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Thompson KMA, Pethick WA, Clarke J, Winegarden A, Johnson E, Coates AM, Stellingwerff T, Burr JF. Blood Flow-Restricted Training and Time Trial Performance: A Cohort Study of World-Class Rowers. Med Sci Sports Exerc 2024; 56:1606-1614. [PMID: 38619968 DOI: 10.1249/mss.0000000000003459] [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: 04/17/2024]
Abstract
INTRODUCTION This study aimed to explore the potential impact of incorporating blood flow restriction (BFR) training within a training block characterized by minimal high-intensity work on 2000-m rowing ergometer time trial (TT) performance in elite/world-class rowers. Physiological markers often associated with endurance performance (maximal aerobic capacity, V̇O 2max ; blood lactate thresholds and hemoglobin mass, Hb mass ) were measured to determine whether changes are related to an improvement in performance. METHODS Using a quasi-experimental, observational study design (no control group), 2000-m TT performance, V̇O 2max , submaximal work rates eliciting blood lactate concentrations of ~2 and ~4 mmol·L -1 , and Hb mass were measured before and after 4 wk of noncompetitive season training, which included BFR rowing. BFR training consisted of 11 sessions of 2 × 10 min of BFR rowing at a workload equating to blood lactate concentrations of ~2 mmol·L -1 . Paired t -tests were used to compare pre-/postvalues, and Pearson correlation was used to examine whether physiological changes were associated with changes to TT performance. RESULTS TT performance improved in both female (1.09% ± 1.2%, ~4.6 ± 5.2 s; P < 0.01) and male (1.17% ± 0.48%, ~4.5 ± 1.9 s; P < 0.001) athletes. V̇O 2max increased in female rowers only ( P < 0.01), but both sexes had an increase in work rates eliciting blood lactate concentrations of 2 mmol·L -1 (female: 184 ± 16 to 195 ± 15 W, P < 0.01; male: 288 ± 23 to 317 ± 26 W, P = 0.04) and 4 mmol·L -1 (female: 217 ± 13 to 227 ± 14 W, P = 0.02; male: 339 ± 43 to 364 ± 39 W, P < 0.01). No changes in Hb mass (both sexes, P = 0.8) were observed. Improvements in TT performance were not related to physiological changes (all correlations P ≥ 0.2). CONCLUSIONS After 4 wk of training with BFR, the improvement in TT performance was greater than what is typical for this population. Physiological variables improved during this training block but did not explain improved TT performance.
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Affiliation(s)
- Kyle M A Thompson
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, CANADA
| | - Wendy A Pethick
- Canadian Sport Institute-Pacific, Victoria, British Columbia, CANADA
| | - Jordan Clarke
- Rowing Canada Aviron National Training Centre, North Cowichan, British Columbia, CANADA
| | - Anneke Winegarden
- Canadian Sport Institute-Pacific, Victoria, British Columbia, CANADA
| | - Elizabeth Johnson
- Canadian Sport Institute-Pacific, Victoria, British Columbia, CANADA
| | - Alexandra M Coates
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, CANADA
| | | | - Jamie F Burr
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, CANADA
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Chen YC, Lo IP, Tsai YY, Zhao CG, Hwang IS. Dual-task improvement of older adults after treadmill walking combined with blood flow restriction of low occlusion pressure: the effect on the heart-brain axis. J Neuroeng Rehabil 2024; 21:116. [PMID: 38997727 PMCID: PMC11241870 DOI: 10.1186/s12984-024-01412-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 06/23/2024] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVE This study explored the impact of one session of low-pressure leg blood flow restriction (BFR) during treadmill walking on dual-task performance in older adults using the neurovisceral integration model framework. METHODS Twenty-seven older adults participated in 20-min treadmill sessions, either with BFR (100 mmHg cuff pressure on both thighs) or without it (NBFR). Dual-task performance, measured through light-pod tapping while standing on foam, and heart rate variability during treadmill walking were compared. RESULTS Following BFR treadmill walking, the reaction time (p = 0.002) and sway area (p = 0.012) of the posture dual-task were significantly reduced. Participants exhibited a lower mean heart rate (p < 0.001) and higher heart rate variability (p = 0.038) during BFR treadmill walking. Notably, BFR also led to band-specific reductions in regional brain activities (theta, alpha, and beta bands, p < 0.05). The topology of the EEG network in the theta and alpha bands became more star-like in the post-test after BFR treadmill walking (p < 0.005). CONCLUSION BFR treadmill walking improves dual-task performance in older adults via vagally-mediated network integration with superior neural economy. This approach has the potential to prevent age-related falls by promoting cognitive reserves.
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Affiliation(s)
- Yi-Ching Chen
- Department of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung City, Taiwan
- Physical Therapy Room, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - I-Ping Lo
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Yi-Ying Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Chen-Guang Zhao
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Ing-Shiou Hwang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan.
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
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Suggitt JO, Eaves BE, Spranger MD. What are the cardiovascular responses during blood flow-restricted resistance exercise? Front Physiol 2024; 15:1417855. [PMID: 38966227 PMCID: PMC11222610 DOI: 10.3389/fphys.2024.1417855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Affiliation(s)
| | | | - Marty D. Spranger
- Department of Physiology, Michigan State University, East Lansing, MI, United States
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Herda AA, Cleary CJ, Young D, Rogers KB, Umana Segura SE, Bernard C, Vopat LM, Vopat BG. Blood Flow Restriction during Walking Does Not Impact Body Composition or Performance Measures in Highly Trained Runners. J Funct Morphol Kinesiol 2024; 9:74. [PMID: 38651432 PMCID: PMC11036251 DOI: 10.3390/jfmk9020074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Blood flow restriction (BFR) is a commonly used training modality that has been demonstrated to enhance muscle characteristics such as size and function. The purpose of this study was to determine if a 4-week walking program with or without BFR in healthy, active adults has an effect on body composition, anaerobic, and aerobic running performance. Thirty-three participants, randomized among three groups, completed the walking program, which included five sets of 2 min walking intervals with 1 min rest, with or without BFR, or 10 min walking with BFR. Assessments completed before and after the walking program included body composition, 40-yard sprints, and a VO2MAX test on a treadmill. A two-way ANOVA revealed no changes among the groups nor for any variables at any time (p > 0.05). Additionally, one main effect for time indicated the VO2 at V-slope threshold was greater following training for all groups combined (p = 0.001). The results demonstrate that low volume and intensity walking with BFR for 4 weeks did not provide a sufficient stimulus for changing body composition or performance metrics in a group of very active adults. Longer or more isolated exposure of BFR on the limbs may contribute to more pronounced adaptations.
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Affiliation(s)
- Ashley A. Herda
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS 66046, USA; (C.J.C.); (K.B.R.); (S.E.U.S.)
- Department of Orthopedics and Sport Medicine, University of Kansas Medical Center, Overland Park, KS 66213, USA
| | - Christopher J. Cleary
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS 66046, USA; (C.J.C.); (K.B.R.); (S.E.U.S.)
| | - Dana Young
- Department of Orthopedics and Sport Medicine, University of Kansas Medical Center, Overland Park, KS 66213, USA
| | - KathleenMae B. Rogers
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS 66046, USA; (C.J.C.); (K.B.R.); (S.E.U.S.)
| | - Santiago E. Umana Segura
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS 66046, USA; (C.J.C.); (K.B.R.); (S.E.U.S.)
| | - Christopher Bernard
- Department of Orthopedics and Sport Medicine, University of Kansas Medical Center, Overland Park, KS 66213, USA
| | - Lisa M. Vopat
- Department of Orthopedics and Sport Medicine, University of Kansas Medical Center, Overland Park, KS 66213, USA
| | - Bryan G. Vopat
- Department of Orthopedics and Sport Medicine, University of Kansas Medical Center, Overland Park, KS 66213, USA
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Does sex influence near-infrared spectroscopy-derived indicators of microvascular reactivity and the response to acute dietary capsaicin. Microvasc Res 2023; 145:104436. [PMID: 36113667 DOI: 10.1016/j.mvr.2022.104436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/28/2022] [Accepted: 09/10/2022] [Indexed: 02/03/2023]
Abstract
Endothelial dysfunction is associated with cardiovascular disease development, nitric oxide (NO) deficiencies, and may be limb or sex-specific. Prior in vitro work indicated that the transient receptor potential vanilloid channel-1 (TRPV1) is expressed in human arteries and the TRPV1 agonist capsaicin alters vasodilation in an endothelium-dependent manner; however, it is unknown if this translates in vivo or is limb or sex-dependent. Therefore, we sought to determine if there was limb or sex-specificity in the effect of capsaicin on microvascular function using near-infrared spectroscopy (NIRS)-derived tissue oxygen saturation (StO2) reperfusion slope. In a blinded placebo-controlled crossover design, 45 young males (M: n = 25) and females (F: n = 20), the reperfusion slopes of the forearm and quadriceps were assessed, and a urine sample obtained to assay for nitrate/nitrite (NOx) concentrations and antioxidant capacity after acutely ingesting placebo or capsaicin. Under placebo, females had greater reperfusion rates in both the forearm (M: 0.44 ± 0.24 vs. F: 0.98 ± 0.46 %/sec; p = 0.002, d = -1.50) and quadricep (M: 0.86 ± 0.31 vs. F: 1.17 ± 0.43 %/sec; p = 0.010, d = -0.85). Capsaicin decreased microvascular responsiveness in the forearm of females (placebo: 0.98 ± 0.45 vs. capsaicin: 0.84 ± 0.45 %/sec) as compared to males (placebo: 0.45 ± 0.24 vs. capsaicin: 0.38 ± 0.16 %/sec, interaction p < 0.001, η2 = 0.475). There was a sex*treatment interaction for NOx concentrations, where males increased (placebo: 21.13 ± 12.83 vs. capsaicin: 23.82 ± 13.34 μM), while females decreased (placebo: 22.78 ± 14.40 vs. capsaicin: 14.43 ± 10.01 μM; p = 0.037, η2 = 0.042). Using NIRS to assess microvascular function, there is apparent limb and sex-specificity, and, for the first-time, document that acute oral capsaicin alters reperfusion slope in a sexually divergent manner.
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Alves TC, Pugliesi Abdalla P, Bohn L, Da Silva LSL, dos Santos AP, Tasinafo Júnior MF, Rossini Venturini AC, Mota J, Lopes Machado DR. Acute and chronic cardiometabolic responses induced by resistance training with blood flow restriction in HIV patients. Sci Rep 2022; 12:16989. [PMID: 36216952 PMCID: PMC9550823 DOI: 10.1038/s41598-022-19857-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 09/06/2022] [Indexed: 12/29/2022] Open
Abstract
Resistance training with blood flow restriction (RTBFR) allows physically impaired people living with HIV (PWH) to exercise at lower intensities than traditional resistance training (TRT). But the acute and chronic cardiac and metabolic responses of PWH following an RTBFR protocol are unknown. The objective was to compare the safety of acute and chronic effects on hemodynamic and lipid profiles between TRT or RTBFR in PWH. In this randomized control trial, 14 PWH were allocated in RTBFR (GRTBFR; n = 7) or TRT (GTRT; n = 7). Both resistance training protocols had 36 sessions (12 weeks, three times per week). Protocol intensity was 30% (GRTBFR) and 80% (GTRT). Hemodynamic (heart rate, blood pressure) and lipid profile were acutely (rest and post exercise 7th, 22nd, and 35th sessions) and chronically (pre and post-program) recorded. General linear models were applied to determine group * time interaction. In the comparisons between groups, the resistance training program showed acute adaptations: hemodynamic responses were not different (p > 0.05), regardless of the assessment session; and chronicles: changes in lipidic profile favors GRTBFR, which significantly lower level of total cholesterol (p = 0.024), triglycerides (p = 0.002) and LDL (p = 0.030) compared to GTRT. RTBFR and TRT induced a similar hemodynamic adaptation in PWH, with no significant risks of increased cardiovascular stress. Additionally, RTBFR promoted better chronic adequacy of lipid profile than TRT. Therefore, RTBFR presents a safe resistance training alternative for PWH.Trial registration: ClinicalTrials.gov ID: NCT02783417; Date of registration: 26/05/2016.
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Affiliation(s)
- Thiago Cândido Alves
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Pedro Pugliesi Abdalla
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil ,grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal
| | - Lucimere Bohn
- grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal ,grid.410936.90000 0001 2199 9085Universidade Lusófona do Porto, Porto, Portugal
| | - Leonardo Santos Lopes Da Silva
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - André Pereira dos Santos
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Márcio Fernando Tasinafo Júnior
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Ana Cláudia Rossini Venturini
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Jorge Mota
- grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil ,grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal
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Pedon WR, Lima FV, Cipriano G, da Silva WA, Fernandes MVS, Gomes NS, Chiappa AMG, Pena de Sousa R, Pereira da Silva ME, Chiappa GR. Acute hemodynamic responses from Low- load resistance exercise with blood flow restriction in young and older individuals: A Systematic Review and Meta-Analysis of Cross-Over Trials. Clin Physiol Funct Imaging 2022; 42:396-412. [PMID: 35808940 DOI: 10.1111/cpf.12779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To summarize the existing evidence on the acute response of low-load (LL) resistance exercise (RE) with blood flow restriction (BFR) on hemodynamic parameters. DATA SOURCES MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, and MedRxiv databases were searched from inception to February 2022. REVIEW METHODS Cross-over trials investigating the acute effect of LLRE+BFR vs. passive (no exercise) and active control methods (LLRE or HLRE) on heart rate (HR), systolic (SBP), diastolic (DBP), and mean (MBP) blood pressure responses. RESULTS The quality of the studies was assessed using the PEDro scale, risk of bias using the RoB 2.0 tool for cross-over trials, and certainty of the evidence using the GRADE method. A total of 15 randomized cross-over studies with 466 participants were eligible for analyses. Our data showed that LLRE+BFR increases all hemodynamic parameters compared to passive control, but not compared to conventional resistance exercise. Subgroup analysis did not demonstrate any differences between LLRE+BFR and low- (LL) or high-load (HL) resistance exercise protocols. Studies including younger volunteers presented higher chronotropic responses (HR) than those with older volunteers. CONCLUSIONS Despite causing notable hemodynamic responses compared to no exercise, the short-term low-load resistance exercise with BFR modulates all hemodynamic parameters HR, SBP, DBP, and MBP, similarly to a conventional resistance exercise protocol, whether at low or high-intensity. The chronotropic response is slightly higher in younger healthy individuals despite the similarity regarding pressure parameters. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- William R Pedon
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | | | | | - Weder A da Silva
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | - Marcos V S Fernandes
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | - Natalia S Gomes
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | | | - Rafael Pena de Sousa
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
| | | | - Gaspar R Chiappa
- Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goias, Brazil
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Stanford DM, Mouser JG, Chatlaong MA, Jessee MB. A narrative review of the effects of blood flow restriction on vascular structure and function. Physiol Int 2022; 109:186-203. [PMID: 35587387 DOI: 10.1556/2060.2022.00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/19/2022]
Abstract
Blood flow restriction is growing in popularity as a tool for increasing muscular size and strength. Currently, guidelines exist for using blood flow restriction alone and in combination with endurance and resistance exercise. However, only about 1.3% of practitioners familiar with blood flow restriction applications have utilized it for vascular changes, suggesting many of the guidelines are based on skeletal muscle outcomes. Thus, this narrative review is intended to explore the literature available in which blood flow restriction, or a similar application, assess the changes in vascular structure or function. Based on the literature, there is a knowledge gap in how applying blood flow restriction with relative pressures may alter the vasculature when applied alone, with endurance exercise, and with resistance exercise. In many instances, the application of blood flow restriction was not in accordance with the current guidelines, making it difficult to draw definitive conclusions as to how the vascular system would be affected. Additionally, several studies report no change in vascular structure or function, but few studies look at variables for both outcomes. By examining outcomes for both structure and function, investigators would be able to generate recommendations for the use of blood flow restriction to improve vascular structure and/or function in the future.
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Affiliation(s)
- Daphney M Stanford
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - J Grant Mouser
- 2 Department of Kinesiology and Health Promotion, Applied Physiology Laboratory, Troy University, Troy, AL, USA
| | - Matthew A Chatlaong
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - Matthew B Jessee
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
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Kilgas MA, Yoon T, McDaniel J, Phillips KC, Elmer SJ. Physiological Responses to Acute Cycling With Blood Flow Restriction. Front Physiol 2022; 13:800155. [PMID: 35360241 PMCID: PMC8963487 DOI: 10.3389/fphys.2022.800155] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Aerobic exercise with blood flow restriction (BFR) can improve muscular function and aerobic capacity. However, the extent to which cuff pressure influences acute physiological responses to aerobic exercise with BFR is not well documented. We compared blood flow, tissue oxygenation, and neuromuscular responses to acute cycling with and without BFR. Ten participants completed four intermittent cycling (6 × 2 min) conditions: low-load cycling (LL), low-load cycling with BFR at 60% of limb occlusion pressure (BFR60), low-load cycling with BFR at 80% of limb occlusion pressure (BFR80), and high-load cycling (HL). Tissue oxygenation, cardiorespiratory, metabolic, and perceptual responses were assessed during cycling and blood flow was measured during recovery periods. Pre- to post-exercise changes in knee extensor function were also assessed. BFR60 and BFR80 reduced blood flow (~33 and ~ 50%, respectively) and tissue saturation index (~5 and ~15%, respectively) when compared to LL (all p < 0.05). BFR60 resulted in lower VO2, heart rate, ventilation, and perceived exertion compared to HL (all p < 0.05), whereas BFR80 resulted in similar heart rates and exertion to HL (both p > 0.05). BFR60 and BFR80 elicited greater pain compared to LL and HL (all p < 0.05). After exercise, knee extensor torque decreased by ~18 and 40% for BFR60 and BFR80, respectively (both p < 0.05), and was compromised mostly through peripheral mechanisms. Cycling with BFR increased metabolic stress, decreased blood flow, and impaired neuromuscular function. However, only BFR60 did so without causing very severe pain (>8 on pain intensity scale). Cycling with BFR at moderate pressure may serve as a potential alternative to traditional high-intensity aerobic exercise.
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Affiliation(s)
- Matthew A. Kilgas
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Tejin Yoon
- Department of Physical Education, Kangwon National University, Chuncheon, South Korea
| | - John McDaniel
- Department of Exercise Physiology, Kent State University, Kent, OH, United States
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Kevin C. Phillips
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Steven J. Elmer
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
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Fini EM, Salimian M, Ahmadizad S. Responses of platelet CD markers and indices to resistance exercise with and without blood flow restriction in patients with type 2 diabetes. Clin Hemorheol Microcirc 2021; 80:281-289. [PMID: 34511492 DOI: 10.3233/ch-211229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Diabetes mellitus is a common disorder with the risk of vascular injury. OBJECTIVE The aim of this study was to compare the effects of low-intensity resistance exercise with blood flow restriction versus high-intensity resistance exercise on platelet CD markers and indices in patients with type 2 diabetes. METHODS Fifteen female patients with type 2 diabetes (Mean±SD; age, 47.6±7.2 yrs) randomly completed two resistance exercise at an intensity corresponding to 20% and 80% of one-repetition maximum (1-RM), with and without blood flow restriction (REBFR and RE), respectively. We measured markers of platelet activation (P-selectin, GpIIb/IIIa, and CD42) and platelet indices before and immediately after exercise, and after 30 min recovery. RESULTS Platelet count (PLT) and plateletcrit (PCT) increased in response to REBFR more than the RE (p < 0.05), though, no significant differences in PDW and MPV were observed (p < 0.05). Although P-selectin (CD62P), CD61, CD41, and CD42 were reduced following resistance exercise in both trials, these reductions were non-significant (p < 0.05). Besides, no significant between-group differences were found for platelet CD markers (p < 0.05). CONCLUSIONS It is concluded that REBFR induces thrombocytosis, but responses of platelet CD markers in patients with type 2 diabetes are similar following low-intensity REBFR and high-intensity RE.
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Affiliation(s)
- Elahe Malekyian Fini
- Department of Biological Sciences in Sport, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Morteza Salimian
- Platelet Research Laboratory, Kashan University of Medical Sciences, Kashan, Iran
| | - Sajad Ahmadizad
- Department of Biological Sciences in Sport, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
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Cherouveim ED, Miliotis P, Dipla K, Koskolou MD, Vrabas IS, Geladas ND. The effect of muscle blood flow restriction on hemodynamics, cerebral oxygenation and activation at rest. Appl Physiol Nutr Metab 2021; 46:1216-1224. [PMID: 33951406 DOI: 10.1139/apnm-2020-1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study tested the hypothesis that muscle blood flow restriction reduces muscle and cerebral oxygenation, at rest. In 26 healthy males, aged 33±2 yrs, physiological variables were continuously recorded during a 10-min period in two experimental conditions: a) with muscle blood flow restriction through thigh cuffs application inflated at 120 mmHg (With Cuffs, WC) and b) without restriction (No Cuffs, NC). Muscle and cerebral oxygenation were reduced by muscle blood flow restriction as suggested by the increase in both muscle and cerebral deoxygenated hemoglobin (Δ[HHb]; p<0.01) and the decrease of muscle and cerebral oxygenation index (Δ[HbDiff]; p<0.01). Hemodynamic responses were not affected by such muscle blood flow restriction, whereas baroreflex sensitivity was reduced (p=0.009). The perception of leg discomfort was higher (p<0.001) in the WC than in the NC condition. This study suggests that thigh cuffs application inflated at 120 mmHg is an effective method to reduce muscle oxygenation at rest. These changes at the muscular level seem to be sensed by the central nervous system, evoking alterations in cerebral oxygenation and baroreflex sensitivity. Novelty bullets: • Thigh cuffs application inflated at 120 mmHg effectively reduces muscle oxygenation at rest. • Limiting muscle oxygenation appears to reduce cerebral oxygenation, and baroreflex sensitivity, at rest. • Even in healthy subjects, limiting muscle oxygenation, at rest, affects neural integration.
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Affiliation(s)
- Evgenia D Cherouveim
- National and Kapodistrian University of Athens, 68993, School of Physical Education and Sport Science, Athens, Attica, Greece;
| | - Panagiotis Miliotis
- National and Kapodistrian University of Athens, 68993, School of Physical Education and Sport Science, Athens, Attica, Greece;
| | - Konstantina Dipla
- Aristotle University of Thessaloniki, Department of Physical Education and Sport Sciences at Serres (TEFAA), Exercise Physiology and Biochemistry Laboratory, Serres, Greece, 62110;
| | - Maria D Koskolou
- National and Kapodistrian University of Athens, 68993, School of Physical Education and Sport Science, Athens, Attica, Greece;
| | | | - Nickos D Geladas
- National and Kapodistrian University of Athens, 68993, School of Physical Education and Sport Science, Athens, Attica, Greece;
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12
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Kambic T, Jug B, Lainscak M. Response: Commentary: Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2021; 12:665568. [PMID: 33868031 PMCID: PMC8044887 DOI: 10.3389/fphys.2021.665568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tim Kambic
- Cardiac Rehabilitation Unit, Department of Research and Education, General Hospital Murska Sobota, Murska Sobota, Slovenia
| | - Borut Jug
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Mitja Lainscak
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia.,Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
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13
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Ferguson RA, Mitchell EA, Taylor CW, Bishop DJ, Christiansen D. Blood-flow-restricted exercise: Strategies for enhancing muscle adaptation and performance in the endurance-trained athlete. Exp Physiol 2021; 106:837-860. [PMID: 33486814 DOI: 10.1113/ep089280] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/19/2021] [Indexed: 12/15/2022]
Abstract
NEW FINDINGS What is the topic of this review? Blood-flow-restricted (BFR) exercise represents a potential approach to augment the adaptive response to training and improve performance in endurance-trained individuals. What advances does it highlight? When combined with low-load resistance exercise, low- and moderate-intensity endurance exercise and sprint interval exercise, BFR can provide an augmented acute stimulus for angiogenesis and mitochondrial biogenesis. These augmented acute responses can translate into enhanced capillary supply and mitochondrial function, and subsequent endurance-type performance, although this might depend on the nature of the exercise stimulus. There is a requirement to clarify whether BFR training interventions can be used by high-performance endurance athletes within their structured training programme. ABSTRACT A key objective of the training programme for an endurance athlete is to optimize the underlying physiological determinants of performance. Training-induced adaptations are governed by physiological and metabolic stressors, which initiate transcriptional and translational signalling cascades to increase the abundance and/or function of proteins to improve physiological function. One important consideration is that training adaptations are reduced as training status increases, which is reflected at the molecular level as a blunting of the acute signalling response to exercise. This review examines blood-flow-restricted (BFR) exercise as a strategy for augmenting exercise-induced stressors and subsequent molecular signalling responses to enhance the physiological characteristics of the endurance athlete. Focus is placed on the processes of capillary growth and mitochondrial biogenesis. Recent evidence supports that BFR exercise presents an intensified training stimulus beyond that of performing the same exercise alone. We suggest that this has the potential to induce enhanced physiological adaptations, including increases in capillary supply and mitochondrial function, which can contribute to an improvement in performance of endurance exercise. There is, however, a lack of consensus regarding the potency of BFR training, which is invariably attributable to the different modes, intensities and durations of exercise and BFR methods. Further studies are needed to confirm its potential in the endurance-trained athlete.
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Affiliation(s)
- Richard A Ferguson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emma A Mitchell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Conor W Taylor
- Ineos Grenadiers Cycling Team, Bollin House, Wilmslow, UK
| | - David J Bishop
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
| | - Danny Christiansen
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
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14
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Franz A, Berndt F, Raabe J, Harmsen JF, Zilkens C, Behringer M. Invasive Assessment of Hemodynamic, Metabolic and Ionic Consequences During Blood Flow Restriction Training. Front Physiol 2021; 11:617668. [PMID: 33391036 PMCID: PMC7772195 DOI: 10.3389/fphys.2020.617668] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/27/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose: Medically recommended training often faces the dilemma that necessary mechanical intensities for muscle adaptations exceed patients' physical capacity. In this regard, blood flow restriction (BFR) training is becoming increasingly popular because it enables gains in muscle mass and strength despite using low-mechanical loads combined with external venous occlusion. Since the underlying mechanisms are still unknown, we applied invasive measurements during exercise with and without BFR to promote physiological understanding and safety of this popular training technique. Methods: In a randomized cross-over design, ten healthy men (28.1 ± 6.5 years) underwent two trials of unilateral biceps curls either with (BFR) and without BFR (CON). For analysis of changes in intravascular pressures, blood gases, oximetry and electrolytes, an arterial and a venous catheter were placed at the exercising arm before exercise. Arterial and venous blood gases and intravascular pressures were analyzed before, during and 5 min after exercise. Results: Intravascular pressures in the arterial and venous system were more increased during exercise with BFR compared to CON (p < 0.001). Furthermore, arterial and venous blood gas analyses revealed a BFR-induced metabolic acidosis (p < 0.05) with increased lactate production (p < 0.05) and associated elevations in [K+], [Ca2+] and [Na+] (p < 0.001). Conclusion: The present study describes for the first time the local physiological changes during BFR training. While BFR causes greater hypertension in the arterial and venous system of the exercising extremity, observed electrolyte shifts corroborate a local metabolic acidosis with concurrent rises in [K+] and [Na+]. Although BFR could be a promising new training concept for medical application, its execution is associated with comprehensive physiological challenges.
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Affiliation(s)
- Alexander Franz
- Department of Orthopedics, University Hospital Duesseldorf, Düsseldorf, Germany.,Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Felix Berndt
- Department of Orthopedics, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Joachim Raabe
- Department of Anesthesiology, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Jan-Frieder Harmsen
- Department of Nutrition and Movement Sciences, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Christoph Zilkens
- Department of Orthopedics, University Hospital Duesseldorf, Düsseldorf, Germany.,Department of Adult Reconstruction, ATOS Orthoparc Clinic Cologne, Cologne, Germany
| | - Michael Behringer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt, Germany
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15
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Spranger MD. Commentary: Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2020; 11:599592. [PMID: 33329051 PMCID: PMC7716798 DOI: 10.3389/fphys.2020.599592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/20/2020] [Indexed: 01/02/2023] Open
Affiliation(s)
- Marty D Spranger
- Department of Physiology, Michigan State University, East Lansing, MI, United States
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16
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EFFECT OF BLOOD FLOW RESTRICTION TRAINING ON MUSCULAR PERFORMANCE, PAIN AND VASCULAR FUNCTION. Int J Sports Phys Ther 2020; 15:892-900. [PMID: 33344005 DOI: 10.26603/ijspt20200892] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Blood flow restriction (BFR) training enhances muscular strength and hypertrophy in several populations including older adults and injured athletes. However, the efficacy of emerging BFR technologies on muscular adaptations, vascular health, and pain is unclear. Purpose The purpose of this study was to examine muscular performance, pain and vascular function in response to eight weeks of BFR compared to traditional resistance training and a control group. Study Design Randomized control trial. Methods Thirty-one overtly healthy participants (age: 23 ± 4y, 65% female) underwent eight weeks of supervised high load resistance training (RES), low load resistance training with BFR (BFR) or no training (control, CON). RES and BFR (with pneumatic bands) performed seven upper and lower body exercises, two to three sessions per week at 60% and 30% of one-repetition maximum (1RM), respectively. Twenty-four hours post-exercise, general muscle soreness was assessed via a visual analog scale (VAS) and present pain intensity (PPI) of the McGill Pain Questionnaire. At baseline and after eight weeks, participants underwent one-repetition maximum (1RM), and flow-mediated dilation (FMD) testing. Results At baseline all groups exhibited similar muscle strength and endurance and vascular function. At the end of training, RES and BFR groups significantly increased muscle strength (1RM) to a similar magnitude as compared to the CON group (p < 0.0001), but did not alter body composition. FMD significantly increased in RES and BFR groups compared to CON group (p = 0.006). VAS and PPI were similar between RES and BFR groups throughout the exercise sessions until VAS decreased in the BFR group after the last session compared to the RES group (p = 0.02). Conclusion Compared to RES, BFR resulted in similar muscular performance (strength and endurance) and vascular improvements at a lower exercise intensity, suggesting BFR is an effective alternative to high load resistance training. Further longitudinal studies may gain greater understanding regarding general muscle pain and soreness when using BFR. Level of Evidence Therapy, Level 2.
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17
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Dos Santos L, Andreatta MV, Curty VM, Marcarini WD, Ferreira LG, Barauna VG. Effects of Blood Flow Restriction on Leukocyte Profile and Muscle Damage. Front Physiol 2020; 11:572040. [PMID: 33162898 PMCID: PMC7581907 DOI: 10.3389/fphys.2020.572040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
Muscle damage affects the blood leukocyte profile. Resistance exercise (RE) with blood flow restriction (BFR) attenuates exercise-induced muscle damage (EIMD).
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Affiliation(s)
- Leandro Dos Santos
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil.,Academic Unity of Serra Talhada, Rural Federal University of Pernambuco, Serra Talhada, Brazil
| | - Michely V Andreatta
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil
| | - Victor M Curty
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil
| | - Wena Dantas Marcarini
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil
| | - Lucas G Ferreira
- Center of Physical Education and Sports, Federal University of Espirito Santo, Vitoria, Brazil
| | - Valerio G Barauna
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil
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18
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Haddock B, Hansen SK, Lindberg U, Nielsen JL, Frandsen U, Aagaard P, Larsson HBW, Suetta C. Physiological responses of human skeletal muscle to acute blood flow restricted exercise assessed by multimodal MRI. J Appl Physiol (1985) 2020; 129:748-759. [PMID: 32853108 DOI: 10.1152/japplphysiol.00171.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Important physiological quantities for investigating muscle hypertrophy include blood oxygenation, cell swelling, and changes in blood flow. The purpose of this study was to compare the acute changes of these parameters in human skeletal muscle induced by low-load (20% 1-RM) blood flow-restricted (BFR-20) knee extensor exercise compared with free-flow work-matched (FF-20WM) and free-flow 50% 1-RM (FF-50) knee extensor exercise using multimodal magnetic resonance imaging (MRI). Subjects (n = 11) completed acute exercise sessions for each exercise mode in an MRI scanner, where interleaved measures of muscle R2 (indicator of edema), [Formula: see text] (indicator of deoxyhemoglobin), macrovascular blood flow, and diffusion were performed before, between sets, and after the final set for each exercise protocol. BFR-20 exercise resulted in larger acute decreases in R2 and greater increases in cross-sectional area than FF-20WM and FF-50 (P < 0.01). Blood oxygenation decreased between sets during BFR-20, as indicated by a 13.6% increase in [Formula: see text] values (P < 0.01)), whereas they remained unchanged for FF-20WM and decreased during FF-50 exercise. Quadriceps blood flow between sets was highest for the heavier load (FF-50), averaging 305 mL/min, and lowest for BFR-20 at 123 ± 73 mL/min until post-exercise cuff release, where blood flow rates in BFR-20 exceeded both FF protocols (P < 0.01). Acute changes in diffusion rates were similar for all exercise protocols. This study was able to differentiate the acute exercise response of selected physiological factors associated with skeletal muscle hypertrophy. Marked differences in these parameters were found to exist between BFR and FF exercise conditions, which contribute to explain the anabolic potential of low-load blood flow restricted muscle exercise.NEW & NOTEWORTHY Acute changes in blood flow, diffusion, blood oxygenation, cross-sectional area, and the "T2 shift" are evaluated in human skeletal muscle in response to blood flow-restricted (BFR) and conventional free-flow knee extensor exercise performed in an MRI scanner. The acute physiological response to exercise was dependent on the magnitude of load and the application of BFR. Physiological variables changed markedly and established a steady state rapidly after the first of four exercise sets.
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Affiliation(s)
- Bryan Haddock
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sofie K Hansen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Geriatric Research Unit, Bispebjerg-Frederiksberg and Herlev-Gentofte Hospitals, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrich Lindberg
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jakob Lindberg Nielsen
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ulrik Frandsen
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Aagaard
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Henrik B W Larsson
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Suetta
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Geriatric Research Unit, Bispebjerg-Frederiksberg and Herlev-Gentofte Hospitals, Copenhagen University Hospital, Copenhagen, Denmark
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19
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Ramis TR, Muller CHDL, Boeno FP, Teixeira BC, Rech A, Pompermayer MG, Medeiros NDS, Oliveira ÁRD, Pinto RS, Ribeiro JL. Effects of Traditional and Vascular Restricted Strength Training Program With Equalized Volume on Isometric and Dynamic Strength, Muscle Thickness, Electromyographic Activity, and Endothelial Function Adaptations in Young Adults. J Strength Cond Res 2020; 34:689-698. [PMID: 30063556 DOI: 10.1519/jsc.0000000000002717] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ramis, TR, Muller, CHdL, Boeno, FP, Teixeira, BC, Rech, A, Pompermayer, MG, Medeiros, NdS, Oliveira, ÁRd, Pinto, RS, and Ribeiro, JL. Effects of traditional and vascular restricted strength training program with equalized volume on isometric and dynamic strength, muscle thickness, electromyographic activity, and endothelial function adaptations in young adults. J Strength Cond Res 34(3): 689-698, 2020-The purpose of the study was to evaluate and compare the acute and chronic effects of partial vascular occlusion training in young, physically active adults. Neuromuscular, morphological, and endothelial function responses were compared between high-intensity resistance training (HI-RT) and low-intensity resistance training with partial vascular occlusion (LI-BFR), despite the same training volume. The 28 subjects (age, 23.96 ± 2.67 years) were randomly assigned into 2 groups: LI-BFR (n = 15) and HI-RT (n = 13). Both groups performed unilateral exercise of elbow flexion (EF) and knee extension (KE) 3 times per week for 8 weeks. This study was approved by the ethics committee. Flow-mediated dilation showed a significant difference in baseline and post-training in the LI-BFR group (4.44 ± 0.51 vs. 6.35 ± 2.08 mm, respectively). For nitrite/nitrate concentrations only, there was a significant difference when comparing pre- and post-acute exercise in both groups. The torque and rep. Sixty percent 1 repetition maximum had improvements in both groups. There were differences between groups only in isometric delta EF and isokinetic delta KE (EF 3.42 ± 5.09 and 9.61 ± 7.52 N·m; KE 12.78 ± 25.61 and 42.69 ± 35.68 N·m; LI-BFR and HI-RT groups, respectively). There was a significant increase of muscle thickness in both groups. An increase of both isokinetic and isometric electromyography (EMG) of biceps of the HI-RT group was observed. The same was observed for the LI-BFR group regarding isokinetic and isometric EMG of vastus lateralis. Thus, in addition to strength and hypertrophy gains, this study also shows benefits related to vascular function. For practical applications, this study demonstrates a clinical importance of LI-BFR training as an alternative methodology.
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Affiliation(s)
| | | | | | | | - Anderson Rech
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | - Jerri Luiz Ribeiro
- IPA Methodist University Center, Porto Alegre, Rio Grande do Sul, Brazil; and
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20
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Hori A, Hasegawa D, Suijo K, Nishigaki K, Ishida K, Hotta N. Exaggerated pressor response to blood flow restriction resistance exercise is associated with a muscle metaboreflex-induced increase in blood pressure in young, healthy humans. Appl Physiol Nutr Metab 2020; 46:182-185. [PMID: 32841573 DOI: 10.1139/apnm-2020-0491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Some researchers are concerned that exercise training with the blood flow restriction (BFR) technique induces an exaggeration in blood pressure response and potentiates adverse cardiovascular events. In the present study, we demonstrate that the blood pressure response to arm-curl exercise was intensified by the BFR technique, and the degree of intensification was associated with a blood pressure response to postexercise muscle ischemia of the elbow flexors, which elicit a muscle metaboreflex. Novelty: BFR technique intensifies blood pressure response to exercise, which was associated with a blood pressure response in postexercise muscle ischemia-induced muscle metaboreflex.
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Affiliation(s)
- Amane Hori
- Graduate School of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan
| | - Daisuke Hasegawa
- Graduate School of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan
| | - Kenichi Suijo
- College of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan
| | - Keita Nishigaki
- School of Health Studies, Tokai University, Hiratsuka 259-1292, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya 464-8601, Japan
| | - Norio Hotta
- College of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan
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21
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Hemodynamic and Hemostatic Response to Blood Flow Restriction Resistance Exercise in Coronary Artery Disease: A Pilot Randomized Controlled Trial. J Cardiovasc Nurs 2020; 36:507-516. [PMID: 32496365 DOI: 10.1097/jcn.0000000000000699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Blood flow-restricted resistance training (BFR-RT) has been proven to be safe and efficacious in healthy older adults, but not in cardiovascular disease. OBJECTIVE The aim of this study was to investigate the acute and training induced effects of BFR-RT on hemostatic and hemodynamic responses in patients with coronary artery disease (CAD). METHODS Stable patients with CAD were randomized to 8 weeks of BFR-RT (30%-40% 1-repetition maximum unilateral knee extension) combined with aerobic training or aerobic training alone (control group). At baseline and after 4 and 8 weeks, blood samples were taken before and after BFR exercise, whereas hemodynamic parameters were monitored throughout the exercise. RESULTS Twenty-four patients (12 per group; mean age, 60 ± 2 years; mostly male [75%]) completed the study. The BFR-RT significantly improved systolic blood pressure (-10 mm Hg; P = .020) and tended to lower diastolic blood pressure (-2 mm Hg; P = .066). In contrast, no posttraining alterations were observed in N-terminal prohormone B-type natriuretic hormone, fibrinogen, and D-dimer values. During BFR exercise, all hemodynamic variables significantly increased after the first and second set, whereas blood pressure immediately lowered after the cuff was released in the third set. Last, significant interaction was only observed for repetitions × intensity (P < .001; partial η2 = 0.908) of diastolic blood pressure at higher exercise intensity (40% 1-repetition maximum). CONCLUSIONS The BFR-RT was proven to be safe, with favorable hemodynamic and hemostatic responses in patients with CAD, and can be recommended as an additional exercise modality in cardiac rehabilitation.Trial Registration:ClinicalTrial.gov Identifier: NCT03087292.
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22
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Joshi S, Mahoney S, Jahan J, Pitts L, Hackney KJ, Jarajapu YP. Blood flow restriction exercise stimulates mobilization of hematopoietic stem/progenitor cells and increases the circulating ACE2 levels in healthy adults. J Appl Physiol (1985) 2020; 128:1423-1431. [PMID: 32324479 DOI: 10.1152/japplphysiol.00109.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Adult CD34+ hematopoietic stem/progenitor cells (HSPC) in the systemic circulation are bone marrow-derived and have the propensity of maintaining cardiovascular health. Activation of angiotensin-converting enzyme-2 (ACE2)-angiotensin-(1-7)-Mas receptor pathway, the vascular protective axis of the renin-angiotensin system (RAS), stimulates vasculogenic functions of HSPCs. In a previous study, exposure to hypoxia increased the expressions of ACE2 and Mas, and stimulated ACE2 shedding. The current study tested if blood flow restriction exercise (BFR)-induced regional hypoxia recapitulates the in vitro observations in healthy adults. Hypoxia was induced by 80% limb occlusion pressure (LOP) via inflation cuff. Muscle oxygen saturation was determined using near-infrared spectroscopy. Peripheral blood was collected 30 min after quiet sitting (control) or after BFR. Lin-CD45lowCD34+ HSPCs were enumerated by flow cytometry, and ACE and ACE2 activities were determined in plasma and cell lysates and supernatants. Regional hypoxia resulted in muscle oxygen saturation of 17.5% compared with 49.7% in the control condition (P < 0.0001, n = 9). Circulating HSPCs were increased following BFR (834.8 ± 62.1/mL) compared with control (365 ± 59, P < 0.001, n = 7), which was associated with increased stromal-derived factor 1α and vascular endothelial growth factor receptor levels by four- and threefold, respectively (P < 0.001). ACE2 activity was increased in the whole cell lysates of HSPCs, resulting in an ACE2-to-ACE ratio of 11.7 ± 0.5 in BFR vs 9.1 ± 0.9 in control (P < 0.05). Cell supernatants have threefold increase in the ACE2-to-ACE ratio following BFR compared with control (P < 0.001). Collectively, these findings provide strong evidence for the upregulation of ACE2 by acute regional hypoxia in vivo. Hypoxic exercise regimens appear to be promising means of enhancing vascular regenerative capacity.NEW & NOTEWORTHY Although many studies have explored the mechanisms of skeletal muscle growth and adaptation with hypoxia exercise interventions, less attention has been given to the potential for vascular adaptation and regenerative capacity. This study shows for the first time an acute upregulation of the angiotensin-converting enzyme 2 and increase in CD34+ vasculogenic cells following an acute bout of blood flow restriction with low-intensity exercise. These rapid changes collectively promote skeletal muscle angiogenesis. Therefore, this study supports the potential of hypoxic exercise interventions with low intensity for vascular and muscle health.
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Affiliation(s)
- Shrinidh Joshi
- Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, North Dakota
| | - Sean Mahoney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Jesmin Jahan
- Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, North Dakota
| | - Logan Pitts
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Yagna Pr Jarajapu
- Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, North Dakota
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23
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Cristina-Oliveira M, Meireles K, Spranger MD, O'Leary DS, Roschel H, Peçanha T. Clinical safety of blood flow-restricted training? A comprehensive review of altered muscle metaboreflex in cardiovascular disease during ischemic exercise. Am J Physiol Heart Circ Physiol 2019; 318:H90-H109. [PMID: 31702969 DOI: 10.1152/ajpheart.00468.2019] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Blood flow restriction training (BFRT) is an increasingly widespread method of exercise that involves imposed restriction of blood flow to the exercising muscle. Blood flow restriction is achieved by inflating a pneumatic pressure cuff (or a tourniquet) positioned proximal to the exercising muscle before, and during, the bout of exercise (i.e., ischemic exercise). Low-intensity BFRT with resistance training promotes comparable increases in muscle mass and strength observed during high-intensity exercise without blood flow restriction. BFRT has expanded into the clinical research setting as a potential therapeutic approach to treat functionally impaired individuals, such as the elderly, and patients with orthopedic and cardiovascular disease/conditions. However, questions regarding the safety of BFRT must be fully examined and addressed before the implementation of this exercise methodology in the clinical setting. In this respect, there is a general concern that BFRT may generate abnormal reflex-mediated cardiovascular responses. Indeed, the muscle metaboreflex is an ischemia-induced, sympathoexcitatory pressor reflex originating in skeletal muscle, and the present review synthesizes evidence that BFRT may elicit abnormal cardiovascular responses resulting from increased metaboreflex activation. Importantly, abnormal cardiovascular responses are more clearly evidenced in populations with increased cardiovascular risk (e.g., elderly and individuals with cardiovascular disease). The evidence provided in the present review draws into question the cardiovascular safety of BFRT, which clearly needs to be further investigated in future studies. This information will be paramount for the consideration of BFRT exercise implementation in clinical populations.
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Affiliation(s)
- Michelle Cristina-Oliveira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Marty D Spranger
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
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24
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Singer TJ, Stavres J, Elmer SJ, Kilgas MA, Pollock BS, Kearney SG, McDaniel J. Knee extension with blood flow restriction: Impact of cuff pressure on hemodynamics. Eur J Appl Physiol 2019; 120:79-90. [PMID: 31705274 DOI: 10.1007/s00421-019-04250-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/26/2019] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Blood flow restriction (BFR) exercise has emerged as a method of increasing muscle size and strength with low intensity resistance training. While the cuff pressures used during BFR are typically a percentage of resting arterial occlusion pressure (AOP), the impact these cuff pressures have on blood flow during lower body exercise is unknown. PURPOSE To determine how various cuff pressures impact blood flow and tissue perfusion during exercise. METHODS Eleven healthy male participants completed four sets of knee extension (30 reps per set at 30% max torque) with 0%, 60%, 80%, and 100% of arterial occlusion pressure (AOP) was applied to the proximal portion of the thigh. Femoral artery blood flow, tissue oxygenation, and central hemodynamics were continuously recorded before, during, and after exercise. Electromyography (EMG) amplitude was recorded from the vastus lateralis during exercise. RESULTS Blood flow increased during exercise compared to rest across all cuff pressures (p < 0.001), however compared to 0%, the absolute blood flow was reduced by 34 ± 17%, 45 ± 22%, and 72 ± 19% for 60, 80, and 100% AOP, respectively. Furthermore, each cuff pressure resulted in similar relative changes in blood flow before, during, and after exercise. During exercise, tissue saturation index (TSI) decreased as cuff pressure increased (p ≤ 0.005) with the exception of 80 to 100% AOP. Deoxyhemoglobin increased (p ≤ 0.001) with cuff pressure. CONCLUSION Our data indicate that while BFR knee extension elicits an absolute hyperemic response at cuff pressures up to 100% resting AOP, the relative reductions in blood flow are consistent across rest, exercise and recovery.
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Affiliation(s)
- Tyler J Singer
- Department of Exercise Physiology, Kent State University, Kent, OH, 44242, USA.
| | - Jon Stavres
- Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA, USA
| | - Steven J Elmer
- Department of Kinesiology and Integrated Physiology, Michigan Technological University, Houghton, MI, USA
| | - Matthew A Kilgas
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, USA
| | | | - Sarah G Kearney
- Department of Exercise Physiology, Kent State University, Kent, OH, 44242, USA
| | - John McDaniel
- Department of Exercise Physiology, Kent State University, Kent, OH, 44242, USA
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Ilett MJ, Rantalainen T, Keske MA, May AK, Warmington SA. The Effects of Restriction Pressures on the Acute Responses to Blood Flow Restriction Exercise. Front Physiol 2019; 10:1018. [PMID: 31456694 PMCID: PMC6700307 DOI: 10.3389/fphys.2019.01018] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 07/23/2019] [Indexed: 12/02/2022] Open
Abstract
Purpose No current guidelines or recommendations exist informing the selection of restriction pressure during blood flow restriction exercise (BFRE). Moreover, the effects of specific relative restriction pressures on the acute muscle, metabolic and cardiopulmonary responses to BFRE are unclear. The purpose of this study was to characterize these acute responses at different levels of restriction pressure. Methods Participants (n = 10) completed rhythmic isometric knee extension exercise across five experimental trials in a balanced randomized order. Three were BFRE trials {B-40 [restriction pressure set to 40% LOP (total limb occlusion pressure)]; B-60 (60% LOP); and B-80 (80% LOP)} with a workload equivalent to 20% maximal voluntary force (MVC), one was non-BFRE at 20% MVC (LL) and one was non-BFRE at 80% MVC (HL). Measurements recorded were torque, muscle activity via electromyography (EMG), tissue oxygenation via near infrared spectroscopy, whole body oxygen consumption, blood lactate and heart rate. Results For the LL and B-40 trials, most measures remained constant. However, for the B-60 and B-80 trials, significant fatigue was demonstrated by a reduction in MVC torque across the trial (p < 0.05). Blood lactate increased from baseline in HL, B-60, and B-80 (p < 0.05). Submaximal EMG was greater in B-60 and B-80 than LL, but lower compared with HL (p < 0.05). Tissue oxygenation decreased in HL, B-40, B-60, and B-80 (p < 0.05), which was lower in the B-80 trial compared to all other trials (p < 0.01). Whole body oxygen consumption was not different between the BFRE trials (p > 0.05). Conclusion We demonstrate graded/progressive acute responses with increasing applied pressure during BFRE, from which we speculate that an effective minimum “threshold” around 60% LOP may be necessary for BFRE to be effective with training. While these data provide some insight on the possible mechanisms by which BFRE develops skeletal muscle size and strength when undertaken chronically across a training program, the outcomes of chronic training programs using different levels of applied restriction pressures remain to be tested. Overall, the present study recommends 60–80% LOP as a suitable “minimum” BFRE pressure.
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Affiliation(s)
- Michael J Ilett
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Timo Rantalainen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Michelle A Keske
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Anthony K May
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Stuart A Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2019; 10:533. [PMID: 31156448 PMCID: PMC6530612 DOI: 10.3389/fphys.2019.00533] [Citation(s) in RCA: 303] [Impact Index Per Article: 60.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
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Affiliation(s)
- Stephen D. Patterson
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Luke Hughes
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jamie Burr
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada
| | - Brendan R. Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Cleiton Augusto Libardi
- MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gabriel Rodrigues Neto
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, Brazil
| | | | - Juan Martin-Hernandez
- I+HeALTH Research Group, Department of Health Sciences, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
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Parganlija D, Nieberg V, Sauer M, Rittweger J, Bloch W, Zange J. Lower body negative pressure enhances oxygen availability in the knee extensor muscles during intense resistive exercise in supine position. Eur J Appl Physiol 2019; 119:1289-1303. [PMID: 30915538 PMCID: PMC6517352 DOI: 10.1007/s00421-019-04113-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 02/26/2019] [Indexed: 12/12/2022]
Abstract
Purpose During exercise in supine posture or under microgravity in space, the gravity-dependent component of local blood pressure in leg muscles at upright posture can be simulated by lower body negative pressure (LBNP). We hypothesized that during resistive exercise LBNP favors oxygen availability in lower extremities, benefiting energy levels and performance of working muscles. Methods In permutated crossover design, nine subjects performed a series of fifteen slow-paced concentric (4 s) and eccentric contractions (4 s) without or with 40 mmHg LBNP and 4 s pause between repetitions. The force at knee flexion was 6% of the one repetition maximum (1-RM) and gradually increased to 60% 1RM in the first half of the individual range of motion, subsequently remaining constant until full extension. Results During the low force periods of continuous exercise, LBNP enhanced the refill of capillary blood measured by near infrared spectroscopy, amplifying the increase of total haemoglobin by about 20 µmol/l (p < 0.01) and oxyhaemoglobin by about 10 µmol/l (p < 0.01). During continuous exercise, LBNP induced a trend towards a lower EMG increment. This LBNP effect was not found when the periods of low forces at knee flexion were extended by 4 s pauses. Increased respiratory oxygen uptake (+ 0.1 l/min, p < 0.05) indicated overall enhanced muscle energy turn-over. Conclusions Our results suggest stimulation of oxidative metabolism through LBNP enables working muscles to meet the energy demands of intense exercise. Further research is needed on the consequences for energy metabolism and the molecular control of growth and differentiation.
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Affiliation(s)
- Dajana Parganlija
- Space Physiology Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany. .,Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany. .,IQWiG, Institute for Quality and Efficiency in Health Care, Im Mediapark 8, 50670, Cologne, Germany.
| | - Vita Nieberg
- Space Physiology Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.,Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Marc Sauer
- Space Physiology Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.,Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Jörn Rittweger
- Space Physiology Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - Wilhelm Bloch
- Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Jochen Zange
- Space Physiology Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
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Blood Flow Restriction Resistance Exercise as a Rehabilitation Modality Following Orthopaedic Surgery: A Review of Venous Thromboembolism Risk. J Orthop Sports Phys Ther 2019; 49:17-27. [PMID: 30208794 DOI: 10.2519/jospt.2019.8375] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Synopsis Restoration of skeletal muscle mass and strength is critical to successful outcomes following orthopaedic surgery. Blood flow restriction (BFR) resistance exercise has emerged as a promising means of augmenting traditional low-intensity physical rehabilitation exercise and has yielded successful outcomes in a wide range of applications. Though BFR is well tolerated and safe for most individuals, patients who have undergone orthopaedic surgery may be an exception, due to their heightened risk for venous thromboembolism (VTE). While the pathogenesis of VTE is multifactorial and specific to the individual, it is commonly described as a combination of blood stasis, endothelial injury, and alterations in the constituents of the blood leading to hypercoagulability. The collective literature suggests that, given the pathogenic mechanisms of VTE, limited use of a wide, partially occluding cuff during resistance exercise should be low risk, and the likelihood that BFR would directly cause a VTE event is remote. Alternatively, it is plausible that BFR may enhance blood flow and promote fibrinolysis. Of greater concern is the individual with pre-existing asymptomatic VTE, which could be dislodged during BFR. However, it is unknown whether the direct risk associated with BFR is greater than the risk accompanying traditional exercise alone. Presently, there are no universally agreed-upon standards indicating which postsurgical orthopaedic patients may perform BFR safely. While excluding all these patients from BFR may be overly cautious, clinicians need to thoroughly screen for VTE signs and symptoms, be cognizant of each patient's risk factors, and use proper equipment and prescription methods prior to initiating BFR. J Orthop Sports Phys Ther 2019;49(1):17-27. Epub 12 Sep 2018. doi:10.2519/jospt.2019.8375.
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Mattocks KT, Mouser JG, Jessee MB, Dankel SJ, Buckner SL, Bell ZW, Abe T, Loenneke JP. Acute hemodynamic changes following high load and very low load lower body resistance exercise with and without the restriction of blood flow. Physiol Meas 2018; 39:125007. [DOI: 10.1088/1361-6579/aaefc9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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30
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Crisafulli A, de Farias RR, Farinatti P, Lopes KG, Milia R, Sainas G, Pinna V, Palazzolo G, Doneddu A, Magnani S, Mulliri G, Roberto S, Oliveira RB. Blood Flow Restriction Training Reduces Blood Pressure During Exercise Without Affecting Metaboreflex Activity. Front Physiol 2018; 9:1736. [PMID: 30618781 PMCID: PMC6299290 DOI: 10.3389/fphys.2018.01736] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/16/2018] [Indexed: 12/12/2022] Open
Abstract
Objective: Blood flow restriction training (BFRT) has been proposed to induce muscle hypertrophy, but its safety remains controversial as it may increase mean arterial pressure (MAP) due to muscle metaboreflex activation. However, BFR training also causes metabolite accumulation that may desensitize type III and IV nerve endings, which trigger muscle metaboreflex. Then, we hypothesized that a period of BFR training would result in blunted hemodynamic activation during muscle metaboreflex. Methods: 17 young healthy males aged 18–25 yrs enrolled in this study. Hemodynamic responses during muscle metaboreflex were assessed by means of postexercise muscle ischemia (PEMI) at baseline (T0) and after 1 month (T1) of dynamic BFRT. BFRT consisted of 3-min rhythmic handgrip exercise applied 3 days/week (30 contractions per minute at 30% of maximum voluntary contraction) in the dominant arm. On the first week, the occlusion was set at 75% of resting systolic blood pressure (always obtained after 3 min of resting) and increased 25% every week, until reaching 150% of resting systolic pressure at week four. Hemodynamic measurements were assessed by means of impedance cardiography. Results: BFRT reduced MAP during handgrip exercise (T1: 96.3 ± 8.3 mmHg vs. T0: 102.0 ± 9.53 mmHg, p = 0.012). However, no significant time effect was detected for MAP during the metaboreflex activation (P > 0.05). Additionally, none of the observed hemodynamic outcomes, including systemic vascular resistance (SVR), showed significant difference between T0 and T1 during the metaboreflex activation (P > 0.05). Conclusion: BFRT reduced blood pressure during handgrip exercise, thereby suggesting a potential hypotensive effect of this modality of training. However, MAP reduction during handgrip seemed not to be provoked by lowered metaboreflex activity.
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Affiliation(s)
- Antonio Crisafulli
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Rafael Riera de Farias
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro, Rio de Janeiro, Brazil.,Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro, Rio de Janeiro, Brazil.,Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niterói, Brazil
| | - Karynne Grutter Lopes
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro, Rio de Janeiro, Brazil.,Graduate Program in Clinical and Experimental Physiopathology, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Laboratory of Vascular Biology, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Raffaele Milia
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Gianmarco Sainas
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Virginia Pinna
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Girolamo Palazzolo
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Azzurra Doneddu
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Sara Magnani
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Gabriele Mulliri
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Silvana Roberto
- Sports Physiology Laboratory, The Department of Medical Sciences and Public Health, and International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Ricardo Brandão Oliveira
- Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Clinical and Experimental Physiopathology, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Laboratory of Active Living (LaVA), University of Rio de Janeiro State, Rio de Janeiro, Brazil
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31
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Limb blood flow and tissue perfusion during exercise with blood flow restriction. Eur J Appl Physiol 2018; 119:377-387. [DOI: 10.1007/s00421-018-4029-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/30/2018] [Indexed: 10/27/2022]
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32
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Hughes L, Paton B, Haddad F, Rosenblatt B, Gissane C, Patterson SD. Comparison of the acute perceptual and blood pressure response to heavy load and light load blood flow restriction resistance exercise in anterior cruciate ligament reconstruction patients and non-injured populations. Phys Ther Sport 2018; 33:54-61. [DOI: 10.1016/j.ptsp.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/07/2018] [Accepted: 07/07/2018] [Indexed: 01/20/2023]
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Domingos E, Polito MD. Blood pressure response between resistance exercise with and without blood flow restriction: A systematic review and meta-analysis. Life Sci 2018; 209:122-131. [PMID: 30086274 DOI: 10.1016/j.lfs.2018.08.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/31/2018] [Accepted: 08/03/2018] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to compare, by means of a systematic review and meta-analysis, the effects of resistance training with and without blood flow restriction (BFR) on blood pressure (BP). MATERIALS AND METHODS This review was composed according to the preferred Reporting items for Systematic Reviews and Meta-Analyses guidelines. Searches were carried out in the databases PubMed, SPORTDiscus, and Web of Science. BP was the main outcome for the analysis of the acute, post-exercise, and chronic effect of resistance exercise with and without BFR. Search results were limited to studies investigating the effect of resistance training with and without BFR on acute or chronic BP, published in a scientific peer-reviewed journal in English. KEY FINDINGS Seventeen references were eligible. During exercise, the diastolic BP (DBP) was higher in exercise with BFR (ES = 17.84) in comparison to traditional exercise with loads ≥60% 1RM (ES = 5.53; P < 0.01); and the systolic BP (SBP) and DBP were higher during exercise with BFR in hypertensive individuals (ES = 69.83 and 43.66) in comparison to traditional exercise with loads <60% 1RM (ES = 48.05 and 28.37; P < 0.05). In the post-exercise analysis, exercise with BFR presented lower values for SBP (ES = -5.13; P = 0.02) and DBP (ES = -4.70; P < 0.01). SIGNIFICANCE Although resistance exercise with BFR resulted in greater post-exercise hypotension than traditional exercise, higher SBP and/or DBP values were observed during exercise with BFR compared to traditional exercise, especially in hypertensive individuals. Thus, exercise with BFR should be prescribed with caution when BP control is necessary during exercise.
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Affiliation(s)
- Everton Domingos
- Research Group of Cardiovascular Response and Exercise, Londrina State University, Londrina, Paraná, PR, Brazil
| | - Marcos D Polito
- Research Group of Cardiovascular Response and Exercise, Londrina State University, Londrina, Paraná, PR, Brazil.
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Dankel SJ, Jessee MB, Mattocks KT, Buckner SL, Mouser JG, Bell ZW, Abe T, Loenneke JP. Perceptual and arterial occlusion responses to very low load blood flow restricted exercise performed to volitional failure. Clin Physiol Funct Imaging 2018; 39:29-34. [PMID: 29938892 DOI: 10.1111/cpf.12535] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/06/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Studies examining perceptual and arterial occlusion responses between blood flow restricted exercise and high load exercise often prescribe an arbitrary number of repetitions, making it difficult for direct comparisons. Therefore, the purpose of this study was to compare these protocols when performed to volitional failure. METHODS Individuals completed four exercise conditions varying in load and pressure: (i) 15% 1RM; no restrictive pressure, (ii) 15% 1RM; 40% arterial occlusion pressure, (iii) 15% 1RM; 80% arterial occlusion pressure, and (iv) 70% 1RM; no pressure. Four sets of knee extension exercises were performed until volitional failure (or until 90 repetitions per set) was completed. RESULTS A total of 23 individuals completed the study. While all conditions increased arterial occlusion pressure, the greatest increases (~30%) were observed in the blood flow restriction conditions. All lower load conditions resulted in greater RPE and discomfort than that of the high load condition, but only discomfort was increased further when adding blood flow restriction. CONCLUSION High load exercise will likely be perceived more favourably than lower load exercise to volitional failure; however, those who are incapable or unwilling to lift heavier loads may use blood flow restriction to help reduce the volume needed to reach volitional failure, although this will likely increase discomfort.
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Affiliation(s)
- Scott J Dankel
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Matthew B Jessee
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Kevin T Mattocks
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Samuel L Buckner
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - J Grant Mouser
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Zachary W Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS, USA
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May AK, Brandner CR, Warmington SA. Hemodynamic responses are reduced with aerobic compared with resistance blood flow restriction exercise. Physiol Rep 2018; 5:5/3/e13142. [PMID: 28183863 PMCID: PMC5309582 DOI: 10.14814/phy2.13142] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/28/2016] [Indexed: 12/31/2022] Open
Abstract
The hemodynamics of light‐load exercise with an applied blood‐flow restriction (BFR) have not been extensively compared between light‐intensity, BFR, and high‐intensity forms of both resistance and aerobic exercise in the same participant population. Therefore, the purpose of this study was to use a randomized crossover design to examine the hemodynamic responses to resistance and aerobic BFR exercise in comparison with a common high‐intensity and light‐intensity non‐BFR exercise. On separate occasions participants completed a leg‐press (resistance) or treadmill (aerobic) trial. Each trial comprised a light‐intensity bout (LI) followed by a light‐intensity bout with BFR (80% resting systolic blood pressure (LI+BFR)), then a high‐intensity bout (HI). To characterize the hemodynamic response, measures of cardiac output, stroke volume, heart rate and blood pressure were taken at baseline and exercise for each bout. Exercising hemodynamics for leg‐press LI+BFR most often resembled those for HI and were greater than LI (e.g. for systolic blood pressure LI+BFR = 152 ± 3 mmHg; HI = 153 ± 3; LI = 143 ± 3 P < 0.05). However, exercising hemodynamics for treadmill LI+BFR most often resembled those for LI and were lower than HI (e.g. for systolic pressure LI+BFR = 124 ± 2 mmHg; LI = 123 ± 2; HI = 140 ± 3 P < 0.05). In conclusion, the hemodynamic response for light aerobic (walking) BFR exercise suggests this mode of BFR exercise may be preferential for chronic use to develop muscle size and strength, and other health benefits in certain clinical populations that are contraindicated to heavy‐load resistance exercise.
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Affiliation(s)
- Anthony K May
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences Deakin University, Burwood, Victoria, Australia
| | | | - Stuart A Warmington
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences Deakin University, Burwood, Victoria, Australia
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37
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Reported Side-effects and Safety Considerations for the Use of Blood Flow Restriction During Exercise in Practice and Research. Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000259] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Jakobsgaard JE, Christiansen M, Sieljacks P, Wang J, Groennebaek T, de Paoli F, Vissing K. Impact of blood flow-restricted bodyweight exercise on skeletal muscle adaptations. Clin Physiol Funct Imaging 2018; 38:965-975. [PMID: 29446524 DOI: 10.1111/cpf.12509] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 01/16/2018] [Indexed: 12/30/2022]
Abstract
This study ascertains the ability of bodyweight blood flow-restricted (BFR) exercise training to promote skeletal muscle adaptations of significance for muscle accretion and metabolism. Six healthy young individuals (three males and three females) performed six weeks of bodyweight BFR training. Each session consisted of five sets of sit-to-stand BFR exercise to volitional failure with 30-second inter-set recovery. Prior to, and at least 72 h after training, muscle biopsies were taken from m. vastus lateralis to assess changes in fibre type-specific cross-sectional area (CSA), satellite cell (SC) and myonuclei content and capillarization, as well as mitochondrial protein expression. Furthermore, magnetic resonance imaging was used to assess changes in whole thigh muscle CSA. Finally, isometric knee extensor muscle strength was evaluated. An increase in knee extensor whole muscle CSA was observed at middle and distal localizations after training (3·2% and 3·5%, respectively) (P<0·05), and a trend was observed towards an increase in type I fibre CSA, whereas muscle strength did not increase. Additionally, the number of SCs and myonuclei associated with type I fibres increased by 65·7% and 20%, respectively (P<0·05). No significant changes were observed in measures of muscle capillarization and mitochondrial proteins. In conclusion, six weeks of bodyweight-based BFR exercise promoted myocellular adaptations related to muscle accretion, but not metabolic properties. Moreover, the study revealed that an appropriate total training volume needs further investigation before recommending bodyweight BFR to patient populations.
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Affiliation(s)
- J E Jakobsgaard
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - M Christiansen
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - P Sieljacks
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - J Wang
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - T Groennebaek
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - F de Paoli
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - K Vissing
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
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Mouser JG, Dankel SJ, Mattocks KT, Jessee MB, Buckner SL, Abe T, Loenneke JP. Blood flow restriction and cuff width: effect on blood flow in the legs. Clin Physiol Funct Imaging 2018; 38:944-948. [PMID: 29356291 DOI: 10.1111/cpf.12504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 12/19/2017] [Indexed: 11/29/2022]
Abstract
Much of the literature examining blood flow restriction in the lower body uses cuffs of differing widths. It is currently unknown whether similar relative pressures using cuffs of differing widths elicit the same blood flow response. PURPOSE To examine the hemodynamic responses to relative pressures using two commonly used cuffs (10 and 12 cm). METHODS In a random order over two laboratory visits, one cuff was applied to the right proximal thigh of the participant (men = 17, women = 14), and arterial occlusion pressure (AOP) was measured. Ultrasound measures of blood flow, mean blood velocity, peak blood velocity and artery diameter were taken from the posterior tibial artery at rest and during the application of 10% increments of the AOP. RESULTS There was no significant difference between the 10- and 12-cm cuff relating to blood flow (-0·501 ml min-1 , SD 7·9, P = 0·728), mean blood velocity (-0·168 cm s-1 , SD 1·7, P = 0·590), peak blood velocity (0·586 cm s-1 , SD 11·7, P = 0·783) or artery diameter (0·003 cm, SD 0·02, P = 0·476). There was a main effect of pressure for blood flow (P<0·0005), mean blood velocity (P<0·0005), peak blood velocity (P<0·0005) and artery diameter (P = 0·005), with each decreasing with increasing pressures. Peak blood velocity increased to 60% of AOP before decreasing with increased pressure. CONCLUSION As long as relative pressures are applied, cuff width appears to have little to no effect on the blood flow stimulus during blood flow restriction at rest.
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Affiliation(s)
- J Grant Mouser
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Scott J Dankel
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Kevin T Mattocks
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Matthew B Jessee
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Samuel L Buckner
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
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40
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Mouser JG, Ade CJ, Black CD, Bemben DA, Bemben MG. Brachial blood flow under relative levels of blood flow restriction is decreased in a nonlinear fashion. Clin Physiol Funct Imaging 2017; 38:425-430. [DOI: 10.1111/cpf.12432] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 03/03/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J. Grant Mouser
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Carl J. Ade
- Department of Kinesiology; Kansas State University; Manhattan KS USA
| | - Christopher D. Black
- Department of Health and Exercise Science; The University of Oklahoma; Norman OK USA
| | - Debra A. Bemben
- Department of Health and Exercise Science; The University of Oklahoma; Norman OK USA
| | - Michael G. Bemben
- Department of Health and Exercise Science; The University of Oklahoma; Norman OK USA
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41
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Shimizu R, Hotta K, Yamamoto S, Matsumoto T, Kamiya K, Kato M, Hamazaki N, Kamekawa D, Akiyama A, Kamada Y, Tanaka S, Masuda T. Low-intensity resistance training with blood flow restriction improves vascular endothelial function and peripheral blood circulation in healthy elderly people. Eur J Appl Physiol 2016; 116:749-57. [PMID: 26822582 DOI: 10.1007/s00421-016-3328-8] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 12/27/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE The present study aimed to investigate the effects of low-intensity resistance training with blood flow restriction (BFR resistance training) on vascular endothelial function and peripheral blood circulation. METHODS Forty healthy elderly volunteers aged 71 ± 4 years were divided into two training groups. Twenty subjects performed BFR resistance training (BFR group), and the remaining 20 performed ordinary resistance training without BFR. Resistance training was performed at 20 % of each estimated one-repetition maximum for 4 weeks. We measured lactate (Lac), norepinephrine (NE), vascular endothelial growth factor (VEGF) and growth hormone (GH) before and after the initial resistance training. The reactive hyperemia index (RHI), von Willebrand factor (vWF) and transcutaneous oxygen pressure in the foot (Foot-tcPO2) were assessed before and after the 4-week resistance training period. RESULTS Lac, NE, VEGF and GH increased significantly from 8.2 ± 3.6 mg/dL, 619.5 ± 243.7 pg/mL, 43.3 ± 15.9 pg/mL and 0.9 ± 0.7 ng/mL to 49.2 ± 16.1 mg/dL, 960.2 ± 373.7 pg/mL, 61.6 ± 19.5 pg/mL and 3.1 ± 1.3 ng/mL, respectively, in the BFR group (each P < 0.01). RHI and Foot-tcPO2 increased significantly from 1.8 ± 0.2 and 62.4 ± 5.3 mmHg to 2.1 ± 0.3 and 68.9 ± 5.8 mmHg, respectively, in the BFR group (each P < 0.01). VWF decreased significantly from 175.7 ± 20.3 to 156.3 ± 38.1 % in the BFR group (P < 0.05). CONCLUSIONS BFR resistance training improved vascular endothelial function and peripheral blood circulation in healthy elderly people.
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Affiliation(s)
- Ryosuke Shimizu
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Kazuki Hotta
- Department of Biomedical Sciences, College of Medicine, Florida State University, 1115 West Call Street, Tallahassee, FL 32306, USA
| | - Shuhei Yamamoto
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
- Department of Rehabilitation, Shinsyu University Hospital, 3-1-1 Asahi, Matsumoto, 390-0862, Japan
| | - Takuya Matsumoto
- Department of Rehabilitation, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, 108-8642, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0375, Japan
| | - Michitaka Kato
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Mizuochi, 1-30 Aoi-ku, Shizuoka, 420-0831, Japan
| | - Nobuaki Hamazaki
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0375, Japan
| | - Daisuke Kamekawa
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Ayako Akiyama
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Yumi Kamada
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Shinya Tanaka
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Takashi Masuda
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan.
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Spranger MD, Krishnan AC, Levy PD, O'Leary DS, Smith SA. Reply to "Letter to the editor: Applying the blood flow restriction pressure: the elephant in the room". Am J Physiol Heart Circ Physiol 2016; 310:H134-5. [PMID: 26724282 PMCID: PMC7002862 DOI: 10.1152/ajpheart.00878.2015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Marty D Spranger
- Department of Physiology, Michigan State University, East Lansing, Michigan; Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan;
| | - Abhinav C Krishnan
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan
| | - Phillip D Levy
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan; Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan
| | - Scott A Smith
- Department of Health Care Sciences, University of Texas Southwestern Medical Center, Dallas, Texas; and Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
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Barnett BE, Dankel SJ, Counts BR, Nooe AL, Abe T, Loenneke JP. Blood flow occlusion pressure at rest and immediately after a bout of low load exercise. Clin Physiol Funct Imaging 2015; 36:436-440. [DOI: 10.1111/cpf.12246] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Brian E. Barnett
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Scott J. Dankel
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Brittany R. Counts
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Allison L. Nooe
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology Laboratory; Department of Health, Exercise Science, and Recreation Management; The University of Mississippi; University MS USA
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44
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Cayot TE, Lauver JD, Silette CR, Scheuermann BW. Effects of blood flow restriction duration on muscle activation and microvascular oxygenation during low-volume isometric exercise. Clin Physiol Funct Imaging 2015; 36:298-305. [PMID: 25564998 DOI: 10.1111/cpf.12228] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/04/2014] [Indexed: 11/30/2022]
Abstract
The purpose of the investigation was to observe how varying occlusion durations affected neuromuscular activation and microvascular oxygenation during low-volume isometric knee extension exercise. Healthy, recreationally active males performed isometric knee extension at a variety of submaximal intensities under different blood flow restriction (BFR) occlusion durations. The occlusion pressure (130% SBP) was applied either 5 min prior to exercise (PO), immediately prior to exercise (IO) or not during exercise (CON). Surface electromyography (sEMG) and near-infrared spectroscopy (NIRS) was used to record the neuromuscular activation and microvascular oxygenation of the knee extensors during exercise. No difference in sEMG was observed in the vastus lateralis or vastus medialis during any exercise condition or any submaximal intensity. PO elicited greater microvascular deoxygenation (deoxy-[Hb + Mb]) compared to CON (P≤0·05) at all submaximal intensities and also compared to IO at 20% maximal voluntary contraction (MVC). IO resulted in a greater deoxy-[Hb + Mb] response during low-intensity exercise (20% and 40% MVC) compared to CON (P≤0·05). These findings suggest that applying BFR 5 min before exercise can enhance the exercise-induced metabolic stress (i.e. deoxy-[Hb + Mb]), measured via NIRS, during low-intensity exercise (20% MVC) compared to applying BFR immediately prior to exercise. Furthermore, the increased metabolic stress observed during IO is attenuated during high-intensity (60% MVC, 80% MVC) exercise when compared to CON conditions. Knowledge of the changes in exercise-induced metabolic stress between the various occlusion durations may assist in developing efficient BFR exercise programmes.
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Affiliation(s)
- Trent E Cayot
- Department of Kinesiology, Cardiopulmonary & Metabolism Research Laboratory, University of Toledo, Toledo, OH, USA
| | - Jakob D Lauver
- Department of Kinesiology, Cardiopulmonary & Metabolism Research Laboratory, University of Toledo, Toledo, OH, USA
| | - Christopher R Silette
- Department of Kinesiology, Cardiopulmonary & Metabolism Research Laboratory, University of Toledo, Toledo, OH, USA
| | - Barry W Scheuermann
- Department of Kinesiology, Cardiopulmonary & Metabolism Research Laboratory, University of Toledo, Toledo, OH, USA
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45
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Brandner CR, Kidgell DJ, Warmington SA. Unilateral bicep curl hemodynamics: Low-pressure continuous vs high-pressure intermittent blood flow restriction. Scand J Med Sci Sports 2014; 25:770-7. [DOI: 10.1111/sms.12297] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 11/30/2022]
Affiliation(s)
- C. R. Brandner
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences; Deakin University; Burwood Victoria Australia
| | - D. J. Kidgell
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences; Deakin University; Burwood Victoria Australia
| | - S. A. Warmington
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences; Deakin University; Burwood Victoria Australia
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