| | - Alyssa M Weatherholt
- Department of Kinesiology and Sport, University of Southern Indiana, Evansville, IN, USA
| | - Lee J Winchester
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | | | - Micah Spears
- Department of Physical Therapy, Western Kentucky University, Bowling Green, KY, USA
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18
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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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19
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McClean Z, Iannetta D, Macinnis M, Aboodarda SJ. Shorter High-Intensity Cycling Intervals Reduce Performance and Perceived Fatigability at Work-Matched but Not Task Failure. Med Sci Sports Exerc 2023; 55:690-699. [PMID: 36729921 DOI: 10.1249/mss.0000000000003097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The intensity, duration, and distribution of work and recovery phases during high-intensity interval training (HIIT) modulate metabolic perturbations during exercise and subsequently influence the development of performance fatigability and exercise tolerance. This study aimed to characterize neuromuscular, perceptual, and cardiorespiratory responses to work-to-rest ratio-matched HIIT protocols differing in work and rest interval duration. METHODS Twelve healthy individuals (six women) first completed a ramp incremental test to determine 90% of peak power output, and then in three randomized visits, they completed three cycling protocols to task failure at 90% of peak power output: (i) 3- to 3-min work-to-passive rest ratio HIIT (HIIT 3min ), (ii) 1- to 1-min work-to-passive rest ratio HIIT (HIIT 1min ), and (iii) constant load (CL). Interpolated twitch technique, including maximal voluntary isometric knee extensions and femoral nerve electrical stimuli, was performed at baseline, every 6 min of work, and task failure. Perceptual and cardiorespiratory responses were recorded every 3 min and continuously across the exercises, respectively. RESULTS The work completed during HIIT 1min (8447 ± 5124 kJ) was considerably greater than HIIT 3min (1930 ± 712 kJ) and CL (1076 ± 356) ( P < 0.001). At work-matched, HIIT 1min resulted in a lesser decline in maximal voluntary contraction and twitch force compared with HIIT 3min and CL ( P < 0.001). Perceived effort, pain, and dyspnea were least in HIIT 1min and HIIT 3min compared with CL ( P < 0.001). At task failure, HIIT 1min resulted in less voluntary activation than HIIT 3min ( P = 0.010) and CL ( P = 0.043), and engendered less twitch force decline than CL ( P = 0.021). CONCLUSIONS Overall, the mitigated physiological and perceptual responses during shorter work periods (HIIT 1min ) enhance exercise tolerance in comparison to longer work intervals at the same intensity (HIIT 3min , CL).
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Affiliation(s)
- Zachary McClean
- Faculty of Kinesiology, University of Calgary, Calgary, CANADA
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20
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Duarte de Oliveira JL, Vieira JG, Sabino de Queiros V, Mourão Júnior CA, Panza PS, Krzysztofik M, Bichowska M, Guilherme de Araújo Tinôco Cabral B, Rolnick N, Wilk M, Vianna JM. Cardiovascular and Perceptual Responses to Resistance Training with Practical Blood Flow Restriction Induced by a Non-Elastic Band vs. Pneumatic Cuff: A Crossover Randomized Study. Percept Mot Skills 2023; 130:1152-1167. [PMID: 36914166 DOI: 10.1177/00315125231162732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Our purpose in this study was to analyze perceptual and cardiovascular responses in low-load resistance training (RT) sessions associated with a fixed non-elastic band compressed to the proximal region of the arms (p-BFR) versus a pneumatic cuff inflated to a pressure of 150 mmHg (t-BFR). Participants (16 healthy trained men) were randomly assigned to two conditions of low-load RT (20% one repetition maximum [1RM]) with BFR (p-BFR or t-BFR). In both conditions, the participants performed five exercises (4 sets/30-15-15-15) for the upper-limbs, but in one of the conditions, the exercises were performed with a p-BFR induced by a non-elastic band, while in the other, the exercises were performed with a t-BFR using a device with similar width. The devices used to generate the BFR had similar widths (5 cm). Brachial blood pressure (bBP) and heart rate (HR) were measured before, after each exercise and after the experimental session (5-, 10-, 15-, and 20 min post-session). Rating of perceived exertion (RPE) and rating of pain perception (RPP) were reported after each exercise and 15 minutes post-session. HR increased during the training session in both conditions, with no differences between p-BFR and t-BFR. Neither intervention increased diastolic BP (DBP) during training, but there was a significant post-session reduction in DBP in the p-BFR, with no differences observed between conditions. There were no significant differences in RPE and RPP in the two training conditions, with both conditions associated with higher RPE and RPP at the end versus beginning of the experimental session. We conclude that when BFR device width and material are similar, low-load training with t-BFR and p-BFR promotes similar acute perceptual and cardiovascular responses in healthy trained men.
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Affiliation(s)
- Jorge Luiz Duarte de Oliveira
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - João Guilherme Vieira
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Victor Sabino de Queiros
- Postgraduate Program in Health Sciences, 28123Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Patrícia Silva Panza
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Michał Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Marta Bichowska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | | | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, New York, USA
| | - Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Jeferson Macedo Vianna
- Postgraduate Program in Physical Education, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Strength Training Research Laboratory, 28113Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
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21
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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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22
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McClean ZJ, Young A, Pohl AJ, Fine NM, Burr JF, MacInnis M, Aboodarda SJ. Blood flow restriction during high-intensity interval cycling exacerbates psychophysiological responses to a greater extent in females than males. J Appl Physiol (1985) 2023; 134:596-609. [PMID: 36701480 DOI: 10.1152/japplphysiol.00567.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This study aimed to characterize neuromuscular, perceptual, and cardiorespiratory responses to high-intensity interval training (HIIT) with superimposed blood flow restriction in males and females. Twenty-four, healthy individuals (n = 12 females) completed two cycling HIIT protocols to task failure (1-min work phases at 90% of peak power output interspersed by 1-min rest phases). The blood flow restriction (BFR) and control (CON) protocols were identical except for the presence and absence of BFR during rest phases, respectively. The interpolated twitch technique, including maximal voluntary isometric knee extension (MVC) and femoral nerve electrical stimuli, was performed at baseline, every six intervals, and task failure. Perceptual and cardiorespiratory responses were recorded every three intervals and continuously during exercise, respectively. Bayesian inference was used to obtain the joint posterior distribution for all parameters and evidence of an effect was determined via the marginal posterior probability (PP). The BFR shortened task duration by 57.3% compared with CON (PP > 0.99), without a sex difference. The application of BFR exacerbated the rate of decline in neuromuscular measures (MVC and twitch force output), increase of perceptual responses (perceived effort, pain, dyspnea, fatigue), and development of cardiorespiratory parameters (minute ventilation and heart rate), compared with CON (PP > 0.95). In addition, BFR exacerbated the neuromuscular, perceptual, and cardiorespiratory responses to a greater extent in females than males (PP > 0.99). Our results suggest that superimposition of blood flow restriction exacerbates psychophysiological responses to a HIIT protocol to a greater extent in females than males.NEW & NOTEWORTHY To our knowledge, no study has explored sex differences in the neuromuscular, perceptual, and cardiorespiratory indices characterizing exercise tolerance during high-intensity interval training (HIIT) with blood flow restriction (BFR) applied only during rest periods. Our results suggest that BFR elicited a decline in exercise performance that could be attributed to integration of psychophysiological responses. However, this integration was sex-dependent where females demonstrated an exacerbated rate of change in these responses compared with males.
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Affiliation(s)
- Zachary J McClean
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Abbey Young
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Andrew J Pohl
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Nowell M Fine
- Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jamie F Burr
- College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Martin MacInnis
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Saied J Aboodarda
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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23
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Effect of Ischemic Preconditioning on Acute Recovery in Elite Judo Athletes: A Randomized, Single-Blind, Crossover Trial. Int J Sports Physiol Perform 2023; 18:180-186. [PMID: 36638812 DOI: 10.1123/ijspp.2022-0280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/05/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The ischemic preconditioning (IPC) method has been shown to aid the recovery processes; however, no studies have been done to assess its acute recovery use in judo. This study aimed to examine IPC of lower limbs effects on recovery after a judo-specific performance in highly trained male judokas and its applicability during a competition day. METHODS A single-blind, placebo-randomized crossover study was carried out on a sample of 13 elite male judo athletes. They undertook measurements of body composition, judo-specific task (Special Judo Fitness Test), jump performance, handgrip strength, lactate, blood pressure, perceived exertion, and delayed-onset muscle soreness. IPC was applied on the legs and inflated 50 mm Hg above the systolic blood pressure for 5 minutes and repeated 3 times for each leg, with 5 minutes of reperfusion. Two-way analysis of variance with repeated measurements was used to determine changes between interventions and measurement times. Paired-sample t test and 1-way repeated-measures analysis of variance was used to determine the difference among measurement times. Statistical significance was set at P < .05. RESULTS The IPC intervention resulted in (1) decreased heart rate at 30 and 60 minutes during recovery (P = .002; P = .001), (2) better countermovement jump performance at 60 minutes (P = .05), (3) lower perceived-muscle-soreness scores (P = .006), and (4) maintained handgrip strength compared with placebo. CONCLUSIONS The present study revealed that IPC applied to judo athletes following judo-specific exercise resulted in better cardiovascular and neuromuscular recovery and could be a useful tool to enhance recovery during judo competition breaks between preliminaries and final block.
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24
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Rolnick N, Kimbrell K, de Queiros V. Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice-A review of the current state of the research. Front Physiol 2023; 14:1089065. [PMID: 37064884 PMCID: PMC10099250 DOI: 10.3389/fphys.2023.1089065] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Training with blood flow restriction (BFR) has been shown to be a useful technique to improve muscle hypertrophy, muscle strength and a host of other physiological benefits in both healthy and clinical populations using low intensities [20%-30% 1-repetition maximum (1RM) or <50% maximum oxygen uptake (VO2max)]. However, as BFR training is gaining popularity in both practice and research, there is a lack of awareness for potentially important design characteristics and features associated with BFR cuff application that may impact the acute and longitudinal responses to training as well as the safety profile of BFR exercise. While cuff width and cuff material have been somewhat addressed in the literature, other cuff design and features have received less attention. This manuscript highlights additional cuff design and features and hypothesizes on their potential to impact the response and safety profile of BFR. Features including the presence of autoregulation during exercise, the type of bladder system used, the shape of the cuff, the set pressure versus the interface pressure, and the bladder length will be addressed as these variables have the potential to alter the responses to BFR training. As more devices enter the marketplace for consumer purchase, investigations specifically looking at their impact is warranted. We propose numerous avenues for future research to help shape the practice of BFR that may ultimately enhance efficacy and safety using a variety of BFR technologies.
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Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, NY, United States
- *Correspondence: Nicholas Rolnick,
| | - Kyle Kimbrell
- Owens Recovery Science, San Antonio, TX, United States
| | - Victor de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), NatalRN, Brazil
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25
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Lauver JD, Moran A, Guilkey JP, Johnson KE, Zanchi NE, Rotarius TR. Acute Responses to Cycling Exercise With Blood Flow Restriction During Various Intensities. J Strength Cond Res 2022; 36:3366-3373. [PMID: 34341317 DOI: 10.1519/jsc.0000000000004099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Lauver, JD, Moran, A, Guilkey, JP, Johnson, KE, Zanchi, NE, and Rotarius, TR. Acute responses to cycling exercise with blood flow restriction during various intensities. J Strength Cond Res 36(12): 3366-3373, 2022-The purpose of this study was to investigate the acute physiological responses during cycling at various intensities with blood flow restriction (BFR). Subjects ( N = 9; V̇ o2 peak = 36.09 ± 5.80 ml·kg -1 ·min -1 ) performed 5 protocols: high-intensity (HIGH), control (CON-90), 90% of ventilatory threshold (VT) work rate with BFR (90-BFR), 70% of VT with BFR (70-BFR), and 30% V̇ o2 peak with BFR (30-BFR). Protocols consisted of five 2-minute work intervals interspersed with 1-minute recovery intervals. Blood flow restriction pressure was 80% of limb occlusion pressure. V̇ o2 , muscle excitation, tissue oxygen saturation (StO 2 ), discomfort, and level of perceived exertion (RPE) were assessed. Muscle excitation was higher during HIGH (302.9 ± 159.9 %BSL [baseline]) compared with 70-BFR (99.7 ± 76.4 %BSL) and 30-BFR (98.2 ± 70.5 %BSL). StO 2 was greater during 90-BFR (40.7 ± 12.5 ∆BSL), 70-BFR (34.4 ± 15.2 ∆BSL), and 30-BFR (31.9 ± 18.7 ∆BSL) compared with CON-90 (4.4 ± 11.5 ∆BSL). 90-BFR (39.6 ± 12.0 ∆BSL) resulted in a greater StO 2 -Avg compared with HIGH (20.5 ± 13.8 ∆BSL). Also, HIGH (23.68 ± 5.31 ml·kg -1 ·min -1 ) resulted in a greater V̇ o2 compared with 30-BFR (15.43 ± 3.19 ml·kg -1 ·min -1 ), 70-BFR (16.65 ± 3.26 ml·kg -1 ·min -1 ), and 90-BFR (18.28 ± 3.89 ml·kg -1 ·min -1 ); 90-BFR (intervals: 4 = 15.9 ± 2.3; intervals: 5 = 16.4 ± 2.5) resulted in a greater RPE compared with 30-BFR (intervals: 4 = 13.3 ± 1.4; intervals: 5 = 13.7 ± 1.7) during intervals 4 and 5. These results suggest that when adding BFR to various intensities of aerobic exercise, consideration should be given to peak work and VT to provide a balance between high local physiological stress and perceptual responses.
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Affiliation(s)
- Jakob D Lauver
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Austin Moran
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Justin P Guilkey
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Kelly E Johnson
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Nelo E Zanchi
- Department of Physical Education, Federal University of Maranhao (UFMA), Sao Luis, Brazil; and
| | - Timothy R Rotarius
- Department of Exercise Science and Athletic Training, Adrian College, Adrian, Michigan
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26
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Parkington T, Maden-Wilkinson T, Klonizakis M, Broom D. Comparative Perceptual, Affective, and Cardiovascular Responses between Resistance Exercise with and without Blood Flow Restriction in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16000. [PMID: 36498075 PMCID: PMC9737453 DOI: 10.3390/ijerph192316000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/20/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Older adults and patients with chronic disease presenting with muscle weakness or musculoskeletal disorders may benefit from low-load resistance exercise (LLRE) with blood flow restriction (BFR). LLRE-BFR has been shown to increase muscle size, strength, and endurance comparable to traditional resistance exercise but without the use of heavy loads. However, potential negative effects from LLRE-BFR present as a barrier to participation and limit its wider use. This study examined the perceptual, affective, and cardiovascular responses to a bout of LLRE-BFR and compared the responses to LLRE and moderate-load resistance exercise (MLRE). Twenty older adults (64.3 ± 4.2 years) performed LLRE-BFR, LLRE and MLRE consisting of 4 sets of leg press and knee extension, in a randomised crossover design. LLRE-BFR was more demanding than LLRE and MLRE through increased pain (p ≤ 0.024, d = 0.8-1.4) and reduced affect (p ≤ 0.048, d = -0.5--0.9). Despite this, LLRE-BFR was enjoyed and promoted a positive affective response (p ≤ 0.035, d = 0.5-0.9) following exercise comparable to MLRE. This study supports the use of LLRE-BFR for older adults and encourages future research to examine the safety, acceptability, and efficacy of LLRE-BFR in patients with chronic disease.
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Affiliation(s)
- Thomas Parkington
- Physical Activity, Wellness and Public Health Research Group, Department of Sport and Physical Activity, Sheffield Hallam University, Sheffield S1 1WB, UK
- Lifestyle, Exercise and Nutrition Improvement Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Thomas Maden-Wilkinson
- Physical Activity, Wellness and Public Health Research Group, Department of Sport and Physical Activity, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Markos Klonizakis
- Lifestyle, Exercise and Nutrition Improvement Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - David Broom
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
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27
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Maga M, Schönborn M, Wachsmann-Maga A, Śliwka A, Krężel J, Włodarczyk A, Olszewska M, Nowobilski R. Stimulation of the Vascular Endothelium and Angiogenesis by Blood-Flow-Restricted Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315859. [PMID: 36497934 PMCID: PMC9739167 DOI: 10.3390/ijerph192315859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/26/2022] [Accepted: 11/27/2022] [Indexed: 05/06/2023]
Abstract
Blood-flow-restricted exercise (BFRE) has been gaining constantly increasing interest in rehabilitation, but its influence on endothelial functions has not been well studied yet. Our aim is to examine the influence of low-resistance BFRE on endothelial functions and angiogenesis. This prospective cross-over study involved 35 young healthy adults. They conducted a 21-min low-resistant exercise with blood flow restricted by pressure cuffs placed on arms and tights. They also did the same training but without blood flow restriction. Endothelial parameters and angiogenesis biomarkers were evaluated before and up to 20 min after exercise. Both types of exercise increased Flow-Mediated Dilatation (FMD) but elevation after BFRE was more significant compared to the controls. The stiffness index decreased only after BFRE, while the reflection index decreased significantly after both types of exercise but was higher after BFRE. Platelet endothelial cell adhesion molecule (PECAM-1) and vascular endothelial growth factor receptor 2 (VEGFR-2) concentrations were increased by both exercise types but elevations were higher after BFRE compared to the controls. Only BFRE elevated the mean serum CD34 protein concentration. Based on these results, we can assume that low-resistance BFR exercise stimulates angiogenesis and improves endothelial functions more significantly compared to the same training performed without blood flow restriction.
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Affiliation(s)
- Mikołaj Maga
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Correspondence: ; Tel.: +48-692814418
| | - Martyna Schönborn
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agnieszka Wachsmann-Maga
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agnieszka Śliwka
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland
| | - Jakub Krężel
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Aleksandra Włodarczyk
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Marta Olszewska
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Roman Nowobilski
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland
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28
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Hori A, Saito R, Suijo K, Kushnick MR, Hasegawa D, Ishida K, Hotta N. Blood flow restriction accelerates aerobic training-induced adaptation of [Formula: see text] kinetics at the onset of moderate-intensity exercise. Sci Rep 2022; 12:18160. [PMID: 36307460 PMCID: PMC9616915 DOI: 10.1038/s41598-022-22852-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/20/2022] [Indexed: 12/31/2022] Open
Abstract
It is unclear whether blood flow restriction (BFR) accelerates the adaptation of the time constant (τ) of phase II oxygen uptake ([Formula: see text]) kinetics in the moderate-intensity exercise domain via moderate-intensity aerobic training. Therefore, healthy participants underwent moderate-intensity [45-60% [Formula: see text] Reserve] aerobic cycle training with or without BFR (BFR group, n = 9; CON group, n = 9) for 8 weeks to evaluate [Formula: see text] kinetics during moderate-intensity cycle exercise before (Pre) and after 4 (Mid) and 8 (Post) weeks of training. Both groups trained for 30 min, 3 days weekly. BFR was performed for 5 min every 10 min by applying cuffs to the upper thighs. The τ significantly decreased by Mid in the BFR group (23.7 ± 2.9 s [Pre], 15.3 ± 1.8 s [Mid], 15.5 ± 1.4 s [Post], P < 0.01) and by Post in the CON group (27.5 ± 2.0 s [Pre], 22.1 ± 0.7 s [Mid], 18.5 ± 1.9 s [Post], P < 0.01). Notably, the BFR group's τ was significantly lower than that of the CON group at Mid (P < 0.01) but not at Post. In conclusion, BFR accelerates the adaptation of the [Formula: see text] kinetics of phase II by moderate-intensity aerobic training.
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Affiliation(s)
- Amane Hori
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Ryuji Saito
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Kenichi Suijo
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Michael R. Kushnick
- College of Health and Human Sciences, Northern Illinois University, DeKalb, IL USA
| | - Daisuke Hasegawa
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Norio Hotta
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
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29
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Effectiveness of Warm-Up Exercises with Tissue Flossing in Increasing Muscle Strength. J Clin Med 2022; 11:jcm11206054. [PMID: 36294375 PMCID: PMC9604749 DOI: 10.3390/jcm11206054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Tissue flossing is an increasingly popular method in physiotherapy and sports. There is a belief that tissue flossing can improve range of motion and muscle strength, shorten muscle recovery time, and reduce the risk of injury. The aim of this study was to analyse the effectiveness of tissue flossing for immediately improving muscle strength in recreational athletes when it is performed during warm-up. All participants were randomly assigned to either an experimental group (n = 36) or a control group (n = 34) using a random number generator. The experimental group (n = 36) performed an intervention comprising exercises with muscle tissue flossing and exercises without flossing. The control group (n = 30) performed the same protocol without a floss band. Muscle strength was measured for knee flexion end extension at three speeds (60, 120, and 180 °/s) 3 times. Analysed parameters include peak torque, work, and power related to body weight, flexors−extensors ratio, and time to peak torque. There were no significant changes in the muscle strength parameters from before to after the warm-up in either group (p > 0.05). Significantly lower values of peak torque, work, and power were observed in the experimental group during the warm-up with the floss band applied to muscles (p < 0.05). No clinically significant changes in time to peak torque or flexors−extensors ratio were observed. A single application of flossing does not improve muscle strength or power and can even reduce individuals’ maximum muscle strength capabilities.
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30
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Jakobsen TL, Thorborg K, Fisker J, Kallemose T, Bandholm T. Blood flow restriction added to usual care exercise in patients with early weight bearing restrictions after cartilage or meniscus repair in the knee joint: a feasibility study. J Exp Orthop 2022; 9:101. [PMID: 36192606 PMCID: PMC9530077 DOI: 10.1186/s40634-022-00533-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Blood flow restriction - low load strength training (BFR-LLST) is theoretically superior to traditional heavy strength training when rehabilitating patients who cannot heavily load tissues following surgery. The main purpose of this study was to examine the feasibility of BFR-LLST added to usual care exercise early after cartilage or meniscus repair in the knee joint. METHODS We included 42 patients with cartilage (n = 21) or meniscus repair (n = 21) of the knee joint. They attended 9 weeks of BFR-LLST added to a usual care exercise program at an outpatient rehabilitation center. Outcome measures were assessed at different time points from four (baseline) to 26 weeks postoperatively and included adherence, harms, knee joint and thigh pain, perceived exertion, thigh circumference (muscle size proxy), isometric knee-extension strength, self-reported disability and quality of life. RESULTS On average, patients with cartilage or meniscus repair completed > 84% of the total BFR-LLST supervised sessions. Thirty-eight patients reported 146 adverse events of which none were considered serious. No decrease in thigh circumference or exacerbation of knee joint or quadriceps muscle pain of the operated leg was found in either group during the intervention period. CONCLUSIONS BFR-LLST added to usual care exercise initiated early after cartilage or meniscus repair seems feasible and may prevent disuse thigh muscle atrophy during a period of weight bearing restrictions. Harms were reported, but no serious adverse events were found. Our findings are promising but need replication using a RCT-design. TRIAL REGISTRATION NCT03371901 , preprint (open access): https://www.medrxiv.org/content/10.1101/2022.03.31.22272398v1.
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Affiliation(s)
| | - Kristian Thorborg
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Amager and Hvidovre Hospital, Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Fisker
- Centre of Rehabilitation, City of Copenhagen, Copenhagen, Denmark
| | - Thomas Kallemose
- Department of Clinical Research, Amager and Hvidovre Hospital, Hvidovre, Denmark
| | - Thomas Bandholm
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Amager and Hvidovre Hospital, Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Research, Amager and Hvidovre Hospital, Hvidovre, Denmark.,Department of Orthopedic Surgery, Amager and Hvidovre Hospital, Hvidovre, Denmark
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Winchester LJ, Blake MT, Fleming AR, Aguiar EJ, Fedewa MV, Esco MR, Earley RL. Hemodynamic Responses to Resistance Exercise with Blood Flow Restriction Using a Practical Method Versus a Traditional Cuff-Inflation System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811548. [PMID: 36141820 PMCID: PMC9517024 DOI: 10.3390/ijerph191811548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 05/22/2023]
Abstract
UNLABELLED The aim of this study was to examine the potential differences in acute hemodynamic responses and muscular performance outcomes following resistance exercise between traditional blood flow restriction (TRABFR) and a novel band tissue flossing method (BTFBFR). METHODS Fifteen healthy young adults (23.27 ± 2.69 years) visited the lab for three sessions (≥72 h apart). Each session's exercise consisted of three sets of 20 maximum-effort seated leg extensions and flexions with one of three conditions: control (CON), TRABFR (50% limb occlusion pressure (LOP)), or BTFBFR. During TRABFR and BTFBFR sessions, occlusion was applied immediately prior to exercise and removed immediately after. Heart rate was collected prior to exercise, after onset of occlusion, immediately after exercise, and one-minute after removal of occlusion. Ultrasonography was performed prior to, and at least 30 s after, occlusion. RESULTS BTFBFR caused greater reductions in arterial distance (14.28%, p = 0.010) and arterial area (28.43%, p = 0.020) than TRABFR. BTFBFR was able to significantly reduce arterial flow below pre-occlusion values, while TRABFR did not. Both conditions caused significant elevations in heart rate following occlusion (TRABFR: +4.67 bpm, p = 0.046 and BTFBFR: +6.07 bpm, p = 0.034), immediately post-exercise (TRABFR: +56.93 bpm, p < 0.001 and BTFBFR: +52.79 bpm, p < 0.001) and one-minute post-exercise (TRABFR: +15.71, p = 0.003 and BTFBFR: +14.57, p < 0.001). Only BTFBFR caused significant reductions in performance as measured by average power per repetition. CONCLUSIONS BTFBFR causes a more exaggerated decrease in arterial blood flow as well as muscular power when compared to traditional TRABFR at 50% of LOP.
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Affiliation(s)
- Lee J. Winchester
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
- Correspondence:
| | - Morgan T. Blake
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Abby R. Fleming
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Elroy J. Aguiar
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Michael V. Fedewa
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Michael R. Esco
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Ryan L. Earley
- Department of Biology, The University of Alabama, Tuscaloosa, AL 35487, USA
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Krzysztofik M, Zygadło D, Trybek P, Jarosz J, Zając A, Rolnick N, Wilk M. Resistance Training with Blood Flow Restriction and Ocular Health: A Brief Review. J Clin Med 2022; 11:jcm11164881. [PMID: 36013119 PMCID: PMC9410392 DOI: 10.3390/jcm11164881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/06/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the many health benefits of resistance training, it has been suggested that high-intensity resistance exercise is associated with acute increases in intraocular pressure which is a significant risk factor for the development of glaucomatous optic nerve damage. Therefore, resistance training using a variety of forms (e.g., resistance bands, free weights, weight machines, and bodyweight) may be harmful to patients with or at risk of glaucoma. An appropriate solution for such people may involve the combination of resistance training and blood flow restriction (BFR). During the last decade, the BFR (a.k.a. occlusion or KAATSU training) method has drawn great interest among health and sports professionals because of the possibility for individuals to improve various areas of fitness and performance at lower exercise intensities. In comparison to studies evaluating the efficiency of BFR in terms of physical performance and body composition changes, there is still a paucity of empirical studies concerning safety, especially regarding ocular health. Although the use of BFR during resistance training seems feasible for glaucoma patients or those at risk of glaucoma, some issues must be investigated and resolved. Therefore, this review provides an overview of the available scientific data describing the influence of resistance training combined with BFR on ocular physiology and points to further directions of research.
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Affiliation(s)
- Michał Krzysztofik
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
- Correspondence:
| | - Dorota Zygadło
- Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzów, Poland
| | - Paulina Trybek
- Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzów, Poland
| | - Jakub Jarosz
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Adam Zając
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, Bronx, New York, NY 10468, USA
| | - Michał Wilk
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
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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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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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Santos IF, Lemos LK, Biral TM, de Souza Cavina AP, Junior EP, Toledo Teixeira Filho CA, Vendrame JW, Vanderlei FM. Relationship between heart rate variability and performance in eccentric training with blood flow restriction. Clin Physiol Funct Imaging 2022; 42:333-347. [DOI: 10.1111/cpf.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Igor Fernandes Santos
- Graduate in PhysiotherapyUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
| | - Leonardo Kesrouani Lemos
- Postgraduate Program in PhysiotherapyUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
| | - Taíse Mendes Biral
- Postgraduate Program in Movement SciencesUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
| | | | - Eduardo Pizzo Junior
- Postgraduate Program in Movement SciencesUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
| | | | - Julia Waszczuk Vendrame
- Graduate in PhysiotherapyUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
| | - Franciele Marques Vanderlei
- Postgraduate Program in Movement SciencesUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
- Department of PhysiotherapyUniversidade Estadual Paulista (FCT/UNESP)Presidente PrudenteSPBrazil
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36
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Zhang XZ, Xie WQ, Chen L, Xu GD, Wu L, Li YS, Wu YX. Blood Flow Restriction Training for the Intervention of Sarcopenia: Current Stage and Future Perspective. Front Med (Lausanne) 2022; 9:894996. [PMID: 35770017 PMCID: PMC9234289 DOI: 10.3389/fmed.2022.894996] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Sarcopenia is a geriatric syndrome that is characterized by a progressive and generalized skeletal muscle disorder and can be associated with many comorbidities, including obesity, diabetes, and fracture. Its definitions, given by the AWGS and EWGSOP, are widely used. Sarcopenia is measured by muscle strength, muscle quantity or mass and physical performance. Currently, the importance and urgency of sarcopenia have grown. The application of blood flow restriction (BFR) training has received increased attention in managing sarcopenia. BFR is accomplished using a pneumatic cuff on the proximal aspect of the exercising limb. Two main methods of exercise, aerobic exercise and resistance exercise, have been applied with BFR in treating sarcopenia. Both methods can increase muscle mass and muscle strength to a certain extent. Intricate mechanisms are involved during BFRT. Currently, the presented mechanisms mainly include responses in the blood vessels and related hormones, such as growth factors, tissue hypoxia-related factors and recruitment of muscle fiber as well as muscle satellite cells. These mechanisms contribute to the positive balance of skeletal muscle synthesis, which in turn mitigates sarcopenia. As a more suited and more effective way of treating sarcopenia and its comorbidities, BFRT can serve as an alternative to traditional exercise for people who have marked physical limitations or even show superior outcomes under low loads. However, the possibility of causing stress or muscle damage must be considered. Cuff size, pressure, training load and other variables can affect the outcome of sarcopenia, which must also be considered. Thoroughly studying these factors can help to better determine an ideal BFRT scheme and better manage sarcopenia and its associated comorbidities. As a well-tolerated and novel form of exercise, BFRT offers more potential in treating sarcopenia and involves deeper insights into the function and regulation of skeletal muscle.
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Affiliation(s)
- Xu-zhi Zhang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Wen-qing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Lin Chen
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, China
| | - Guo-dong Xu
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, China
| | - Li Wu
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, China
| | - Yu-sheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Yu-sheng Li
| | - Yu-xiang Wu
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, China
- Yu-xiang Wu
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Lemos LK, Filho CATT, Santana dos Santos F, Biral TM, Cavina APDS, Junior EP, de Oliveira Damasceno S, Vendrame JW, Pastre CM, Vanderlei FM. Autonomic and cardiovascular responses on post-eccentric exercise recovery with blood flow restriction at different loads: randomized controlled trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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38
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Effects of Low-Load Blood Flow Restriction Training on Hemodynamic Responses and Vascular Function in Older Adults: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116750. [PMID: 35682336 PMCID: PMC9180641 DOI: 10.3390/ijerph19116750] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/21/2022]
Abstract
Background: The combination of low-load (LL) training with blood flow restriction (BFR) has recently been shown to trigger a series of hemodynamic responses and promote vascular function in various populations. To date, however, evidence is sparse as to how this training regimen influences hemodynamic response and vascular function in older adults. Objective: To systematically evaluate the effects of LL-BFR training on hemodynamic response and vascular function in older adults. Methods: A PRISMA-compliant systematic review and meta-analysis were conducted. The systematic literature research was performed in the following electronic databases from their inception to 30 February 2022: PubMed, Web of Science, Scopus, EBSCO host, the Cochrane Library and CNKI. Subsequently, a meta-analysis with inverse variance weighting was conducted. Results: A total of 1437 articles were screened, and 12 randomized controlled trials with a total 378 subjects were included in the meta-analysis. The meta-analysis results showed that LL-BFR training caused a significant acute increase in heart rate (WMD: 4.02, 95% CI: 0.93, 7.10, p < 0.05), systolic blood pressure (WMD: 5.05, 95% CI: 0.63, 9.48, p < 0.05) and diastolic blood pressure (WMD: 4.87, 95% CI: 1.37, 8.37, p < 0.01). The acute hemodynamic response induced by LL-BFR training is similar to that elicited by high-load (HL) training. Training volume, cuff pressure and width were identified as significant moderators in our subgroup and meta-regression analyses. After 30 min of training, resting systolic blood pressure significantly decreased (WMD: −6.595, 95% CI: −8.88, −3.31, p < 0.01) in the LL-BFR training group, but resting hemodynamic indexes exhibited no significant differences compared with common LL and HL training; long-term LL-BFR training resulted in significant improvements in flow-mediated vasodilation (FMD) (WMD: 1.30, 95% CI: 0.50, 2.10, p < 0.01), cardio ankle vascular index (CAVI) (WMD: 0.55, 95% CI: 0.11, 0.99, p < 0.05) and ankle brachial index (ABI) (WMD: 0.03, 95% CI: 0.00, 0.06, p < 0.05) in older adults. Conclusion: This systematic review and meta-analysis reveals that LL-BFR training will cause an acute hemodynamic response in older adults, which can return to normal levels 30 min after training, and systolic blood pressure significantly decreased. Furthermore, the beneficial effect of LL-BFR training on vascular function is to improve FMD, CAVI and ABI of older adults. However, due to the influence of the quality of the included studies and the sample size, more high-quality studies are needed to confirm such issues as BFR pressure and training risk.
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Rolnick N, de Sousa Neto IV, da Fonseca EF, Neves RVP, Rosa TDS, Nascimento DDC. Potential implications of blood flow restriction exercise on patients with chronic kidney disease: a brief review. J Exerc Rehabil 2022; 18:81-95. [PMID: 35582687 PMCID: PMC9081410 DOI: 10.12965/jer.2244082.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/04/2022] [Indexed: 11/22/2022] Open
Abstract
Combining blood flow restriction (BFR) with exercise is considered a relevant, helpful method in load-compromised individuals and a viable replacement for traditional heavy-load strength training. BFR exercise may be particularly useful for those unable to withstand high mechanical stresses on joints resulting in skeletal muscle dysfunction, such as patients with chronic kidney disease (CKD). Current literature suggests that BFR training displays similar positive health benefits to exercise training alone for CKD patients, including maintenance of muscle strength, glomerular filtration rate maintenance, uremic parameters, inflammatory profile, redox status, glucose homeostasis, blood pressure adjustments, and low adverse reports. In this review of nine studies in CKD patients, we clarify the potential safety and health effects of exercise training with BFR compared to exercise training alone and recommend insights for future research and practical use. Furthermore, we introduce relevant gaps in this emerging field, providing substantial guidance, critical discussion, and valuable preliminary conclusions in this demographic of patients. However, based on the limited studies in this area, more research is necessary to determine the optimal BFR exercise programming.
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Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY,
USA
| | - Ivo Vieira de Sousa Neto
- Laboratory of Molecular Analysis, Faculty of Ceilândia, Universidade de Brasília, Distrito Federal, Brasilia,
Brazil
- Graduate Program of Sciences and Technology of Health, Faculty of Ceilândia, Universidade de Brasília, Distrito Federal, Brasilia,
Brazil
| | - Eduardo Fernandes da Fonseca
- Post-Graduate Program of Physical Education, Catholic University of Brasilia, Distrito Federal, Brasilia,
Brazil
| | | | - Thiago dos Santos Rosa
- Post-Graduate Program of Physical Education, Catholic University of Brasilia, Distrito Federal, Brasilia,
Brazil
| | - Dahan da Cunha Nascimento
- Post-Graduate Program of Physical Education, Catholic University of Brasilia, Distrito Federal, Brasilia,
Brazil
- Corresponding author: Dahan da Cunha Nascimento, Post-Graduate Program of Physical Education, Catholic University of Brasilia, Distrito Federal, Brasilia 71966-700, Brazil,
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Stanford DM, Chatlaong MA, Miller WM, Grant Mouser J, Dankel SJ, Jessee MB. A comparison of variability between absolute and relative blood flow restriction pressures. Clin Physiol Funct Imaging 2022; 42:278-285. [PMID: 35396926 DOI: 10.1111/cpf.12757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
Recommendations are that blood flow restriction (BFR) be applied relative to arterial occlusion pressure (AOP) to provide a similar stimulus. PURPOSE Compare variability of the change in blood flow, shear rate, and discomfort between recommended relative pressures and an absolute pressure. METHODS During one visit, brachial arterial blood flow was measured in 91 participants using pulse-wave Doppler ultrasonography. After 5-min seated rest, AOP was measured. Following another 5-min rest, blood flow and discomfort were assessed twice before cuff inflation as controls (C1 and C2), then again with a cuff inflated to each BFR pressure (all measures separated by 1-min). Change scores from C1 to all subsequent measures were calculated (i.e., C2-C1; 40%AOP-C1; 80%AOP-C1; 100mmHg-C1). Variability of the changes were compared via pairwise modified Pitman-Morgan tests (α=.008). RESULTS Variance (95%CI) of the change for blood flow (mL/min), shear rate (1/sec), and discomfort (AU) had similar trends. C2-C1 differed from all conditions (all p<.001), 40%AOP-C1 differed from 80%AOP-C1 and 100mmHg-C1 (all p<.001), which did not differ (both p≥.117). Blood flow: C2-C1=469.79 (357.90, 644.07), 40%AOP-C1=1263.18 (962.34, 1731.80), 80%AOP-C1=1752.90 (1335.42, 2403.18), 100mmHg-C1=1603.18 (1221.36, 2197.92); Shear rate: C2-C1=6248.24 (4760.10, 8566.15), 40%AOP-C1=14625.30 (11142.06, 20050.95), 80%AOP-C1=22064.02 (16809.13, 30249.27), 100mmHg-C1=20778.76 (15829.98, 28487.21); Discomfort: C2-C1=0.07 (0.05, 0.08), 40%AOP-C1=2.03 (1.55, 2.78), 80%AOP-C1=4.26 (3.25, 5.84), 100mmHg-C1=4.50 (3.43, 6.17). CONCLUSION Contrary to previous suggestions, applying relative pressures does not necessarily guarantee a similar stimulus. It seems that higher pressures produce more variable changes even if the external pressure applied is made relative to each individual. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Daphney M Stanford
- Applied Human Health and Physical Function Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Mississippi, USA
| | - Matthew A Chatlaong
- Applied Human Health and Physical Function Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Mississippi, USA
| | - William M Miller
- Applied Human Health and Physical Function Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Mississippi, USA
| | - J Grant Mouser
- Applied Physiology Laboratory, Department of Kinesiology and Health Promotion, Troy University, Troy, AL, USA
| | - Scott J Dankel
- Exercise Physiology Laboratory, Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
| | - Matthew B Jessee
- Applied Human Health and Physical Function Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Mississippi, USA
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Martin PM, Bart RM, Ashley RL, Velasco T, Wise SR. An Overview of Blood Flow Restriction Physiology and Clinical Considerations. Curr Sports Med Rep 2022; 21:123-128. [PMID: 35394953 DOI: 10.1249/jsr.0000000000000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT The utilization of blood flow restriction has garnished considerable attention due to its widespread application and benefits that include strength enhancement, muscle hypertrophy, and increased level of function for specific populations. Blood flow restriction induces a hypoxic environment within a muscle group, initiating a metabolic cascade that stimulates muscle protein synthesis, altered gene regulation of muscle satellite cells, and increased muscle fiber recruitment, ultimately resulting in improved strength and endurance. When using blood flow restriction, consideration of the individual patient, occlusion pressure, cuff width, and cuff size are paramount. Blood flow restriction has been proven to be a consistently safe and effective tool for augmenting rehabilitative regimens for the upper and lower extremity.
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Affiliation(s)
- Peter Mitchell Martin
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | - Ryan M Bart
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | - Robert L Ashley
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | | | - Sean R Wise
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
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Amorim S, Gaspar AP, Degens H, Cendoroglo MS, de Mello Franco FG, Ritti-Dias RM, Cucato GG, Rolnick N, de Matos LDNJ. The Effect of a Single Bout of Resistance Exercise with Blood Flow Restriction on Arterial Stiffness in Older People with Slow Gait Speed: A Pilot Randomized Study. J Cardiovasc Dev Dis 2022; 9:jcdd9030085. [PMID: 35323633 PMCID: PMC8950238 DOI: 10.3390/jcdd9030085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose: Low-intensity resistance exercise with moderate blood-flow restriction (LIRE-BFR) is a new trending form of exercises worldwide. The purpose of this study was to compare the acute effect of a single bout of traditional resistance exercise (TRE) and LIRE-BFR on arterial stiffness in older people with slow gait speeds. Methods: This was a randomized, controlled clinical study. Seventeen older adults (3 men; 14 women; 82 ± 5 years old) completed a session of TRE (n = 7) or LIRE-BFR (n = 10). At baseline and after 60 min post-exercise, participants were subject to blood pressure measurement, heart rate measurements and a determination of arterial stiffness parameters. Results: There was no significant difference between the TRE and LIRE-BFR group at baseline. Pulse-wave velocity increased in both groups (p < 0.05) post-exercise with no between-group differences. Both exercise modalities did not produce any adverse events. The increase in systolic blood pressure, pulse pressure, augmentation pressure and pulse wave velocity (all p > 0.05) were similar after both TRE and LIRE-BFR. Conclusion: TRE and LIRE-BFR had similar responses regarding hemodynamic parameters and pulse-wave velocity in older people with slow gait speed. Long-term studies should assess the cardiovascular risk and safety of LIRE-BFR training in this population.
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Affiliation(s)
- Samuel Amorim
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (S.A.); (A.P.G.); (F.G.d.M.F.)
| | - Alexandra Passos Gaspar
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (S.A.); (A.P.G.); (F.G.d.M.F.)
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester M1 5GD, UK;
| | - Maysa Seabra Cendoroglo
- Division of Geriatrics, Paulista Medical School, The Federal University, Sao Paulo 04020-050, Brazil;
| | | | - Raphael Mendes Ritti-Dias
- Postgraduate Program in Rehabilitation Science, Universidade Nove de Julho, Sao Paulo 01525-000, Brazil;
| | | | - Nicholas Rolnick
- Department of Health Sciences, Lehman College, City University of New York (CUNY), New York, NY 10468, USA;
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43
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Anderson KD, Rask DMG, Bates TJ, Nuelle JAV. Overall Safety and Risks Associated with Blood Flow Restriction Therapy: A Literature Review. Mil Med 2022; 187:1059-1064. [PMID: 35284924 DOI: 10.1093/milmed/usac055] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Blood flow restriction therapy (BFRT) is used in scenarios ranging from muscle building in athletic performance to decreasing recovery time in postoperative orthopedic rehabilitation. The efficacy of BFRT for treating diseases has been increasingly researched; however, there has been less literature focused on establishing the safety of this therapy. MATERIALS AND METHODS An extensive literature review pertaining to BFRT and any deleterious events related to its usage was completed by searching multiple databases, including PubMed, EMBASE, and Cochrane Library using the terms "blood flow restriction therapy" or "KAATSU." RESULTS Ten case reports, five case series, two national surveys, two questionnaires, six randomized controlled studies, and one systematic review were included. A total of 1,672 individuals reported an adverse event following BFRT use out of 25,813 individuals. Commonly reported adverse events were numbness, dizziness, subcutaneous hemorrhage, and rhabdomyolysis. There were unique adverse effects of this therapy reported in individuals with comorbid conditions, such as hypertension and thoracic outlet syndrome, which included isolated cases of central retinal vein occlusion and Paget-Schroeder syndrome. CONCLUSION Blood flow restriction provides tremendous opportunity with a potential for accelerated exercise rehabilitation and injury prevention. This modality could be used in the military setting to help injured active duty personnel expeditiously return to deployable status. Further prospective randomized controlled trials are warranted to further support BFRT safety; however, from this literature review, it can be concluded that BFRT can be utilized safely in the proper patient population when administered by qualified professionals who have undergone the appropriate training.
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Affiliation(s)
- Kevin D Anderson
- Department of General Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Dawn M G Rask
- Department of Orthopaedic Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Taylor J Bates
- Department of Orthopaedic Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Julia A V Nuelle
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, Columbia, MO 65212, USA
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44
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Nascimento DDC, Rolnick N, Neto IVDS, Severin R, Beal FLR. A Useful Blood Flow Restriction Training Risk Stratification for Exercise and Rehabilitation. Front Physiol 2022; 13:808622. [PMID: 35360229 PMCID: PMC8963452 DOI: 10.3389/fphys.2022.808622] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
Blood flow restriction training (BFRT) is a modality with growing interest in the last decade and has been recognized as a critical tool in rehabilitation medicine, athletic and clinical populations. Besides its potential for positive benefits, BFRT has the capability to induce adverse responses. BFRT may evoke increased blood pressure, abnormal cardiovascular responses and impact vascular health. Furthermore, some important concerns with the use of BFRT exists for individuals with established cardiovascular disease (e.g., hypertension, diabetes mellitus, and chronic kidney disease patients). In addition, considering the potential risks of thrombosis promoted by BFRT in medically compromised populations, BFRT use warrants caution for patients that already display impaired blood coagulability, loss of antithrombotic mechanisms in the vessel wall, and stasis caused by immobility (e.g., COVID-19 patients, diabetes mellitus, hypertension, chronic kidney disease, cardiovascular disease, orthopedic post-surgery, anabolic steroid and ergogenic substance users, rheumatoid arthritis, and pregnant/postpartum women). To avoid untoward outcomes and ensure that BFRT is properly used, efficacy endpoints such as a questionnaire for risk stratification involving a review of the patient’s medical history, signs, and symptoms indicative of underlying pathology is strongly advised. Here we present a model for BFRT pre-participation screening to theoretically reduce risk by excluding people with comorbidities or medically complex histories that could unnecessarily heighten intra- and/or post-exercise occurrence of adverse events. We propose this risk stratification tool as a framework to allow clinicians to use their knowledge, skills and expertise to assess and manage any risks related to the delivery of an appropriate BFRT exercise program. The questionnaires for risk stratification are adapted to guide clinicians for the referral, assessment, and suggestion of other modalities/approaches if/when necessary. Finally, the risk stratification might serve as a guideline for clinical protocols and future randomized controlled trial studies.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Department of Physical Education, Catholic University of Brasília (UCB), Brasília, Brazil
- Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil
- *Correspondence: Dahan da Cunha Nascimento,
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States
| | - Ivo Vieira de Sousa Neto
- Laboratory of Molecular Analysis, Graduate Program of Sciences and Technology of Health, University of Brasília, Brasília, Brazil
| | - Richard Severin
- Department of Physical Therapy, College of Applied Health Sciences, The University of Illinois at Chicago, Chicago, IL, United States
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States
| | - Fabiani Lage Rodrigues Beal
- Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil
- Department of Nutrition, Health and Medicine School, Catholic University of Brasília (UCB), Brasília, Brazil
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45
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Hughes L, Hackney KJ, Patterson SD. Optimization of Exercise Countermeasures to Spaceflight Using Blood Flow Restriction. Aerosp Med Hum Perform 2022; 93:32-45. [PMID: 35063054 DOI: 10.3357/amhp.5855.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION: During spaceflight missions, astronauts work in an extreme environment with several hazards to physical health and performance. Exposure to microgravity results in remarkable deconditioning of several physiological systems, leading to impaired physical condition and human performance, posing a major risk to overall mission success and crew safety. Physical exercise is the cornerstone of strategies to mitigate physical deconditioning during spaceflight. Decades of research have enabled development of more optimal exercise strategies and equipment onboard the International Space Station. However, the effects of microgravity cannot be completely ameliorated with current exercise countermeasures. Moreover, future spaceflight missions deeper into space require a new generation of spacecraft, which will place yet more constraints on the use of exercise by limiting the amount, size, and weight of exercise equipment and the time available for exercise. Space agencies are exploring ways to optimize exercise countermeasures for spaceflight, specifically exercise strategies that are more efficient, require less equipment, and are less time-consuming. Blood flow restriction exercise is a low intensity exercise strategy that requires minimal equipment and can elicit positive training benefits across multiple physiological systems. This method of exercise training has potential as a strategy to optimize exercise countermeasures during spaceflight and reconditioning in terrestrial and partial gravity environments. The possible applications of blood flow restriction exercise during spaceflight are discussed herein.Hughes L, Hackney KJ, Patterson SD. Optimization of exercise countermeasures to spaceflight using blood flow restriction. Aerosp Med Hum Perform. 2021; 93(1):32-45.
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46
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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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47
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Suga T, Dora K, Mok E, Sugimoto T, Tomoo K, Takada S, Hashimoto T, Isaka T. Exercise adherence-related perceptual responses to low-load blood flow restriction resistance exercise in young adults: A pilot study. Physiol Rep 2021; 9:e15122. [PMID: 34877802 PMCID: PMC8652406 DOI: 10.14814/phy2.15122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/24/2021] [Accepted: 10/31/2021] [Indexed: 12/28/2022] Open
Abstract
Resistance exercise (RE) with blood flow restriction (BFR) is recognized as a beneficial strategy in increasing skeletal muscle mass and strength. However, the effects of BFR on changes in perceptual parameters, particularly those related to exercise adherence, induced by RE are not completely understood. In this study, we examined the exercise adherence-related perceptual responses to low-load BFR-RE. Sixteen young males performed both BFR and non-BFR (NBFR) sessions in a crossover design. The bilateral knee extensor low-load RE was performed with a standard BFR-RE protocol, consisting of four sets (total 75 repetitions), using 20% of one-repetition maximum. BFR-RE was performed with 200 mmHg pressure cuffs placed around the proximal region of the thighs. NBFR-RE was performed without pressure cuffs. The ratings of perceived exertion and leg discomfort measured using the Borg's Scales were higher for BFR-RE session than for NBFR-RE session (both p < 0.001 for interaction effect). The Feeling Scale-measured affect and Task Motivation Scale-measured task motivation were lower for BFR-RE session than for NBFR-RE session (both p < 0.05 for interaction effect); by contrast, the Numerical Rating Scale-measured perceived pain was higher for BFR-RE session than for NBFR-RE session (p < 0.001 for interaction effect). The Physical Activity Enjoyment Scale-measured enjoyment immediately after RE was lower with BFR than with NBFR (p < 0.001). These findings suggest that BFR exacerbates the exercise adherence-related perceptual responses to low-load RE in young males. Therefore, further studies are needed to develop effective strategies that minimize the BFR-RE-induced negative effects on perceptual responses.
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Affiliation(s)
- Tadashi Suga
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
- Research Organization of Science and TechnologyRitsumeikan UniversityKusatsuShigaJapan
| | - Kento Dora
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Ernest Mok
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Takeshi Sugimoto
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Keigo Tomoo
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Shingo Takada
- Faculty of Lifelong Sport, Department of Sports EducationHokusho UniversityEbetsuHokkaidoJapan
| | - Takeshi Hashimoto
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Tadao Isaka
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
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48
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Sardeli A, Ferreira M, Santos L, Cavaglieri C, Chacon-Mikahil M. Cardiovascular responses during and after aerobic and strength exercises with blood flow restriction in older adults. Sci Sports 2021. [DOI: 10.1016/j.scispo.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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49
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Andrade DC, Melipillan C, Toledo C, Rios-Gallardo A, Marcus NJ, Ortiz FC, Martinez G, Muñoz Venturelli P, Del Rio R. Heart rate and cardiac autonomic responses to concomitant deep breathing, hand grip exercise, and circulatory occlusion in healthy young adult men and women. Biol Res 2021; 54:32. [PMID: 34565477 PMCID: PMC8474820 DOI: 10.1186/s40659-021-00355-1] [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: 07/19/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deep breathing (DB) and handgrip (HG) exercise -with and without circulatory occlusion (OC) in muscle-, have been shown to have beneficial effects on cardiovascular function; however, the combination of these maneuvers on heart rate (HR) and cardiac sympathovagal balance have not been previously investigated. Therefore, the aim of the present study was to evaluate the effect of simultaneous DB, HG, and OC maneuvers on the sympathovagal balance in healthy women and men subjects. METHODS AND RESULTS Electrocardiogram and ventilation were measured in 20 healthy subjects (Women: n = 10; age = 27 ± 4 years; weight = 67.1 ± 8.4 kg; and height = 1.6 ± 0.1 m. Men: n = 10; age = 27 ± 3 years; weight = 77.5 ± 10.1 kg; and height = 1.7 ± 0.1 m) at baseline and during DB, DB + HG, or DB + HG + OC protocols. Heart rate (HR) and respiratory rate were continuously recorded, and spectral analysis of heart rate variability (HRV) were calculated to indirectly estimate cardiac autonomic function. Men and women showed similar HR responses to DB, DB + HG and DB + HG + OC. Men exhibited a significant HR decrease following DB + HG + OC protocol which was accompanied by an improvement in cardiac autonomic control evidenced by spectral changes in HRV towards parasympathetic predominance (HRV High frequency: 83.95 ± 1.45 vs. 81.87 ± 1.50 n.u., DB + HG + OC vs. baseline; p < 0.05). In women, there was a marked decrease in HR after completion of both DB + HG and DB + HG + OC tests which was accompanied by a significant increase in cardiac vagal tone (HRV High frequency: 85.29 ± 1.19 vs. 77.93 ± 0.92 n.u., DB + HG vs. baseline; p < 0.05). No adverse effects or discomfort were reported by men or women during experimental procedures. Independent of sex, combination of DB, HG, and OC was tolerable and resulted in decreases in resting HR and elevations in cardiac parasympathetic tone. CONCLUSIONS These data indicate that combined DB, HG and OC are effective in altering cardiac sympathovagal balance and reducing resting HR in healthy men and women.
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Affiliation(s)
- David C Andrade
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile.,Centro de Fisiología Y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Claudia Melipillan
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile.,Corporación de Rehabilitación Club de Leones Cruz del Sur, Punta Arenas, Chile
| | - Camilo Toledo
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile.,Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, Punta Arenas, Chile
| | - Angélica Rios-Gallardo
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile.,Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, Punta Arenas, Chile
| | - Noah J Marcus
- Dept. of Physiology and Pharmacology, Des Moines University, Des Moines, IA, USA
| | - Fernando C Ortiz
- Mechanism of Myelin Formation and Repair Laboratory, Instituto de Ciencias Biomédicas, Facultad de Ciencias de Salud, Universidad Autónoma de Chile, Santiago, Chile
| | - Gonzalo Martinez
- Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Muñoz Venturelli
- Centro de Estudios Clínicos, Instituto de Ciencias E Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Del Rio
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile. .,Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, Punta Arenas, Chile. .,Centro de Envejecimiento Y Regeneración (CARE), Pontificia Universidad Católica de Chile, Santiago, Chile.
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50
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Fashi M, Ahmadizad S. Short-term hypoxic resistance training improves muscular performance in untrained males. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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