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Dong J, Chi J, Lei EF, Wang D. Effects of blood flow restriction training on aerobic capacity, lower limb muscle strength and mass in healthy adults: a meta-analysis. J Sports Med Phys Fitness 2024; 64:1060-1070. [PMID: 38888563 DOI: 10.23736/s0022-4707.24.15905-1] [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: 06/20/2024]
Abstract
INTRODUCTION The aim of this study was to systematically evaluate the effects of blood flow restriction combined with aerobic exercise on aerobic capacity, lower limb muscle strength and mass in healthy adults. EVIDENCE ACQUISITION According to PRISMA's statement, we searched Web of science, Medline, Embase, Cochrane library, CNKI, Wan fang, and VIP databases to collect randomized controlled trials on the effects of aerobic exercise with blood flow restriction on improving aerobic capacity, lower limb muscle strength, and muscle mass in healthy adults. The studies were published from the establishment of the database to November 2023. A supplementary search has been conducted on March 8, 2024. Review Manager5.3 and Stata17 were used for statistical analysis. EVIDENCE SYNTHESIS A total of 16 RCTs with 388 participants were included. The results of meta-analysis showed: Aerobic exercise with BFR significantly affected aerobic capacity (MD and 95%CI 1.06[0.29,1.83], P<0.05), lower limb muscle strength (MD and 95%CI 7.56[5.80,9.33], P<0.05) and lower limb muscle mass (MD and 95%CI were 3.02[1.63,4.42], P<0.05) in healthy adults. The results of subgroup analysis showed that intermittent pressure was better than continuous pressure (P<0.05). Compared with the elderly, the effect of young and middle-aged was better (P<0.05). At the same time, the training form using power bikes is better than walking or running. Finally, 2-6 weeks, 2-3 sessions per week, 10-45 minutes per session can effectively improve the aerobic capacity of healthy adults. CONCLUSIONS Aerobic exercise with BFR can significantly improve aerobic capacity, lower limb muscle strength and mass in healthy adults. In the future, the effects of blood flow restriction training on healthy adults should be further studied, and the form of pressure, intervention cycle, frequency, time, intensity and other variables should be further controlled.
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Affiliation(s)
- Jin Dong
- Physical Education Institute, Shanxi University, Taiyuan, China
| | - Jinjin Chi
- Physical Education Institute, Shanxi University, Taiyuan, China -
| | - Evander F Lei
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Desheng Wang
- Physical Education Institute, Shanxi University, Taiyuan, China
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Shadgan B, Nourizadeh M, Saremi Y, Baktash L, Lazarevic S. Enhancing upper extremity muscle strength in individuals with spinal cord injury using low-intensity blood flow restriction exercise. J Rehabil Med 2024; 56:jrm40608. [PMID: 39315626 PMCID: PMC11439758 DOI: 10.2340/jrm.v56.40608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
OBJECTIVES This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury. STUDY DESIGN Pilot randomized clinical trial. PATIENTS AND METHODS Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant's contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences. RESULTS The study revealed a significant increase in participants' forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen's d = -6.32, 95% CI -8.34, -6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient's Global Impression of Change score of 2.2 reflected overall improvements in participants' daily activities and health status. CONCLUSION This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.
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Affiliation(s)
- Babak Shadgan
- International Collaboration on Repair Discoveries, Vancouver, Canada; Department of Orthopaedics, University of British Columbia, Vancouver, Canada; Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, Canada; School of Biomedical Engineering, University of British Columbia, Vancouver, Canada.
| | - Mehdi Nourizadeh
- International Collaboration on Repair Discoveries, Vancouver, Canada; Department of Orthopaedics, University of British Columbia, Vancouver, Canada; Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Yekta Saremi
- International Collaboration on Repair Discoveries, Vancouver, Canada
| | - Leila Baktash
- International Collaboration on Repair Discoveries, Vancouver, Canada
| | - Stefan Lazarevic
- International Collaboration on Repair Discoveries, Vancouver, Canada
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Proppe CE, Rivera PM, Kelly RT, Rotenberger NP, Salazar S, Lubiak SM, Hill EC. Indices of exercise induced muscle damage following low load resistance exercise with blood flow restriction in untrained males. J Sports Med Phys Fitness 2024; 64:880-888. [PMID: 38863419 DOI: 10.23736/s0022-4707.24.15896-3] [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: 06/13/2024]
Abstract
BACKGROUND There is conflicting evidence regarding the presence and magnitude of exercise-induced muscle damage (EIMD) following low-load resistance training with blood flow restriction (LL+BFR), which may be related to the protocol implemented or exercise volume. Therefore, the purpose of this investigation was to examine the effects of a 75 repetition (BFR-75) (1×30, 3×15) and four sets to volitional failure (BFR-4x) protocols on indices of EIMD among untrained men. METHODS Twelve males with no history of lower-body resistance training during the previous six months volunteered for this investigation. One leg was randomly assigned to BFR-75, and the other to BFR-4x. Participants performed isokinetic, unilateral, concentric-eccentric, leg extension muscle actions at 30% of maximal strength with BFR. Indices of EIMD (limb circumference, perceived muscle soreness, pain pressure threshold [PPT], passive range of motion, and maximal strength [MVIC]) were recorded before exercise and 0, 24, 48, 72, and 96-hours post-exercise for each protocol. RESULTS There were no significant changes (P>0.05) in limb circumference, PPT, passive range of motion, or MVIC. For both BFR-75 and BFR-4x, perceived muscle soreness increased (P<0.001) similarly 24- (2.5±1.7 AU) and 48-hours (1.9±1.7 AU) post-exercise. CONCLUSIONS There was an increase in muscle soreness 24-48 hours post-exercise for both conditions, which may be due to metabolic stress, but this did not affect the force-generating capacity of the muscle (MVIC), suggesting minimal EIMD. The conflicting evidence of EIMD following LL+BFR may be related to differences in restriction time or overall exercise time.
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Affiliation(s)
- Christopher E Proppe
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA -
| | - Paola M Rivera
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
| | - Ryan T Kelly
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
| | - Nathaniel P Rotenberger
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
| | - Santiago Salazar
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
| | - Sean M Lubiak
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
| | - Ethan C Hill
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
- Florida Space Institute, Partnership I, Research Parkway, University of Central Florida, Orlando, FL, USA
- College of Medicine, University of Central Florida, Orlando, FL, USA
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Hill EC, Schmidt JT, Reedy KR, Lubiak SM, Proppe CE, Rivera PM, Gonzalez-Rojas DH, Lawson JE, Prajapati AJ, Shah NM, Patel NN, Guirgis AM, Silverio AA, Howard MA, Choi H, Keller JL. Progression and perceptual responses to blood flow restriction resistance training among people with multiple sclerosis. Eur J Appl Physiol 2024:10.1007/s00421-024-05584-2. [PMID: 39162881 DOI: 10.1007/s00421-024-05584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/10/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE Resistance exercise can attenuate muscular impairments associated with multiple sclerosis (MS), and blood flow restriction (BFR) may provide a viable alternative to prescribing heavy training loads. The purpose of this investigation was to examine the progression of upper and lower body low-load (30% of one-repetition maximum [1RM]) resistance training (RT) with BFR applied intermittently during the exercise intervals (RT + BFR) versus volume-matched heavy-load (65% of 1RM) RT. METHODS Men and women with MS (n = 16) were randomly assigned to low-load RT + BFR (applied intermittently) or heavy-load RT and completed 12 weeks (2 × /week) of RT that consisted of bilateral chest press, seated row, shoulder press, leg press, leg extension, and leg curl exercises. Exercise load, tonnage, and rating of perceived exertion were assessed at baseline and every 6 weeks. RESULTS Training load increased to a greater extent and sometimes earlier for RT + BFR (57.7-106.3%) than heavy-load RT (42.3-54.3%) during chest press, seated row, and leg curl exercises, while there were similar increases (63.5-101.1%) for shoulder press, leg extension, and leg press exercises. Exercise tonnage was greater across all exercises for RT + BFR than heavy-load RT, although tonnage only increased during the chest press (70.7-80.0%) and leg extension (89.1%) exercises. Perceptions of exertion (4.8-7.2 au) and compliance (97.9-99.0%) were similar for both interventions. CONCLUSION The training-induced increases in load, high compliance, and moderate levels of exertion suggested that RT + BFR and heavy-load RT are viable interventions among people with MS. RT + BFR may be a preferred modality if heavy loads are not well tolerated and/or to promote early-phase training responses.
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Affiliation(s)
- Ethan C Hill
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA.
- Florida Space Institute, University of Central Florida, Partnership I, Research Parkway, Orlando, FL, 32826, USA.
- College of Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA.
| | - Jeffrey T Schmidt
- AdventHealth Sports Med and Rehab, 265 E Rollins St. Suite 9100, Orlando, FL, 32804, USA
| | - Kyle R Reedy
- AdventHealth Sports Med and Rehab, 265 E Rollins St. Suite 9100, Orlando, FL, 32804, USA
| | - Sean M Lubiak
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Chris E Proppe
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Paola M Rivera
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - David H Gonzalez-Rojas
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - John E Lawson
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Anuj J Prajapati
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Niriham M Shah
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Nihar N Patel
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Andrew M Guirgis
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Abner-Alexander Silverio
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Mason A Howard
- School of Kinesiology and Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816, USA
| | - Hwan Choi
- College of Engineering, Mechanical and Aerospace, University of Central Florida, 4328 Scorpius St, Orlando, FL, 32816, USA
| | - Joshua L Keller
- College of Education and Professional Studies, University of South Alabama, 75 S University Blvd #3600, Mobile, AL, 36618, USA
- College of Medicine, Department of Physiology and Cell Biology, University of South Alabama, 5851 USA Dr. N, Mobile, AL, 36618, USA
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Perlet MR, Hosick PA, Licameli N, Matthews EL. Microvascular Reactivity Is Greater Following Blood Flow Restriction Resistance Exercise Compared with Traditional Resistance Exercise. J Strength Cond Res 2024:00124278-990000000-00488. [PMID: 39074191 DOI: 10.1519/jsc.0000000000004873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
ABSTRACT Perlet, MR, Hosick, PA, Licameli, N, and Matthews, EL. Microvascular reactivity is greater following blood flow restriction resistance exercise compared with traditional resistance exercise. J Strength Cond Res XX(X): 000-000, 2024-Chronic blood flow restriction (BFR) resistance exercise can improve muscular strength, hypertrophy, and microvasculature function, but the acute microvascular effects are unknown. We aimed to test the effects of acute BFR resistance exercise on postexercise microvascular reactivity in an exercising muscle and nonexercising muscle compared with traditional resistance exercise (TRE). Twenty-five adults (men = 14, women = 11, age: 22 ± 3 years, body mass: 71.69 ± 14.49 kg, height: 170 ± 10 cm) completed barbell back squat 1-repetition maximum (1RM) testing followed by 2 randomized and counterbalanced resistance exercise visits separated by ≥48 hours. The 2 visits involved either BFR (4 sets of 30-15-15-15 repetitions at 30% 1RM, with 60-second rest intervals) or TRE (4 sets of 10 repetitions at 70% 1RM, 60-second rest intervals). During each exercise visit, a pre- and postbarbell back squat vascular occlusion test was performed using near-infrared spectroscopy to measure skeletal muscle oxygen (SmO2) in the vastus lateralis (VL) and flexor carpi radialis (FCR). Two-way repeated-measures ANOVA found an interaction effect (p = 0.020) for SmO2 reactivity in the VL. Post hoc analysis found greater reactive hyperemia postexercise in the VL for the BFR condition (p < 0.001) but not the TRE condition (p ≥ 0.05). There were no time, condition, or interaction effects (all p > 0.05) for the same analysis in the FCR. This analysis suggests that BFR, but not TRE, lead to acutely improved microvasculature function. Moreover, it suggests that the effects of BFR resistance exercise are local to the exercised or occluded limb and not systemic.
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Affiliation(s)
- Michael R Perlet
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, New Jersey; and
| | - Peter A Hosick
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, New Jersey; and
| | | | - Evan L Matthews
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, New Jersey; and
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Lin YT, Wong CM, Chen YC, Chen Y, Hwang IS. Differential training benefits and motor unit remodeling in wrist force precision tasks following high and low load blood flow restriction exercises under volume-matched conditions. J Neuroeng Rehabil 2024; 21:123. [PMID: 39030574 PMCID: PMC11264616 DOI: 10.1186/s12984-024-01419-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Blood flow restriction (BFR) resistance training has demonstrated efficacy in promoting strength gains beneficial for rehabilitation. Yet, the distinct functional advantages of BFR strength training using high-load and low-load protocols remain unclear. This study explored the behavioral and neurophysiological mechanisms that explain the differing effects after volume-matched high-load and low-load BFR training. METHODS Twenty-eight healthy participants were randomly assigned to the high-load blood flow restriction (BFR-HL, n = 14) and low-load blood flow restriction (BFR-LL, n = 14) groups. They underwent 3 weeks of BFR training for isometric wrist extension at intensities of 25% or 75% of maximal voluntary contraction (MVC) with matched training volume. Pre- and post-tests included MVC and trapezoidal force-tracking tests (0-75%-0% MVC) with multi-channel surface electromyography (EMG) from the extensor digitorum. RESULTS The BFR-HL group exhibited a greater strength gain than that of the BFR-LL group after training (BFR_HL: 26.96 ± 16.33% vs. BFR_LL: 11.16 ± 15.34%)(p = 0.020). However, only the BFR-LL group showed improvement in force steadiness for tracking performance in the post-test (p = 0.004), indicated by a smaller normalized change in force fluctuations compared to the BFR-HL group (p = 0.048). After training, the BFR-HL group activated motor units (MUs) with higher recruitment thresholds (p < 0.001) and longer inter-spike intervals (p = 0.002), contrary to the BFR-LL group, who activated MUs with lower recruitment thresholds (p < 0.001) and shorter inter-spike intervals (p < 0.001) during force-tracking. The discharge variability (p < 0.003) and common drive index (p < 0.002) of MUs were consistently reduced with training for the two groups. CONCLUSIONS BFR-HL training led to greater strength gains, while BFR-LL training better improved force precision control due to activation of MUs with lower recruitment thresholds and higher discharge rates.
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Affiliation(s)
- Yen-Ting Lin
- Department of Ball Sport, National Taiwan University of Sport, Taichung City, Taiwan
| | - Chun-Man Wong
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Yi-Ching Chen
- Department of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung City, Taiwan
| | - Yueh Chen
- Orthopedic Department, Kaohsiung Veterans General Hospital Tainan Branch, Tainan City, Taiwan
| | - Ing-Shiou Hwang
- Department of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung City, Taiwan.
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan.
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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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Fleming AR, MacDonald HV, Buckner SL, Winchester LJ. Lower limb blood flow occlusion increases systemic pressor response without increasing brachial arterial blood flow redistribution in women. Clin Physiol Funct Imaging 2024; 44:285-296. [PMID: 38402408 DOI: 10.1111/cpf.12873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 01/16/2024] [Accepted: 02/08/2024] [Indexed: 02/26/2024]
Abstract
This study was conducted to investigate the systemic hemodynamic and vascular changes in women during and after two commonly used clinical blood flow restriction (BFR) pressures at rest. There are minimal data regarding the independent effects of BFR on hemodynamic and systemic vascular changes due to pressor response, particularly among women. Therefore, this study investigated BFR-induced alterations in pressor response and systemic flow redistribution at rest during two commonly used pressures (50% and 80% limb occlusion pressure [LOP]). Fifteen women (22.1 ± 4.2 years) completed two randomised sessions involving 8-min of bilateral, lower limb restriction at 50% or 80% LOP followed by 8-min of recovery post-deflation. Changes in vascular (arterial diameter [DIA], time-averaged mean velocity [TAMV], volume flow [VF], and area) and hemodynamic (heart rate [HR] and blood pressure) measures over time (pre-, during, post-occlusion) and by session (50% vs. 80% LOP) were tested using repeated measures analysis of variance. Repeated measures correlations (rrm) quantified common intraindividual associations between BFR-induced hemodynamic and vascular responses. HR increased from baseline during 50% LOP and remained elevated during recovery (p < 0.05). HR increased from baseline during 80% LOP, while tibial VF and TAMV decreased (p < 0.03 for all). HR and TAMV values returned to baseline during recovery, while brachial artery VF decreased (p < 0.05). Changes in HR, brachial VF, and brachial TAMV were similar between 50% and 80% LOP (rrm = 0.32-0.70, p < 0.05 for all). At 80% LOP, changes in HR were positively correlated with brachial VF (rrm = 0.38) and TAMV (rrm = 0.43) and negatively correlated with tibial VF (rrm = -0.36) and TAMV (rrm = -0.30) (p < 0.05 for all). Results suggest that BFR at 80% LOP elicits an acute systemic pressor reflex without concomitant increases in brachial arterial flow, while 50% LOP elicits a subdued response.
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Affiliation(s)
- Abby R Fleming
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama, USA
| | - Hayley V MacDonald
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama, USA
| | - Samuel L Buckner
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, USA
| | - Lee J Winchester
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama, USA
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Macedo AG, Massini DA, Almeida TAF, dos Reis LM, Galdino G, Santos ATS, da Silva Júnior OT, Venditti Júnior R, Pessôa Filho DM. Effects of Resistance Exercise with and without Blood Flow Restriction on Acute Hemodynamic Responses: A Systematic Review and Meta-Analysis. Life (Basel) 2024; 14:826. [PMID: 39063580 PMCID: PMC11277576 DOI: 10.3390/life14070826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/28/2024] Open
Abstract
Low-load intensity resistance exercise with blood flow restriction (BFR) is an alternative method for enhancing strength and muscle mass. However, acute cardiovascular responses to a complete training session remain uncertain compared to high-load intensity resistance exercise (HI). Therefore, the objective of this study to examine acute and post-exercise hemodynamic responses to low-load BFR and HI protocols. This systematic review and meta-analysis (RD42022308697) followed PRISMA guidelines to investigate whether the responses of heart rate (HR), blood systolic (SBP), blood diastolic pressure (DBP), and rate pressure product (RPP) immediately after and up to 60 min post-exercise from BFR were consistent with those reported after resistance exercises performed at HI in healthy individuals. Searches using PICO descriptors were conducted in databases from January 2011 to December 2023, and effect sizes were determined by Hedge's g. The selected studies involved 160 participants in nine articles, for which the responses immediately after BFR and HI exercises showed no differences in HR (p = 0.23) or SBP (p = 0.57), but significantly higher DBP (p < 0.01) and lower RPP (p < 0.01) responses were found when comparing BFR to HI. Furthermore, the BFR and HI protocols showed no differences regarding SBP (p = 0.21) or DBP (p = 0.68) responses during a 15 to 60 min post-exercise period. Thus, these results indicated that hemodynamic responses are similar between BFR and HI, with a similar hypotensive effect up to 60 min following exercise.
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Affiliation(s)
- Anderson Geremias Macedo
- Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas 37133-840, MG, Brazil; (A.G.M.); (L.M.d.R.); (G.G.); (A.T.S.S.)
- Pos-Graduation Program in Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
- Graduate Programe in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, SP, Brazil; (O.T.d.S.J.); (R.V.J.)
| | - Danilo Alexandre Massini
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, SP, Brazil; (D.A.M.); (T.A.F.A.)
| | - Tiago André Freire Almeida
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, SP, Brazil; (D.A.M.); (T.A.F.A.)
| | - Luciana Maria dos Reis
- Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas 37133-840, MG, Brazil; (A.G.M.); (L.M.d.R.); (G.G.); (A.T.S.S.)
- Pos-Graduation Program in Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Giovane Galdino
- Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas 37133-840, MG, Brazil; (A.G.M.); (L.M.d.R.); (G.G.); (A.T.S.S.)
- Pos-Graduation Program in Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Adriana Teresa Silva Santos
- Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas 37133-840, MG, Brazil; (A.G.M.); (L.M.d.R.); (G.G.); (A.T.S.S.)
- Pos-Graduation Program in Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Osvaldo Tadeu da Silva Júnior
- Graduate Programe in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, SP, Brazil; (O.T.d.S.J.); (R.V.J.)
| | - Rubens Venditti Júnior
- Graduate Programe in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, SP, Brazil; (O.T.d.S.J.); (R.V.J.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, SP, Brazil; (D.A.M.); (T.A.F.A.)
| | - Dalton Muller Pessôa Filho
- Graduate Programe in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, SP, Brazil; (O.T.d.S.J.); (R.V.J.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, SP, Brazil; (D.A.M.); (T.A.F.A.)
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10
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Vehrs PR, Hager R, Richards ND, Richards S, Baker L, Burbank T, Clegg S, Frazier IK, Nielsen JR, Watkin JH. Measurement of arterial occlusion pressure using straight and curved blood flow restriction cuffs. Physiol Rep 2024; 12:e16119. [PMID: 38898580 PMCID: PMC11186747 DOI: 10.14814/phy2.16119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024] Open
Abstract
Arterial occlusion pressure (AOP) is influenced by the characteristics of the cuff used to measure AOP. Doppler ultrasound was used to measure AOP of the brachial and superficial femoral arteries using straight and curved blood flow restriction cuffs in 21 males and 21 females. Vessel diameter and blood flow were evaluated as independent predictors of AOP. Overall, there were no significant differences in AOP when using the straight and curved cuffs in the brachial (129 mmHg vs. 128 mmHg) or superficial femoral artery (202 mmHg vs. 200 mmHg), respectively. Overall, AOP was greater (p < 0.05) in males than in females in the arm (135 mmHg, 123 mmHg) and leg (211 mmHg, 191 mmHg). Brachial (0.376 mm, 0.323 mm) and superficial femoral (0.547 mm, 0.486 mm) arteries were larger (p = 0.016) in males than in females, respectively. Systolic blood pressure (SBP) and arm circumference were predictive of brachial artery AOP, whereas SBP, diastolic blood pressure, thigh circumference, and vessel diameter were predictive of superficial femoral artery AOP. Straight and curved cuffs are efficacious in the measurement of AOP in the arm and leg. Differences in vessel size may contribute to sex differences in AOP but this requires further investigation.
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Affiliation(s)
- Pat R. Vehrs
- Department of Exercise Sciences, 106 SFHBrigham Young UniversityProvoUtahUSA
| | - Ron Hager
- Department of Exercise Sciences, 106 SFHBrigham Young UniversityProvoUtahUSA
| | | | - Shay Richards
- Department of Exercise Sciences, 106 SFHBrigham Young UniversityProvoUtahUSA
| | - Luke Baker
- Department of StatisticsOhio State UniversityColumbusOhioUSA
| | - Tyler Burbank
- Department of Exercise Sciences, 106 SFHBrigham Young UniversityProvoUtahUSA
| | - Shelby Clegg
- Department of Exercise Sciences, 106 SFHBrigham Young UniversityProvoUtahUSA
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11
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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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12
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Machado FA, Almeida GJ, do Vale ALM, Ribeiro ALDA, Cipriano GFB, Cipriano Junior G, Martins WR. Effects of blood flow restriction therapy in patients with knee osteoarthritis: protocol for an overview of systematic reviews. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1318951. [PMID: 38361773 PMCID: PMC10867121 DOI: 10.3389/fresc.2024.1318951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024]
Abstract
Background Osteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored. Objective To perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA. Methodology Systematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the "Assessment of Multiple Systematic Reviews" (AMSTAR-2) tool. Systematic Review Registration PROSPERO, CRD42022367209.
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Affiliation(s)
| | - Gustavo J. Almeida
- Department of Physical Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | | | | | | | - Gerson Cipriano Junior
- Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Ceilândia, Brazil
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Saeterbakken AH, Stien N, Pedersen H, Langer K, Scott S, Michailov ML, Gronhaug G, Baláš J, Solstad TEJ, Andersen V. The Connection Between Resistance Training, Climbing Performance, and Injury Prevention. SPORTS MEDICINE - OPEN 2024; 10:10. [PMID: 38240903 PMCID: PMC10798940 DOI: 10.1186/s40798-024-00677-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Climbing is an intricate sport composed of various disciplines, holds, styles, distances between holds, and levels of difficulty. In highly skilled climbers the potential for further strength-specific adaptations to increase performance may be marginal in elite climbers. With an eye on the upcoming 2024 Paris Olympics, more climbers are trying to maximize performance and improve training strategies. The relationships between muscular strength and climbing performance, as well as the role of strength in injury prevention, remain to be fully elucidated. This narrative review seeks to discuss the current literature regarding the effect of resistance training in improving maximal strength, muscle hypertrophy, muscular power, and local muscular endurance on climbing performance, and as a strategy to prevent injuries. MAIN BODY Since sport climbing requires exerting forces against gravity to maintain grip and move the body along the route, it is generally accepted that a climber`s absolute and relative muscular strength are important for climbing performance. Performance characteristics of forearm flexor muscles (hang-time on ledge, force output, rate of force development, and oxidative capacity) discriminate between climbing performance level, climbing styles, and between climbers and non-climbers. Strength of the hand and wrist flexors, shoulders and upper limbs has gained much attention in the scientific literature, and it has been suggested that both general and specific strength training should be part of a climber`s training program. Furthermore, the ability to generate sub-maximal force in different work-rest ratios has proved useful, in examining finger flexor endurance capacity while trying to mimic real-world climbing demands. Importantly, fingers and shoulders are the most frequent injury locations in climbing. Due to the high mechanical stress and load on the finger flexors, fingerboard and campus board training should be limited in lower-graded climbers. Coaches should address, acknowledge, and screen for amenorrhea and disordered eating in climbers. CONCLUSION Structured low-volume high-resistance training, twice per week hanging from small ledges or a fingerboard, is a feasible approach for climbers. The current injury prevention training aims to increase the level of performance through building tolerance to performance-relevant load exposure and promoting this approach in the climbing field.
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Affiliation(s)
- Atle Hole Saeterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway.
| | - Nicolay Stien
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Helene Pedersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Kaja Langer
- Department of Human Sciences, Institute of Sports Science, Technical University Darmstadt, Darmstadt, Germany
| | - Suzanne Scott
- School of Anatomy, Faculty of Health and Life Sciences, University of Bristol, Bristol, UK
| | | | - Gudmund Gronhaug
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Jiří Baláš
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tom Erik Jorung Solstad
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
| | - Vidar Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Røyrgata 6, 6856, Sogndal, Norway
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14
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Li R, Chee CS, Kamalden TF, Ramli AS, Yang K. Effects of blood flow restriction training on sports performance in athletes: a systematic review with meta-analysis. J Sports Med Phys Fitness 2024; 64:55-65. [PMID: 37902798 DOI: 10.23736/s0022-4707.23.15220-0] [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: 10/31/2023]
Abstract
INTRODUCTION Blood flow restriction training (BFRT) is an effective training method to improve sports performance in healthy athletes. Nevertheless, a systematic review with meta-analysis regarding how BFRT affects sports performance in athletes is still lacking. Consequently, the study attempted to expand and consolidate the prior studies regarding the effect of BFRT on technical and physical performance in athletes. EVIDENCE ACQUISITION This study was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) statement guidelines for a systematic review of the academic databases Scopus, Web of Science, PubMed, EBSCOhost (SportDiscus), and Google Scholar. The PEDro scale was used to assess the methodological quality of the included publications, which ranged from moderate to high quality. The systematic review protocol was registered on inplasy.com (INPLASY202380049). EVIDENCE SYNTHESIS Out of 249 studies identified, 93 articles were evaluated as eligible, and after the screening, 18 studies were finally included in this systematic review. Meta-analysis results showed a significant enhancement on vertical jump height in the BFRT group compared to the control group (SMD=1.39, 95% CI=0.30-2.49, P=0.01). BFRT was able to significantly increase maximal oxygen uptake (SMD=1.65, 95% CI=0.56-2.74, P<0.01). While no significant improvement in sprint time was observed (SMD= -0.18, 95% CI=-1.18-0.82, P=0.115). CONCLUSIONS The finding suggests that BFRT is beneficial to athletes as this training method can be effective in enhancing physical and technical performance in athletes. Nevertheless, further analysis needs to be conducted to fully determine the effectiveness of the moderators of the intervention on sports performance.
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Affiliation(s)
- Rui Li
- Department of Sport Studies, Faculty of Educational Studies, Putra Malaysia University, Selangor, Malaysia
| | - Chen S Chee
- Department of Sport Studies, Faculty of Educational Studies, Putra Malaysia University, Selangor, Malaysia -
| | - Tengku F Kamalden
- Department of Sport Studies, Faculty of Educational Studies, Putra Malaysia University, Selangor, Malaysia
| | - Alif S Ramli
- Department of Sport Studies, Faculty of Educational Studies, Putra Malaysia University, Selangor, Malaysia
| | - Kun Yang
- Department of Sport Studies, Faculty of Educational Studies, Putra Malaysia University, Selangor, Malaysia
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15
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Santos KO, Filho DMP, Ventura TMO, Thomassian LTG, Macedo AG, Buzalaf MAR, Braga AS, Faria MH, Magalhães AC. Salivary proteomic profile of response to different resistance training protocols: A case report. Cell Biochem Funct 2024; 42:e3936. [PMID: 38269522 DOI: 10.1002/cbf.3936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
Resistance training (RT) with blood flow restriction (BFR) or high intensity (HI) are effective to increase muscle mass. To understand this effect, techniques known as "omics" are used to identify possible biomarkers. This study analyzed the salivary proteomic profile of healthy individuals trained before and after two RT protocols both designed with eight exercises for upper- and lower-limbs, one performed at low percentage of one-maximum repetition (%1RM) with BFR technique, and other at high %1RM (HI) without BRF technique. Four healthy males between 18 and 28 years participated in the study. Stimulated saliva was collected before (BBFR/BHI) and immediately after (ABFR/AHI) the two RT protocols. All protein-related processing was performed using label-free proteomic. The difference in expression between groups was expressed as p < .05 for downregulated proteins and 1-p > .95 for upregulated proteins. There was difference in salivary flow between ABFR and BBFR (p = .005). For HI, 87 proteins were found after the practice and 119 before. Three hemoglobin isoforms were increased in AHI compared with BHI. In the BFR comparison, 105 proteins were identified after (ABFR) and 70 before (BBFR). Among those increased ABFR, we highlight five hemoglobin isoforms and Deleted in malignant brain tumors 1 protein. Between ABFR and AHI, 17 isoforms of histones, Transaldolase, Transketolase, Glyceraldehyde-3-phosphate dehydrogenase, and Antileukoproteinase were decreased ABFR. For HI, there was an increase in proteins related to oxidative stress and metabolism of the musculoskeletal system, compared with BFR. HI seems to induce higher anabolic signaling to muscle mass increase and antiatherosclerotic effects.
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Affiliation(s)
- Karina Oliveira Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo, Brazil
| | - Dalton Muller Pessôa Filho
- Post-graduate Program in Human Development and Technology, Bioscience Institute (IB), São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru, São Paulo, Brazil
| | | | | | - Anderson Geremias Macedo
- Post-graduate Program in Human Development and Technology, Bioscience Institute (IB), São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
- Pos-Graduation Program in Rehabilitation Sciences, Institute of Motricity Sciences, Federal University of Alfenas, Santa Clara Campus, Alfenas, Minas Gerais, Brazil
| | - Marília Afonso Rabelo Buzalaf
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo, Brazil
| | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo, Brazil
| | - Murilo Henrique Faria
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, School of Sciences, São Paulo State University (UNESP), Bauru, São Paulo, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo, Brazil
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Ptaszek B, Podsiadło S, Czerwińska-Ledwig O, Zając B, Niżankowski R, Mika P, Teległów A. The Influence of Interval Training Combined with Occlusion and Cooling on Selected Indicators of Blood, Muscle Metabolism and Oxidative Stress. J Clin Med 2023; 12:7636. [PMID: 38137705 PMCID: PMC10743385 DOI: 10.3390/jcm12247636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
There is increasing evidence to support the use of interval training and/or low-impact blood flow restriction exercises in musculoskeletal rehabilitation. The aim of the study was to assess the effect of interval training combined with occlusion and cooling in terms of changes in selected blood parameters affecting the development and progression of atherosclerosis of the lower limbs, as well as selected parameters of muscle metabolism and oxidative stress affecting the growth of muscle mass and regeneration after training. MATERIAL AND METHODS The study included 30 young, healthy and untrained people. The VASPER (Vascular Performance) training system was used-High-Intensity Interval Training with the simultaneous use of occlusion and local cryotherapy. Blood from the project participants was collected six times (2 weeks before the start of training, on the day of training, after the first training, after the 10th training, after the 20th training and two weeks after the end of training). The subjects were randomly divided into three groups: exercises only (controlled), with occlusion and with occlusion and local cryotherapy. RESULTS Statistical analysis of changes in the average values of indicators in all study groups showed a significant change increase due to the time of testing IGF-1 (F = 2.37, p = 0.04), XOD (F = 14.26, p = 0.00), D-Dimer (F = 2.90, p = 0.02), and decrease in MDA (F = 7.14, p = 0.00), T-AOC (F = 11.17, p = 0.00), PT Quick (F = 26.37, p = 0.00), INR (F = 8.79, p = 0.00), TT (F = 3.81, p = 0.00). The most pronounced changes were observed in the occlusion and cooling group. CONCLUSIONS Both interval training without and with the modifications used in the study influences coagulation and oxidative stress parameters and, to a small extent, muscle metabolism. It seems reasonable to use occlusion and local cryotherapy in combination with occlusion.
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Affiliation(s)
- Bartłomiej Ptaszek
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Szymon Podsiadło
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland; (S.P.); (P.M.)
| | - Olga Czerwińska-Ledwig
- Institute of Basic Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland; (O.C.-L.); (A.T.)
| | - Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Krakow, 31-571 Krakow, Poland;
| | - Rafał Niżankowski
- Sano Science, Centre for Computational Medicine, 30-054 Krakow, Poland;
| | - Piotr Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland; (S.P.); (P.M.)
| | - Aneta Teległów
- Institute of Basic Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland; (O.C.-L.); (A.T.)
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Russo A, Boppre G, Schmidt C, Bohn L. Chronic hemodynamic adaptations induced by resistance training with and without blood flow restriction in adults: A systematic review and meta-analysis. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:259-268. [PMID: 38314050 PMCID: PMC10831382 DOI: 10.1016/j.smhs.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 02/06/2024] Open
Abstract
The purposes of this systematic review and meta-analysis of peer-reviewed literature were to examine the chronic effects of resistance training with blood flow restriction (RT-BFR) on hemodynamics, and to compare these adaptations to those induced by traditional resistance training (TRT) programs in adults (PROSPERO: Registry: CRD42022339510). A literature search was conducted across PubMed, Sports Discus, Scielo, and Web of Science databases. Two independent reviewers extracted study characteristics and blood pressure measures. Risk of bias (The Cochrane risk of bias tool for randomized controlled trials [RoB-2]), and the certainty of the evidence (Grading of Recommendations, Assessment, Development, and Evaluation [GRADE]) were used. A total of eight studies met the inclusion criteria for systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP). Regarding the comparison of RT-BFR vs. non-exercise, no significant differences favoring the exercise group were observed (p > 0.05). However, when compared to TRT, RT-BFR elicited additional improvements on DBP (-3.35; 95%CI -6.00 to -0.71; I2 = 14%; z = -2.48, p = 0.01), and on MAP (-3.96; 95%CI -7.94 to 0.02; I2 = 43%; z = -1.95, p = 0.05). Results indicate that RT-BFR may elicit a decrease in DBP in comparison with TRT, but the lack of data addressing this topic makes any conclusion speculative. Future research on this topic is warranted.
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Affiliation(s)
- Allison Russo
- Lusofona University, Faculty of Psychology, Education and Sport, Porto, Portugal
| | - Giorjines Boppre
- University of Porto, Faculty of Sports (FADEUP), Porto, Portugal
- Human Motricity Research Center, University Adventist, Chillan, Chile
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Portugal
| | - Cristine Schmidt
- University of Porto, Faculty of Sports (FADEUP), Porto, Portugal
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Portugal
- Surgery and Physiology Department, University of Porto, Faculty of Medicine (FMUP), Porto, Portugal
| | - Lucimere Bohn
- Lusofona University, Faculty of Psychology, Education and Sport, Porto, Portugal
- University of Porto, Faculty of Sports (FADEUP), Porto, Portugal
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Portugal
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18
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Gene J, Colado JC, Perez-Castilla A, García-Ramos A, Redondo B, Jiménez R, Vera J, Martín-Rivera F. Acute Intraocular Pressure Responses to Resistance Training in Combination With Blood Flow Restriction. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:1110-1116. [PMID: 36130122 DOI: 10.1080/02701367.2022.2119197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Objective: To determine the effect of blood flow restriction (BFR) applied to the legs at different pressures (40% and 60%) on intraocular pressure (IOP) during the execution of ten repetitions maximum (10RM) in the half-squat exercise. Methods: Quasi-experimental, prospective study with 17 healthy physically active subjects (9 males and 8 females; 24.1 ± 4.2 years). Two sessions were conducted. The 10RM load was determined in the first session. The second session consisted of 10RM under three BFR conditions (no-BFR, 40%-BFR, and 60%-BFR) that were applied in random order. IOP was measured before each condition, immediately after each repetition, and after 1 minute of passive recovery. A two-way repeated-measures ANOVA (restriction type [no-BFR, 40%-BFR, and 60%-BFR] x measurement point [basal, repetitions 1-10, and recovery]) was applied on the IOP measurements. Results: A significant main effect of the BFR condition (p = .022, ƞp2 = 0.21) was observed due to the significantly higher mean IOP values for the 60%-BFR (19.0 ± 0.7 mmHg) compared to the no-BFR (18.0 ± 0.8 mmHg; p = .048, dunb = 1.30). Non-significant differences with a large effect size were reached between 60%-BFR and 40%-BFR (18.1 ± 0.8 mmHg; p = .081, dunb = 1.16) and between no-BFR and 40%-BFR (p = .686, dunb = 0.18). IOP increased approximately 3-4 mmHg from baseline to the last repetition. Conclusions: Low-pressure BFR (40%-BFR) in combination with moderate-load (10RM load) resistance exercise could be an effective and safe strength training strategy while avoiding IOP peaks associated with heavy-load resistance exercises. These findings incorporate novel insights into the most effective exercise strategies in individuals who need to maintain stable IOP levels (e.g., glaucoma patients).
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McClean ZJ, Zhang J, Khaledi N, Yacoub M, Aboodarda SJ. Intermittent blood flow occlusion modulates neuromuscular, perceptual, and cardiorespiratory determinants of exercise tolerance during cycling. Eur J Appl Physiol 2023; 123:2295-2306. [PMID: 37278835 DOI: 10.1007/s00421-023-05242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
PURPOSE Constant blood flow occlusion (BFO) superimposed on aerobic exercise can impair muscle function and exercise tolerance; however, no study has investigated the effect of intermittent BFO on the associated responses. Fourteen participants (n = 7 females) were recruited to compare neuromuscular, perceptual, and cardiorespiratory responses to shorter (5:15s, occlusion-to-release) and longer (10:30s) BFO applied during cycling to task failure. METHODS In randomized order, participants cycled to task failure (task failure 1) at 70% of peak power output with (i) shorter BFO, (ii) longer BFO, and (iii) no BFO (Control). Upon task failure in the BFO conditions, BFO was removed, and participants continued cycling until a second task failure (task failure 2). Maximum voluntary isometric knee contractions (MVC) and femoral nerve stimuli were performed along with perceptual measures at baseline, task failure 1, and task failure 2. Cardiorespiratory measures were recorded continuously across the exercises. RESULTS Task failure 1 was longer in Control than 5:15s and 10:30s (P < 0.001), with no differences between the BFO conditions. At task failure 1, 10:30s elicited a greater decline in twitch force compared to 5:15s and Control (P < 0.001). At task failure 2, twitch force remained lower in 10:30s than Control (P = 0.002). Low-frequency fatigue developed to a greater extent in 10:30s compared to Control and 5:15s (P < 0.047). Dyspnea and Fatigue were greater for Control than 5:15s and 10:30s at the end of task failure 1 (P < 0.002). CONCLUSION Exercise tolerance during BFO is primarily dictated by the decline in muscle contractility and accelerated development of effort and pain.
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Affiliation(s)
- Zachary John McClean
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Jenny Zhang
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Neda Khaledi
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Matthew Yacoub
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Saied Jalal Aboodarda
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.
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Vehrs PR, Richards S, Blazzard C, Hart H, Kasper N, Lacey R, Lopez D, Baker L. Use of a handheld Doppler to measure brachial and femoral artery occlusion pressure. Front Physiol 2023; 14:1239582. [PMID: 37664423 PMCID: PMC10470651 DOI: 10.3389/fphys.2023.1239582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Objective: Measurement of arterial occlusion pressure (AOP) is essential to the safe and effective use of blood flow restriction during exercise. Use of a Doppler ultrasound (US) is the "gold standard" method to measure AOP. Validation of a handheld Doppler (HHDOP) device to measure AOP could make the measurement of AOP more accessible to practitioners in the field. The purpose of this study was to determine the accuracy of AOP measurements of the brachial and femoral arteries using an HHDOP. Methods: We simultaneously measured AOP using a "gold standard" US and a HHDOP in the dominant and non-dominant arms (15 males; 15 females) and legs (15 males; 15 females). Results: There were no differences in limb circumference or limb volume in the dominant and non-dominant arms and legs between males and females or between the dominant and non-dominant arms and legs of males and females. The differences between US and HHDOP measures of AOP in the dominant and non-dominant arms and legs were either not significant or small (<10 mmHg) and of little practical importance. There were no sex differences in AOP measurements of the femoral artery (p > 0.60). Bland-Altman analysis yielded an average bias (-0.65 mmHg; -2.93 mmHg) and reasonable limits of agreement (±5.56 mmHg; ±5.58 mmHg) between US and HHDOP measures of brachial and femoral artery AOP, respectively. Conclusion: HHDOP yielded acceptable measures of AOP of the brachial and femoral arteries and can be used to measure AOP by practitioners for the safe and effective use of blood flow restriction. Due to the potential differences in AOP between dominant and non-dominant limbs, AOP should be measured in each limb.
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Affiliation(s)
- Pat R. Vehrs
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Shay Richards
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Chase Blazzard
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Hannah Hart
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Nicole Kasper
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Ryan Lacey
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Daniela Lopez
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Luke Baker
- Department of Statistics, Ohio State University, Columbus, OH, United States
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21
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Wang X, Wang Y, Yang X, Mohd Nasiruddin NJB, Dong D, Samsudin SB, Qin XM. Effects of blood flow restriction training on bone metabolism: a systematic review and meta-analysis. Front Physiol 2023; 14:1212927. [PMID: 37621760 PMCID: PMC10445948 DOI: 10.3389/fphys.2023.1212927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction: The efficacy of low-intensity blood flow restriction (LI-BFR) training programs in bone metabolism remains unclear compared to low-intensity (LI) training and high-intensity (HI) training. The aim of this review was to quantitatively identify the effects of LI-BFR training on changes in bone formation markers (i.e., bone-specific alkaline phosphatase, BALP), bone resorption (i.e., C-terminal telopeptide of type I collagen, CTX) and bone mineral density (BMD) compared with conventional resistance training programmes. Additionally, the effectiveness of walking with and without BFR was assessed. Methods: PubMed, Scopus, SPORTDiscus, Web of Science and Google Scholar databases were searched for articles based on eligibility criteria. Review Manager Version 5.4 was used for Meta-analysis. Physiotherapy Evidence Database (PEDro) was applied to assess the methodological quality of studies. Results: 12 articles were included in the meta-analysis, with a total of 378 participants. Meta-results showed that compared with LI training, LI-BFR training induced greater increments in BALP (young adults: MD = 6.70, p < 0.001; old adults: MD = 3.94, p = 0.002), slight increments in BMD (young adults: MD = 0.05, p < 0.00001; old adults: MD = 0.01, p < 0.00001), and greater decrements in CTX (young adults: MD = -0.19, p = 0.15; old adults: MD = -0.07, p = 0.003). Compared with HI training, LI-BFR training produced smaller increments in BALP (young adults: MD = -6.87, p = 0.24; old adults: MD = -0.6, p = 0.58), similar increments in BMD (MD = -0.01, p = 0.76) and similar decrements in CTX (young adults: MD = 0, p = 0.96; old adults: MD = -0.08, p = 0.13). Although there were only two studies on walking training intervention, walking training with BFR had a better effect on bone metabolism than training without BFR. Discussion: In conclusion, LI-BFR training induces greater improvements in bone health than LI training, but is less effective than HI training. Therefore, LI-BFR training may be an effective and efficient way to improve bone health for untrained individuals, older adults, or those undergoing musculoskeletal rehabilitation. Clinical Trial Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42023411837].
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Affiliation(s)
- Xiaolin Wang
- Department of Sport Studies, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yifei Wang
- Department of Physical Education, Ludong University, Yantai, China
| | - Xuezhen Yang
- School of Nursing, Shandong First Medical University, Jinan, China
| | | | - Delong Dong
- Department of Physical Education, Ludong University, Yantai, China
| | - Shamsulariffin Bin Samsudin
- Department of Sport Studies, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Xin-Min Qin
- Department of Smart Health Science and Technology Convergence (Sport Science), Department of Sport Science, Kangwon National University, Chuncheon, Republic of Korea
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22
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Hu H, Wu C, Kwok JYY, Ho MH, Chau PH, Lok KYW, Choi EPH. Effects of Different Exercises on Physical Function, Dialysis Adequacy, and Health-Related Quality of Life in Maintenance Hemodialysis Patients: A Systematic Review and Network Meta-Analysis. Am J Nephrol 2023; 54:379-390. [PMID: 37536298 DOI: 10.1159/000532109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Clinical guidelines recommend exercise training for patients undergoing maintenance hemodialysis (MHD). However, the effectiveness of different types of exercise remains uncertain. OBJECTIVES The aims of the study were to compare and rank the effect of different types of exercise on walking capacity, cardiorespiratory fitness, dialysis adequacy, and health-related quality of life (HRQOL) in patients undergoing MHD. METHODS Eight databases (four English and four Chinese) were searched from inception to January 1, 2022. Randomized controlled trials evaluating the efficacy of different exercises for patients undergoing MHD were included. Two independent reviewers screened the literature, extracted data, assessed the risk of bias, and evaluated the certainty of evidence. A frequentist random-effect network meta-analysis was conducted. RESULTS Ninety trials with 4,084 participants comparing 15 types of exercise were included, reporting on the six-minute walking test (45 trials), peak oxygen uptake (22 trials), dialysis adequacy (30 trials), and HRQOL (23 trials). Network meta-analysis showed that the most effective intervention for walking capacity was intradialytic aerobic exercise combined with blood flow restriction with a mean difference and 95% confidence interval of 97.35 (11.89-182.81), for peak oxygen uptake it was non-intradialytic combined aerobic and resistance exercise with a value of 4.35 (2.25-6.44), for dialysis adequacy it was intradialytic combined aerobic and resistance exercise with a value of 0.17 (0.06-0.28), for the physical component summary of HRQOL it was intradialytic aerobic exercise with a value of 4.93 (2.31-7.54), and for the mental component summary of HRQOL it was non-intradialytic combined aerobic and resistance exercise with a value of 6.36 (0.45-12.27). Ultimately, intradialytic combined aerobic and resistance exercise could improve all the above outcomes compared to usual care. CONCLUSIONS This study concluded that intradialytic combined aerobic and resistance exercise is optimal for MHD patients due to its significant positive effects on multiple outcomes. Walking capacity can be further enhanced by combining blood flow restriction with exercise. For improving dialysis adequacy, intradialytic exercise proves to be more effective than non-intradialytic exercise. Further well-designed clinical trials are needed to investigate the effects of exercise with varying durations, intensities, and frequencies.
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Affiliation(s)
- Huagang Hu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China,
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China,
| | - Chanchan Wu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kris Yuet Wan Lok
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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23
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Li SN, Ihsan M, Shaykevich A, Girard O. Exercise responses to heart rate clamped cycling with graded blood flow restriction. J Sci Med Sport 2023; 26:434-439. [PMID: 37394395 DOI: 10.1016/j.jsams.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES To quantify the acute effects of graded blood flow restriction on the interaction between changes in mechanical output, muscle oxygenation trends and perceptual responses to heart rate clamped cycling. DESIGN Repeated measures. METHODS Twenty-five adults (21 men) performed six, 6-min cycling bouts (24 min of recovery) at a clamped heart rate corresponding to their first ventilatory threshold at 0 % (unrestricted), 15 %, 30 %, 45 %, 60 % and 75 % of arterial occlusion pressure with the cuffs inflated bilaterally from the fourth to the sixth minute. Power output, arterial oxygen saturation (pulse oximetry) and vastus lateralis muscle oxygenation (near-infrared spectroscopy) were monitored during the final 3 min of pedalling, whilst perceptual responses (modified Borg CR10 scales) were obtained immediately after exercise. RESULTS Compared to unrestricted cycling, average power output for minutes 4-6 decreased exponentially for cuff pressures ranging 45-75 % of arterial occlusion pressure (P < 0.001). Peripheral oxygen saturation averaged ∼96 % across all cuff pressures (P = 0.318). Deoxyhemoglobin changes were larger at 45-75 % versus 0 % of arterial occlusion pressure (P < 0.05), whereas higher total haemoglobin values occurred at 60-75 % of arterial occlusion pressure (P < 0.05). Sense of effort, ratings of perceived exertion, pain from cuff pressure, and limb discomfort were exaggerated at 60-75 % versus 0 % of arterial occlusion pressure (P < 0.001). CONCLUSIONS Blood flow restriction of at least 45 % of arterial occlusion pressure is required to reduce mechanical output during heart rate clamped cycling at the first ventilatory threshold. Whilst power decreases non-linearly above this pressure threshold, higher occlusion levels ranging 60-75 % of arterial occlusion pressure also accentuate muscle deoxygenation and exercise-related sensations.
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Affiliation(s)
- Siu Nam Li
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia
| | - Mohammed Ihsan
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore; Department of Rehabilitation, Faculty of Medicine, Chiang Mai University, Thailand
| | - Alex Shaykevich
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia; Perron Institute for Neurological and Translational Science, Perth, WA, Australia
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia.
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24
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Ahn H, Bae SH, Kim KY. Effects of left thigh blood flow restriction exercise on muscle strength and golf performance in amateur golfers. J Exerc Rehabil 2023; 19:237-244. [PMID: 37662529 PMCID: PMC10468289 DOI: 10.12965/jer.2346302.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
This study aimed to investigate the effect of lower-extremity strengthening exercise (LSE) with and without blood flow restriction (BFR) on the left thigh on golf performance. Eighteen amateur golfers with more than 1 year of golf experience participated in the study and were randomly divided into two groups: LSE+BFR group (LSE with BFR on the left thigh, n=9) and LSE group (LSE without BFR, n=9). The LSEs consisted of squats, lunges, and standing leg curls. All exercises were performed 3 times a week for 6 weeks. Changes in thigh muscle strength, plantar foot pressure (weight transfer), and golf performance, such as club head speed, ball speed, and carry distance were measured before and after the exercise program. Right knee extension (P<0.001) and left knee extension and flexion (P<0.001) strength were higher in the LSE+BFR group than in the LSE group. The changes in plantar foot pressure confirmed that smooth weight transfer appeared in E1 (event 1) (address) (P<0.05) of the LSE+BFR group, which confirmed that the carry distance (P<0.05) of the LSE+BFR group improved after the exercise program. The results of this study showed that BFR muscle strengthening exercise are more effective than basic simple muscle strengthening exercise in improving golf performance through muscle strength and weight transfer improvement.
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Affiliation(s)
- Hyun Ahn
- Department of Physical Therapy, Samsung Electronic Musculoskeletal Disorders Prevention Center, Gwangju,
Korea
| | - Sea-Hyun Bae
- Department of Physical Therapy, Dongshin University, Naju,
Korea
| | - Kyung-Yoon Kim
- Department of Physical Therapy, Dongshin University, Naju,
Korea
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25
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García-Sillero M, Maroto-Izquierdo S, Galván-García M, Benitez-Porres J, Vargas-Molina S, Jurado-Castro JM. Acute Effects of Blood Flow Restriction Training on Movement Velocity and Neuromuscular Signal during the Back Squat Exercise. J Clin Med 2023; 12:4824. [PMID: 37510938 PMCID: PMC10381307 DOI: 10.3390/jcm12144824] [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: 05/18/2023] [Revised: 06/30/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back squat exercise. METHODS Twenty-four university students participated in this study. In two randomized sessions 72 h apart, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity (MPV), peak concentric velocity (Vmax), and the effort index (EI)). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. RESULTS The BFR condition showed higher (p < 0.05) EI, peak, and rooted mean square normalized EMG in Set 1 compared to Set 2. Similar MPV and Vmax were observed in each set for both the BFR and control conditions. No significant differences were observed between conditions in any set. CONCLUSIONS BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less excitation of the muscles involved.
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Affiliation(s)
- Manuel García-Sillero
- Physical Education and Sport, Faculty of Medicine, EADE-University of Wales Trinity Saint David, 29018 Malaga, Spain
| | - Sergio Maroto-Izquierdo
- Department of Health Sciences, European University Miguel de Cervantes (UEMC), 47012 Valladolid, Spain
| | - María Galván-García
- Physical Education and Sport, Faculty of Medicine, EADE-University of Wales Trinity Saint David, 29018 Malaga, Spain
| | - Javier Benitez-Porres
- Physical Education and Sport, Faculty of Medicine, University of Málaga, 29016 Málaga, Spain
| | - Salvador Vargas-Molina
- Physical Education and Sport, Faculty of Medicine, EADE-University of Wales Trinity Saint David, 29018 Malaga, Spain
| | - Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Ciencias De La Actividad Física y El Deporte, Escuela Universitaria de Osuna (Centro Adscrito a la Universidad de Sevilla), 41640 Osuna, Spain
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26
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Chen YC, Lin YT, Hu CL, Hwang IS. Low-Level Laser Therapy Facilitates Postcontraction Recovery with Ischemic Preconditioning. Med Sci Sports Exerc 2023; 55:1326-1333. [PMID: 36878185 DOI: 10.1249/mss.0000000000003149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
PURPOSE Despite early development of muscle fatigue, ischemic preconditioning is gaining popularity for strength training combined with low-load resistance exercise. This study investigated the effect of low-level laser (LLL) on postcontraction recovery with ischemic preconditioning. METHODS Forty healthy adults (22.9 ± 3.5 yr) were allocated into sham (11 men, 9 women) and LLL (11 men, 9 women) groups. With ischemic preconditioning, they were trained with three bouts of intermittent wrist extension of 40% maximal voluntary contraction (MVC). During the recovery period, the LLL group received LLL (wavelength of 808 nm, 60 J) on the working muscle, whereas the sham group received no sham therapy. MVC, force fluctuations, and discharge variables of motor units (MU) for a trapezoidal contraction were compared between groups at baseline (T0), postcontraction (T1), and after-recovery (T2). RESULTS At T2, the LLL group exhibited a higher normalized MVC (T2/T0; 86.22% ± 12.59%) than that of the sham group (71.70% ± 13.56%; P = 0.001). The LLL group had smaller normalized force fluctuations (LLL, 94.76% ± 21.95%; sham, 121.37% ± 29.02%; P = 0.002) with greater normalized electromyography amplitude (LLL, 94.33% ± 14.69%; sham, 73.57% ± 14.94%; P < 0.001) during trapezoidal contraction. In the LLL group, the smaller force fluctuations were associated with lower coefficients of variation of interspike intervals of MUs (LLL, 0.202 ± 0.053; sham, 0.208 ± 0.048; P = 0.004) with higher recruitment thresholds (LLL, 11.61 ± 12.68 %MVC; sham, 10.27 ± 12.73 %MVC; P = 0.003). CONCLUSIONS LLL expedites postcontraction recovery with ischemic preconditioning, manifesting as superior force generation capacity and force precision control for activation of MU with a higher recruitment threshold and lower discharge variability.
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Affiliation(s)
| | - Yen-Ting Lin
- Department of Ball Sport, National Taiwan University of Sport, Taichung City, TAIWAN
| | - Chia-Ling Hu
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, TAIWAN
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27
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McClean ZJ, Young A, Pohl AJ, Fine NM, Burr JF, MacInnis M, Aboodarda SJ. Blood flow restriction during high-intensity interval cycling exacerbates psychophysiological responses to a greater extent in females than males. J Appl Physiol (1985) 2023; 134:596-609. [PMID: 36701480 DOI: 10.1152/japplphysiol.00567.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This study aimed to characterize neuromuscular, perceptual, and cardiorespiratory responses to high-intensity interval training (HIIT) with superimposed blood flow restriction in males and females. Twenty-four, healthy individuals (n = 12 females) completed two cycling HIIT protocols to task failure (1-min work phases at 90% of peak power output interspersed by 1-min rest phases). The blood flow restriction (BFR) and control (CON) protocols were identical except for the presence and absence of BFR during rest phases, respectively. The interpolated twitch technique, including maximal voluntary isometric knee extension (MVC) and femoral nerve electrical stimuli, was performed at baseline, every six intervals, and task failure. Perceptual and cardiorespiratory responses were recorded every three intervals and continuously during exercise, respectively. Bayesian inference was used to obtain the joint posterior distribution for all parameters and evidence of an effect was determined via the marginal posterior probability (PP). The BFR shortened task duration by 57.3% compared with CON (PP > 0.99), without a sex difference. The application of BFR exacerbated the rate of decline in neuromuscular measures (MVC and twitch force output), increase of perceptual responses (perceived effort, pain, dyspnea, fatigue), and development of cardiorespiratory parameters (minute ventilation and heart rate), compared with CON (PP > 0.95). In addition, BFR exacerbated the neuromuscular, perceptual, and cardiorespiratory responses to a greater extent in females than males (PP > 0.99). Our results suggest that superimposition of blood flow restriction exacerbates psychophysiological responses to a HIIT protocol to a greater extent in females than males.NEW & NOTEWORTHY To our knowledge, no study has explored sex differences in the neuromuscular, perceptual, and cardiorespiratory indices characterizing exercise tolerance during high-intensity interval training (HIIT) with blood flow restriction (BFR) applied only during rest periods. Our results suggest that BFR elicited a decline in exercise performance that could be attributed to integration of psychophysiological responses. However, this integration was sex-dependent where females demonstrated an exacerbated rate of change in these responses compared with males.
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Affiliation(s)
- Zachary J McClean
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Abbey Young
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Andrew J Pohl
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Nowell M Fine
- Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jamie F Burr
- College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Martin MacInnis
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Saied J Aboodarda
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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28
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Hornikel B, Saffold KS, Esco MR, Mota JA, Fedewa MV, Wind SA, Adams TL, Winchester LJ. Acute Responses to High-Intensity Back Squats with Bilateral Blood Flow Restriction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3555. [PMID: 36834246 PMCID: PMC9959773 DOI: 10.3390/ijerph20043555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
This study examined the acute effects of high-intensity resistance exercise with blood flow restriction (BFR) on performance and fatigue, metabolic stress, and markers of inflammation (interleukin-6 (IL-6)), muscle damage (myoglobin), angiogenesis (vascular endothelial growth factor (VEGF)). Thirteen resistance-trained participants (four female, 24.8 ± 4.7 years) performed four sets of barbell back-squats (75% 1RM) to failure under two conditions: blood flow restriction (BFR, bilateral 80% occlusion pressure) and control (CTRL). Completed repetitions and pre-post-exercise changes in maximal voluntary isometric contractions, countermovement jump, barbell mean propulsive velocity, and surface electromyography were recorded. Pre-post blood lactate (BLa) and venous blood samples for analysis of IL-6, myoglobin, and VEGF were collected. Ratings of perceived exertion (RPE) and pain were recorded for each set. Fewer repetitions were performed during BFR (25.5 ± 9.6 reps) compared to CTRL (43.4 ± 14.2 reps, p < 0.001), with greater repetitions performed during sets 1, 2, and 4 (p < 0.05) in CTRL. Although RPE between conditions was similar across all sets (p > 0.05), pain was greater in BFR across all sets (p < 0.05). Post-exercise fatigue was comparable between conditions. BLa was significantly greater in CTRL compared to BFR at two minutes (p = 0.001) but not four minutes post-exercise (p = 0.063). IL-6 was significantly elevated following BFR (p = 0.011). Comparable increases in myoglobin (p > 0.05) and no changes in VEGF were observed (p > 0.05). BFR increases the rate of muscular fatigue during high-intensity resistance exercise and acutely enhances IL-6 response, with significantly less total work performed, but increases pain perception, limiting implementation.
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Affiliation(s)
- Bjoern Hornikel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Keith S. Saffold
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Michael R. Esco
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Jacob A. Mota
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA
| | - Michael V. Fedewa
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Stefanie A. Wind
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Tiffany L. Adams
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Lee J. Winchester
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, USA
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Yuan J, Wu L, Xue Z, Xu G, Wu Y. Application and progress of blood flow restriction training in improving muscle mass and strength in the elderly. Front Physiol 2023; 14:1155314. [PMID: 37035674 PMCID: PMC10079911 DOI: 10.3389/fphys.2023.1155314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/17/2023] [Indexed: 04/11/2023] Open
Abstract
As an emerging training method, blood flow restriction training has been proved to promote the growth of muscle mass and strength. In recent years, it has been gradually applied in different populations. However, there are few studies on how blood flow restriction training affects muscle mass and strength in the elderly. The relevant literature is compiled and summarized in this study. Through the comparison of blood flow restriction training with traditional training methods and its application in the elderly, it shows that blood flow restriction training can effectively increase muscle mass and strength, prevent muscle atrophy, improve cardiopulmonary function, facilitate injury and postoperative rehabilitation, and intervene in related degenerative diseases as a training method suitable for the elderly,. The main mechanism of blood flow restriction training promoting muscle mass and strength growth is metabolic stress response, including muscle fiber recruitment, protein synthesis signal pathway activation, hormone secretion, etc., and is also related to cell swelling caused by pressure. At present, although the application of blood flow restriction training in the elderly population is increasing, there is a lack of personalized programs. In the future, more research on the dose effect and safety of blood flow restriction training is needed to develop more accurate personalized training programs.
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Affiliation(s)
| | | | | | - Guodong Xu
- *Correspondence: Guodong Xu, ; Yuxiang Wu,
| | - Yuxiang Wu
- *Correspondence: Guodong Xu, ; Yuxiang Wu,
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Vilaça-Alves J, Magalhães PS, Rosa CV, Reis VM, Garrido ND, Payan-Carreira R, Neto GR, Costa PB. Acute Hormonal Responses to Multi-Joint Resistance Exercises with Blood Flow Restriction. J Funct Morphol Kinesiol 2022; 8:jfmk8010003. [PMID: 36648895 PMCID: PMC9844496 DOI: 10.3390/jfmk8010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to investigate the acute effects of multi-joint resistance exercises (MJRE) with blood flow restriction on hormonal responses. Ten men participated in the study and underwent two experimental protocols in random order: four sets (30, 15, 15, and 15 reps, respectively) of MJRE (half squat and horizontal chest press) were performed with 20% of 1RM and a rest time between sets of 30 s, combined with intermittent blood flow restriction (LI + BFR protocol); and four sets (8, 8, 8, 20 reps, respectively) of the same MJRE performed with 75% of 1RM load (HI protocol), with a 90 s rest between the first three sets and 30 s between the third to the fourth set. Blood samples were collected before (PRE), immediately after (POST), and 15 min after the performance of MJRE (POST15). A time effect was observed for growth hormone (GH) and insulin-like-growth-factor-1-binding-protein-3 (IGFPB-3), but no protocol effects or interactions between protocol and times were observed (p > 0.05). There was no effect of either protocol or time (p > 0.05) on total testosterone, free testosterone, or cortisol concentrations. However, significant (p < 0.05) increases were observed in the GH serum concentrations of 2072.73% and 2278.5%, HI, and LI + BFR protocols, respectively, from the PRE to POST15 test. In addition, there was an increase of 15.30% and 13.29% in the IGFPB-3 concentrations (p < 0.05) from PRE to POST0 times for HI and LI + BFR protocols, respectively. Furthermore, there was a decrease of −6.17% and −11.54%, p = 0.00, between the times POST0 to POST15 in the IGFPB-3 for the HI and LI + BFR protocols, respectively. It is concluded that multi-joint resistance exercises combined with intermittent blood flow restriction seemed to promote acute hormonal responses in a manner similar to traditional exercise with high loads. Future studies may investigate whether chronic use of LI + BFR with MJRE may promote muscle hypertrophy.
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Affiliation(s)
- José Vilaça-Alves
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
- Research Group in Strength Training and Fitness Activities (GEETFAA), 5000-801 Vila Real, Portugal
| | - Patrício S. Magalhães
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Claudio V. Rosa
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Group in Strength Training and Fitness Activities (GEETFAA), 5000-801 Vila Real, Portugal
| | - Victor M. Reis
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
- Research Group in Strength Training and Fitness Activities (GEETFAA), 5000-801 Vila Real, Portugal
| | - Nuno D. Garrido
- Sport Sciences Department, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
| | - Rita Payan-Carreira
- Department of Veterinary Medicine, University of Évora, 7004-516 Évora, Portugal
| | - Gabriel R. Neto
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa 58051-900, Paraíba, Brazil
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa 58067-698, Paraíba, Brazil
- Coordination of Physical Education, Center for Higher Education and Development (CESED-UNIFACISA/FCM/ESAC), Campina Grande 58408-326, Paraíba, Brazil
| | - Pablo B. Costa
- Exercise Physiology Laboratory, Department of Kinesiology, California State University, Fullerton, CA 92831, USA
- Correspondence:
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Smith NDW, Scott BR, Girard O, Peiffer JJ. Aerobic Training With Blood Flow Restriction for Endurance Athletes: Potential Benefits and Considerations of Implementation. J Strength Cond Res 2022; 36:3541-3550. [PMID: 34175880 DOI: 10.1519/jsc.0000000000004079] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Smith, NDW, Scott, BR, Girard, O, and Peiffer, JJ. Aerobic training with blood flow restriction for endurance athletes: potential benefits and considerations of implementation. J Strength Cond Res 36(12): 3541-3550, 2022-Low-intensity aerobic training with blood flow restriction (BFR) can improve maximal oxygen uptake, delay the onset of blood lactate accumulation, and may provide marginal benefits to economy of motion in untrained individuals. Such a training modality could also improve these physiological attributes in well-trained athletes. Indeed, aerobic BFR training could be beneficial for those recovering from injury, those who have limited time for training a specific physiological capacity, or as an adjunct training stimulus to provide variation in a program. However, similarly to endurance training without BFR, using aerobic BFR training to elicit physiological adaptations in endurance athletes will require additional considerations compared with nonendurance athletes. The objective of this narrative review is to discuss the acute and chronic aspects of aerobic BFR exercise for well-trained endurance athletes and highlight considerations for its effective implementation. This review first highlights key physiological capacities of endurance performance. The acute and chronic responses to aerobic BFR exercise and their impact on performance are then discussed. Finally, considerations for prescribing and monitoring aerobic BFR exercise in trained endurance populations are addressed to challenge current views on how BFR exercise is implemented.
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Affiliation(s)
- Nathan D W Smith
- Exercise Science, Murdoch University, Perth, Western Australia.,Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, Western Australia
| | - Brendan R Scott
- Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, Western Australia.,Center for Healthy Ageing, Murdoch University, Perth, Western Australia ; and
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia
| | - Jeremiah J Peiffer
- Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, Western Australia.,Center for Healthy Ageing, Murdoch University, Perth, Western Australia ; and
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Changes in Arterial Stiffness in Response to Various Types of Exercise Modalities: A Narrative Review on Physiological and Endothelial Senescence Perspectives. Cells 2022; 11:cells11223544. [PMID: 36428973 PMCID: PMC9688701 DOI: 10.3390/cells11223544] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/12/2022] Open
Abstract
Arterial stiffness is a reliable independent predictor of cardiovascular events. Exercise training might enhance arterial compliance through improved metabolic health status. Different modes of exercise may have different effects on arterial stiffness. However, the interactions among different modes of exercise on endothelial senescence, the development of arterial vascular stiffness, and the associated molecular mechanisms are not completely understood. In this narrative review, we evaluate the current evidence focusing on the effects of various exercise modes on arterial stiffness and vascular health, and the known underlying physiological mechanisms are discussed as well. Here, we discuss the most recent evidence of aerobic exercise, high-intensity interval training (HIIT), and resistance exercise (RE) on arterial stiffness and endothelial senescence in physiological and cellular studies. Indeed, aerobic, HIIT, and progression RE-induced arterial compliance may reduce arterial stiffness by effectively promoting nitric oxide (NO) bioavailability and reducing endothelial senescence. However, the transient increase in inflammation and sympathetic activation may contribute to the temporary elevation in arterial stiffness following whole-body high-intensity acute resistance exercise.
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Rodrigues S, Forte P, Dewaele E, Branquinho L, Teixeira JE, Ferraz R, Barbosa TM, Monteiro AM. Effect of Blood Flow Restriction Technique on Delayed Onset Muscle Soreness: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58091154. [PMID: 36143831 PMCID: PMC9505400 DOI: 10.3390/medicina58091154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The effect of the blood flow restriction technique (BFR) on delayed onset muscular soreness (DOMS) symptoms remains unclear. Since there is no consensus in the literature, the aim of the present study is to systematically identify and appraise the available evidence on the effects of the BFR technique on DOMS, in healthy subjects. Materials and Methods: Computerized literature search in the databases Pubmed, Google Scholar, EBSCO, Cochrane and PEDro to identify randomized controlled trials that assessed the effects of blood flow restriction on delayed onset muscular soreness symptoms. Results: Eight trials met the eligibility criteria and were included in this review, presenting the results of 118 participants, with a mean methodological rating of 6/10 on the PEDro scale. Conclusions: So far, there is not enough evidence to confirm or refute the influence of BFR on DOMS, and more studies with a good methodological basis are needed, in larger samples, to establish protocols and parameters of exercise and intervention. Data analysis suggests a tendency toward the proinflammatory effect of BFR during high restrictive pressures combined with eccentric exercises, while postconditioning BFR seems to have a protective effect on DOMS. Prospero ID record: 345457, title registration: “Effect of Blood Flow Restriction Technique on the Prevention of Delayed Onset Muscle Soreness: A Systematic Review”.
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Affiliation(s)
- Sandra Rodrigues
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Rua Delfim Maia, 334, 4200-253 Porto, Portugal
- Correspondence:
| | - Pedro Forte
- Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - Eva Dewaele
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Rua Delfim Maia, 334, 4200-253 Porto, Portugal
| | - Luís Branquinho
- Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - José E. Teixeira
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - Ricardo Ferraz
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
- Department of Sports Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal
| | - Tiago M. Barbosa
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - António M. Monteiro
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
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Yang S, Zhang P, Sevilla-Sanchez M, Zhou D, Cao J, He J, Gao B, Carballeira E. Low-Load Blood Flow Restriction Squat as Conditioning Activity Within a Contrast Training Sequence in High-Level Preadolescent Trampoline Gymnasts. Front Physiol 2022; 13:852693. [PMID: 35770193 PMCID: PMC9234321 DOI: 10.3389/fphys.2022.852693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
To investigate the effects of implementing low-load blood flow restriction exercises (LL-BFRE) instead of high-load exercises (HL-RE) in a contrast training program on strength and power performance of high-level young gymnasts. Fifteen high-level pre-pubescent trampoline gymnasts (national level, Tanner Stage II, intermediate experience in strength training) were divided into two groups to complete the same structure of a ten-week contrast strength training program differing only in the configuration of the first resistance exercise of the contrast sequence. The LL-BFRE group (n = 7, four girls, 13.9 ± 0.4 y) performed the first resistance exercise of the contrast with LL-BFRE (20%–30% 1RM, perceived pressure of 7 on a scale from 0 to 10). The HL-RE group (n = 8, four girls, 13.8 ± 0.5 y) trained the first resistance exercise of the contrast sequence with moderate-to-high load (60%–85% 1RM). Before and after the training period, isometric mid-thigh pull (IMTP), squat jump (SJ), counter movement jump (CMJ), and drop-jump (DJ) were performed to evaluate the effect of the intervention on strength and power capacities as primary outcomes. Changes in participants’ anthropometric measures, muscle mass, left and right thigh girth, IMTP relative to bodyweight (IMTP-R), eccentric utilization ratio (EUR), and reactive strength index (RSI) were assessed as secondary outcomes. There was no significant interaction (p > 0.05) between group x time in any power and strength outcome, although SJ and EUR showed a trend to significant interaction (p = 0.06 and p = 0.065, respectively). There was an overall effect of time (p < 0.05) in all power and strength variables (CMJ, SJ, EUR, DJ, RSI, IMTP, and IMTP-R). There was a significant interaction in muscle mass (MM) [β = 0.57 kg, 95% CI = (0.15; 0.98), t13 = 2.67, p = 0.019], revealing that participants in LL-BFRE increased their muscle mass (6.6 ± 3.1%) compared to HL-RE (3.6 ± 2.0%). Anthropometric variables did not present any group or interaction effect. However, there was a time effect (p < 0.05). Implementing LL-BFRE in place of HL-RE as a conditioning activity in a contrast training sequence might be equally effective in improving lower-body strength and power in preadolescent trampoline gymnasts.
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Affiliation(s)
- Shengtao Yang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, China
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Peng Zhang
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Marta Sevilla-Sanchez
- Department of Physical Education and Sport, Faculty of Sport Sciences and Physical Education, Campus Bastiagueiro, University of A Coruna, Oleiros, Spain
| | - Dong Zhou
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Jie Cao
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Jiajian He
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Binghong Gao
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, China
- *Correspondence: Binghong Gao, ; Eduardo Carballeira,
| | - Eduardo Carballeira
- Department of Physical Education and Sport, Faculty of Sport Sciences and Physical Education, Campus Bastiagueiro, University of A Coruna, Oleiros, Spain
- *Correspondence: Binghong Gao, ; Eduardo Carballeira,
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Callanan MC, Plummer HA, Green TM, Opitz T, Broderick T, Rendos N, Anz AW. Blood Flow Restriction Using a Pneumatic Tourniquet Is Not Associated With a Cellular Systemic Response. Arthrosc Sports Med Rehabil 2022; 4:e877-e882. [PMID: 35747643 PMCID: PMC9210389 DOI: 10.1016/j.asmr.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 12/23/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose The purpose of this study was to determine the effects of blood flow restriction (BFR) using a pneumatic tourniquet on CD34+ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose compared with standard exercise. Methods Fifteen healthy volunteers (8 males and 7 females, 28.6 ± 3.6 years old) who were able to perform the exercise sessions on a VersaClimber participated. Participants were randomized to undergo an experimental (EXP) occluded testing session using the pneumatic tourniquets on all 4 extremities and a control (CON) session. The exercise protocol concluded after 9 minutes or when participants reached a rating of perceived exertion of 20. Blood draws were performed before testing and immediately after the exercise session. Blood analysis consisted of complete blood counts as well as flow cytometry to measure peripheral CD34+ counts as a marker for hematopoietic progenitor cells (HPCs). Results A significant increase from before to after exercise values was observed in both the EXP and CON groups with CD34+, WBC counts, platelets, and lymphocytes; however, no differences existed between EXP and CON groups for any variable. CD34+ increased in the EXP (3.1 ± 1.6 vs. 4.3 ± 1.8 cells · L–1; P < .001) and CON (3.3 ± 1.9 vs. 4.4 ± 1.4 cells · L–1; P < .001) sessions. White blood cells also significantly increased in both the EXP (7.8 ± 1.4 vs. 11.8 ± 2.5 K · L–1 K · L–1; P < .001) and CON (7.5 ± 1.8 vs. 11.3 ± 3.0 K · L–1; P < .001) sessions. Platelets also increased in both the EXP (258.6 ± 52.5 vs. 309.9 ± 52.7 K · L–1; P < .001) and CON (263.1 ± 44.7 vs. 316.1 ± 43.9 K · L–1; P < .001) sessions, and conversely, a significant decrease in the average neutrophil counts in the EXP (mean difference = –13.7%; P < .001) and CON (mean difference = –13.2%; P < .001) sessions was observed. Lymphocyte counts in the EXP (mean difference = 22.8%; P < .001) and CON (mean difference = 19.3%; P < .001) sessions increased significantly. Conclusions There were no significant differences in systemic cellular responses when undergoing aerobic-based exercise with and without a pneumatic tourniquet system. Level of Evidence 2, prospective comparative study.
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Saraf A, Goyal M, Goyal K. Blood Flow Restriction Training-An Overview and Implication in New Generation Physical Therapy: A Narrative Review. J Lifestyle Med 2022; 12:63-68. [PMID: 36157885 PMCID: PMC9490016 DOI: 10.15280/jlm.2022.12.2.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
Abstract
Blood Flow Restriction Training (BFRT) is a novel strengthening technique utilitarian in many conditions. But there is lack of exploration on this clinical intervention. The training can prove to be a boon in many conditions such as muscle weakness, degenerative among others. It can serve to be an essential treatment in prevention of disuse atrophy occurring on the initial days of bed-rest on post surgical patients and improve circulation. BFRT with aerobic activities can improve cardiovascular fitness and holistically help in rehabilitation. The electronic databases such as PubMed, ScienceDirect, Scopus and Google Scholars were reviewed including the reference lists to retrieve relevant information regarding the topic. The result of the review states that BFRT is a novel strength training program that has not been explored in India but is very effective, less expensive and innovative way of rehabilitation. The utility of BFRT is evident in post-operative disuse atrophy in the initial days of bed-rest. The evidence depict that BFRT is a very effective training modality that can efficiently improve the muscle function, strength and mass.
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Affiliation(s)
- Aakansha Saraf
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India
| | - Manu Goyal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India
| | - Kanu Goyal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India
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Cordingley DM, Anderson JE, Cornish SM. Myokine Response to Blood-Flow Restricted Resistance Exercise in Younger and Older Males in an Untrained and Resistance-Trained State: A Pilot Study. JOURNAL OF SCIENCE IN SPORT AND EXERCISE 2022. [PMCID: PMC9099348 DOI: 10.1007/s42978-022-00164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose The purpose of this study was to examine the response of myokines to blood-flow restricted resistance-exercise (BFR-RE) in younger and older males before and after completing a 12-week resistance-training program. Methods There were 8 younger (24.8 ± 3.9 yrs) and 7 older (68.3 ± 5.0 yrs) untrained male participants completed this study. Anthropometric and maximal strength (1RM) measurements were collected before and after a 12-week, supervised, progressive full-body resistance-training program. As well, an acute bout of full-body BFR-RE was performed with venipuncture blood samples collected before and immediately following the BFR-RE, followed by sampling at 3, 6, 24 and 48 h. Results The 12-week training program stimulated a 32.2% increase in average strength and 30% increase in strength per kg of fat free mass. The response of particular myokines to the acute bout of BFR-RE was influenced training status (IL-4, untrained = 78.1 ± 133.2 pg/mL vs. trained = 59.8 ± 121.6 pg/mL, P = 0.019; IL-7, untrained = 3.46 ± 1.8 pg/mL vs. trained = 2.66 ± 1.3 pg/mL, P = 0.047) or both training and age (irisin, P = 0.04; leukemia inhibitory factor, P < 0.001). As well, changes in strength per kg of fat free mass were correlated with area under the curve for IL-4 (r = 0.537; P = 0.039), IL-6 (r = 0. 525; P = 0.044) and LIF (r = − 0.548; P = 0.035) in the untrained condition. Conclusion This study identified that both age and training status influence the myokine response to an acute bout of BFR-RE with the release of IL-4, IL-6 and LIF in the untrained state being associated with changes in strength per kg of fat free mass.
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Affiliation(s)
- Dean M. Cordingley
- Applied Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
- Pan Am Clinic Foundation, 75 Poseidon Bay, Winnipeg, MB R3M 3E4 Canada
| | | | - Stephen M. Cornish
- Applied Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
- Faculty of Kinesiology and Recreation Management, University of Manitoba, 110 Frank Kennedy Centre, Winnipeg, MB R3T 2N2 Canada
- Centre for Aging, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
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Ienaga K, Yamaguchi K, Ota N, Goto K. Augmented muscle deoxygenation during repeated sprint exercise with post-exercise blood flow restriction. Physiol Rep 2022; 10:e15294. [PMID: 35586958 PMCID: PMC9117971 DOI: 10.14814/phy2.15294] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 06/15/2023] Open
Abstract
Blood flow restriction (BFR) during low-intensity exercise has been known to be a potent procedure to alter metabolic and oxygen environments in working muscles. Moreover, the use of BFR during inter-set rest periods of repeated sprint exercise has been recently suggested to be a potent procedure for improving training adaptations. The present study was designed to determine the effect of repeated sprint exercise with post-exercise BFR (BFR during rest periods between sprints) on muscle oxygenation in working muscles. Eleven healthy males performed two different conditions on different days: either repeated sprint exercise with BFR during rest periods between sets (BFR condition) or without BFR (CON condition). A repeated sprint exercise consisted of three sets of 3 × 6-s maximal sprints (pedaling) with 24s rest periods between sprints and 5 min rest periods between sets. In BFR condition, two min of BFR (100-120 mmHg) for both legs was conducted between sets. During the exercise, power output and arterial oxygen saturation (SpO2 ) were evaluated. Muscle oxygenation for the vastus lateralis muscle, exercise-induced changes in muscle blood flow, and muscle oxygen consumption were measured. During BFR between sets, BFR condition presented significantly higher deoxygenated hemoglobin + myoglobin (p < 0.01) and lower tissue saturation index (p < 0.01) than those in CON condition. However, exercise-induced blood lactate elevation and reduction of blood pH did not differ significantly between the conditions. Furthermore, power output throughout nine sprints did not differ significantly between the two conditions. In conclusion, repeated sprint exercise with post-exercise BFR augmented muscle deoxygenation and local hypoxia, without interfering power output.
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Affiliation(s)
- Koki Ienaga
- Graduate School of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Keiichi Yamaguchi
- Graduate School of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Naoki Ota
- Graduate School of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Kazushige Goto
- Graduate School of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
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Short-term effects of isometric exercise with local and systemic hypoxia and normoxia on fatigue and muscle function in trained men. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00917-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Anderson KD, Rask DMG, Bates TJ, Nuelle JAV. Overall Safety and Risks Associated with Blood Flow Restriction Therapy: A Literature Review. Mil Med 2022; 187:1059-1064. [PMID: 35284924 DOI: 10.1093/milmed/usac055] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Blood flow restriction therapy (BFRT) is used in scenarios ranging from muscle building in athletic performance to decreasing recovery time in postoperative orthopedic rehabilitation. The efficacy of BFRT for treating diseases has been increasingly researched; however, there has been less literature focused on establishing the safety of this therapy. MATERIALS AND METHODS An extensive literature review pertaining to BFRT and any deleterious events related to its usage was completed by searching multiple databases, including PubMed, EMBASE, and Cochrane Library using the terms "blood flow restriction therapy" or "KAATSU." RESULTS Ten case reports, five case series, two national surveys, two questionnaires, six randomized controlled studies, and one systematic review were included. A total of 1,672 individuals reported an adverse event following BFRT use out of 25,813 individuals. Commonly reported adverse events were numbness, dizziness, subcutaneous hemorrhage, and rhabdomyolysis. There were unique adverse effects of this therapy reported in individuals with comorbid conditions, such as hypertension and thoracic outlet syndrome, which included isolated cases of central retinal vein occlusion and Paget-Schroeder syndrome. CONCLUSION Blood flow restriction provides tremendous opportunity with a potential for accelerated exercise rehabilitation and injury prevention. This modality could be used in the military setting to help injured active duty personnel expeditiously return to deployable status. Further prospective randomized controlled trials are warranted to further support BFRT safety; however, from this literature review, it can be concluded that BFRT can be utilized safely in the proper patient population when administered by qualified professionals who have undergone the appropriate training.
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Affiliation(s)
- Kevin D Anderson
- Department of General Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Dawn M G Rask
- Department of Orthopaedic Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Taylor J Bates
- Department of Orthopaedic Surgery, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Julia A V Nuelle
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, Columbia, MO 65212, USA
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Acute Effects of Tissue Flossing Coupled with Functional Movements on Knee Range of Motion, Static Balance, in Single-Leg Hop Distance, and Landing Stabilization Performance in Female College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031427. [PMID: 35162447 PMCID: PMC8835546 DOI: 10.3390/ijerph19031427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/15/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
Flexibility, specifically that in the amplitude of sagittal-plane range of motion (ROM), can improve jump landing patterns and reduce the potential for sports injury. The use of floss bands (FLOSS) reportedly increases joint range of motion (ROM) in the shoulder, ankle, and elbow joints. However, little research on the effectiveness of FLOSS on the knee joint has been conducted. This study investigated the effects of FLOSS on knee ROM, static balance, single-leg-hop distance, and landing stabilization performance in women. This study had a crossover design. Twenty active female college students without musculoskeletal disorders were randomly assigned to receive a FLOSS intervention or elastic bandage (ELA) control on their dominant knees. The participants underwent FLOSS and ELA activities on two occasions with 48 h of rest between both sets of activities. The outcomes were flexibility of the quadriceps and hamstrings, how long one could maintain a single-leg stance (with and without eyes closed), distance on a single-leg triple hop, and score on the Landing Error Scoring System (LESS); these outcomes were evaluated at preintervention and postintervention (immediately following band removal and 20 min later). After the FLOSS intervention, the participants’ hamstring flexibility improved significantly (immediately after: p = 0.001; 20 min later: p = 0.002), but their quadricep flexibility did not. In addition, FLOSS use did not result in worse single-leg stance timing, single-leg triple-hop distance, or landing stabilization performance relative to ELA use. Compared with the ELA control, the FLOSS intervention yielded significantly better LESS at 20 min postintervention (p = 0.032), suggesting that tissue flossing can improve landing stability. In conclusion, the application of FLOSS to the knee improves hamstring flexibility without impeding static balance, and improves single-leg hop distance and landing stabilization performance in women for up to 20 min. Our findings elucidate the effects of tissue flossing on the knee joint and may serve as a reference for physiotherapists or athletic professionals in athletic practice settings.
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Feng Y, Yin Y, Zhao X, Zhang Y, Zhou Y, Wu Z. A bibliometric analysis study of blood flow restriction using CiteSpace. J Phys Ther Sci 2022; 34:657-667. [PMID: 36213193 PMCID: PMC9535246 DOI: 10.1589/jpts.34.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To assess the current state-of-the-art and the prevailing trends regarding the
global use of blood flow restriction (BFR) in the past 20 years. [Participants and
Methods] We retrieved literature relating to BFR from 1999 to 2020 using Web of Science.
We conducted a bibliometric analysis of countries/institutions, cited journals,
authors/cited authors, cited references, and keywords using CiteSpace. An analysis of
counts and centrality was used to examine publication output, countries/institutions, core
journals, active authors, foundation references, hot topics, and frontiers. [Results]
Seven hundred seventy five references were included and the total number of publications
has been continually increasing over the investigated period. Representatives of important
academic groups are the Japanese scholars from the University of Tokyo as represented by
Takashi Abe. Jeremy Paul Loenneke’s article (centrality: 0.15) was the most representative
and symbolic reference with the highest centrality. The three topics identified were
intervention (intensity resistance exercise, IRE), physiology (ischemia and muscular
function) and behavior (adaptation and increase). The four frontier topics were
phosphorylation, reduction, low intensity and arterial occlusion. [Conclusion] This study
provides an insight into BFR and offers valuable information for BFR researchers to
identify new perspectives for potential cooperation with collaborators and their related
cooperative institutions.
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Affiliation(s)
- Yali Feng
- Hospital of Southwest University, Southwest University: Tiansheng Road 2, Chongqing 400715, China
| | - Ying Yin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Xuemei Zhao
- Department of Rehabilitation Therapy, Chongqing Medical University, China
| | - Yue Zhang
- Department of Rehabilitation Therapy, Chongqing Medical University, China
| | - Yi Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Zonghui Wu
- Hospital of Southwest University, Southwest University: Tiansheng Road 2, Chongqing 400715, China
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Effects of Blood Flow Restriction Combined With Resistance Training or Neuromuscular Electrostimulation on Muscle Cross-Sectional Area. J Sport Rehabil 2021; 31:319-324. [PMID: 34929663 DOI: 10.1123/jsr.2021-0101] [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: 03/23/2021] [Revised: 08/16/2021] [Accepted: 10/10/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Low-load resistance training (LL) and neuromuscular electrostimulation (NES), both combined with blood flow restriction (BFR), emerge as effective strategies to maintain or increase muscle mass. It is well established that LL-BFR promotes similar increases in muscle cross-sectional area (CSA) and lower rating of perceived exertion (RPE) and pain compared with traditional resistance training protocols. On the other hand, only 2 studies with conflicting results have investigated the effects of NES-BFR on CSA, RPE, and pain. In addition, no study directly compared LL-BFR and NES-BFR. OBJECTIVE The aim of the study was to compare the effects of LL-BFR and NES-BFR on vastus lateralis CSA, RPE, and pain. Individual response for muscle hypertrophy was also compared between protocols. DESIGN Intrasubject longitudinal study. SETTING University research laboratory. INTERVENTION Fifteen healthy young males (age = 23 [5] y; weight = 77.6 [11.3] kg; height = 1.76 [0.08] m). MAIN OUTCOME MEASURES Vastus lateralis CSA was measured through ultrasound at baseline (pre) and after 20 training sessions (post). The RPE and pain responses were obtained through modified 10-point scales, handled during all training sessions. RESULTS Both protocols demonstrated significant increases in muscle CSA (P < .0001). However, the LL-BFR demonstrated significantly greater CSA changes compared with NES-BFR (LL-BFR = 11.2%, NES-BFR = 4.6%; P < .0001). Comparing individual increases in CSA, 12 subjects (85.7% of the sample) presented greater muscle hypertrophy for LL-BFR than for the NES-BFR protocol. In addition, LL-BFR produced significantly lower RPE and pain responses (P < .0001). CONCLUSIONS The LL-BFR produced significantly greater increases in CSA with significant less RPE and pain than NES-BFR. In addition, LL-BFR resulted in greater individual muscle hypertrophy responses for most subjects compared with NES-BFR.
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Effects of a Single Session of Floss Band Intervention on Flexibility of Thigh, Knee Joint Proprioception, Muscle Force Output, and Dynamic Balance in Young Adults. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112412052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The floss band (FB) has been correlated with increases in the joint range of motion (ROM). However, the literature on FB effectiveness in knee joint ROM and athletic performance remains sparse. This study investigated the effects of FB on the flexibility of the quadriceps and hamstrings, knee joint proprioception, muscle force output, and dynamic balance in men. Thirty recreationally active men without musculoskeletal disorders were randomized to receive FB (Lime Green; Sanctband flossband) and elastic bandage (EB) intervention on the dominant knee joint. Participants received two interventions on two occasions with 2 days of rest between interventions. The primary outcome was the flexibility of the quadriceps and hamstrings; the secondary outcomes were knee proprioception (joint reposition angle error), knee muscle force output, and dynamic balance. Preintervention and postintervention (immediately following band removal and 20 min later) measurements were obtained. After FB intervention, hamstring flexibility (immediately: p < 0.001; 20 min later: p < 0.001) and quadriceps flexibility (immediately: p < 0.001; 20 min later: p < 0.001), quadriceps muscle force output (immediately: p = 0.007; 20 min later: p < 0.001), and dynamic balance (both immediately and 20 min later, p < 0.001) were significantly improved. Compared with EB intervention, FB intervention significantly improved knee extension ROM (immediately and 20 min later, both p < 0.001), knee flexion ROM (immediately, p = 0.01; 20 min later, p = 0.03), hamstrings muscle force output (20 min later, p = 0.022) and dynamic balance (immediately, p = 0.016; 20 min later, p = 0.004). Regarding proprioception, no significant difference among time points and conditions was observed. In conclusion, FB intervention can significantly improve the flexibility of the quadriceps and hamstrings, quadriceps muscle force output, and dynamic balance without impeding knee proprioception. Physiotherapists or athletic professionals may consider FB intervention as a potential tool as a warmup to enhance the flexibility of the quadriceps and hamstrings, quadriceps muscle force output, and dynamic balance in young adults.
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Curley AJ, Conroy CM, West RV, Chang ES. Postoperative Use of Blood Flow Restriction in Orthopedics. Orthopedics 2021; 44:e694-e698. [PMID: 34618631 DOI: 10.3928/01477447-20211001-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Blood flow restriction (BFR) therapy is being used more frequently for rehabilitation from orthopedic injuries. Several physiologic mechanisms of action, at local and systemic levels, have been proposed. Numerous studies have investigated the effects of BFR training in healthy athletes; however, limited clinical data exist supporting the use of BFR after surgery. Given that BFR training may facilitate muscle development using low-load resistance exercises, it offers a unique advantage for the post-surgical patient who cannot tolerate traditional high resistance training. [Orthopedics. 2021;44(6):e694-e698.].
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Mahmoud WS, Osailan A, Ahmed AS, Elnaggar RK, Radwan NL. Optimal parameters of blood flow restriction and resistance training on quadriceps strength and cross-sectional area and pain in knee osteoarthritis. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-200235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND: Knee osteoarthritis (KOA) is one of the most common chronic diseases impacting millions of elderly people. OBJECTIVES: The study compared the effects of two intensities of partial blood flow restriction (BFR) with low-intensity resistance training on quadriceps strength and cross-sectional area (CSA), and pain in people with knee osteoarthritis (PwKOA). METHODS: Thirty-five PwKOA, aged 50–65, participated. Quadriceps CSA was measured by ultrasonography, quadriceps strength – by isokinetic dynamometry and pain by VAS. These outcome variables were obtained at the beginning of the study and re-evaluated eight weeks after the intervention. RESULTS: An interaction effect was present for quadriceps CSA (P= 0.042) and quadriceps strength (P= 0.006), showing that using 70% of total occlusion pressure with 30% 1RM had a more significant effect. Knee pain improved significantly through the main effect of BFR (P< 0.001), and low-intensity resistance training (P= 0.011). Pain improved more at 70% of total occlusion pressure, with 30% of 1RM (2.5 ± 1.06) than 50% total occlusion pressure with 10% of 1RM (5.77 ± 1.46). CONCLUSION: A combination of 70% of total occlusion pressure with 30% 1RM could be beneficial in PwKOA in improving pain, and increasing the quadriceps strength. The changes in the quadriceps strength could be a predictor for knee pain.
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Affiliation(s)
- Waleed S. Mahmoud
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Riyadh, Alkharj, Saudi Arabia
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmad Osailan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Riyadh, Alkharj, Saudi Arabia
| | - Ahmed S. Ahmed
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Riyadh, Alkharj, Saudi Arabia
- Department of Physical Therapy for Cardiopulmonary, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ragab K. Elnaggar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Riyadh, Alkharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nadia L. Radwan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Riyadh, Alkharj, Saudi Arabia
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Bielitzki R, Behrendt T, Behrens M, Schega L. Current Techniques Used for Practical Blood Flow Restriction Training: A Systematic Review. J Strength Cond Res 2021; 35:2936-2951. [PMID: 34319939 DOI: 10.1519/jsc.0000000000004104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Bielitzki, R, Behrendt, T, Behrens, M, and Schega, L. Current techniques used for practical blood flow restriction training: a systematic review. J Strength Cond Res 35(10): 2936-2951, 2021-The purpose of this article was to systematically review the available scientific evidence on current methods used for practical blood flow restriction (pBFR) training together with application characteristics as well as advantages and disadvantages of each technique. A literature search was conducted in different databases (PubMed, Web of Science, Scopus, and Cochrane Library) for the period from January 2000 to December 2020. Inclusion criteria for this review were (a) original research involving humans, (b) the use of elastic wraps or nonpneumatic cuffs, and (c) articles written in English. Of 26 studies included and reviewed, 15 were conducted using an acute intervention (11 in the lower body and 4 in the upper body), and 11 were performed with a chronic intervention (8 in the lower body, 1 in the upper body, and 2 in both the upper and the lower body). Three pBFR techniques could be identified: (a) based on the perceptual response (perceived pressure technique), (b) based on the overlap of the cuff (absolute and relative overlap technique), and (c) based on the cuffs' maximal tensile strength (maximal cuff elasticity technique). In conclusion, the perceived pressure technique is simple, valid for the first application, and can be used independently of the cuffs' material properties, but is less reliable within a person over time. The absolute and relative overlap technique as well as the maximal cuff elasticity technique might be applied more reliably due to markings, but require a cuff with constant material properties over time.
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Affiliation(s)
- Robert Bielitzki
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
| | - Tom Behrendt
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
- Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany; and
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48
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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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Silva JCG, Domingos-Gomes JR, Freitas EDS, Neto GR, Aniceto RR, Bemben MG, Lima-Dos-Santos A, Cirilo-Sousa MS. Physiological and Perceptual Responses to Aerobic Exercise With and Without Blood Flow Restriction. J Strength Cond Res 2021; 35:2479-2485. [PMID: 31136546 DOI: 10.1519/jsc.0000000000003178] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Silva, JCG, Domingos-Gomes, JR, Freitas, EDS, Neto, GR, Aniceto, RR, Bemben, MG, Lima-dos-Santos, A, and Cirilo-Sousa, MS. Physiological and perceptual responses to aerobic exercise with and without blood flow restriction. J Strength Cond Res 35(9): 2479-2485, 2021-Although previous studies have demonstrated the potential benefits of aerobic exercise (AE) with blood flow restriction (BFR), these findings have been limited by the approaches used to determine the occlusive pressure. In addition, the physiological and perceptual responses of AE with BFR compared to high-intensity interval exercise (HIIE) remain unclear. Thus, we investigated the physiological and perceptual responses to AE with and without BFR, and HIIE. Twenty-two men were randomly assigned to 4 experimental conditions: AE (40% of maximal oxygen consumption [V˙o2peak]), AE with 50% of BFR (AE-BFR: 40% VV˙o2peak), HIIE (80% V˙o2peak), and a no exercise control condition (CON: 50% of BFR). Each exercise bout lasted 18 minutes, during which oxygen consumption (V˙o2), heart rate (HR), and ratings of perceived exertion (RPE) were measured at rest and at every 3 minutes during exercise. Ratings of discomfort before and after each trial. The HIIE condition induced the greatest increases in V˙o2 and HR (p < 0.05), whereas AE-BFR was significantly (p < 0.05) greater than AE and CON. HIIE and AE-BFR also elicited the greatest (p < 0.05), but similar (p > 0.05), increases in RPE during exercise, although AE-BFR was significantly greater than HIIE immediately after exercise (p < 0.05). AE-BFR and HIIE also induced similar levels of discomfort after exercise (p > 0.05). In conclusion, HIIE induced the greatest increases in V˙o2 and HR, although the perceptual responses were essentially the same compared with AE-BFR. However, albeit inferior to HIIE, V˙o2 was greater during AE-BFR compared with AE, indicating that this training method may be used to replace HIIE and still significantly elevate V˙o2.
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Affiliation(s)
- Júlio C G Silva
- Department of Physical Education, Associate Graduate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Brazil ; and
| | - Jarbas R Domingos-Gomes
- Department of Physical Education, Associate Graduate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Brazil ; and
| | - Eduardo D S Freitas
- Department of Health and Exercise Science, Neuromuscular Laboratory, University of Oklahoma, Norman, Oklahoma
| | - Gabriel R Neto
- Department of Physical Education, Associate Graduate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Brazil ; and
| | - Rodrigo R Aniceto
- Department of Physical Education, Associate Graduate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Brazil ; and
| | - Michael G Bemben
- Department of Health and Exercise Science, Neuromuscular Laboratory, University of Oklahoma, Norman, Oklahoma
| | - Adeilma Lima-Dos-Santos
- Department of Physical Education, Associate Graduate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Brazil ; and
| | - Maria S Cirilo-Sousa
- Department of Physical Education, Associate Graduate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Brazil ; and
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50
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Differences in Femoral Artery Occlusion Pressure between Sexes and Dominant and Non-Dominant Legs. ACTA ACUST UNITED AC 2021; 57:medicina57090863. [PMID: 34577785 PMCID: PMC8471356 DOI: 10.3390/medicina57090863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/21/2021] [Accepted: 08/21/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Blood flow restriction during low-load exercise stimulates similar muscle adaptations to those normally observed with higher loads. Differences in the arterial occlusion pressure (AOP) between limbs and between sexes are unclear. We compared the AOP of the superficial femoral artery in the dominant and non-dominant legs, and the relationship between blood flow and occlusion pressure in 35 (16 males, 19 females) young adults. Materials and Methods: Using ultrasound, we measured the AOP of the superficial femoral artery in both legs. Blood flow at occlusion pressures ranging from 0% to 100% of the AOP was measured in the dominant leg. Results: There was a significant difference in the AOP between males and females in the dominant (230 ± 41 vs. 191 ± 27 mmHg; p = 0.002) and non-dominant (209 ± 37 vs. 178 ± 21 mmHg; p = 0.004) legs, and between the dominant and non-dominant legs in males (230 ± 41 vs. 209 ± 37 mmHg; p = 0.009) but not females (191 ± 27 vs. 178 ± 21 mmHg; p = 0.053), respectively. Leg circumference was the most influential independent predictor of the AOP. There was a linear relationship between blood flow (expressed as a percentage of unoccluded blood flow) and occlusion pressure (expressed as a percentage of AOP). Conclusions: Arterial occlusion pressure is not always greater in the dominant leg or the larger leg. Practitioners should measure AOP in both limbs to determine if occlusion pressures used during exercise should be limb specific. Occlusion pressures used during blood flow restriction exercise should be chosen carefully.
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