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Fuchs CJ, Hermans WJH, Nyakayiru J, Weijzen MEG, Smeets JSJ, Aussieker T, Senden JM, Wodzig WKHW, Snijders T, Verdijk LB, van Loon LJC. Daily blood flow restriction does not preserve muscle mass and strength during 2 weeks of bed rest. J Physiol 2024. [PMID: 38411283 DOI: 10.1113/jp286065] [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: 11/29/2023] [Accepted: 02/08/2024] [Indexed: 02/28/2024] Open
Abstract
We measured the impact of blood flow restriction on muscle protein synthesis rates, muscle mass and strength during 2 weeks of strict bed rest. Twelve healthy, male adults (age: 24 ± 3 years, body mass index: 23.7 ± 3.1 kg/m2 ) were subjected to 14 days of strict bed rest with unilateral blood flow restriction performed three times daily in three 5 min cycles (200 mmHg). Participants consumed deuterium oxide and we collected blood and saliva samples throughout 2 weeks of bed rest. Before and immediately after bed rest, lean body mass (dual-energy X-ray absorptiometry scan) and thigh muscle volume (magnetic resonance imaging scan) were assessed in both the blood flow restricted (BFR) and control (CON) leg. Muscle biopsies were collected and unilateral muscle strength (one-repetition maximum; 1RM) was assessed for both legs before and after the bed rest period. Bed rest resulted in 1.8 ± 1.0 kg lean body mass loss (P < 0.001). Thigh muscle volume declined from 7.1 ± 1.1 to 6.7 ± 1.0 L in CON and from 7.0 ± 1.1 to 6.7 ± 1.0 L in BFR (P < 0.001), with no differences between treatments (P = 0.497). In addition, 1RM leg extension strength decreased from 60.2 ± 10.6 to 54.8 ± 10.9 kg in CON and from 59.2 ± 12.1 to 52.9 ± 12.0 kg in BFR (P = 0.014), with no differences between treatments (P = 0.594). Muscle protein synthesis rates during bed rest did not differ between the BFR and CON leg (1.11 ± 0.12 vs. 1.08 ± 0.13%/day, respectively; P = 0.302). Two weeks of bed rest substantially reduces skeletal muscle mass and strength. Blood flow restriction during bed rest does not modulate daily muscle protein synthesis rates and does not preserve muscle mass or strength. KEY POINTS: Bed rest, often necessary for recovery from illness or injury, leads to the loss of muscle mass and strength. It has been postulated that blood flow restriction may attenuate the loss of muscle mass and strength during bed rest. We investigated the effect of blood flow restriction on muscle protein synthesis rates, muscle mass and strength during 2 weeks of strict bed rest. Blood flow restriction applied during bed rest does not modulate daily muscle protein synthesis rates and does not preserve muscle mass or strength. Blood flow restriction is not effective in preventing muscle atrophy during a prolonged period of bed rest.
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Affiliation(s)
- Cas J Fuchs
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Wesley J H Hermans
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Jean Nyakayiru
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Michelle E G Weijzen
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Joey S J Smeets
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Thorben Aussieker
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Joan M Senden
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Will K H W Wodzig
- Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Tim Snijders
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Lex B Verdijk
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Luc J C van Loon
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
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Machado FA, Almeida GJ, do Vale ALM, Ribeiro ALDA, Cipriano GFB, Cipriano Junior G, Martins WR. Effects of blood flow restriction therapy in patients with knee osteoarthritis: protocol for an overview of systematic reviews. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1318951. [PMID: 38361773 PMCID: PMC10867121 DOI: 10.3389/fresc.2024.1318951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024]
Abstract
Background Osteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored. Objective To perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA. Methodology Systematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the "Assessment of Multiple Systematic Reviews" (AMSTAR-2) tool. Systematic Review Registration PROSPERO, CRD42022367209.
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Affiliation(s)
| | - Gustavo J. Almeida
- Department of Physical Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | | | | | | | - Gerson Cipriano Junior
- Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Ceilândia, Brazil
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Franz A, Ji S, Fröschen FS, Kerstin M, Wahl P, Behringer M. Effects of low-load blood flow restriction on the venous system in comparison to traditional low-load and high-load exercises. Front Physiol 2023; 14:1285462. [PMID: 38162828 PMCID: PMC10757371 DOI: 10.3389/fphys.2023.1285462] [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: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose: Blood-Flow-Restriction (BFR) training provides the ability to achieve hypertrophy effects even though only light mechanical loads are applied. However, its impact on venous pressures and function are still unknown. Therefore, the present study investigates the influence of BFR-training on intravascular venous pressure and venous function in comparison to control exercises with low or high mechanical loads. Methods: In a randomized cross-over design, ten healthy men (27.6 ± 6.4 years) underwent three trials of unilateral knee-extensor exercise with three different training protocols, low-load- (LL-RT, 30% of the individual 1-repetition-maximum, 1RM), low-load BFR- (LL-BFR-RT, 30% 1RM, 50% limb occlusion pressure, LOP) and high-load resistance exercise (HL-RT, 75% 1RM). Exercise protocols contain about four sets of knee extension exercise (Range-of-Motion: 0-0-95°), separated by 60 s of rest. Each set was performed until volitional muscle failure. For analysis of changes in intravascular venous pressures and venous function, a venous catheter was placed at the exercising leg before each trial. Whereas venous pressures were recorded throughout the exercise trials, phlebodynamometric investigations were performed before and after each trial. Furthermore, subjective pain perception during and after exercise was accessed by visual analogue scale. One-way ANOVA was used to assess mean differences between training protocols, while two-way repeated-measures ANOVA (rANOVA; time x condition) was performed to compare changes in measures over time among conditions. Data were given as means ± standard deviation (SD). Results: In comparison to the exercise trials without venous occlusion, total workload was significantly lower in the LL-BFR-RT (LL-RT: 1745 ± 604 kg vs LL-BFR-RT: 1274 ± 237 kg vs HL-RT: 1847 ± 367 kg, p = 0.004) without indicating statistical differences in venous pressures during the exercise sets (interaction: p = 0.140) or pain perception (interaction: p = 0.574). Similarly, phlebodynamometric assessment of venous function (e.g. refill-time of the venous system pre-vs. post exercise trials-LL-RT: 29.7 ± 11.0 s vs 25.5 ± 9.6 s, LL-BFR-RT: 26.6 ± 13.0 s vs 27.3 ± 13.8 s, HL-RT: 25.9 ± 10.9 s vs 23.1 ± 8.2 s) revealed no time (p = 0.156), condition effect (p = 0.802) or their interactions (p = 0.382). Conclusion: The present study is the first one describing the acute effects of LL-BFR-RT to muscle failure on venous pressures and function in comparison to a LL- and HL-RT in the lower limbs. In contrast to the existing literature, LL-BFR-RT does not elevate the venous pressures during exercise higher than a comparative exercise without BFR and does not show any adverse effects on venous function after the exercise.
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Affiliation(s)
- Alexander Franz
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany
- Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Sanghyeon Ji
- Section Exercise Physiology, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
- German Research Centre of Elite Sport (momentum), German Sport University Cologne, Cologne, Germany
| | | | - Marleen Kerstin
- Section Exercise Physiology, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Patrick Wahl
- Section Exercise Physiology, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
- German Research Centre of Elite Sport (momentum), German Sport University Cologne, Cologne, Germany
| | - Michael Behringer
- Department of Sports Sciences, Goethe University Frankfurt, Frankfurt, Germany
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Ptaszek B, Podsiadło S, Czerwińska-Ledwig O, Zając B, Niżankowski R, Mika P, Teległów A. The Influence of Interval Training Combined with Occlusion and Cooling on Selected Indicators of Blood, Muscle Metabolism and Oxidative Stress. J Clin Med 2023; 12:7636. [PMID: 38137705 PMCID: PMC10743385 DOI: 10.3390/jcm12247636] [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: 11/05/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
There is increasing evidence to support the use of interval training and/or low-impact blood flow restriction exercises in musculoskeletal rehabilitation. The aim of the study was to assess the effect of interval training combined with occlusion and cooling in terms of changes in selected blood parameters affecting the development and progression of atherosclerosis of the lower limbs, as well as selected parameters of muscle metabolism and oxidative stress affecting the growth of muscle mass and regeneration after training. MATERIAL AND METHODS The study included 30 young, healthy and untrained people. The VASPER (Vascular Performance) training system was used-High-Intensity Interval Training with the simultaneous use of occlusion and local cryotherapy. Blood from the project participants was collected six times (2 weeks before the start of training, on the day of training, after the first training, after the 10th training, after the 20th training and two weeks after the end of training). The subjects were randomly divided into three groups: exercises only (controlled), with occlusion and with occlusion and local cryotherapy. RESULTS Statistical analysis of changes in the average values of indicators in all study groups showed a significant change increase due to the time of testing IGF-1 (F = 2.37, p = 0.04), XOD (F = 14.26, p = 0.00), D-Dimer (F = 2.90, p = 0.02), and decrease in MDA (F = 7.14, p = 0.00), T-AOC (F = 11.17, p = 0.00), PT Quick (F = 26.37, p = 0.00), INR (F = 8.79, p = 0.00), TT (F = 3.81, p = 0.00). The most pronounced changes were observed in the occlusion and cooling group. CONCLUSIONS Both interval training without and with the modifications used in the study influences coagulation and oxidative stress parameters and, to a small extent, muscle metabolism. It seems reasonable to use occlusion and local cryotherapy in combination with occlusion.
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Affiliation(s)
- Bartłomiej Ptaszek
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Szymon Podsiadło
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland; (S.P.); (P.M.)
| | - Olga Czerwińska-Ledwig
- Institute of Basic Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland; (O.C.-L.); (A.T.)
| | - Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Krakow, 31-571 Krakow, Poland;
| | - Rafał Niżankowski
- Sano Science, Centre for Computational Medicine, 30-054 Krakow, Poland;
| | - Piotr Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland; (S.P.); (P.M.)
| | - Aneta Teległów
- Institute of Basic Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland; (O.C.-L.); (A.T.)
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Kong J, Li Z, Zhu L, Li L, Chen S. Comparison of blood flow restriction training and conventional resistance training for the improvement of sarcopenia in the older adults: A systematic review and meta-analysis. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:269-276. [PMID: 38314044 PMCID: PMC10831374 DOI: 10.1016/j.smhs.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/16/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Age-related sarcopenia places a tremendous burden on healthcare providers and patients' families. Blood flow restriction (BFR) training may be a promising treatment to bring sarcopenia down, and it offers numerous advantages over traditional resistance training. The purpose of this review was to compare the effects of BFR training and conventional resistance training on clinically delayed sarcopenia in the elderly. Databases such as PubMed, Web of Science, Embase, and Science Direct were searched to identify eligible studies; blinded data extraction was performed to assess study quality, and conflicts were submitted to third parties. Someone made the decision. One author used Review Manager (RevMan) 5.4 and compared it with data obtained by another author for this purpose. A total of 14 studies met the inclusion criteria for this review. The funnel plots of the studies did not show any substantial publication bias. Low-load blood flow restriction (LL-BFR) had no significant effect on muscle mass compared with high-load resistance training (HL-RT) (p = 0.74, SMD = 0.07, 95% CI: 0.33 to 0. 46) and LL-BFR had a significant effect on muscle strength compared with HL-RT (p = 0.03, Z = 2.16, SMD = -0.34, 95% CI: 0.65 to -0.03). LL-BFR showed a slight effect on mass compared to LL-RT (p = 0.26, SMD = 0.25, 95% CI: 0.19 to 0.69). Sensitivity analysis produced a nonsignificant change, suggesting that the results of this study are reasonable. In conclusion, the data suggest the possibility that BFR training improves age-related sarcopenia.
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Affiliation(s)
| | | | - Lei Zhu
- Qufu Normal University, China
| | - Lin Li
- Qufu Normal University, China
| | - Si Chen
- Qufu Normal University, China
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Hasegawa ME, Delos Reyes CD, Rimm JB, Radi JK, Singh DS, Obana KK, Weldon EJ, Thorne TJ, Tamate TM, Alferos SR, Min KS. Update on Current Concepts of Blood Flow Restriction in the Perioperative Period of Anterior Cruciate Ligament Reconstruction. Orthopedics 2023; 46:e333-e340. [PMID: 37561100 DOI: 10.3928/01477447-20230804-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Anterior cruciate ligament tears or ruptures are common orthopedic injuries. Anterior cruciate ligament reconstruction (ACLR) is an orthopedic procedure allowing for earlier return to sports, improved maintenance of lifestyle demands, and restored knee stability and kinematics. A perioperative rehabilitative adjunct recently gaining interest is blood flow restriction (BFR), a method in which temporary restriction of blood flow to a chosen extremity is introduced and can be used as early as a few days postoperative. There has been increasing investigation and recent literature regarding BFR. This review synthesizes current concepts of BFR use in the ACLR perioperative period. [Orthopedics. 2023;46(6):e333-e340.].
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Roberts MD, McCarthy JJ, Hornberger TA, Phillips SM, Mackey AL, Nader GA, Boppart MD, Kavazis AN, Reidy PT, Ogasawara R, Libardi CA, Ugrinowitsch C, Booth FW, Esser KA. Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: current understanding and future directions. Physiol Rev 2023; 103:2679-2757. [PMID: 37382939 PMCID: PMC10625844 DOI: 10.1152/physrev.00039.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
Mechanisms underlying mechanical overload-induced skeletal muscle hypertrophy have been extensively researched since the landmark report by Morpurgo (1897) of "work-induced hypertrophy" in dogs that were treadmill trained. Much of the preclinical rodent and human resistance training research to date supports that involved mechanisms include enhanced mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling, an expansion in translational capacity through ribosome biogenesis, increased satellite cell abundance and myonuclear accretion, and postexercise elevations in muscle protein synthesis rates. However, several lines of past and emerging evidence suggest that additional mechanisms that feed into or are independent of these processes are also involved. This review first provides a historical account of how mechanistic research into skeletal muscle hypertrophy has progressed. A comprehensive list of mechanisms associated with skeletal muscle hypertrophy is then outlined, and areas of disagreement involving these mechanisms are presented. Finally, future research directions involving many of the discussed mechanisms are proposed.
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Affiliation(s)
- Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Troy A Hornberger
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gustavo A Nader
- Department of Kinesiology and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Marni D Boppart
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Andreas N Kavazis
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Paul T Reidy
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, Ohio, United States
| | - Riki Ogasawara
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Cleiton A Libardi
- MUSCULAB-Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Karyn A Esser
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, Florida, United States
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Hjortshoej MH, Aagaard P, Storgaard CD, Juneja H, Lundbye‐Jensen J, Magnusson SP, Couppé C. Hormonal, immune, and oxidative stress responses to blood flow-restricted exercise. Acta Physiol (Oxf) 2023; 239:e14030. [PMID: 37732509 PMCID: PMC10909497 DOI: 10.1111/apha.14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/12/2023] [Accepted: 07/30/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Heavy-load free-flow resistance exercise (HL-FFRE) is a widely used training modality. Recently, low-load blood-flow restricted resistance exercise (LL-BFRRE) has gained attention in both athletic and clinical settings as an alternative when conventional HL-FFRE is contraindicated or not tolerated. LL-BFRRE has been shown to result in physiological adaptations in muscle and connective tissue that are comparable to those induced by HL-FFRE. The underlying mechanisms remain unclear; however, evidence suggests that LL-BFRRE involves elevated metabolic stress compared to conventional free-flow resistance exercise (FFRE). AIM The aim was to evaluate the initial (<10 min post-exercise), intermediate (10-20 min), and late (>30 min) hormonal, immune, and oxidative stress responses observed following acute sessions of LL-BFRRE compared to FFRE in healthy adults. METHODS A systematic literature search of randomized and non-randomized studies was conducted in PubMed, Embase, Cochrane Central, CINAHL, and SPORTDiscus. The Cochrane Risk of Bias (RoB2, ROBINS-1) and TESTEX were used to evaluate risk of bias and study quality. Data extractions were based on mean change within groups. RESULTS A total of 12525 hits were identified, of which 29 articles were included. LL-BFRRE demonstrated greater acute increases in growth hormone responses when compared to overall FFRE at intermediate (SMD 2.04; 95% CI 0.87, 3.22) and late (SMD 2.64; 95% CI 1.13, 4.16) post-exercise phases. LL-BFRRE also demonstrated greater increase in testosterone responses compared to late LL-FFRE. CONCLUSION These results indicate that LL-BFRRE can induce increased or similar hormone and immune responses compared to LL-FFRE and HL-FFRE along with attenuated oxidative stress responses compared to HL-FFRE.
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Affiliation(s)
- M. H. Hjortshoej
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
- Centre for Health and RehabilitationUniversity College AbsalonSlagelseDenmark
| | - P. Aagaard
- Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
| | - C. D. Storgaard
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Nutrition, Exercise and Sports, Section of Integrative PhysiologyUniversity of CopenhagenCopenhagenDenmark
| | - H. Juneja
- Centre for Health and RehabilitationUniversity College AbsalonSlagelseDenmark
| | - J. Lundbye‐Jensen
- Department of Nutrition, Exercise and Sports, Section of Integrative PhysiologyUniversity of CopenhagenCopenhagenDenmark
| | - S. P. Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
| | - C. Couppé
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
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Javorský T, Saeterbakken AH, Andersen V, Baláš J. Comparing low volume of blood flow restricted to high-intensity resistance training of the finger flexors to maintain climbing-specific strength and endurance: a crossover study. Front Sports Act Living 2023; 5:1256136. [PMID: 37841889 PMCID: PMC10570524 DOI: 10.3389/fspor.2023.1256136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction It is acknowledged that training during recovery periods after injury involves reducing both volume and intensity, often resulting in losses of sport-specific fitness. Therefore, this study aimed to compare the effects of high-intensity training (HIT) and low-intensity training with blood flow restriction (LIT + BFR) of the finger flexors in order to preserve climbing-specific strength and endurance. Methods In a crossover design, thirteen intermediate climbers completed two 5-week periods of isometric finger flexors training on a hangboard. The trainings consisted of ten LIT + BFR (30% of max) or HIT sessions (60% of max without BFR) and were undertaken in a randomized order. The training session consisted of 6 unilateral sets of 1 min intermittent hanging at a 7:3 work relief ratio for both hands. Maximal voluntary contraction (MVC), force impulse from the 4 min all out test (W), critical force (CF) and force impulse above the critical force (W') of the finger flexors were assessed before, after the first, and after the second training period, using a climbing-specific dynamometer. Forearm muscle oxidative capacity was estimated from an occlusion test using near-infrared spectroscopy at the same time points. Results Both training methods led to maintaining strength and endurance indicators, however, no interaction (P > 0.05) was found between the training methods for any strength or endurance variable. A significant increase (P = 0.002) was found for W, primarily driven by the HIT group (pretest-25078 ± 7584 N.s, post-test-27327 ± 8051 N.s, P = 0.012, Cohen's d = 0.29). There were no significant (P > 0.05) pre- post-test changes for MVC (HIT: Cohen's d = 0.13; LIT + BFR: Cohen's d = -0.10), CF (HIT: Cohen's d = 0.36; LIT + BFR = 0.05), W` (HIT: Cohen's d = -0.03, LIT + BFR = 0.12), and forearm muscle oxidative capacity (HIT: Cohen's d = -0.23; LIT + BFR: Cohen's d = -0.07). Conclusions Low volume of BFR and HIT led to similar results, maintaining climbing-specific strength and endurance in lower grade and intermediate climbers. It appears that using BFR training may be an alternative approach after finger injury as low mechanical impact occurs during training.
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Affiliation(s)
- Tomáš Javorský
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Atle Hole Saeterbakken
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Vidar Andersen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Jiří Baláš
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
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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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11
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Hinz M, Franz A, Pirker C, Traimer S, Lappen S, Doucas A, Siebenlist S. [Blood flow restriction training as a treatment option for lateral elbow tendinopathy-a study presentation]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:365-370. [PMID: 37079041 DOI: 10.1007/s00132-023-04370-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/21/2023]
Abstract
Blood flow restriction training, developed in 1966 in Japan, is a training modality that utilizes partial arterial and complete venous blood flow occlusion. Combined with low load resistance training, it aims to induce hypertrophy and strength gains. This makes it particularly suitable for people recovering from injury or surgery, for whom the use of high training loads is unfeasible. In this article, the mechanism behind blood flow restriction training and its applicability for the treatment of lateral elbow tendinopathy is explained. An ongoing prospective, randomized, controlled trial on the treatment of lateral elbow tendinopathy is presented.
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Affiliation(s)
- Maximilian Hinz
- Sektion Sportorthopädie, Technische Universität München, München, Deutschland.
| | - Alexander Franz
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Christina Pirker
- Physiotherapie, Sektion Sportorthopädie, Technische Universität München, München, Deutschland
| | - Sophie Traimer
- Physiotherapie, Sektion Sportorthopädie, Technische Universität München, München, Deutschland
| | - Sebastian Lappen
- Sektion Sportorthopädie, Technische Universität München, München, Deutschland
| | - Alexandros Doucas
- Sektion Sportorthopädie, Technische Universität München, München, Deutschland
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12
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Wang J, Rindom E, Groennebaek T, Sieljacks P, Jakobsgaard JE, Farup J, Vissing K, Pedersen TH, de Paoli FV. Six weeks of high-load resistance and low-load blood flow restricted training increase Na/K-ATPase sub-units α2 and β1 equally, but does not alter ClC-1 abundance in untrained human skeletal muscle. J Muscle Res Cell Motil 2023; 44:25-36. [PMID: 37014477 DOI: 10.1007/s10974-023-09644-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/08/2023] [Indexed: 04/05/2023]
Abstract
Contractile function of skeletal muscle relies on the ability of muscle fibers to trigger and propagate action potentials (APs). These electrical signals are created by transmembrane ion transport through ion channels and membrane transporter systems. In this regard, the Cl- ion channel 1 (ClC-1) and the Na+/K--ATPase (NKA) are central for maintaining ion homeostasis across the sarcolemma during intense contractile activity. Therefore, this randomized controlled trial aimed to investigate the changes in ClC-1 and specific NKA subunit isoform expression in response to six weeks (18 training sessions) of high-load resistance exercise (HLRE) and low-load blood flow restricted resistance exercise (BFRRE), respectively. HLRE was conducted as 4 sets of 12 repetitions of knee extensions performed at 70% of 1 repetition maximum (RM), while BFRRE was conducted as 4 sets of knee extensions at 30% of 1RM performed to volitional fatigue. Furthermore, the potential associations between protein expression and contractile performance were investigated. We show that muscle ClC-1 abundance was not affected by either exercise modality, whereas NKA subunit isoforms [Formula: see text]2 and [Formula: see text]1 increased equally by appx. 80-90% with BFRRE (p < 0.05) and 70-80% with HLRE (p < 0.05). No differential impact between exercise modalities was observed. At baseline, ClC-1 protein expression correlated inversely with dynamic knee extensor strength (r=-0.365, p = 0.04), whereas no correlation was observed between NKA subunit content and contractile performance at baseline. However, training-induced changes in NKA [Formula: see text]2 subunit (r = 0.603, p < 0.01) and [Formula: see text]1 subunit (r = 0.453, p < 0.05) correlated with exercise-induced changes in maximal voluntary contraction. These results suggest that the initial adaptation to resistance-based exercise does not involve changes in ClC-1 abundance in untrained skeletal muscle, and that increased content of NKA subunits may facilitate increases in maximal force production.
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Affiliation(s)
- Jakob Wang
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Emil Rindom
- Department of Zoophysiology, Aarhus University, Aarhus, Denmark
| | - Thomas Groennebaek
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Peter Sieljacks
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Jean Farup
- Department of Biomedicine - Physiology, Aarhus University, Ole Worms Allé, Building 1163, Aarhus C, DK-8000, Denmark
- Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - Kristian Vissing
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Thomas Holm Pedersen
- Department of Biomedicine - Physiology, Aarhus University, Ole Worms Allé, Building 1163, Aarhus C, DK-8000, Denmark
| | - Frank Vincenzo de Paoli
- Department of Biomedicine - Physiology, Aarhus University, Ole Worms Allé, Building 1163, Aarhus C, DK-8000, Denmark.
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13
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Salimi K, Alvandi M, Saberi Pirouz M, Rakhshan K, Howatson G. Regulating eEF2 and eEF2K in skeletal muscle by exercise. Arch Physiol Biochem 2023:1-12. [PMID: 36633938 DOI: 10.1080/13813455.2023.2164898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/13/2023]
Abstract
Skeletal muscle is a flexible and adaptable tissue that strongly responds to exercise training. The skeletal muscle responds to exercise by increasing muscle protein synthesis (MPS) when energy is available. One of protein synthesis's major rate-limiting and critical regulatory steps is the translation elongation pathway. The process of translation elongation in skeletal muscle is highly regulated. It requires elongation factors that are intensely affected by various physiological stimuli such as exercise and the total available energy of cells. Studies have shown that exercise involves the elongation pathway by numerous signalling pathways. Since the elongation pathway, has been far less studied than the other translation steps, its comprehensive prospect and quantitative understanding remain in the dark. This study highlights the current understanding of the effect of exercise training on the translation elongation pathway focussing on the molecular factors affecting the pathway, including Ca2+, AMPK, PKA, mTORC1/P70S6K, MAPKs, and myostatin. We further discussed the mode and volume of exercise training intervention on the translation elongation pathway.What is the topic of this review? This review summarises the impacts of exercise training on the translation elongation pathway in skeletal muscle focussing on eEF2 and eEF2K.What advances does it highlight? This review highlights mechanisms and factors that profoundly influence the translation elongation pathway and argues that exercise might modulate the response. This review also combines the experimental observations focussing on the regulation of translation elongation during and after exercise. The findings widen our horizon to the notion of mechanisms involved in muscle protein synthesis (MPS) through translation elongation response to exercise training.
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Affiliation(s)
- Kia Salimi
- Department of Exercise Physiology, Faculty of Sport and Exercise Sciences, University of Tehran, Tehran, Iran
| | - Masoomeh Alvandi
- Department of Biological Science in Sport and Health, University of Shahid Beheshti, Tehran, Iran
| | - Mahdi Saberi Pirouz
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Rakhshan
- Department of Medical Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Electrophysiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
- Water Research Group, North West University, Potchefstroom, South Africa
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14
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Identification, Purification, Characterization and Biopreservation Potential of Antimicrobial Peptide of Pediococcus acidilactici NCDC 252. Int J Pept Res Ther 2023. [DOI: 10.1007/s10989-022-10485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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15
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Jacobs E, Rolnick N, Wezenbeek E, Stroobant L, Capelleman R, Arnout N, Witvrouw E, Schuermans J. Investigating the autoregulation of applied blood flow restriction training pressures in healthy, physically active adults: an intervention study evaluating acute training responses and safety. Br J Sports Med 2023:bjsports-2022-106069. [PMID: 36604156 DOI: 10.1136/bjsports-2022-106069] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the effects of autoregulated (AUTO) and non-autoregulated (NAUTO) blood flow restriction (BFR) application on adverse effects, performance, cardiovascular and perceptual responses during resistance exercise. METHODS Fifty-six healthy participants underwent AUTO and NAUTO BFR resistance exercise in a randomised crossover design using a training session with fixed amount of repetitions and a training session until volitional failure. Cardiovascular parameters, rate of perceived effort (RPE), rate of perceived discomfort (RPD) and number of repetitions were investigated after training, while the presence of delayed onset muscle soreness (DOMS) was verified 24 hours post-session. Adverse events during or following training were also monitored. RESULTS AUTO outperformed NAUTO in the failure protocol (p<0.001), while AUTO scored significantly lower for DOMS 24 hours after exercise (p<0.001). Perceptions of effort and discomfort were significantly higher in NAUTO compared with AUTO in both fixed (RPE: p=0.014, RPD: p<0.001) and failure protocol (RPE: p=0.028, RPD: p<0.001). Sixteen adverse events (7.14%) were recorded, with a sevenfold incidence in the fixed protocol for NAUTO compared with AUTO (NAUTO: n=7 vs AUTO: n=1) and five (NAUTO) vs three (AUTO) adverse events in the failure protocol. No significant differences in cardiovascular parameters were found comparing both pressure applications. CONCLUSION Autoregulation appears to enhance safety and performance in both fixed and failure BFR-training protocols. AUTO BFR training did not seem to affect cardiovascular stress differently, but was associated with lower DOMS, perceived effort and discomfort compared with NAUTO. TRIAL REGISTRATION NUMBER NCT04996680.
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Affiliation(s)
- Ewoud Jacobs
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York City, New York, USA
| | - Evi Wezenbeek
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Lenka Stroobant
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Robbe Capelleman
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Nele Arnout
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
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16
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Ferlito JV, Rolnick N, Ferlito MV, De Marchi T, Deminice R, Salvador M. Acute effect of low-load resistance exercise with blood flow restriction on oxidative stress biomarkers: A systematic review and meta-analysis. PLoS One 2023; 18:e0283237. [PMID: 37083560 PMCID: PMC10121002 DOI: 10.1371/journal.pone.0283237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The purpose of this review was to analyze the acute effects of low-load resistance exercise with blood flow restriction (LLE-BFR) on oxidative stress markers in healthy individuals in comparison with LLE or high-load resistance exercise (HLRE) without BFR. MATERIALS AND METHODS A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. These searches were performed in CENTRAL, SPORTDiscus, EMBASE, PubMed, CINAHL and Virtual Health Library- VHL, which includes Lilacs, Medline and SciELO. The risk of bias and quality of evidence were assessed through the PEDro scale and GRADE system, respectively. RESULTS Thirteen randomized clinical trials were included in this review (total n = 158 subjects). Results showed lower post-exercise damage to lipids (SMD = -0.95 CI 95%: -1.49 to -0. 40, I2 = 0%, p = 0.0007), proteins (SMD = -1.39 CI 95%: -2.11 to -0.68, I2 = 51%, p = 0.0001) and redox imbalance (SMD = -0.96 CI 95%: -1.65 to -0.28, I2 = 0%, p = 0.006) in favor of LLRE-BFR compared to HLRE. HLRE presents higher post-exercise superoxide dismutase activity but in the other biomarkers and time points, no significant differences between conditions were observed. For LLRE-BFR and LLRE, we found no difference between the comparisons performed at any time point. CONCLUSIONS Based on the available evidence from randomized trials, providing very low or low certainty of evidence, this review demonstrates that LLRE-BFR promotes less oxidative stress when compared to HLRE but no difference in levels of oxidative damage biomarkers and endogenous antioxidants between LLRE. TRIAL REGISTRATION Register number: PROSPERO number: CRD42020183204.
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Affiliation(s)
- João Vitor Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States of America
| | - Marcos Vinicius Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
| | - Thiago De Marchi
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Rafael Deminice
- Department of Physical Education, State University of Londrina, Londrina, Brazil
| | - Mirian Salvador
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
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17
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Yuan J, Wu L, Xue Z, Xu G, Wu Y. Application and progress of blood flow restriction training in improving muscle mass and strength in the elderly. Front Physiol 2023; 14:1155314. [PMID: 37035674 PMCID: PMC10079911 DOI: 10.3389/fphys.2023.1155314] [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: 01/31/2023] [Accepted: 03/17/2023] [Indexed: 04/11/2023] Open
Abstract
As an emerging training method, blood flow restriction training has been proved to promote the growth of muscle mass and strength. In recent years, it has been gradually applied in different populations. However, there are few studies on how blood flow restriction training affects muscle mass and strength in the elderly. The relevant literature is compiled and summarized in this study. Through the comparison of blood flow restriction training with traditional training methods and its application in the elderly, it shows that blood flow restriction training can effectively increase muscle mass and strength, prevent muscle atrophy, improve cardiopulmonary function, facilitate injury and postoperative rehabilitation, and intervene in related degenerative diseases as a training method suitable for the elderly,. The main mechanism of blood flow restriction training promoting muscle mass and strength growth is metabolic stress response, including muscle fiber recruitment, protein synthesis signal pathway activation, hormone secretion, etc., and is also related to cell swelling caused by pressure. At present, although the application of blood flow restriction training in the elderly population is increasing, there is a lack of personalized programs. In the future, more research on the dose effect and safety of blood flow restriction training is needed to develop more accurate personalized training programs.
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Affiliation(s)
| | | | | | - Guodong Xu
- *Correspondence: Guodong Xu, ; Yuxiang Wu,
| | - Yuxiang Wu
- *Correspondence: Guodong Xu, ; Yuxiang Wu,
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18
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Park HS, Song JS, Kim EK. Effects of low-intensity resistance exercise with blood flow restriction after high tibial osteotomy in middle-aged women. Medicine (Baltimore) 2022; 101:e32294. [PMID: 36595769 PMCID: PMC9794348 DOI: 10.1097/md.0000000000032294] [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] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND High tibial osteotomy (HTO) is an effective surgical method for treating medial compartment osteoarthritis. However, in most cases after surgery, muscle strength is decreased, and rapid muscle atrophy is observed. Therefore, the purpose of this study is to verify the effects of low-intensity resistance exercise (LIE) with blood flow restriction (BFR) on the cross-sectional area (CSA) of thigh muscles, knee extensor strength, pain, and knee joint function and investigate proper arterial occlusion pressure (AOP) in middle-aged women who underwent HTO. METHOD This study was designed as a prospective randomized controlled trial. Forty-two middle-aged women who underwent HTO were randomly divided into three groups and participated in LIE with (40% or 80% AOP applied) or without BFR. The main outcome was the measurement of the CSA of thigh muscles (at 30% and 50% distal length of the femur) before and 12 weeks after treatment. Additionally, knee extension muscle strength, pain, and joint function were evaluated before and 6 and 12 weeks after treatment. RESULTS CSA of thigh muscles at 30% and 50% distal length of the femur decreased in the AOP 40% and control groups and was the largest in the AOP 80% group 12 weeks after treatment. Knee extension strength increased in all groups and was the highest in the AOP 80% group 6 and 12 weeks after treatment. Pain improved in all groups, with no intergroup differences. Knee joint function improved in all groups and was superior in the 80% AOP group 12 weeks after treatment. CONCLUSION LIE with BFR at 80% AOP was effective in preventing atrophy of the thigh muscle, increasing muscle strength, and improving function. BFR at 40% AOP had no difference in the results when compared with the group in which BFR was not applied. Therefore, LIE with an AOP of 80% is recommended for patients undergoing HTO.
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Affiliation(s)
- Han-Soo Park
- Korean National Sports University, Songpa-gu, Seoul, Republic of Korea
| | - Jun-Seob Song
- Gangnam JS Hospital, Gangnam-gu, Seoul, Republic of Korea
| | - Eun-Kuk Kim
- SRC Hospital, Chowol-eup, Gwangju-si, Gyeonggi-do, Republic of Korea
- * Correspondence: Eun-Kuk Kim, SRC Hospital, 25, Gyeongsu-gil, Chowol-eup, Gwangju-si, Gyeonggi-do, Republic of Korea (e-mail: )
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19
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Vilaça-Alves J, Magalhães PS, Rosa CV, Reis VM, Garrido ND, Payan-Carreira R, Neto GR, Costa PB. Acute Hormonal Responses to Multi-Joint Resistance Exercises with Blood Flow Restriction. J Funct Morphol Kinesiol 2022; 8:jfmk8010003. [PMID: 36648895 PMCID: PMC9844496 DOI: 10.3390/jfmk8010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to investigate the acute effects of multi-joint resistance exercises (MJRE) with blood flow restriction on hormonal responses. Ten men participated in the study and underwent two experimental protocols in random order: four sets (30, 15, 15, and 15 reps, respectively) of MJRE (half squat and horizontal chest press) were performed with 20% of 1RM and a rest time between sets of 30 s, combined with intermittent blood flow restriction (LI + BFR protocol); and four sets (8, 8, 8, 20 reps, respectively) of the same MJRE performed with 75% of 1RM load (HI protocol), with a 90 s rest between the first three sets and 30 s between the third to the fourth set. Blood samples were collected before (PRE), immediately after (POST), and 15 min after the performance of MJRE (POST15). A time effect was observed for growth hormone (GH) and insulin-like-growth-factor-1-binding-protein-3 (IGFPB-3), but no protocol effects or interactions between protocol and times were observed (p > 0.05). There was no effect of either protocol or time (p > 0.05) on total testosterone, free testosterone, or cortisol concentrations. However, significant (p < 0.05) increases were observed in the GH serum concentrations of 2072.73% and 2278.5%, HI, and LI + BFR protocols, respectively, from the PRE to POST15 test. In addition, there was an increase of 15.30% and 13.29% in the IGFPB-3 concentrations (p < 0.05) from PRE to POST0 times for HI and LI + BFR protocols, respectively. Furthermore, there was a decrease of −6.17% and −11.54%, p = 0.00, between the times POST0 to POST15 in the IGFPB-3 for the HI and LI + BFR protocols, respectively. It is concluded that multi-joint resistance exercises combined with intermittent blood flow restriction seemed to promote acute hormonal responses in a manner similar to traditional exercise with high loads. Future studies may investigate whether chronic use of LI + BFR with MJRE may promote muscle hypertrophy.
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Affiliation(s)
- José Vilaça-Alves
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
- Research Group in Strength Training and Fitness Activities (GEETFAA), 5000-801 Vila Real, Portugal
| | - Patrício S. Magalhães
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Claudio V. Rosa
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Group in Strength Training and Fitness Activities (GEETFAA), 5000-801 Vila Real, Portugal
| | - Victor M. Reis
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
- Research Group in Strength Training and Fitness Activities (GEETFAA), 5000-801 Vila Real, Portugal
| | - Nuno D. Garrido
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
| | - Rita Payan-Carreira
- Department of Veterinary Medicine, University of Évora, 7004-516 Évora, Portugal
| | - Gabriel R. Neto
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa 58051-900, Paraíba, Brazil
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa 58067-698, Paraíba, Brazil
- Coordination of Physical Education, Center for Higher Education and Development (CESED-UNIFACISA/FCM/ESAC), Campina Grande 58408-326, Paraíba, Brazil
| | - Pablo B. Costa
- Exercise Physiology Laboratory, Department of Kinesiology, California State University, Fullerton, CA 92831, USA
- Correspondence:
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The Impacts of Combined Blood Flow Restriction Training and Betaine Supplementation on One-Leg Press Muscular Endurance, Exercise-Associated Lactate Concentrations, Serum Metabolic Biomarkers, and Hypoxia-Inducible Factor-1α Gene Expression. Nutrients 2022; 14:nu14235040. [PMID: 36501070 PMCID: PMC9739923 DOI: 10.3390/nu14235040] [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: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The purpose of this investigation was to compare the impacts of a potential blood flow restriction (BFR)-betaine synergy on one-leg press performance, lactate concentrations, and exercise-associated biomarkers. Eighteen recreationally trained males (25 ± 5 y) were randomized to supplement 6 g/day of either betaine anhydrous (BET) or cellulose placebo (PLA) for 14 days. Subsequently, subjects performed four standardized sets of one-leg press and two additional sets to muscular failure on both legs (BFR [LL-BFR; 20% 1RM at 80% arterial occlusion pressure] and high-load [HL; 70% 1RM]). Toe-tip lactate concentrations were sampled before (PRE), as well as immediately (POST0), 30 min (POST30M), and 3 h (POST3H) post-exercise. Serum homocysteine (HCY), growth hormone (GH) and insulin-like growth factor-1 concentrations were additionally assessed at PRE and POST30M. Analysis failed to detect any significant between-supplement differences for total repetitions completed. Baseline lactate changes (∆) were significantly elevated from POST0 to POST30 and from POST30 to POST3H (p < 0.05), whereby HL additionally demonstrated significantly higher ∆Lactate versus LL-BFR (p < 0.001) at POST3H. Although serum ∆GH was not significantly impacted by supplement or condition, serum ∆IGF-1 was significantly (p = 0.042) higher in BET versus PLA and serum ∆HCY was greater in HL relative to LL-BFR (p = 0.044). Although these data fail to support a BFR-betaine synergy, they otherwise support betaine’s anabolic potential.
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Ke J, Zhou X, Yang Y, Shen H, Luo X, Liu H, Gao L, He X, Zhang X. Blood flow restriction training promotes functional recovery of knee joint in patients after arthroscopic partial meniscectomy: A randomized clinical trial. Front Physiol 2022; 13:1015853. [PMID: 36311243 PMCID: PMC9611541 DOI: 10.3389/fphys.2022.1015853] [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: 08/10/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: To explore the effect of blood flow restriction training (BFRT) on the recovery of knee function in patients after arthroscopic partial meniscectomy (APM). Methods: Forty patients undergoing APM surgery were included in this parallel group, two-arm, single-assessor blinded, randomized clinical trial. The subjects were randomly divided into two groups: routine rehabilitation group (RR Group, n = 20) and routine rehabilitation + blood flow restriction training group (RR + BFRT Group, n = 20). One subject in each group dropped out during the experiment. All patients received 8 weeks of routine rehabilitation starting from the second day after APM. In addition, patients in the RR + BFRT group required additional BFRT twice a week. Visual analogue scale (VAS) score, range of motion (ROM), one-leg standing test (OLST) score, Lysholm knee score, quadriceps muscle strength, quadriceps thickness, and thigh circumference were evaluated at preoperative, postoperative, 4 and 8 weeks after surgery. SPSS 25.0 software was used for statistical analysis of the data. Repeated measures ANOVA was used if the data were normally distributed and had homogeneity of variance. Generalized estimating equations were chosen if the data were not normally distributed or had homogeneity of variance. Results: There were no significant differences in VAS score, ROM, OLST score, Lysholm knee score, quadriceps muscle strength, quadriceps thickness, and thigh circumference between the two groups before surgery (p > 0.05). Compared with postoperative, VAS score, ROM, OLST score, Lysholm knee score, and thigh circumference were significantly improved in the RR group (p < 0.05), while quadriceps muscle strength and quadriceps thickness were not significantly enhanced at 8 weeks postoperatively (p > 0.05). However, VAS score, ROM, OLST score, Lysholm knee score, quadriceps muscle strength, quadriceps thickness, and thigh circumference were all significantly improved in the RR + BFRT group at 8 weeks postoperatively (p < 0.05). Furthermore, compared with the RR group, VAS score (50% vs. 86%), ROM (7.9% vs. 16.0%), OLST score (57.3% vs. 130.1%), Lysholm knee score (38.4% vs. 55.7%), relative peak torque (11.0% vs. 84.7%), mean power (20.6% vs. 88.1%), rectus femoris thickness (0.40% vs. 13.0%), vastus medialis (0.29% vs. 5.32%), vastus lateralis (0% vs. 6.2%), vastus internus (0% vs. 5.8%), and thigh circumference (2.7% vs. 5.8%) in the RR + BFRT group were significantly improved at 4 and 8 weeks postoperatively (p < 0.05). Conclusion: BFRT combined with routine rehabilitation training can better promote the recovery of knee joint function in patients after APM, especially the improvement of quadriceps muscle strength and thickness.
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Affiliation(s)
- Junjie Ke
- Sichuan Provincial Orthopedic Hospital, Chengdu, China
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Xuchang Zhou
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Yajing Yang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Hai Shen
- Sichuan Provincial Orthopedic Hospital, Chengdu, China
| | - Xiaobing Luo
- Sichuan Provincial Orthopedic Hospital, Chengdu, China
| | - Hui Liu
- Sichuan Provincial Orthopedic Hospital, Chengdu, China
| | - Lu Gao
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Xin He
- Sichuan Provincial Orthopedic Hospital, Chengdu, China
| | - Xin Zhang
- Sichuan Provincial Orthopedic Hospital, Chengdu, China
- *Correspondence: Xin Zhang,
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Blood-Flow-Restriction-Training-Induced Hormonal Response is not Associated with Gains in Muscle Size and Strength. J Hum Kinet 2022; 83:235-243. [PMID: 36157947 PMCID: PMC9465748 DOI: 10.2478/hukin-2022-0095] [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] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to determine whether increases in post-exercise endocrine response to low-load resistance exercise with blood flow restriction and high-load resistance exercise would have association with increases in muscle size and strength after an 8-week training period. Twenty-nine untrained men were randomly allocated into three groups: low-load resistance exercise with (LL-BFR) or without blood flow restriction (LL), and high-load resistance exercise (HL). Participants from LL-BFR and LL groups performed leg extension exercise at 20% of one repetition maximum (1RM), four sets of 15 repetitions and the HL group performed four sets of eight repetitions at 80% 1RM. Before the first training session, growth hormone (GH), insulin-like growth factor 1 (IGF-1), testosterone, cortisol, and lactate concentration were measured at rest and 15 min after the exercise. Quadriceps CSA and 1RM knee extension were assessed at baseline and after an 8-week training period. GH increased 15 min after exercise in the LL-BFR (p = 0.032) and HL (p < 0.001) groups, with GH concentration in the HL group being higher than in the LL group (p = 0.010). There was a time effect for a decrease in testosterone (p = 0.042) and an increase in cortisol (p = 0.005), while IGF-1 remained unchanged (p = 0.346). Both muscle size and strength were increased after training in LL-BFR and HL groups, however, these changes were not associated with the acute post-exercise hormone levels (p > 0.05). Our data suggest that other mechanisms than the acute post-exercise increase in systemic hormones induced by LL-BFR and HL produce changes in muscle size and strength.
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Jack RA, Lambert BS, Hedt CA, Delgado D, Goble H, McCulloch PC. Blood Flow Restriction Therapy Preserves Lower Extremity Bone and Muscle Mass After ACL Reconstruction. Sports Health 2022; 15:361-371. [PMID: 35762124 PMCID: PMC10170230 DOI: 10.1177/19417381221101006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Muscle atrophy is common after an injury to the knee and anterior cruciate ligament reconstruction (ACLR). Blood flow restriction therapy (BFR) combined with low-load resistance exercise may help mitigate muscle loss and improve the overall condition of the lower extremity (LE). PURPOSE To determine whether BFR decreases the loss of LE lean mass (LM), bone mass, and bone mineral density (BMD) while improving function compared with standard rehabilitation after ACLR. STUDY DESIGN Randomized controlled clinical trial. METHODS A total of 32 patients undergoing ACLR with bone-patellar tendon-bone autograft were randomized into 2 groups (CONTROL: N = 15 [male = 7, female = 8; age = 24.1 ± 7.2 years; body mass index [BMI] = 26.9 ± 5.3 kg/m2] and BFR: N = 17 [male = 12, female = 5; age = 28.1 ± 7.4 years; BMI = 25.2 ± 2.8 kg/m2]) and performed 12 weeks of postsurgery rehabilitation with an average follow-up of 2.3 ± 1.0 years. Both groups performed the same rehabilitation protocol. During select exercises, the BFR group exercised under 80% arterial occlusion of the postoperative limb (Delfi tourniquet system). BMD, bone mass, and LM were measured using DEXA (iDXA, GE) at presurgery, week 6, and week 12 of rehabilitation. Functional measures were recorded at week 8 and week 12. Return to sport (RTS) was defined as the timepoint at which ACLR-specific objective functional testing was passed at physical therapy. A group-by-time analysis of covariance followed by a Tukey's post hoc test were used to detect within- and between-group changes. Type I error; α = 0.05. RESULTS Compared with presurgery, only the CONTROL group experienced decreases in LE-LM at week 6 (-0.61 ± 0.19 kg, -6.64 ± 1.86%; P < 0.01) and week 12 (-0.39 ± 0.15 kg, -4.67 ± 1.58%; P = 0.01) of rehabilitation. LE bone mass was decreased only in the CONTROL group at week 6 (-12.87 ± 3.02 g, -2.11 ± 0.47%; P < 0.01) and week 12 (-16.95 ± 4.32 g,-2.58 ± 0.64%; P < 0.01). Overall, loss of site-specific BMD was greater in the CONTROL group (P < 0.05). Only the CONTROL group experienced reductions in proximal tibia (-8.00 ± 1.10%; P < 0.01) and proximal fibula (-15.0±2.50%,P < 0.01) at week 12 compared with presurgery measures. There were no complications. Functional measures were similar between groups. RTS time was reduced in the BFR group (6.4 ± 0.3 months) compared with the CONTROL group (8.3 ± 0.5 months; P = 0.01). CONCLUSION After ACLR, BFR may decrease muscle and bone loss for up to 12 weeks postoperatively and may improve time to RTS with functional outcomes comparable with those of standard rehabilitation.
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Affiliation(s)
- Robert A Jack
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas
| | - Bradley S Lambert
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas
| | - Corbin A Hedt
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas
| | - Domenica Delgado
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas
| | - Haley Goble
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas
| | - Patrick C McCulloch
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas
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Lim ZX, Goh J. Effects of blood flow restriction (BFR) with resistance exercise on musculoskeletal health in older adults: a narrative review. Eur Rev Aging Phys Act 2022; 19:15. [PMID: 35725379 PMCID: PMC9208167 DOI: 10.1186/s11556-022-00294-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background Aging leads to a number of structural and physiological deficits such as loss of muscle mass and strength. Strength training at ~ 70% of 1 repetition max (RM) is recommended to prevent age-related loss of muscle mass and strength. However, most older adults may not be able to perform 70% of 1RM or higher intensity. An alternative exercise training program combining low intensity resistance exercise with blood flow restriction (BFR) can result in similar acute and chronic benefits to skeletal muscles in older adults. Main body and short conclusion The potential mechanisms involved are discussed, and include reactive hyperaemia, metabolic stress, and hypoxia. Key issues and safety with the use of BFR in older adults, especially those with chronic conditions are also discussed. Although there has been no reported evidence to suggest that BFR elevates the risk of clinical complications any more than high intensity exercise, it is recommended for individuals to be medically cleared of any cardiovascular risks, prior to engaging in BFR exercise.
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Affiliation(s)
- Zi Xiang Lim
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore.,Centre for Healthy Longevity, National University Health System (NUHS), Singapore, 117456, Singapore
| | - Jorming Goh
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore. .,Centre for Healthy Longevity, National University Health System (NUHS), Singapore, 117456, Singapore. .,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore.
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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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Callanan MC, Plummer HA, Green TM, Opitz T, Broderick T, Rendos N, Anz AW. Blood Flow Restriction Using a Pneumatic Tourniquet Is Not Associated With a Cellular Systemic Response. Arthrosc Sports Med Rehabil 2022; 4:e877-e882. [PMID: 35747643 PMCID: PMC9210389 DOI: 10.1016/j.asmr.2021.12.018] [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: 05/08/2021] [Accepted: 12/23/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose The purpose of this study was to determine the effects of blood flow restriction (BFR) using a pneumatic tourniquet on CD34+ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose compared with standard exercise. Methods Fifteen healthy volunteers (8 males and 7 females, 28.6 ± 3.6 years old) who were able to perform the exercise sessions on a VersaClimber participated. Participants were randomized to undergo an experimental (EXP) occluded testing session using the pneumatic tourniquets on all 4 extremities and a control (CON) session. The exercise protocol concluded after 9 minutes or when participants reached a rating of perceived exertion of 20. Blood draws were performed before testing and immediately after the exercise session. Blood analysis consisted of complete blood counts as well as flow cytometry to measure peripheral CD34+ counts as a marker for hematopoietic progenitor cells (HPCs). Results A significant increase from before to after exercise values was observed in both the EXP and CON groups with CD34+, WBC counts, platelets, and lymphocytes; however, no differences existed between EXP and CON groups for any variable. CD34+ increased in the EXP (3.1 ± 1.6 vs. 4.3 ± 1.8 cells · L–1; P < .001) and CON (3.3 ± 1.9 vs. 4.4 ± 1.4 cells · L–1; P < .001) sessions. White blood cells also significantly increased in both the EXP (7.8 ± 1.4 vs. 11.8 ± 2.5 K · L–1 K · L–1; P < .001) and CON (7.5 ± 1.8 vs. 11.3 ± 3.0 K · L–1; P < .001) sessions. Platelets also increased in both the EXP (258.6 ± 52.5 vs. 309.9 ± 52.7 K · L–1; P < .001) and CON (263.1 ± 44.7 vs. 316.1 ± 43.9 K · L–1; P < .001) sessions, and conversely, a significant decrease in the average neutrophil counts in the EXP (mean difference = –13.7%; P < .001) and CON (mean difference = –13.2%; P < .001) sessions was observed. Lymphocyte counts in the EXP (mean difference = 22.8%; P < .001) and CON (mean difference = 19.3%; P < .001) sessions increased significantly. Conclusions There were no significant differences in systemic cellular responses when undergoing aerobic-based exercise with and without a pneumatic tourniquet system. Level of Evidence 2, prospective comparative study.
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Werasirirat P, Yimlamai T. Effect of supervised rehabilitation combined with blood flow restriction training in athletes with chronic ankle instability: a randomized placebo-controlled trial. J Exerc Rehabil 2022; 18:123-132. [PMID: 35582686 PMCID: PMC9081407 DOI: 10.12965/jer.2244018.009] [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: 01/12/2022] [Accepted: 02/05/2022] [Indexed: 11/24/2022] Open
Abstract
Blood flow restriction (BFR) resistance exercise has been advocated as an alternative approach for improving muscle strength in patients undergoing musculoskeletal rehabilitation. The present study aimed to evaluate the effectiveness of a 4-week supervised rehabilitation (R) with and without BFR on muscle strength, cross-sectional area (CSA), dynamic balance, and functional performance in athletes with chronic ankle instability (CAI). A total of 16 collegiate athletes with CAI participated in this study. They were randomly assigned to the BFR+R group (n=8) or the R group (n=8). Both groups underwent supervised rehabilitation 3 times weekly for 4 consecutive weeks. Additionally, the BFR+R group was applied with a cuff around the proximal thigh at 80% arterial occlusion pressure in addition to the traditional rehabilitation program, whereas the R group received the sham BFR only. Before and after 4 weeks of intervention, isokinetic muscle strength, CSA, Y-balance test, and side hop test (SHT) were measured. Following a 4-week intervention, the BFR+R group exhibited significant improvements in muscle strength of ankle plantarflexor and evertor, CSA of fibularis longus, and SHT timed performance compared with prior training and the R group (all, P<0.05). However, no significant difference was observed on dynamic balance among the groups. The present finding indicated that a 4-week supervised rehabilitation combined with BFR is more effective in improving muscle strength and size and functional performance compared with the traditional rehabilitation alone. This information could have implications for physical therapists and clinician in developing and designing a rehabilitation program for athletes with CAI.
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Affiliation(s)
| | - Tossaporn Yimlamai
- Corresponding author: Tossaporn Yimlamai, Department of Sports Science, Faculty of Sports Science, Chulalongkorn University, Rama I Road, Pathumwan District, Bangkok 10330, Thailand,
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Selected Methods of Resistance Training for Prevention and Treatment of Sarcopenia. Cells 2022; 11:cells11091389. [PMID: 35563694 PMCID: PMC9102413 DOI: 10.3390/cells11091389] [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: 02/17/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022] Open
Abstract
Resistance training is an extremely beneficial intervention to prevent and treat sarcopenia. In general, traditional high-load resistance training improves skeletal muscle morphology and strength, but this method is impractical and may even reduce arterial compliance by about 20% in aged adults. Thus, the progression of resistance training methods for improving the strength and morphology of muscles without applying a high load is essential. Over the past two decades, various resistance training methods that can improve skeletal muscle mass and muscle function without using high loads have attracted attention, and their training effects, molecular mechanisms, and safety have been reported. The present study focuses on the relationship between exercise load/intensity, training effects, and physiological mechanisms as well as the safety of various types of resistance training that have attracted attention as a measure against sarcopenia. At present, there is much research evidence that blood-flow-restricted low-load resistance training (20–30% of one repetition maximum (1RM)) has been reported as a sarcopenia countermeasure in older adults. Therefore, this training method may be particularly effective in preventing sarcopenia.
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Short-term effects of isometric exercise with local and systemic hypoxia and normoxia on fatigue and muscle function in trained men. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00917-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Das A, Paton B. Is There a Minimum Effective Dose for Vascular Occlusion During Blood Flow Restriction Training? Front Physiol 2022; 13:838115. [PMID: 35464074 PMCID: PMC9024204 DOI: 10.3389/fphys.2022.838115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background Blood flow restriction (BFR) training at lower exercise intensities has a range of applications, allowing subjects to achieve strength and hypertrophy gains matching those training at high intensity. However, there is no clear consensus on the percentage of limb occlusion pressure [%LOP, expressed as a % of the pressure required to occlude systolic blood pressure (SBP)] and percentage of one repetition max weight (%1RM) required to achieve these results. This review aims to explore what the optimal and minimal combination of LOP and 1RM is for significant results using BFR. Method A literature search using PubMed, Scopus, Wiley Online, Springer Link, and relevant citations from review papers was performed, and articles assessed for suitability. Original studies using BFR with a resistance training exercise intervention, who chose a set %LOP and %1RM and compared to a non-BFR control were included in this review. Result Twenty-one studies met the inclusion criteria. %LOP ranged from 40 to 150%. %1RM used ranged from 15 to 80%. Training at 1RM ≤20%, or ≥ 80% did not produce significant strength results compared to controls. Applying %LOP of ≤50% and ≥ 80% did not produce significant strength improvement compared to controls. This may be due to a mechanism mediated by lactate accumulation, which is facilitated by increased training volume and a moderate exercise intensity. Conclusion Training at a minimum of 30 %1RM with BFR is required for strength gains matching non-BFR high intensity training. Moderate intensity training (40-60%1RM) with BFR may produce results exceeding non-BFR high intensity however the literature is sparse. A %LOP of 50-80% is optimal for BFR training.
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Affiliation(s)
- Arpan Das
- Institute of Sports, Exercise and Health, Department of Medical Sciences, University College of London, London, United Kingdom
| | - Bruce Paton
- Institute of Sports, Exercise and Health, Department of Medical Sciences, University College of London, London, United Kingdom
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Fekri-Kourabbaslou V, Shams S, Amani-Shalamzari S. Effect of different recovery modes during resistance training with blood flow restriction on hormonal levels and performance in young men: a randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14:47. [PMID: 35337391 PMCID: PMC8957130 DOI: 10.1186/s13102-022-00442-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/21/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Resistance training with blood flow restriction (BFR) results in hypertrophy, and its magnitude depends on various training variables. This study aimed to compare the long-term effect of passive recovery (PR) and active recovery (AR) during low-intensity resistance training with BFR on hormonal levels and performance in young men. METHODS In the randomized clinical trial, 20 men were randomly divided into PR and AR groups during resistance training with BFR. The intervention consisted of six upper and lower body movements with 30% of one maximum repetition (1RM), three sessions per week for six weeks. Both groups wore pneumatic cuffs on the proximal part of thighs and arms. The cuff pressure was 60% of the calculated arterial blood occlusion and increased 10% every two weeks. The AR group performed seven repetitions in 30 s break between sets by one second for concentric and eccentric phases and two seconds rest, and the other group had passive rest. The blood samples and a series of performance tests were gathered before and after the intervention. A repeated measure ANOVA was used to analyze data. RESULTS AR and PR interventions significantly improved the C-reactive protein (CRP) (- 38% vs. - 40%), Lactate dehydrogenase (LDH) (- 11% vs. - 3%), Sargent jump (9% vs. 10%), peak power (20% vs.18%), and average power (14% vs. 14%), upper 1RM (8% vs. 8%) and no significant differences were observed between groups. The AR intervention significantly increased growth hormone (GH) (423% vs. 151%, p = 0.03), lower body 1RM (18% vs. 11%) and muscle endurance (34% vs. 22% for the upper body, p = 0.02 and 32% vs. 24% for the lower body, p = 0.04) than the PR group. The PR intervention further increased the minimum power than the AR group (19% vs. 10%). There were no significant changes in testosterone (p = 0.79) and cortisol (p = 0.34) following interventions. CONCLUSION The findings indicated that by increasing muscle activation and higher metabolic load, AR during resistance training with BFR might cause more remarkable improvements in serum GH, muscle strength, and endurance. Thus, to gain further benefits, AR during training with BFR is recommended. TRIAL REGISTRATION IRCT20191207045644N1. Registration date: 14/03/2020. URL: https://www.irct.ir/search/result?query=IRCT20191207045644N1.
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Affiliation(s)
- Vahid Fekri-Kourabbaslou
- grid.412265.60000 0004 0406 5813Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Sara Shams
- grid.412265.60000 0004 0406 5813Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Sadegh Amani-Shalamzari
- grid.412265.60000 0004 0406 5813Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
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Bemben DA, Sherk VD, Buchanan SR, Kim S, Sherk K, Bemben MG. Acute and Chronic Bone Marker and Endocrine Responses to Resistance Exercise With and Without Blood Flow Restriction in Young Men. Front Physiol 2022; 13:837631. [PMID: 35370772 PMCID: PMC8969015 DOI: 10.3389/fphys.2022.837631] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/22/2022] [Indexed: 12/28/2022] Open
Abstract
In this study, we compared acute and chronic bone marker and hormone responses to 6 weeks of low intensity (20% 1RM) blood flow restriction (BFR20) resistance training to high intensity (70% 1RM) traditional resistance training (TR70) and moderate intensity (45% 1RM) traditional resistance training (TR45) in young men (18–35 years). Participants were randomized to one of the training groups or to a control group (CON). The following training programs were performed 3 days per week for 6 weeks for knee extension and knee flexion exercises: BFR20, 20%1RM, 4 sets (30, 15, 15, 15 reps) wearing blood flow restriction cuffs around the proximal thighs; TR70, 70% 1RM 3 sets 10 reps; and TR45, 45% 1RM 3 sets 15 reps. Muscle strength and thigh cross-sectional area were assessed at baseline, between week 3 and 6 of training. Acute bone marker (Bone ALP, CTX-I) and hormone (testosterone, IGF-1, IGFBP-3, cortisol) responses were assessed at weeks 1 and 6, with blood collection done in the morning after an overnight fast. The main findings were that the acute bone formation marker (Bone ALP) showed significant changes for TR70 and BFR20 but there was no difference between weeks 1 and 6. TR70 had acute increases in testosterone, IGF-1, and IGFBP-3 (weeks 1 and 6). BFR20 had significant acute increases in testosterone (weeks 1 and 6) and in IGF-1 at week 6, while TR45 had significant acute increases in testosterone (week 1), IGF-1 (week 6), and IGFBP-3 (week 6). Strength and muscle size gains were similar for the training groups. In conclusion, low intensity BFR resistance training was effective for stimulating acute bone formation marker and hormone responses, although TR70 showed the more consistent hormone responses than the other training groups.
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Affiliation(s)
- Debra A. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
- *Correspondence: Debra A. Bemben,
| | - Vanessa D. Sherk
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Samuel R. Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - SoJung Kim
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ, United States
| | - Kyle Sherk
- Hanger Clinic, Denver, CO, United States
| | - Michael G. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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Hedt C, McCulloch PC, Harris JD, Lambert BS. Blood Flow Restriction Enhances Rehabilitation and Return to Sport: The Paradox of Proximal Performance. Arthrosc Sports Med Rehabil 2022; 4:e51-e63. [PMID: 35141536 PMCID: PMC8811501 DOI: 10.1016/j.asmr.2021.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022] Open
Abstract
The use of blood flow restriction (BFR) within rehabilitation is rapidly increasing as further research is performed elucidating purported benefits such as improved muscular strength and size, neuromuscular control, decreased pain, and increased bone mineral density. Interestingly, these benefits are not isolated to structures distal to the occlusive stimulus. Proximal gains are of high interest to rehabilitation professionals, especially those working with patients who are limited due to pain or postsurgical precautions. The review to follow will focus on current evidence and ongoing hypotheses regarding physiologic responses to BFR, current clinical applications, proximal responses to BFR training, potential practical applications for rehabilitation and injury prevention, and directions for future research. Interestingly, benefits have been found in musculature proximal to the occlusive stimulus, which may lend promise to a greater variety of patient populations and conditions. Furthermore, an increasing demand for BFR use in the sports world warrants further research for performance research and recovery. LEVEL OF EVIDENCE Level V, expert opinion.
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Affiliation(s)
- Corbin Hedt
- Address correspondence to Corbin Hedt, P.T., D.P.T., S.C.S., C.S.C.S., Houston Methodist Orthopedics & Sports Medicine, 5505 West Loop South, Houston, TX 77081.
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May AK, Russell AP, Della Gatta PA, Warmington SA. Muscle Adaptations to Heavy-Load and Blood Flow Restriction Resistance Training Methods. Front Physiol 2022; 13:837697. [PMID: 35185627 PMCID: PMC8850930 DOI: 10.3389/fphys.2022.837697] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
Resistance-based blood flow restriction training (BFRT) improves skeletal muscle strength and size. Unlike heavy-load resistance training (HLRT), there is debate as to whether strength adaptations following BFRT interventions can be primarily attributed to concurrent muscle hypertrophy, as the magnitude of hypertrophy is often minor. The present study aimed to investigate the effect of 7 weeks of BFRT and HLRT on muscle strength and hypertrophy. The expression of protein growth markers from muscle biopsy samples was also measured. Male participants were allocated to moderately heavy-load training (HL; n = 9), low-load BFRT (LL + BFR; n = 8), or a control (CON; n = 9) group to control for the effect of time. HL and LL + BFR completed 21 training sessions (3 d.week−1) comprising bilateral knee extension and knee flexion exercises (HL = 70% one-repetition maximum (1-RM), LL + BFR = 20% 1-RM + blood flow restriction). Bilateral knee extension and flexion 1-RM strength were assessed, and leg muscle CSA was measured via peripheral quantitative computed tomography. Protein growth markers were measured in vastus lateralis biopsy samples taken pre- and post the first and last training sessions. Biopsy samples were also taken from CON at the same time intervals as HL and LL + BFR. Knee extension 1-RM strength increased in HL (19%) and LL + BFR (19%) but not CON (2%; p < 0.05). Knee flexion 1-RM strength increased similarly between all groups, as did muscle CSA (50% femur length; HL = 2.2%, LL + BFR = 3.0%, CON = 2.1%; TIME main effects). 4E-BP1 (Thr37/46) phosphorylation was lower in HL and LL + BFR immediately post-exercise compared with CON in both sessions (p < 0.05). Expression of other growth markers was similar between groups (p > 0.05). Overall, BFRT and HLRT improved muscle strength and size similarly, with comparable changes in intramuscular protein growth marker expression, both acutely and chronically, suggesting the activation of similar anabolic pathways. However, the low magnitude of muscle hypertrophy was not significantly different to the non-training control suggesting that strength adaptation following 7 weeks of BFRT is not driven by hypertrophy, but rather neurological adaptation.
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Garcia NF, de Moraes C, Rebelo MA, de Castro FMP, Peters SMGR, Pernomian L, de Mello MMB, de Castro MM, Puggina EF. Low load strength training, associated with or without blood flow restriction increased NO production and decreased production of reactive oxygen species in the in rats aorta. Life Sci 2022; 294:120350. [PMID: 35065990 DOI: 10.1016/j.lfs.2022.120350] [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: 10/30/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
Studies have shown that strength training (ST) with blood flow restriction (BFR) in which low load is used (20-50% of 1 maximum voluntary contraction - MVC) can produce positive adaptations similar to ST with loads equal to or greater than 70% 1 MVC. Furthermore, recent studies have investigated the effects of STBFR on muscle adaptations, but few studies investigated the effects of STBFR on vascular function. This study aimed to evaluate the effects of the STBFR program on the vascular reactivity of the abdominal aorta of Wistar rats with femoral arteriovenous blood flow restriction. Male rats were divided into four groups: sedentary sham (S/S), sedentary with blood flow restriction (S/BFR), trained sham (T/S), and trained with blood flow restriction (T/BFR). The animals in the S/BFR and T/BFR groups underwent surgery to BFR in the femoral artery and vein. After one week, the trained groups started the ST which consisted of climbing ladder, six sets of 10 repetitions with 50% of 1 MVC assessed by maximum loaded weight (MLW) carried out for four weeks. Concentration-response curves to Acetylcholine (ACh: 10 nM - 100 μM) and Phenylephrine (PHE: 1 nM - 30 μM) were performed in aortic rings with intact endothelium. The production of nitric oxide (NO) and reactive oxygen species (ROS) in situ and the vascular remodeling marker (MMP-2) were also measured. The ST increased the strength of the T/S and T/BFR groups in MLW tests. The S/BFR group showed a 22% reduction in relaxation to acetylcholine, but exercise prevented this reduction in the T/BFR group. In animals without BFR, ST did not alter the response to acetylcholine. An increase in NO production was seen in T/S and T/BFR showed a reduction in ROS production (62% and 40%, respectively). In conclusion low load ST with BFR promotes similar vascular function responses to ST without BFR. Low load ST with and without BFR is interventions that can improve performance with similar magnitudes. Both training methods could have some benefits for vascular health due to NO production in the aorta increased in the T/S group and decreased production of reactive oxygen species in the T/BFR group.
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Affiliation(s)
- Nádia Fagundes Garcia
- Graduate Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of São Paulo, Brazil
| | - Camila de Moraes
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Brazil
| | - Macário Arosti Rebelo
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Brazil
| | - Fábio Marzliak Pozzi de Castro
- Graduate Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of São Paulo, Brazil
| | | | - Laena Pernomian
- Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | | | | | - Enrico Fuini Puggina
- Graduate Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of São Paulo, Brazil; School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Brazil.
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Feng Y, Yin Y, Zhao X, Zhang Y, Zhou Y, Wu Z. A bibliometric analysis study of blood flow restriction using CiteSpace. J Phys Ther Sci 2022; 34:657-667. [PMID: 36213193 PMCID: PMC9535246 DOI: 10.1589/jpts.34.657] [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: 03/26/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To assess the current state-of-the-art and the prevailing trends regarding the
global use of blood flow restriction (BFR) in the past 20 years. [Participants and
Methods] We retrieved literature relating to BFR from 1999 to 2020 using Web of Science.
We conducted a bibliometric analysis of countries/institutions, cited journals,
authors/cited authors, cited references, and keywords using CiteSpace. An analysis of
counts and centrality was used to examine publication output, countries/institutions, core
journals, active authors, foundation references, hot topics, and frontiers. [Results]
Seven hundred seventy five references were included and the total number of publications
has been continually increasing over the investigated period. Representatives of important
academic groups are the Japanese scholars from the University of Tokyo as represented by
Takashi Abe. Jeremy Paul Loenneke’s article (centrality: 0.15) was the most representative
and symbolic reference with the highest centrality. The three topics identified were
intervention (intensity resistance exercise, IRE), physiology (ischemia and muscular
function) and behavior (adaptation and increase). The four frontier topics were
phosphorylation, reduction, low intensity and arterial occlusion. [Conclusion] This study
provides an insight into BFR and offers valuable information for BFR researchers to
identify new perspectives for potential cooperation with collaborators and their related
cooperative institutions.
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Affiliation(s)
- Yali Feng
- Hospital of Southwest University, Southwest University: Tiansheng Road 2, Chongqing 400715, China
| | - Ying Yin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Xuemei Zhao
- Department of Rehabilitation Therapy, Chongqing Medical University, China
| | - Yue Zhang
- Department of Rehabilitation Therapy, Chongqing Medical University, China
| | - Yi Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Zonghui Wu
- Hospital of Southwest University, Southwest University: Tiansheng Road 2, Chongqing 400715, China
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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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Blood Flow Restriction Therapy and Its Use for Rehabilitation and Return to Sport: Physiology, Application, and Guidelines for Implementation. Arthrosc Sports Med Rehabil 2022; 4:e71-e76. [PMID: 35141538 PMCID: PMC8811521 DOI: 10.1016/j.asmr.2021.09.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/22/2021] [Indexed: 12/26/2022] Open
Abstract
Blood flow restriction (BFR) is an expanding rehabilitation modality that uses a tourniquet to reduce arterial inflow and occlude venous outflow in the setting of resistance training or exercise. Initially, this technique was seen as a way to stimulate muscular development, but improved understanding of its physiologic benefits and mechanism of action has allowed for innovative clinical applications. BFR represents a way to decrease stress placed on the joints without compromising improvements in strength, whereas for postoperative, injured, or load-compromised individuals BFR represents a way to accelerate recovery and prevent atrophy. There is also growing evidence to suggest that it augments cardiovascular fitness and attenuates pain. The purpose of this review is to highlight the physiology and evidence behind the various applications of BFR, with a focus on postoperative rehabilitation. While much remains to be learned, it is clear that blood flow restriction therapy stimulates muscle hypertrophy via a synergistic response to metabolic stress and mechanical tension, with supplemental benefits on cardiovascular fitness and pain. New forms of BFR and expanding applications in postoperative patients and athletes hold promise for expedited recovery. Continued adherence to rehabilitation guidelines and exploration of BFRs physiology and various applications will help optimize its effect and prescription. Level of Evidence V, expert opinion.
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Chen Y, Ma C, Wang J, Gu Y, Gao Y. Effects of 40% of Maximum Oxygen Uptake Intensity Cycling Combined with Blood Flow Restriction Training on Body Composition and Serum Biomarkers of Chinese College Students with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:168. [PMID: 35010428 PMCID: PMC8750492 DOI: 10.3390/ijerph19010168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Blood flow restriction training (BFRT) is a new method for promoting muscle growth and improving muscle function, even with relatively low-intensity exercise. BFRT on patients with obesity has not been extensively studied. This study aimed to analyze the effects of cycling at 40% of maximum oxygen uptake (VO2max) combined with BFRT on body composition and serum biomarkers among college students with obesity. This pilot study included thirty-seven male college students with obesity aged 18-22 years (experimental group (EG): n = 18; control group (CG): n = 19). The EG conducted 40% VO2max cycling combined with BFRT activities and the CG conducted 40% VO2max cycling without BFRT two times per week for 12 weeks. Our results showed that in EG, there were significant differences in weight, thigh skinfold thickness (TS), waist circumference, abdominal skinfold thickness, fat mass, body fat percentage, body mass index and glucose (GLU), total cholesterol (TC), triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels before and after the experiment (p < 0.05, p < 0.01, and p < 0.001). After the experiment, TS, GLU, TC, HDL-C, and LDL-C in EG were significantly different than those of the CG (p < 0.05, p < 0.01, and p < 0.001). Together, our results demonstrate that cycling at 40% VO2max combined with BFRT may improve body composition and blood lipid profile of male college students with obesity. Our findings have important implications for those who cannot perform moderate- and high-intensity exercises.
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Affiliation(s)
- Yong Chen
- Department of Physical Education, Huaiyin Normal University, Huaian 223300, China; (Y.C.); (C.M.); (J.W.)
| | - Chunlin Ma
- Department of Physical Education, Huaiyin Normal University, Huaian 223300, China; (Y.C.); (C.M.); (J.W.)
| | - Junmin Wang
- Department of Physical Education, Huaiyin Normal University, Huaian 223300, China; (Y.C.); (C.M.); (J.W.)
| | - Ying Gu
- College of Sports Science, Shenyang Normal University, Shenyang 110034, China
| | - Yan Gao
- School of Foreign Languages, Shenyang Normal University, Shenyang 110034, China;
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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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Curley AJ, Conroy CM, West RV, Chang ES. Postoperative Use of Blood Flow Restriction in Orthopedics. Orthopedics 2021; 44:e694-e698. [PMID: 34618631 DOI: 10.3928/01477447-20211001-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Blood flow restriction (BFR) therapy is being used more frequently for rehabilitation from orthopedic injuries. Several physiologic mechanisms of action, at local and systemic levels, have been proposed. Numerous studies have investigated the effects of BFR training in healthy athletes; however, limited clinical data exist supporting the use of BFR after surgery. Given that BFR training may facilitate muscle development using low-load resistance exercises, it offers a unique advantage for the post-surgical patient who cannot tolerate traditional high resistance training. [Orthopedics. 2021;44(6):e694-e698.].
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Evaluating the beneficial effects of dietary restrictions: A framework for precision nutrigeroscience. Cell Metab 2021; 33:2142-2173. [PMID: 34555343 PMCID: PMC8845500 DOI: 10.1016/j.cmet.2021.08.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/17/2021] [Accepted: 08/30/2021] [Indexed: 12/12/2022]
Abstract
Dietary restriction (DR) has long been viewed as the most robust nongenetic means to extend lifespan and healthspan. Many aging-associated mechanisms are nutrient responsive, but despite the ubiquitous functions of these pathways, the benefits of DR often vary among individuals and even among tissues within an individual, challenging the aging research field. Furthermore, it is often assumed that lifespan interventions like DR will also extend healthspan, which is thus often ignored in aging studies. In this review, we provide an overview of DR as an intervention and discuss the mechanisms by which it affects lifespan and various healthspan measures. We also review studies that demonstrate exceptions to the standing paradigm of DR being beneficial, thus raising new questions that future studies must address. We detail critical factors for the proposed field of precision nutrigeroscience, which would utilize individualized treatments and predict outcomes using biomarkers based on genotype, sex, tissue, and age.
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Yinghao L, Jing Y, Yongqi W, Jianming Z, Zeng G, Yiting T, Shuoqi L. Effects of a blood flow restriction exercise under different pressures on testosterone, growth hormone, and insulin-like growth factor levels. J Int Med Res 2021; 49:3000605211039564. [PMID: 34486432 PMCID: PMC8424606 DOI: 10.1177/03000605211039564] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the changes in serum growth hormone (GH), testosterone, and insulin-like growth factor 1 (IGF-1) during low-intensity resistance exercise under different cuff pressures. METHODS We performed a single-blind, cross-over design study. Twenty-five healthy young men performed three exercise protocols as follows: 1) no blood flow restriction exercise (control group), 2) resistance exercise at 40% of arterial occlusion pressure (AOP) (low group), and 3) resistance exercise at 70% of AOP (high group). Blood lactate, GH, testosterone, and IGF-1 levels were measured at four time points. RESULTS There were no differences in the indices before exercise. The blood flow restriction exercise under different pressures had different effects on each index and there was an interactive effect. GH levels were significantly higher in the high group than in the other groups after exercise. Immediately after exercise, IGF-1 and testosterone levels were significantly higher in the high group than in the other groups. At 15 minutes after exercise, testosterone levels were significantly higher in the high group than in the other groups. CONCLUSIONS Low-intensity resistance exercise combined with blood flow restriction effectively increases GH, IGF-1, and testosterone levels in young men. Increasing the cuff pressure results in greater levels of hormone secretion.
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Affiliation(s)
- Li Yinghao
- Department of Physical Education, Zhengzhou Shengda University, Zhengzhou, China
| | - Yang Jing
- Internal Medicine-Cardiovascular Department, Tangshan Hongci Hospital, Tangshan, China
| | - Wang Yongqi
- Department of Life Sciences, Inner Mongolia University, Inner Mongolia, China
| | - Zhou Jianming
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Gao Zeng
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Tang Yiting
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Li Shuoqi
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Effects of single bouts of different endurance exercises with different intensities on microRNA biomarkers with and without blood flow restriction: a three-arm, randomized crossover trial. Eur J Appl Physiol 2021; 121:3243-3255. [PMID: 34435273 PMCID: PMC8505326 DOI: 10.1007/s00421-021-04786-2] [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: 01/27/2021] [Accepted: 08/10/2021] [Indexed: 10/27/2022]
Abstract
PURPOSE Physical activity is associated with altered levels of circulating microRNAs (ci-miRNAs). Changes in miRNA expression have great potential to modulate biological pathways of skeletal muscle hypertrophy and metabolism. This study was designed to determine whether the profile of ci-miRNAs is altered after different approaches of endurance exercise. METHODS Eighteen healthy volunteers (aged 24 ± 3 years) participated this three-arm, randomized-balanced crossover study. Each arm was a single bout of treadmill-based acute endurance exercise at (1) 100% of the individual anaerobic threshold (IANS), (2) at 80% of the IANS and (3) at 80% of the IANS with blood flow restriction (BFR). Load-associated outcomes (fatigue, feeling, heart rate, and exhaustion) as well as acute effects (circulating miRNA patterns and lactate) were determined. RESULTS All training interventions increased the lactate concentration (LC) and heart rate (HR) (p < 0.001). The high-intensity intervention (HI) resulted in a higher LC than both lower intensity protocols (p < 0.001). The low-intensity blood flow restriction (LI-BFR) protocol led to a higher HR and higher LC than the low-intensity (LI) protocol without BFR (p = 0.037 and p = 0.003). The level of miR-142-5p and miR-197-3p were up-regulated in both interventions without BFR (p < 0.05). After LI exercise, the expression of miR-342-3p was up-regulated (p = 0.038). In LI-BFR, the level of miR-342-3p and miR-424-5p was confirmed to be up-regulated (p < 0.05). Three miRNAs and LC show a significant negative correlation (miR-99a-5p, p = 0.011, r = - 0.343/miR-199a-3p, p = 0.045, r = - 0.274/miR-125b-5p, p = 0.026, r = - 0.302). Two partial correlations (intervention partialized) showed a systematic impact of the type of exercise (LI-BFR vs. HI) (miR-99a-59: r = - 0.280/miR-199a-3p: r = - 0.293). CONCLUSION MiRNA expression patterns differ according to type of activity. We concluded that not only the intensity of the exercise (LC) is decisive for the release of circulating miRNAs-as essential is the type of training and the oxygen supply.
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Wilburn DT, Machek SB, Zechmann B, Willoughby DS. Comparison of skeletal muscle ultrastructural changes between normal and blood flow-restricted resistance exercise: A case report. Exp Physiol 2021; 106:2177-2184. [PMID: 34438467 DOI: 10.1113/ep089858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/16/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the main observation in this case? The main observation of this case report is that blood flow-restricted exercise can cause myofibrils to have an aberrant wave-like appearance that is accompanied by irregular pockets of sarcoplasm in the intermyofibrillar space, while traditional forms of damage to the Z-discs and contractile elements are not as apparent. What insights does it reveal? Our findings indicate that blood flow restriction-mediated fluid pooling might cause alterations in skeletal muscle ultrastructure after exercise that might be directly related to myofibre swelling. ABSTRACT The acute effects of blood flow-restricted (BFR) exercise training on skeletal muscle ultrastructure are poorly understood owing to inconsistent findings and the use of largely imprecise systemic markers for indications of muscle damage. The purpose of this study was to compare myofibrillar ultrastructure before and 30 min after normal and BFR resistance exercise using transmission electron microscopy in a single individual to evaluate the feasibility of this more nuanced approach. One apparently healthy male with 13 years of resistance exercise completed six sets of both BFR [30% of one-repetition maximum (1-RM)] and normal non-occluded (70% of 1-RM) unilateral angled leg press on the contralateral leg, as a control, after assessment of 1-RM 72 h before. Vastus lateralis muscle biopsies were collected before and 30 min after each exercise session. The lengths and widths of 250 sarcomeres and the sarcoplasmic area were assessed via 20 individual transmission electron photomicrographs. Analysis revealed that BFR training (1.769 ± 0.12 μm) increased sarcomere length when compared with normal exercise (1.64 ± 0.17 μm; P < 0.001), without differences in sarcomere width between conditions (BFR, 0.90 ± 0.26 μm; normal, 0.93 ± 0.27 μm; P = 0.172). Furthermore, there were no significant interaction (P = 0.168) or condition effects between BFR (25.98 ± 4.17%) and normal (27.3 ± 6.49%) resistance exercise for sarcoplasmic area (P = 0.229). Exercise also increased sarcoplasmic area within the myofibril (pre-exercise, 24.42 ± 5.13%; postexercise, 28.95 ± 5.92%) for both conditions (P = 0.001). This case study demonstrates a unique BFR training-induced alteration in myofibril ultrastructure that appeared wave like and was accompanied by intracellular abnormalities that appeared to be fluid pockets of sarcoplasm disrupting the surrounding myofibrils.
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Affiliation(s)
- Dylan T Wilburn
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance & Recreation, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Steven B Machek
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance & Recreation, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Bernd Zechmann
- Center for Microscopy and Imaging, Baylor University, Waco, Texas, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, USA
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Lysenko EA, Vinogradova OL, Popov DV. The Mechanisms of Muscle Mass and Strength Increase during Strength Training. J EVOL BIOCHEM PHYS+ 2021. [DOI: 10.1134/s0022093021040104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Yamada Y, Song JS, Bell ZW, Wong V, Spitz RW, Abe T, Loenneke JP. Effects of isometric handgrip exercise with or without blood flow restriction on interference control and feelings. Clin Physiol Funct Imaging 2021; 41:480-487. [PMID: 34392595 DOI: 10.1111/cpf.12723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/14/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to investigate whether isometric handgrip exercise, with or without blood flow restriction, would alter interference control and feelings. 60 healthy young adults completed three experimental visits, consisting of four sets of 2 min isometric handgrip exercise, at 30% of maximal strength with or without blood flow restriction (50% of arterial occlusion pressure), or a non-exercise/time-matched control. Exercise-induced feeling inventory and Stroop Color Word Test were performed at pre- and ~10-min post-exercise, respectively. Bayes factors (BF10 ) quantified the evidence for or against the null. There were no changes or differences between conditions for interference control following exercise with or without blood flow restriction (Incongruent BF10 : 0.155; Stroop Interference BF10 : 0.082). There were also no differences in the error rate as well as no differences between conditions for changes in 'positivity' or 'revitalization'. Feelings of 'tranquility' were reduced relative to a control following exercise with (median δ [95% credible interval]: -0.74 (-1.05, -0.45), BF10 : 5515.7) and without (median δ: -0.72 [-1.02, -0.41], BF10 : 571.3) blood flow restriction. These changes were not different between exercise conditions. Feelings of 'physical exhaustion' were increased relative to a control following exercise without blood flow restriction (median δ: 0.35[0.09, 0.61], BF10 : 5.84). However, this increase was not different from the same exercise with blood flow restriction. These results suggest that 1) isometric handgrip exercise could be performed without impairing interference control, even when blood flow restriction is added, and that 2) changes in feelings occur independent of changes in interference control.
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Affiliation(s)
- Yujiro Yamada
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, Mississippi, USA
| | - Jun Seob Song
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, Mississippi, USA
| | - Zachary W Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, Mississippi, USA
| | - Vickie Wong
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, Mississippi, USA
| | - Robert W Spitz
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, Mississippi, USA
| | - Takashi Abe
- Graduate School of Health and Sports Science, Juntendo University, Inzai, Chiba, Japan
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, Mississippi, USA
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Teixeira EL, de Salles Painelli V, Silva-Batista C, de Souza Barros T, Longo AR, Lasevicius T, Schoenfeld BJ, Aihara AY, de Almeida Peres B. Blood Flow Restriction Does Not Attenuate Short-Term Detraining-Induced Muscle Size and Strength Losses After Resistance Training With Blood Flow Restriction. J Strength Cond Res 2021; 35:2082-2088. [DOI: 10.1519/jsc.0000000000003148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lambert B, Hedt C, Daum J, Taft C, Chaliki K, Epner E, McCulloch P. Blood Flow Restriction Training for the Shoulder: A Case for Proximal Benefit. Am J Sports Med 2021; 49:2716-2728. [PMID: 34110960 DOI: 10.1177/03635465211017524] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although blood flow restriction (BFR) is becoming increasingly popular in physical therapy and athletic training settings, little is known about the effects of BFR combined with low-intensity exercise (LIX) on muscles proximal to the site of occlusion. HYPOTHESIS/PURPOSE Determine whether LIX combined with BFR applied distally to the shoulder on the brachial region of the arm (BFR-LIX) promotes greater increases in shoulder lean mass, rotator cuff strength, endurance, and acute increases in shoulder muscle activation compared with LIX alone. We hypothesized that BFR-LIX would elicit greater increases in rotator cuff strength, endurance, and muscle mass. We also hypothesized that the application of BFR would increase EMG amplitude in the shoulder muscles during acute exercise. STUDY DESIGN Controlled laboratory study. METHODS 32 healthy adults were randomized into 2 groups (BFR group, 13 men, 3 women; No-BFR group, 10 men, 6 women) who performed 8 weeks of shoulder LIX (2 times per week; 4 sets [30/15/15/fatigue]; 20% maximum) using common rotator cuff exercises (cable external rotation [ER], cable internal rotation [IR], dumbbell scaption, and side-lying dumbbell ER). The BFR group also trained with an automated tourniquet placed at the proximal arm (50% occlusion). Regional lean mass (dual-energy x-ray absorptiometry), isometric strength, and muscular endurance (repetitions to fatigue [RTF]; 20% maximum; with and without 50% occlusion) were measured before and after training. Electromyographic amplitude (EMGa) was recorded from target shoulder muscles during endurance testing. A mixed-model analysis of covariance (covaried on baseline measures) was used to detect within-group and between-group differences in primary outcome measures (α = .05). RESULTS The BFR group had greater increases in lean mass in the arm (mean ± 95% CI: BFR, 175 ± 54 g; No BFR, -17 ± 77 g; P < .01) and shoulder (mean ± 95% CI: BFR, 278 ± 90 g; No BFR, 96 ± 61 g; P < .01), isometric IR strength (mean ± 95% CI: BFR, 2.9 ± 1.3 kg; No BFR, 0.1 ± 1.3 kg; P < .01), single-set RTF volume (repetitions × resistance) for IR (~1.7- to 2.1-fold higher; P < .01), and weekly training volume (weeks 4, 6-8, ~5%-22%; P < .05). Acute occlusion (independent of group or timepoint) yielded increases in EMGa during RTF (~10%-20%; P < .05). CONCLUSION Combined BFR-LIX may yield greater increases in shoulder and arm lean mass, strength, and muscular endurance compared with fatiguing LIX alone during rotator cuff exercises. These findings may be due, in part, to a greater activation of shoulder muscles while using BFR. CLINICAL RELEVANCE The present study demonstrates that BFR-LIX may be a suitable candidate for augmenting preventive training or rehabilitation outcomes for the shoulder.
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Affiliation(s)
- Bradley Lambert
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Corbin Hedt
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Joshua Daum
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Carter Taft
- Department of Kinesiology, Rice University, Houston, Texas, USA
| | - Kalyan Chaliki
- Department of Kinesiology, Rice University, Houston, Texas, USA
| | - Eden Epner
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Patrick McCulloch
- Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
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Kojima C, Yamaguchi K, Ito H, Kasai N, Girard O, Goto K. Acute Effect of Repeated Sprint Exercise With Blood Flow Restriction During Rest Periods on Muscle Oxygenation. Front Physiol 2021; 12:665383. [PMID: 34393809 PMCID: PMC8358934 DOI: 10.3389/fphys.2021.665383] [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: 02/08/2021] [Accepted: 06/21/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to examine the effect of applying BFR during rest periods of repeated cycling sprints on muscle oxygenation. Methods Seven active males performed 5 × 10-s maximal pedaling efforts with 40-s passive rest, with or without BFR application during rest period. BFR was applied for 30 s between sprints (between 5 and 35 s into rest) through a pneumatic pressure cuff inflated at 140 mmHg. Vastus lateralis muscle oxygenation was monitored using near-infrared spectroscopy. In addition, blood lactate concentration and heart rate were also evaluated. Results The BFR trial showed significantly lower oxyhemoglobin (oxy-Hb) and tissue saturation (StO2) levels than the CON trial (P < 0.05). However, power output and blood lactate concentration did not significantly differ between the two trials (P > 0.05). Conclusion Applying BFR during rest periods of repeated cycling sprints decreased muscle oxygenation of active musculature, without interfering with power output during sprints.
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Affiliation(s)
| | - Keiichi Yamaguchi
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Hiroto Ito
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | | | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawly, WA, Australia
| | - Kazushige Goto
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
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