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Rodríguez-Bautista JC, López-Lluch G, Rodríguez-Torres P, López-Moral Á, Quijada-Carrera J, Bueno-Antequera J, Blanco-Suárez M, Cáceres-Calle Ó, Munguia-Izquierdo D. Feasibility, Safety, and Effects of an Aerobic Training Program with Blood Flow Restriction on Functional Capacity, and Symptomatology in Women with Fibromyalgia: A Pilot Study. Biomedicines 2024; 12:1895. [PMID: 39200359 PMCID: PMC11351873 DOI: 10.3390/biomedicines12081895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/24/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Evidence suggests that aerobic training with blood flow restriction is beneficial for treating fibromyalgia. This study evaluated the feasibility, safety, and effects of an aerobic training program with blood flow restriction for women with fibromyalgia. METHODS Thirty-seven women with fibromyalgia were included, and thirteen with an average age of 59 ± 3, a BMI of 26 ± 3, and who were polymedicated started the intervention period. The intervention group performed aerobic exercise with blood flow restriction using occlusive bands placed in the upper part of the rectus femoris, with a total duration of 14 min of restriction divided into two periods of 7 min with a rest period of 3 min and a total session duration of 17 min. Pressure intensity was measured using the visual pain scale (VAS), scoring 7 out of 10 (n = 7). The non-intervention group performed aerobic exercise without restriction of blood flow for the same periods, rest periods, and total duration of the session (n = 6). The intervention included 2 weekly sessions with 72 h between aerobic walking for 9 weeks. Walking was measured individually using the rating of perceived exertion scale (RPE) with an intensity between 6 and 7 out of 10. Visual and verbal support for the VAS and RPE scale was always provided throughout the sessions supervised by the investigator. Functional capacity was assessed using tests (six-minute walk test, incremental shuttle walk test, knee extension and handgrip test by dynamometer, 30 s chair stand test, and timed up-and-go test). Symptomatology was assessed using questionnaires (Widespread Pain Index, Symptom Severity Score, Fibromyalgia Impact Questionnaire, and Multidimensional Fatigue Inventory), and blood samples were collected. RESULTS There were no adverse effects, and only one participant in the intervention group withdrew. Between-group and intragroup differences showed that the intervention group obtained improvements in the functional tests; CST p = 0.005; 6MWT p = 0.011; Handgrip p = 0.002; TUGT p = 0.002 with reduced impact of the disease according to the questionnaires; FIQ Stiffness p = 0.027 compared with the nonintervention group. Biochemical results remained within normal ranges in both groups. CONCLUSIONS Blood flow-restricted aerobic training may be feasible, safe, and more effective than unrestricted aerobic training as a physical exercise prescription tool to improve cardiorespiratory fitness, strength, balance, and stiffness in women with fibromyalgia.
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Affiliation(s)
- José Carlos Rodríguez-Bautista
- Physical Performance and Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sport Sciences, Universidad Pablo de Olavide, 41013 Seville, Spain; (Á.L.-M.); (J.B.-A.); (D.M.-I.)
| | - Guillermo López-Lluch
- Department of Physiology, Anatomy and Cell Biology, Andalusian Centre of Developmental Biology (CABD-UPO-JA), Centro de Investigación en Rendimiento Físico y Deportivo (CIRFD), Universidad Pablo de Olavide, 41013 Seville, Spain;
| | - Patricia Rodríguez-Torres
- Department of Internal Medicine, Hospital Universitario Nuestra Señora de Valme, 41014 Seville, Spain;
| | - Álvaro López-Moral
- Physical Performance and Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sport Sciences, Universidad Pablo de Olavide, 41013 Seville, Spain; (Á.L.-M.); (J.B.-A.); (D.M.-I.)
| | - Jesús Quijada-Carrera
- Rheumatology Department, Hospital Viamed Santa Ángela de la Cruz, 41014 Seville, Spain;
| | - Javier Bueno-Antequera
- Physical Performance and Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sport Sciences, Universidad Pablo de Olavide, 41013 Seville, Spain; (Á.L.-M.); (J.B.-A.); (D.M.-I.)
| | - Manuel Blanco-Suárez
- SHC Medical, Hospital Viamed Santa Ángela de la Cruz, 41014 Seville, Spain; (M.B.-S.); (Ó.C.-C.)
| | - Óscar Cáceres-Calle
- SHC Medical, Hospital Viamed Santa Ángela de la Cruz, 41014 Seville, Spain; (M.B.-S.); (Ó.C.-C.)
| | - Diego Munguia-Izquierdo
- Physical Performance and Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sport Sciences, Universidad Pablo de Olavide, 41013 Seville, Spain; (Á.L.-M.); (J.B.-A.); (D.M.-I.)
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Clarkson MJ. Refining safety considerations for intradialytic blood flow restriction exercise. Commentary on "Concerns on the application of blood-flow restriction resistance exercise and thrombosis risk in hemodialysis patients". JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:455-456. [PMID: 38514001 PMCID: PMC11184307 DOI: 10.1016/j.jshs.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Matthew J Clarkson
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia.
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Yasuda T, Sato Y, Nakajima T. Effects of Acute Piano Performance With Blood Flow Restriction on Upper Limb Muscle and Perceptual Response in Pianists. Cureus 2024; 16:e63074. [PMID: 39055424 PMCID: PMC11272406 DOI: 10.7759/cureus.63074] [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] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Long-term and prolonged piano performance does not provide essential skeletal muscle training benefits while increasing the risk of injury to the upper extremities. Unlike high-intensity exercise training, moderate blood flow restriction (BFR) training has been found to improve neuromuscular mechanisms with a variety of physical exercises (machine, elastic band, walking, electrical stimulation, and body weight). AIM AND METHODS We investigated the physiological and perceptual responses related to piano performance with or without BFR based on acute responses of neuromuscular mechanisms. Student or professional pianists (n=7) performed the "Revolutionary Etude" on the piano with (Piano-BFR) and without (Piano-Ctrl) BFR. During the Piano-BFR performance, 150-180 mmHg of cuff pressure was applied around the most proximal region of both arms as a moderate BFR. RESULTS Changes in upper limb girth, muscle thickness, and hand grip strength were measured before and immediately after the performance. After the performance, perceptual and other responses were recorded. Immediately after the performance, the Piano-BFR condition induced greater changes in girth (forearm and upper arm), muscle thickness (forearm), and handgrip strength than the Piano-Ctrl condition. Piano-BFR was (p<0.01) higher than Piano-Ctrl on eight questions regarding perceptual response (upper arm fatigue and difficulty playing the piano). Piano performance with BFR was revealed to increase upper extremity muscle size and fatigue in pianists after playing. CONCLUSION Piano performance with BFR was revealed to increase upper extremity muscle size and fatigue in pianists after playing. The effect of BFR on neuromuscular mechanisms on piano performance was greater in the forearm than in the upper arm.
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Affiliation(s)
- Tomohiro Yasuda
- Exercise Physiology, Seirei Christopher University, Hamamatsu, JPN
| | - Yumi Sato
- Child Education, Okazaki Women's University, Aichi, JPN
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Warneke K, Lohmann LH, Behm DG, Wirth K, Keiner M, Schiemann S, Wilke J. Effects of Chronic Static Stretching on Maximal Strength and Muscle Hypertrophy: A Systematic Review and Meta-Analysis with Meta-Regression. SPORTS MEDICINE - OPEN 2024; 10:45. [PMID: 38637473 PMCID: PMC11026323 DOI: 10.1186/s40798-024-00706-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Increases in maximal strength and muscle volume represent central aims of training interventions. Recent research suggested that the chronic application of stretch may be effective in inducing hypertrophy. The present systematic review therefore aimed to syntheisize the evidence on changes of strength and muscle volume following chronic static stretching. METHODS Three data bases were sceened to conduct a systematic review with meta-analysis. Studies using randomized, controlled trials with longitudinal (≥ 2 weeks) design, investigating strength and muscle volume following static stretching in humans, were included. Study quality was rated by two examiners using the PEDro scale. RESULTS A total of 42 studies with 1318 cumulative participants were identified. Meta-analyses using robust variance estimation showed small stretch-mediated maximal strength increases (d = 0.30 p < 0.001) with stretching duration and intervention time as significant moderators. Including all studies, stretching induced small magnitude, but significant hypertrophy effects (d = 0.20). Longer stretching durations and intervention periods as well as higher training frequencies revealed small (d = 0.26-0.28), but significant effects (p < 0.001-0.005), while lower dosage did not reach the level of significance (p = 0.13-0.39). CONCLUSIONS While of minor effectiveness, chronic static stretching represents a possible alternative to resistance training when aiming to improve strength and increase muscle size. As a dose-response relationship may exist, higher stretch durations and frequencies as well as long program durations should be further elaborated.
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Affiliation(s)
- Konstantin Warneke
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
- Department of Movement Sciences, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Lars Hubertus Lohmann
- Department of Human Motion Science and Exercise Physiology, Friedrich Schiller University, 07743, Jena, Germany.
| | - David G Behm
- School of Human Kinetics and Recreation, Newfoundland and Labrador, Memorial University of Newfoundland, St. John's, Canada
| | - Klaus Wirth
- University of Applied Sciences Wiener Neustadt, Wiener Neustadt, Austria
| | - Michael Keiner
- Department of Sport Science, German University of Health & Sport, Ismaning, Germany
| | - Stephan Schiemann
- Institute of Exercise, Sport and Health, Leuphana University, Lüneburg, Germany
| | - Jan Wilke
- Department of Movement Sciences, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Hahm JH, Nirmala FS, Ha TY, Ahn J. Nutritional approaches targeting mitochondria for the prevention of sarcopenia. Nutr Rev 2024; 82:676-694. [PMID: 37475189 DOI: 10.1093/nutrit/nuad084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
A decline in function and loss of mass, a condition known as sarcopenia, is observed in the skeletal muscles with aging. Sarcopenia has a negative effect on the quality of life of elderly. Individuals with sarcopenia are at particular risk for adverse outcomes, such as reduced mobility, fall-related injuries, and type 2 diabetes mellitus. Although the pathogenesis of sarcopenia is multifaceted, mitochondrial dysfunction is regarded as a major contributor for muscle aging. Hence, the development of preventive and therapeutic strategies to improve mitochondrial function during aging is imperative for sarcopenia treatment. However, effective and specific drugs that can be used for the treatment are not yet approved. Instead studies on the relationship between food intake and muscle aging have suggested that nutritional intake or dietary control could be an alternative approach for the amelioration of muscle aging. This narrative review approaches various nutritional components and diets as a treatment for sarcopenia by modulating mitochondrial homeostasis and improving mitochondria. Age-related changes in mitochondrial function and the molecular mechanisms that help improve mitochondrial homeostasis are discussed, and the nutritional components and diet that modulate these molecular mechanisms are addressed.
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Affiliation(s)
- Jeong-Hoon Hahm
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
| | - Farida S Nirmala
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| | - Tae Youl Ha
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| | - Jiyun Ahn
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
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Fallon NE, Faust CE, Dankel SJ. The combined effectiveness of therapeutic ultrasound, electrical stimulations, and blood flow restriction to treat symptoms of muscle damage. Res Sports Med 2024:1-13. [PMID: 38419341 DOI: 10.1080/15438627.2024.2324262] [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: 08/01/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
This study assessed whether symptoms of muscle damage could be reduced by a combination of therapeutic ultrasound and electrical stimulations, and whether this could be enhanced by blood flow restriction. Before and 48 h after performing eccentric elbow flexion exercises, individuals completed assessments of muscle damage. A 10-min therapeutic ultrasound and electrical stimulation treatment was then applied with and without blood flow restriction to assess short (5 min) and long-term (24 h) improvements. Twenty-three individuals completed the study (11 females). Data were analysed using Bayesian repeated measures ANOVAs. The damaging exercise increased discomfort (BF10 = 2.93e14) and relaxed joint angle (BF10 = 2425.90) while decreasing pain pressure threshold (BF10 = 289.71). Each of these variables was acutely improved with the combination treatment protocol (all BF10 ≥ 74) with no added effect of blood flow restriction. A combination of therapeutic ultrasound and interferential electrical stimulations appeared effective at acutely alleviating symptoms of muscle damage with no additive effect of blood flow restriction.
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Affiliation(s)
- Nicole E Fallon
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Catherine E Faust
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
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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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Hughes L, Centner C. Idiosyncratic bone responses to blood flow restriction exercise: new insights and future directions. J Appl Physiol (1985) 2024; 136:283-297. [PMID: 37994414 PMCID: PMC11212818 DOI: 10.1152/japplphysiol.00723.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
Applying blood flow restriction (BFR) during low-load exercise induces beneficial adaptations of the myotendinous and neuromuscular systems. Despite the low mechanical tension, BFR exercise facilitates a localized hypoxic environment and increase in metabolic stress, widely regarded as the primary stimulus for tissue adaptations. First evidence indicates that low-load BFR exercise is effective in promoting an osteogenic response in bone, although this has previously been postulated to adapt primarily during high-impact weight-bearing exercise. Besides studies investigating the acute response of bone biomarkers following BFR exercise, first long-term trials demonstrate beneficial adaptations in bone in both healthy and clinical populations. Despite the increasing number of studies, the physiological mechanisms are largely unknown. Moreover, heterogeneity in methodological approaches such as biomarkers of bone metabolism measured, participant and study characteristics, and time course of measurement renders it difficult to formulate accurate conclusions. Furthermore, incongruity in the methods of BFR application (e.g., cuff pressure) limits the comparability of datasets and thus hinders generalizability of study findings. Appropriate use of biomarkers, effective BFR application, and befitting study design have the potential to progress knowledge on the acute and chronic response of bone to BFR exercise and contribute toward the development of a novel strategy to protect or enhance bone health. Therefore, the purpose of the present synthesis review is to 1) evaluate current mechanistic evidence; 2) discuss and offer explanations for similar and contrasting data findings; and 3) create a methodological framework for future mechanistic and applied research.
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Affiliation(s)
- Luke Hughes
- Department of Sport Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
- Praxisklinik Rennbahn, Muttenz, Switzerland
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Bahat G, Ozkok S. The Current Landscape of Pharmacotherapies for Sarcopenia. Drugs Aging 2024; 41:83-112. [PMID: 38315328 DOI: 10.1007/s40266-023-01093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
Sarcopenia is a skeletal muscle disorder characterized by progressive and generalized decline in muscle mass and function. Although it is mostly known as an age-related disorder, it can also occur secondary to systemic diseases such as malignancy or organ failure. It has demonstrated a significant relationship with adverse outcomes, e.g., falls, disabilities, and even mortality. Several breakthroughs have been made to find a pharmaceutical therapy for sarcopenia over the years, and some have come up with promising findings. Yet still no drug has been approved for its treatment. The key factor that makes finding an effective pharmacotherapy so challenging is the general paradigm of standalone/single diseases, traditionally adopted in medicine. Today, it is well known that sarcopenia is a complex disorder caused by multiple factors, e.g., imbalance in protein turnover, satellite cell and mitochondrial dysfunction, hormonal changes, low-grade inflammation, senescence, anorexia of aging, and behavioral factors such as low physical activity. Therefore, pharmaceuticals, either alone or combined, that exhibit multiple actions on these factors simultaneously will likely be the drug of choice to manage sarcopenia. Among various drug options explored throughout the years, testosterone still has the most cumulated evidence regarding its effects on muscle health and its safety. A mas receptor agonist, BIO101, stands out as a recent promising pharmaceutical. In addition to the conventional strategies (i.e., nutritional support and physical exercise), therapeutics with multiple targets of action or combination of multiple therapeutics with different targets/modes of action appear to promise greater benefit for the prevention and treatment of sarcopenia.
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Affiliation(s)
- Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Serdar Ozkok
- Division of Geriatrics, Department of Internal Medicine, Hatay Training and Research Hospital, Hatay, 31040, Turkey
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Zhuang M, Shi J, Liu J, He X, Chen N. Comparing the efficacy of low-load resistance exercise combined with blood flow restriction versus conventional-load resistance exercise in Chinese community-dwelling older people with sarcopenic obesity: a study protocol for a randomised controlled trial. BMC Geriatr 2023; 23:874. [PMID: 38114934 PMCID: PMC10731711 DOI: 10.1186/s12877-023-04592-9] [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: 04/11/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Sarcopenic obesity (SO) is characterised by decreased muscle mass, diminished muscle strength and/or reduced physical performance and a high percentage of body fat (PBF). Conventional-load resistance exercise (CRE) may be difficult for older people with SO owing to their declining physical functions. Low-load resistance exercise (LRE) combined with blood flow restriction (BFR; LRE-BFR) is a viable alternative to CRE for improving muscle mass and strength and potential exercise mode for managing SO. This study has two objectives: (1) to comprehensively evaluate the efficacy of CRE and LRE-BFR in improving body composition, muscle strength, physical performance, haematological parameters, cardiovascular disease (CVD) risk factors and quality of life and (2) to compare the efficacy of CRE and LRE-BFR and explore their potential mechanisms. METHODS AND ANALYSIS This work is a 12-week assessor-blinded randomised clinical trial that will be conducted thrice a week. Sarcopenia will be defined using the Asian Working Group for Sarcopenia 2019, and obesity will be determined using the criteria developed by the World Health Organization. Community-dwelling older people aged ≥ 65 years will be screened as the participants using inclusion and exclusion criteria. A total of 33 participants will be randomised into a CRE group (n = 11), an LRE-BFR group (n = 11) and a control group that will be given only health education (n = 11). The primary outcomes will be knee extensor strength and PBF, and the secondary outcomes will be body composition, anthropometric measurements, muscle strength of upper limbs, physical performance, haematological parameters, CVD risk factors and quality of life. The outcomes will be measured at the baseline (week 0), end of the intervention (week 12) and follow up (week 24). All the collected data will be analysed following the intention-to-treat principle. ETHICS AND DISSEMINATION The Ethics Research Committee has approved this study (approval No. CMEC-2022-KT-51). Changes or developments in this study will be reported at www.chictr.org.cn . TRIAL REGISTRATION ChiCTR2300067296 (3 January 2023).
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Grants
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 82102651 Mechanism of the Regulation of Skeletal Muscle Cell AMPK Pathway by Intestinal P.merdae in the Progression of Sarcopenia
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- 2020YJZX0137 a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, "Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model"
- a special health research project of Shanghai Municipal Health Commission on the Health of Ageing, Woman and Children, “Exploration on the Screening and Rehabilitation Intervention Model for Sarcopenia among Community-dwelling Older people in Chongming District under the Medical Union Model”
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Affiliation(s)
- Min Zhuang
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Jinli Shi
- Community Health Service Center of Chengqiao Town, Chongming District, Shanghai, China
| | - Jian Liu
- Community Health Service Center of Gangxi Town, Chongming District, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Nan Chen
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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12
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Zang W, Chen H, Yan J, Li D, Xiao N, Zheng X, Zhang Z. Research trends and hotspots of exercise for people with sarcopenic: A bibliometric analysis. Medicine (Baltimore) 2023; 102:e35148. [PMID: 38115285 PMCID: PMC10727540 DOI: 10.1097/md.0000000000035148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/15/2023] [Accepted: 08/18/2023] [Indexed: 12/21/2023] Open
Abstract
This study aimed to analyze the trends and themes in exercise and sarcopenia research using a bibliometric approach. The Web of Science citation database was used to identify papers published on exercise and sarcopenia. The retrieved data on institutions, journals, countries, authors, journal distribution, and keywords were analyzed scientometric ally using CiteSpace and VOSviewer. 2895 papers were included according to our specified inclusion criteria eventually. The data showed an upward trend in the number of published articles on exercise and sarcopenia. The countries with the highest number of publications were the United States, Japan, and England; research institutions were mainly composed of universities in Europe and the United States, and high-producing authors formed major collaborative teams, but cross-geographical and cross-institutional collaboration was not apparent; research was closely focused on 3 aspects: resistance exercise, resistance combined with other forms of exercise, and exercise combined with nutritional supplementation, of which resistance exercise was a particular focus; and recently, the research hotspots were mainly the effects of exercise on grip strength. The most cited articles were consensus guidelines published by the working group on sarcopenia in the elderly from different continents. The prevention and rehabilitation of sarcopenia in the elderly are gaining attention. Current primary exercise therapies for sarcopenia and exercise combined with nutritional supplementation have significant advantages and the potential to delay muscle decay. This suggests a promising area for future research that could benefit from further advances.
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Affiliation(s)
- Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Haohao Chen
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
- College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
| | - Dong Li
- Department of International Culture Education, Chodang University, Jeollanam-do, Republic of Korea
| | - Ningkun Xiao
- Department of Psychology, Ural Federal University, Yekaterinburg, Russia
| | - Xiaoqin Zheng
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Zezhong Zhang
- Postgraduate School, University of Harbin Sport, Harbin, China
- Department of Sports, Harbin University, Harbin, China
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13
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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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14
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Zota IM, Ghiciuc CM, Cojocaru DC, Dima-Cozma CL, Leon MM, Gavril RS, Roca M, Costache AD, Maștaleru A, Anghel L, Stătescu C, Sascău RA, Mitu F. Changes in Arterial Stiffness in Response to Blood Flow Restriction Resistance Training: A Narrative Review. J Clin Med 2023; 12:7602. [PMID: 38137671 PMCID: PMC10743779 DOI: 10.3390/jcm12247602] [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: 10/18/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Arterial stiffness naturally increases with age and is a known predictor of cardiovascular morbimortality. Blood flow restriction (BFR) training involves decreasing muscle blood flow by applying a strap or a pneumatic cuff during exercise. BFR induces muscle hypertrophy even at low intensities, making it an appealing option for older, untrained individuals. However, BFR use in patients with cardiovascular comorbidities is limited by the increased pressor and chronotropic response observed in hypertensive elderly patients. Furthermore, the impact of BFR on vascular function remains unclear. We conducted a comprehensive literature review according to PRISMA guidelines, summarizing available data on the acute and long-term consequences of BFR training on vascular function. Although evidence is still scarce, it seems that BFR has a mild or neutral long-term impact on arterial stiffness. However, current research shows that BFR can cause an abrupt, albeit transient, increase in PWV and central blood pressure. BFR and, preferably, lower-body BFR, should be prescribed with caution in older populations, especially in hypertensive patients who have an exacerbated muscle metaboreflex pressor response. Longer follow-up studies are required to assess the chronic effect of BFR training on arterial stiffness, especially in elderly patients who are usually unable to tolerate high-intensity resistance exercises.
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Affiliation(s)
- Ioana Mădălina Zota
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania
| | - Doina Clementina Cojocaru
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Corina Lucia Dima-Cozma
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Maria Magdalena Leon
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Radu Sebastian Gavril
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Mihai Roca
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Alexandru Dan Costache
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Alexandra Maștaleru
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Larisa Anghel
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Cristian Stătescu
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Radu Andy Sascău
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Florin Mitu
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
- Academy of Medical Sciences of Romania, Ion C. Brătianu Boulevard No 1, 030167 Bucharest, Romania
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15
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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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16
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Warneke K, Lohmann LH, Lima CD, Hollander K, Konrad A, Zech A, Nakamura M, Wirth K, Keiner M, Behm DG. Physiology of Stretch-Mediated Hypertrophy and Strength Increases: A Narrative Review. Sports Med 2023; 53:2055-2075. [PMID: 37556026 PMCID: PMC10587333 DOI: 10.1007/s40279-023-01898-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/10/2023]
Abstract
Increasing muscle strength and cross-sectional area is of crucial importance to improve or maintain physical function in musculoskeletal rehabilitation and sports performance. Decreases in muscular performance are experienced in phases of reduced physical activity or immobilization. These decrements highlight the need for alternative, easily accessible training regimens for a sedentary population to improve rehabilitation and injury prevention routines. Commonly, muscle hypertrophy and strength increases are associated with resistance training, typically performed in a training facility. Mechanical tension, which is usually induced with resistance machines and devices, is known to be an important factor that stimulates the underlying signaling pathways to enhance protein synthesis. Findings from animal studies suggest an alternative means to induce mechanical tension to enhance protein synthesis, and therefore muscle hypertrophy by inducing high-volume stretching. Thus, this narrative review discusses mechanical tension-induced physiological adaptations and their impact on muscle hypertrophy and strength gains. Furthermore, research addressing stretch-induced hypertrophy is critically analyzed. Derived from animal research, the stretching literature exploring the impact of static stretching on morphological and functional adaptations was reviewed and critically discussed. No studies have investigated the underlying physiological mechanisms in humans yet, and thus the underlying mechanisms remain speculative and must be discussed in the light of animal research. However, studies that reported functional and morphological increases in humans commonly used stretching durations of > 30 min per session of the plantar flexors, indicating the importance of high stretching volume, if the aim is to increase muscle mass and maximum strength. Therefore, the practical applicability seems limited to settings without access to resistance training (e.g., in an immobilized state at the start of rehabilitation), as resistance training seems to be more time efficient. Nevertheless, further research is needed to generate evidence in different human populations (athletes, sedentary individuals, and rehabilitation patients) and to quantify stretching intensity.
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Affiliation(s)
- Konstantin Warneke
- Institute for Exercise, Sport and Health, Leuphana University, Universitätsallee 1, 21335, Lüneburg, Deutschland, Germany.
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada.
- Institute of Sport Science, Alpen-Adria University Klagenfurt, Klagenfurt, Germany.
| | - Lars H Lohmann
- University Sports Center, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Camila D Lima
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Astrid Zech
- Department of Human Motion Science and Exercise Physiology, Friedrich Schiller University, Jena, Germany
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, Ozaki, Kanzaki, Saga, Japan
| | - Klaus Wirth
- Institute of Sport Science, University of Applied Sciences Wiener Neustadt, Wiener Neustadt, Austria
| | - Michael Keiner
- Department of Sport Science, German University of Health and Sport, Ismaning, Germany
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
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17
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Ely IA, Phillips BE, Smith K, Wilkinson DJ, Piasecki M, Breen L, Larsen MS, Atherton PJ. A focus on leucine in the nutritional regulation of human skeletal muscle metabolism in ageing, exercise and unloading states. Clin Nutr 2023; 42:1849-1865. [PMID: 37625315 DOI: 10.1016/j.clnu.2023.08.010] [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: 01/13/2023] [Revised: 04/23/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Muscle protein synthesis (MPS) and muscle protein breakdown (MPB) are influenced through dietary protein intake and physical (in)activity, which it follows, regulate skeletal muscle (SKM) mass across the lifespan. Following consumption of dietary protein, the bio-availability of essential amino acids (EAA), and primarily leucine (LEU), drive a transient increase in MPS with an ensuing refractory period before the next MPS stimulation is possible (due to the "muscle full" state). At the same time, MPB is periodically constrained via reflex insulin actions. Layering exercise on top of protein intake increases the sensitivity of SKM to EAA, therefore extending the muscle full set-point (∼48 h), to permit long-term remodelling (e.g., hypertrophy). In contrast, ageing and physical inactivity are associated with a premature muscle full set-point in response to dietary protein/EAA and contractile activity. Of all the EAA, LEU is the most potent stimulator of the mechanistic target of rapamycin complex 1 (mTORC1)-signalling pathway, with the phosphorylation of mTORC1 substrates increasing ∼3-fold more than with all other EAA. Furthermore, maximal MPS stimulation is also achieved following low doses of LEU-enriched protein/EAA, negating the need for larger protein doses. As a result, LEU supplementation has been of long term interest to maximise muscle anabolism and subsequent net protein accretion, especially when in tandem with resistance exercise. This review highlights current knowledge vis-à-vis the anabolic effects of LEU supplementation in isolation, and in enriched protein/EAA sources (i.e., EAA and/or protein sources with added LEU), in the context of ageing, exercise and unloading states.
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Affiliation(s)
- Isabel A Ely
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Bethan E Phillips
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Kenneth Smith
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Daniel J Wilkinson
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Mathew Piasecki
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | - Philip J Atherton
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK.
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18
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Judd K, Morales C, White M, Wilkie K, Faller J, Ives SJ. The Effects of Accessory Blood Flow Restriction Training on Muscle Size and Strength in Division III Soccer Athletes: A Preliminary Ecological Study. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:1244-1256. [PMID: 38288384 PMCID: PMC10824293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Blood flow restriction training (BFRT) uses occlusion during low-intensity resistance training (< 50% of 1-repetition maximum, 1RM) to reduce arterial blood flow and venous return, imposing greater metabolic stress but similar muscular hypertrophy and strength gains as high-intensity resistance training (HIRT). However, no study, to date, has incorporated BFRT in a collegiate strength and conditioning setting to assess ecological validity. We aimed to investigate the effects of adding 6-weeks of accessory BFRT or HIRT to NCAA Division III soccer players prescribed resistance training regimen on muscle strength and size. Male and female (n = 17) athletes were randomly assigned to complete biceps curls 2x/week under BFRT or control (HIRT), following regularly scheduled strength training. Bicep strength (1RM) and circumference (BC) were assessed at weeks 0, 3, and 6 (men only). In men, for BC no significant interaction of condition x time was observed (p = 0.861), though condition (BFRT vs Control, p = 0.025) and time (p = 0.024) were significant. For 1RM, there was no significant interaction of condition x time (BFRT vs HIRT, p = 0.067) or of condition (p = 0.598), but there was a significant effect of time (p = 0.004). In women, there was no significant interaction between time and condition (p = 0.765) or of condition (p = 0.971) on BC, but time was significant (p = 0.045). For 1RM, there was no significant interaction of condition x time (p = 0.227) or of condition (p = 0.741), but time was (p = 0.018). In this preliminary ecological study, BFRT induced similar increases in muscle strength and circumference as HIRT in soccer players, suggesting that BFRT could be incorporated into collegiate athlete training.
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Affiliation(s)
- Kaitlyn Judd
- Health & Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Christian Morales
- Health & Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Megan White
- Health & Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Kate Wilkie
- Health & Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Justin Faller
- Department of Kinesiology, Sports Studies and Physical Education, SUNY Brockport, Brockport, NY, 14420, USA
| | - Stephen J Ives
- Health & Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
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19
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Chang H, Yan J, Lu G, Chen B, Zhang J. Muscle strength adaptation between high-load resistance training versus low-load blood flow restriction training with different cuff pressure characteristics: a systematic review and meta-analysis. Front Physiol 2023; 14:1244292. [PMID: 37693006 PMCID: PMC10485702 DOI: 10.3389/fphys.2023.1244292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose: In this systematic review and meta-analysis, blood flow restriction (BFR) with low-load resistance training (BFR-RT) was compared with high-load resistance training (HL-RT) on muscle strength in healthy adults. The characteristics of cuff pressure suitable for muscle strength gain were also investigated by analyzing the effects of applying different occlusion pressure prescriptions and cuff inflation patterns on muscle strength gain. Methods: Literature search was conducted using PubMed, Ovid Medline, ProQuest, Cochrane Library, Embase, and Scopus databases to identify literature published until May 2023. Studies reporting the effects of BFR-RT interventions on muscle strength gain were compared with those of HL-RT. The risk of bias in the included trials was assessed using the Cochrane tool, followed by a meta-analysis to calculate the combined effect. Subgroup analysis was performed to explore the beneficial variables. Results: Nineteen articles (42 outcomes), with a total of 458 healthy adults, were included in the meta-analysis. The combined effect showed higher muscle strength gain with HL-RT than with BFR-RT (p = 0.03, SMD = -0.16, 95% CI: -0.30 to -0.01). The results of the subgroup analysis showed that the BFR-RT applied with incremental and individualized pressure achieved muscle strength gain similar to the HL-RT (p = 0.8, SMD = -0.05, 95% CI: -0.44 to 0.34; p = 0.68, SMD = -0.04, 95% CI: -0.23 to 0.15), but muscle strength gain obtained via BFR-RT applied with absolute pressure was lower than that of HL-RT (p < 0.05, SMD = -0.45, 95% CI: -0.71 to -0.19). Furthermore, muscle strength gain obtained by BFR-RT applied with intermittent pressure was similar to that obtained by HL-RT (p = 0.88, SMD = -0.02, 95% CI: -0.27 to 0.23), but muscle strength gain for BFR-RT applied with continuous pressure showed a less prominent increase than that for HL-RT (p < 0.05, SMD = -0.3, 95% CI: -0.48 to -0.11). Conclusion: In general, HL-RT produces superior muscle strength gains than BFR-RT. However, the application of individualized, incremental, and intermittent pressure exercise protocols in BFR-RT elicits comparable muscle strength gains to HL-RT. Our findings indicate that cuff pressure characteristics play a significant role in establishing a BFR-RT intervention program for enhancing muscle strength in healthy adults. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails; Identifier: PROSPERO (CRD42022364934).
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Affiliation(s)
- Hualong Chang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jing Yan
- College of Education, Anyang Normal University, Anyang, China
| | - Guiwei Lu
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Biao Chen
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jianli Zhang
- Exercise and Metabolism Research Center, College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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20
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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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21
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Reidy PT, Borack MS, Dickinson JM, Carroll CC, Burd NA, Drummond MJ, Fry CS, Lambert BS, Gundermann DM, Glynn EL, Markofski MM, Timmerman KL, Moro T, Volpi E, Trappe S, Trappe TA, Harber MP, Rasmussen BB. Postabsorptive muscle protein synthesis is higher in outpatients as compared to inpatients. Am J Physiol Endocrinol Metab 2023; 325:E113-E118. [PMID: 37315157 PMCID: PMC10393319 DOI: 10.1152/ajpendo.00144.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
Several factors affect muscle protein synthesis (MPS) in the postabsorptive state. Extreme physical inactivity (e.g., bedrest) may reduce basal MPS, whereas walking may augment basal MPS. We hypothesized that outpatients would have a higher postabsorptive MPS than inpatients. To test this hypothesis, we conducted a retrospective analysis. We compared 152 outpatient participants who arrived at the research site the morning of the MPS assessment with 350 Inpatient participants who had an overnight stay in the hospital unit before the MPS assessment the following morning. We used stable isotopic methods and collected vastus lateralis biopsies ∼2 to 3 h apart to assess mixed MPS. MPS was ∼12% higher (P < 0.05) for outpatients than inpatients. Within a subset of participants, we discovered that after instruction to limit activity, outpatients (n = 13) took 800 to 900 steps in the morning to arrive at the unit, seven times more steps than inpatients (n = 12). We concluded that an overnight stay in the hospital as an inpatient is characterized by reduced morning activity and causes a slight but significant reduction in MPS compared with participants studied as outpatients. Researchers should be aware of physical activity status when designing and interpreting MPS results.NEW & NOTEWORTHY The postabsorptive muscle protein synthesis rate is lower in the morning after an overnight inpatient hospital stay compared with an outpatient visit. Although only a minimal amount of steps was conducted by outpatients (∼900), this was enough to increase postabsorptive muscle protein synthesis rate.
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Affiliation(s)
- Paul T Reidy
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, Ohio, United States
| | - Michael S Borack
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
| | - Jared M Dickinson
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
| | - Chad C Carroll
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Nicholas A Burd
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Micah J Drummond
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, Utah, United States
- Molecular Medicine Program, University of Utah, Salt Lake City, Utah, United States
| | - Christopher S Fry
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States
| | - Bradley S Lambert
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
| | - David M Gundermann
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
| | - Erin L Glynn
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
| | - Melissa M Markofski
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States
| | - Kyle L Timmerman
- Department of Internal Medicine/Geriatrics, University of Texas Medical Branch, Galveston, Texas, United States
| | - Tatiana Moro
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States
- Department of Internal Medicine/Geriatrics, University of Texas Medical Branch, Galveston, Texas, United States
| | - Scott Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Todd A Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Matthew P Harber
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Blake B Rasmussen
- Center for Metabolic Health, University of Texas Medical Branch, Galveston, Texas, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States
- Department of Biochemistry & Molecular Biology, University of Texas Medical Branch, Galveston, Texas, United States
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22
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Chen YC, Lin YT, Hu CL, Hwang IS. Low-Level Laser Therapy Facilitates Postcontraction Recovery with Ischemic Preconditioning. Med Sci Sports Exerc 2023; 55:1326-1333. [PMID: 36878185 DOI: 10.1249/mss.0000000000003149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
PURPOSE Despite early development of muscle fatigue, ischemic preconditioning is gaining popularity for strength training combined with low-load resistance exercise. This study investigated the effect of low-level laser (LLL) on postcontraction recovery with ischemic preconditioning. METHODS Forty healthy adults (22.9 ± 3.5 yr) were allocated into sham (11 men, 9 women) and LLL (11 men, 9 women) groups. With ischemic preconditioning, they were trained with three bouts of intermittent wrist extension of 40% maximal voluntary contraction (MVC). During the recovery period, the LLL group received LLL (wavelength of 808 nm, 60 J) on the working muscle, whereas the sham group received no sham therapy. MVC, force fluctuations, and discharge variables of motor units (MU) for a trapezoidal contraction were compared between groups at baseline (T0), postcontraction (T1), and after-recovery (T2). RESULTS At T2, the LLL group exhibited a higher normalized MVC (T2/T0; 86.22% ± 12.59%) than that of the sham group (71.70% ± 13.56%; P = 0.001). The LLL group had smaller normalized force fluctuations (LLL, 94.76% ± 21.95%; sham, 121.37% ± 29.02%; P = 0.002) with greater normalized electromyography amplitude (LLL, 94.33% ± 14.69%; sham, 73.57% ± 14.94%; P < 0.001) during trapezoidal contraction. In the LLL group, the smaller force fluctuations were associated with lower coefficients of variation of interspike intervals of MUs (LLL, 0.202 ± 0.053; sham, 0.208 ± 0.048; P = 0.004) with higher recruitment thresholds (LLL, 11.61 ± 12.68 %MVC; sham, 10.27 ± 12.73 %MVC; P = 0.003). CONCLUSIONS LLL expedites postcontraction recovery with ischemic preconditioning, manifesting as superior force generation capacity and force precision control for activation of MU with a higher recruitment threshold and lower discharge variability.
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Affiliation(s)
| | - Yen-Ting Lin
- Department of Ball Sport, National Taiwan University of Sport, Taichung City, TAIWAN
| | - Chia-Ling Hu
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, TAIWAN
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23
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Signals for Muscular Protein Turnover and Insulin Resistance in Critically Ill Patients: A Narrative Review. Nutrients 2023; 15:nu15051071. [PMID: 36904071 PMCID: PMC10005516 DOI: 10.3390/nu15051071] [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: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/24/2023] Open
Abstract
Sarcopenia in critically ill patients is a highly prevalent comorbidity. It is associated with a higher mortality rate, length of mechanical ventilation, and probability of being sent to a nursing home after the Intensive Care Unit (ICU). Despite the number of calories and proteins delivered, there is a complex network of signals of hormones and cytokines that affect muscle metabolism and its protein synthesis and breakdown in critically ill and chronic patients. To date, it is known that a higher number of proteins decreases mortality, but the exact amount needs to be clarified. This complex network of signals affects protein synthesis and breakdown. Some hormones regulate metabolism, such as insulin, insulin growth factor glucocorticoids, and growth hormone, whose secretion is affected by feeding states and inflammation. In addition, cytokines are involved, such as TNF-alpha and HIF-1. These hormones and cytokines have common pathways that activate muscle breakdown effectors, such as the ubiquitin-proteasome system, calpain, and caspase-3. These effectors are responsible for protein breakdown in muscles. Many trials have been conducted with hormones with different results but not with nutritional outcomes. This review examines the effect of hormones and cytokines on muscles. Knowing all the signals and pathways that affect protein synthesis and breakdown can be considered for future therapeutics.
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24
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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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25
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Pavlou K, Korakakis V, Whiteley R, Karagiannis C, Ploutarchou G, Savva C. The effects of upper body blood flow restriction training on muscles located proximal to the applied occlusive pressure: A systematic review with meta-analysis. PLoS One 2023; 18:e0283309. [PMID: 36952451 PMCID: PMC10035935 DOI: 10.1371/journal.pone.0283309] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Blood flow restriction combined with low load resistance training (LL-BFRT) is associated with increases in upper limb muscle strength and size. The effect of LL-BFRT on upper limb muscles located proximal to the BFR cuff application is unclear. OBJECTIVE The aim of this systematic review was to evaluate the effect of LL-BFRT compared to low load, or high load resistance training (LL-RT, HL-RT) on musculature located proximal to cuff placement. METHODS Six electronic databases were searched for randomized controlled trials (RCTs). Two reviewers independently evaluated the risk of bias using the PEDro scale. We performed a meta-analysis using a random effects model, or calculated mean differences (fixed-effect) where appropriate. We judged the certainty of evidence using the GRADE approach. RESULTS The systematic literature searched yielded 346 articles, of which 9 studies were eligible. The evidence for all outcomes was of very low to low certainty. Across all comparisons, a significant increase in bench press and shoulder flexion strength was found in favor of LL-BFRT compared to LL-RT, and in shoulder lean mass and pectoralis major thickness in favor of the LL-BFRT compared to LL-RT and HL-RT, respectively. No significant differences were found between LL-BFRT and HL-RT in muscle strength. CONCLUSION With low certainty LL-BFRT appears to be equally effective to HL-RT for improving muscle strength in upper body muscles located proximal to the BFR stimulus in healthy adults. Furthermore, LL-BFRT may induce muscle size increase, but these adaptations are not superior to LL-RT or HL-RT.
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Affiliation(s)
- Kyriakos Pavlou
- Department of Health Science, European University Cyprus, Engomi, Nicosia, Cyprus
| | - Vasileios Korakakis
- Department of Population Health Sciences, School of Life Course & Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Christos Karagiannis
- Department of Health Science, European University Cyprus, Engomi, Nicosia, Cyprus
| | - George Ploutarchou
- Department of Health Science, European University Cyprus, Engomi, Nicosia, Cyprus
| | - Christos Savva
- Department of Health Science, European University Cyprus, Engomi, Nicosia, Cyprus
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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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27
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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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28
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Fabero-Garrido R, Gragera-Vela M, del Corral T, Izquierdo-García J, Plaza-Manzano G, López-de-Uralde-Villanueva I. Effects of Low-Load Blood Flow Restriction Resistance Training on Muscle Strength and Hypertrophy Compared with Traditional Resistance Training in Healthy Adults Older Than 60 Years: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11247389. [PMID: 36556004 PMCID: PMC9787798 DOI: 10.3390/jcm11247389] [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: 11/24/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is clinical interest in determining the effects of low-load blood flow restriction (LL-BFR) resistance training on muscle strength and hypertrophy compared with traditional high- and low-load (HL and LL) resistance training in healthy older adults and the influence of LL-BFR training cuff-pressure on these outcomes. METHODS A search was performed on the MEDLINE, PEDro, CINHAL, Web of Science, Science Direct, Scopus, and CENTRAL databases. RESULTS The analysis included 14 studies. HL resistance training produces a small increase in muscle strength (eight studies; SMD, -0.23 [-0.41; -0.05]) but not in muscle hypertrophy (six studies; (SMD, 0.08 [-0.22; 0.38]) when compared with LL-BFR resistance training. Compared with traditional LL resistance training, LL-BFR resistance training produces small-moderate increases in muscle strength (seven studies; SMD, 0.44 [0.28; 0.60]) and hypertrophy (two studies; SMD, 0.51 [0.06; 0.96]). There were greater improvements in muscle strength when higher cuff pressures were applied versus traditional LL resistance training but not versus HL resistance training. CONCLUSIONS LL-BFR resistance training results in lower muscle strength gains than HL resistance training and greater than traditional LL resistance training in healthy adults older than 60 years. LL-BFR resistance training promotes a similar muscle hypertrophy to HL resistance training but is greater than that of traditional LL resistance training. Applying cuff pressures above the limb occlusion pressure could enhance the increases in muscle strength compared with traditional LL resistance training.
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Affiliation(s)
- Raúl Fabero-Garrido
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Miguel Gragera-Vela
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Tamara del Corral
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-91-394-15-17
| | - Juan Izquierdo-García
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Multidisciplinary Cardiac Rehabilitation Unit, University Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Effects of Training with Blood Flow Restriction on Muscular Strength: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:1563-1577. [PMID: 36583141 PMCID: PMC9762165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to analyze how blood flow restriction (BFR) training influences muscular strength through a systematic review and meta-analysis. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The following databases were used to conduct the research: Academic Search Complete, Medline, Web of Science, SPORT-Discus, HealthSource: Consumer, and HealthSource: Nursing. The following search limitations were included in this study: full-text articles investigating the effects of BFR training on muscular strength, published in a peer-reviewed academic journal, and published in the English language. Out of 327 articles, 25 were eligible to be included in this study. Comprehensive meta-analysis v.3 software was used to run statistics of the collected data from each study. The results showed that BFR training positively affects muscular strength. However, no group difference was found by gender, duration, workload, and cuff type/pressure in current data. This study provides additional information that can be used in future studies to obtain optimum strength results during BFR training.
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Jeon BH. Effects of Low Intensity Blood Flow Restriction Training on Muscle Volume, Strength and Power in Healthy Middle-Aged Females. THE ASIAN JOURNAL OF KINESIOLOGY 2022. [DOI: 10.15758/ajk.2022.24.4.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The purpose of this study is to investigate the efficacy of weight training with controlled blood flow occlusion compared to conventional resistance training, in the ageing population.METHODS Twenty-three healthy female subjects (aged 40-55) were randomly assigned to one of three groups; low intensity blood flow restriction training (LI-BFRT) (n = 9), conventional resistance training (RT) (n = 7) and control (CON) (n = 7). The RT group trained between 65-70% one repetition maximum (1RM) and the LI-BFRT group trained at 30% 1RM while wearing pressure cuffs inflated to 100-120% of brachial systolic blood pressure (bSBP). Relative appendicular skeletal muscle mass (ASM/weight), isokinetic strength and power were tested pre and post 8 weeks of training.RESULTS Upper limb ASM/weight increased significantly in the LI-BFRT and RT groups (both p < 0.001). Only LI-BFRT showed significant difference compared with the CON group (p < 0.01). Lower limb ASM/weight improved in both the LI-BFRT (p < 0.01) and CON (p < 0.01) groups without group differences. Lower limb flexion strength increased in the LI-BFRT and RT groups (both p < 0.01), with differences between groups (p < 0.01, LI-BFRT > RT > CON). Only RT increased extension muscle strength (p < 0.05). Lower limb flexion and extension power improved following LI-BFRT (p < 0.05 and p < 0.01, respectively), significantly greater than RT in both flexion (p < 0.001) and extension (p < 0.01).CONCLUSIONS LI-BFRT may be as, if not more effective than RT for increasing muscle volume, strength and power in middle-aged women.
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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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Chen Y, Wang J, Li S, Li Y. Acute effects of low load resistance training with blood flow restriction on serum growth hormone, insulin-like growth factor-1, and testosterone in patients with mild to moderate unilateral knee osteoarthritis. Heliyon 2022; 8:e11051. [PMID: 36281415 PMCID: PMC9586906 DOI: 10.1016/j.heliyon.2022.e11051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/05/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To investigate the acute effects of blood flow restriction (BFR) with single-leg low load resistance exercise and high load resistance exercise on serum insulin-like growth factor-1 (IGF-1), growth hormone (GH), and testosterone in patients with unilateral knee osteoarthritis (OA). Methods This study recruited 18 postmenopausal female patients with mild to moderate unilateral knee OA, which was then followed by randomly conducting three resistance exercise protocols by drawing lots: 1. A 30% 1-repetition maximum (1-RM) resistance exercise with BFR of 70% arterial occlusive pressure (AOP) (BFR group); 2. A 70% 1-RM resistance exercise without BFR (RES group); 3. A 30% 1-RM resistance exercise without BFR (CON group). Blood lactate (BLA) and muscle growth related hormone levels were tested at 4-time points: before exercise, immediately after exercise, 15 min after exercise, and 30 min after exercise. Results There was no statistical difference between the indexes in each group before exercise, but the different exercise had different effects on each index and also an interactive effect (P < 0.05). The increase of rating of perceived exertion in the BFR and RES groups, which were of similar magnitude, was greater compared to the levels in the CON group (P < 0.05). Post-exercise BLA levels were lower in the CON group in comparison to the BFR and RES groups (P < 0.05). Rather than the RES group, GH levels of the BFR group were also significantly higher than the CON group (P < 0.05) at 15 min post-exercise. At post- and 15 min after exercise, the CON group recorded significantly lower IGF-1 levels compared to the BFR and RES groups (P < 0.05). At post- and 15 min after exercise, the CON group (P < 0.05) reflected the lowest testosterone levels, followed by the RES group (P < 0.05), and the highest in the BFR group (P < 0.05). Conclusions Myogenesis-related hormones in women with unilateral knee OA could be increased by high load resistance exercise and low load resistance exercise with BFR on unaffected limb.
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Affiliation(s)
- Yangguang Chen
- College of Physical Education, Zhengzhou Shengda University, Zhengzhou, Henan, China
| | - Junguo Wang
- Center for Osteoarticular and Trauma Surgery, Qingdao Hospital of Traditional Chinese Medicine (Qingdao Hiser Hospital), Qingdao, Shandong, China
| | - Shuoqi Li
- College of Physical Education, Yangzhou University, Yangzhou, Zhejiang, China
| | - Yinghao Li
- College of Physical Education, Zhengzhou Shengda University, Zhengzhou, Henan, China
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Effects of Blood Flow Restriction Therapy for Muscular Strength, Hypertrophy, and Endurance in Healthy and Special Populations: A Systematic Review and Meta-Analysis. Clin J Sport Med 2022; 32:531-545. [PMID: 36083329 DOI: 10.1097/jsm.0000000000000991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Blood flow restriction (BFR) training is an increasingly applied tool with potential benefits in muscular hypertrophy, strength, and endurance. This study investigates the effectiveness of BFR training relative to other forms of training on muscle strength, hypertrophy, and endurance. DATA SOURCES We performed systematic searches of MEDLINE, Embase, and PubMed and assessed the methodological quality of included studies using the Cochrane risk of bias tool. MAIN RESULTS We included 53 randomized controlled trials with 31 included in meta-analyses. For muscular strength comparing low-intensity BFR (LI-BFR) training with high-intensity resistance training (HIRT), the pooled mean difference (MD) for 1 repetition maximum was 5.34 kg (95% CI, 2.58-8.09; P < 0.01) favoring HIRT. When comparing LI-BFR training with HIRT for torque, the MD was 6.35 N·m (95% CI, 0.5-12.3; P = 0.04) also favoring HIRT. However, comparing LI-BFR with low-intensity resistance training (LIRT) for torque, there was a MD of 9.94 N·m (95% CI, 5.43-14.45; P < 0.01) favoring BFR training. Assessing muscle hypertrophy, the MD in cross-sectional area was 0.96 cm2 (95% CI, 0.21-1.7; P = 0.01) favoring pooled BFR training compared with nonocclusive training. Assessing endurance, V̇o2 maximum demonstrated a greater mean increase of 0.37 mL/kg/min (95% CI, -0.97 to 3.17; P = 0.64) in BFR endurance training compared with endurance training alone. CONCLUSION Blood flow restriction training produced increases in muscular strength, hypertrophy, and endurance. Comparing LI-BFR training with HIRT, HIRT was a significantly better training modality for increasing muscle hypertrophy and strength. However, LI-BFR was superior when compared with a similar low-intensity protocol. Blood flow restriction training is potentially beneficial to those unable to tolerate the high loads of HIRT; however, better understanding of its risk to benefit ratio is needed before clinical application. LEVEL OF EVIDENCE Level 1.
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Guo ZJ, Xie WQ, Cai ZJ, Zhang YY, Ding YL, Naranmandakh S, Li YS, Xiao WF. The top 100 most-cited articles on exercise therapy for sarcopenia: A bibliometric analysis. Front Med (Lausanne) 2022; 9:961318. [PMID: 36035407 PMCID: PMC9412013 DOI: 10.3389/fmed.2022.961318] [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: 06/07/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Vast quantities of literature regarding the applications of exercise therapy for sarcopenia have been published. The main objective of this study is to determine the top 100 most-cited articles and analyze their bibliometric characteristics. Design This study reports a bibliometric analysis via a systematic search of the academic literature regarding the applications of exercise therapy for sarcopenia. Methods All databases in the Web of Science were searched with the following strategy: term search (TS) = (exercise* OR training OR “physical activit*”) AND TS = (sarcopenia) on 25 February 2022. The results were presented in descending order by their total citations. The list of the top 100 articles was finally determined by negotiation of two independent researchers. Results The top 100 articles were published between 1993 and 2020. More than half of the articles (n = 54) were published during the decade 2006–2015. Total citations of the top 100 articles ranged from 155 to 1,131 with a median of 211.5. The average of annual citations was constantly increasing with year (P < 0.05). The most studied exercise therapy is strength/resistance training, with about 71% articles had discussed about it. The top 100 articles were from 54 different journals, and the Journal of Applied Physiology was the journal that contributed the most articles (n = 8). A total of 75 different first corresponding authors from 15 countries made contributions to the top 100 list. Luc J.C. van Loon from the Maastricht University in the Netherlands published the most articles (n = 5) as the first corresponding author. Most articles (87%) were from North America (58%) and Europe (29%), while the United States as a country contributed over half of the articles (51%). Conclusion Our study determined the top 100 most-cited articles on exercise therapy for sarcopenia and analyzed their bibliometric characteristics, which may provide a recommended list for researchers in this field and pave the way for further research.
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Affiliation(s)
- Zhao-jing Guo
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Wen-qing Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zi-jun Cai
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yue-yao Zhang
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yi-lan Ding
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Shinen Naranmandakh
- School of Arts and Sciences, National University of Mongolia, Ulaanbaatar, Mongolia
| | - Yu-sheng Li
- Deparment 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
| | - Wen-feng Xiao
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Wen-feng Xiao
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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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Cordingley DM, Anderson JE, Cornish SM. Myokine Response to Blood-Flow Restricted Resistance Exercise in Younger and Older Males in an Untrained and Resistance-Trained State: A Pilot Study. JOURNAL OF SCIENCE IN SPORT AND EXERCISE 2022. [PMCID: PMC9099348 DOI: 10.1007/s42978-022-00164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose The purpose of this study was to examine the response of myokines to blood-flow restricted resistance-exercise (BFR-RE) in younger and older males before and after completing a 12-week resistance-training program. Methods There were 8 younger (24.8 ± 3.9 yrs) and 7 older (68.3 ± 5.0 yrs) untrained male participants completed this study. Anthropometric and maximal strength (1RM) measurements were collected before and after a 12-week, supervised, progressive full-body resistance-training program. As well, an acute bout of full-body BFR-RE was performed with venipuncture blood samples collected before and immediately following the BFR-RE, followed by sampling at 3, 6, 24 and 48 h. Results The 12-week training program stimulated a 32.2% increase in average strength and 30% increase in strength per kg of fat free mass. The response of particular myokines to the acute bout of BFR-RE was influenced training status (IL-4, untrained = 78.1 ± 133.2 pg/mL vs. trained = 59.8 ± 121.6 pg/mL, P = 0.019; IL-7, untrained = 3.46 ± 1.8 pg/mL vs. trained = 2.66 ± 1.3 pg/mL, P = 0.047) or both training and age (irisin, P = 0.04; leukemia inhibitory factor, P < 0.001). As well, changes in strength per kg of fat free mass were correlated with area under the curve for IL-4 (r = 0.537; P = 0.039), IL-6 (r = 0. 525; P = 0.044) and LIF (r = − 0.548; P = 0.035) in the untrained condition. Conclusion This study identified that both age and training status influence the myokine response to an acute bout of BFR-RE with the release of IL-4, IL-6 and LIF in the untrained state being associated with changes in strength per kg of fat free mass.
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Affiliation(s)
- Dean M. Cordingley
- Applied Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
- Pan Am Clinic Foundation, 75 Poseidon Bay, Winnipeg, MB R3M 3E4 Canada
| | | | - Stephen M. Cornish
- Applied Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
- Faculty of Kinesiology and Recreation Management, University of Manitoba, 110 Frank Kennedy Centre, Winnipeg, MB R3T 2N2 Canada
- Centre for Aging, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
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Zhang T, Wang X, Wang J. Effect of blood flow restriction combined with low-intensity training on the lower limbs muscle strength and function in older adults: A meta-analysis. Exp Gerontol 2022; 164:111827. [DOI: 10.1016/j.exger.2022.111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022]
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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: 9] [Impact Index Per Article: 4.5] [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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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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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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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
- Houston Methodist Orthopedics & Sports Medicine, Houston, Texas, U.S.A
| | | | - Joshua D. Harris
- Houston Methodist Orthopedics & Sports Medicine, Houston, Texas, U.S.A
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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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Freitas EDS, Karabulut M, Bemben MG. The Evolution of Blood Flow Restricted Exercise. Front Physiol 2021; 12:747759. [PMID: 34925056 PMCID: PMC8674694 DOI: 10.3389/fphys.2021.747759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022] Open
Abstract
The use of blood flow restricted (BFR) exercise has become an accepted alternative approach to improve skeletal muscle mass and function and improve cardiovascular function in individuals that are not able to or do not wish to use traditional exercise protocols that rely on heavy loads and high training volumes. BFR exercise involves the reduction of blood flow to working skeletal muscle by applying a flexible cuff to the most proximal portions of a person’s arms or legs that results in decreased arterial flow to the exercising muscle and occluded venous return back to the central circulation. Safety concerns, especially related to the cardiovascular system, have not been consistently reported with a few exceptions; however, most researchers agree that BFR exercise can be a relatively safe technique for most people that are free from serious cardiovascular disease, as well as those with coronary artery disease, and also for people suffering from chronic conditions, such as multiple sclerosis, Parkinson’s, and osteoarthritis. Potential mechanisms to explain the benefits of BFR exercise are still mostly speculative and may require more invasive studies or the use of animal models to fully explore mechanisms of adaptation. The setting of absolute resistive pressures has evolved, from being based on an individual’s systolic blood pressure to a relative measure that is based on various percentages of the pressures needed to totally occlude blood flow in the exercising limb. However, since several other issues remain unresolved, such as the actual external loads used in combination with BFR, the type of cuff used to induce the blood flow restriction, and whether the restriction is continuous or intermittent, this paper will attempt to address these additional concerns.
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Affiliation(s)
- Eduardo D S Freitas
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Murat Karabulut
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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