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Rolnick N, Licameli N, Moghaddam M, Marquette L, Walter J, Fedorko B, Werner T. Autoregulated and Non-Autoregulated Blood Flow Restriction on Acute Arterial Stiffness. Int J Sports Med 2024; 45:23-32. [PMID: 37562444 PMCID: PMC10776212 DOI: 10.1055/a-2152-0015] [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: 08/05/2023] [Indexed: 08/12/2023]
Abstract
This study aimed to investigate the acute effects of autoregulated and non-autoregulated applied pressures during blood flow restriction resistance exercise to volitional fatigue on indices of arterial stiffness using the Delfi Personalized Tourniquet System. Following a randomized autoregulated or non-autoregulated blood flow restriction familiarization session, 20 physically active adults (23±5 years; 7 females) participated in three randomized treatment-order sessions with autoregulated and non-autoregulated and no blood flow restriction training. Participants performed four sets of dumbbell wall squats to failure using 20% of one repetition maximum. Blood flow restriction was performed with 60% of supine limb occlusion pressure. Testing before and post-session included an ultrasonic scan of the carotid artery, applanation tonometry, and blood pressure acquisition.Carotid-femoral pulse wave velocity increased in the non-autoregulated and no blood flow restriction training groups following exercise while carotid-radial pulse wave velocity increased in the no blood flow restriction training group (all p<0.05). Carotid-femoral pulse wave velocity exhibited an interaction effect between autoregulated and non-autoregulated blood flow restriction in favor of autoregulated blood flow restriction (p<0.05). Autoregulated blood flow restriction training does not influence indices of arterial stiffness while non-autoregulated and no blood flow restriction training increases central stiffness.
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Affiliation(s)
- Nicholas Rolnick
- Exercise Science, Lehman College, Bronx, United States
- Physical Therapy, The Human Performance Mechanic, Manhattan, United
States
| | | | - Masoud Moghaddam
- Physical Therapy, University of Maryland Eastern Shore, Princess Anne,
United States
| | - Lisa Marquette
- Exercise Science, Salisbury University, Salisbury, United
States
| | - Jessica Walter
- Exercise Science, Salisbury University, Salisbury, United
States
| | - Brent Fedorko
- Exercise Science, Salisbury University, Salisbury, United
States
| | - Tim Werner
- Exercise Science, Salisbury University, Salisbury, United
States
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Cuffe M, Novak J, Saithna A, Strohmeyer HS, Slaven E. Current Trends in Blood Flow Restriction. Front Physiol 2022; 13:882472. [PMID: 35874549 PMCID: PMC9298746 DOI: 10.3389/fphys.2022.882472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: The purpose of the study was to explore how individuals in the United States of America applied BFR/KAATSU devices and administered BFR/KAATSU training. In addition, the study sought to examine safety topics related to BFR/KAATSU training. Methods: The study was completed using survey research. Subjects were recruited through Facebook, email, and word of mouth. The survey was developed, piloted, and finally deployed March 22, 2021-April 21, 2021. Results: In total, 148 consented to the research; 108 completed the survey, and of those 108, 70 indicated current use with BFR/KAATSU equipment. Professions represented included athletic training, personal training, physical therapy, and strength and conditioning. Among those currently using BFR/KAATSU training (n = 70), the following results were found. The most common devices used were inflatable devices (n = 43, 61.4%). Education completed prior to device administration was formal (n = 39, 55.7%) and/or self-directed (n = 37, 52.9%). Barriers were faced by 29 (41.4%) when trying to enact training. Techniques and parameters varied during application. Screening processes were used (n = 50, 71.4%) prior to training. The devices were used to determine restrictive pressure (n = 31, 44.3%), and a supine position was used most when determining initial restrictive pressure (n = 33, 47.1%). For subsequent restrictive pressure measurements, respondents repeated the same method used initially (n = 38, 54.3%). Workload was often defined as the length of time under tension/load (n = 22, 31.4%) and exercise was directly supervised (n = 52, 74.3%). Adverse effects included bruising, lightheadedness, and cramping (n = 15, 21.4%). The devices have also been applied on those with pathology (n = 16, 22.9%). Conclusion: Those using blood flow restriction/KAATSU devices came from several professions and used an assortment of devices for BFR/KAATSU training. Individuals applied devices using a variety of parameters on populations for which efficacy has and has not been well defined.
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Affiliation(s)
- Molly Cuffe
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg, MO, United States
| | - Joel Novak
- Community Health Network, Physical Therapy & Rehab Department, Noblesville, IN, United States
| | | | - H. Scott Strohmeyer
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg, MO, United States
| | - Emily Slaven
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, United States
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Stanford DM, Mouser JG, Chatlaong MA, Jessee MB. A narrative review of the effects of blood flow restriction on vascular structure and function. Physiol Int 2022; 109:186-203. [PMID: 35587387 DOI: 10.1556/2060.2022.00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/19/2022]
Abstract
Blood flow restriction is growing in popularity as a tool for increasing muscular size and strength. Currently, guidelines exist for using blood flow restriction alone and in combination with endurance and resistance exercise. However, only about 1.3% of practitioners familiar with blood flow restriction applications have utilized it for vascular changes, suggesting many of the guidelines are based on skeletal muscle outcomes. Thus, this narrative review is intended to explore the literature available in which blood flow restriction, or a similar application, assess the changes in vascular structure or function. Based on the literature, there is a knowledge gap in how applying blood flow restriction with relative pressures may alter the vasculature when applied alone, with endurance exercise, and with resistance exercise. In many instances, the application of blood flow restriction was not in accordance with the current guidelines, making it difficult to draw definitive conclusions as to how the vascular system would be affected. Additionally, several studies report no change in vascular structure or function, but few studies look at variables for both outcomes. By examining outcomes for both structure and function, investigators would be able to generate recommendations for the use of blood flow restriction to improve vascular structure and/or function in the future.
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Affiliation(s)
- Daphney M Stanford
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - J Grant Mouser
- 2 Department of Kinesiology and Health Promotion, Applied Physiology Laboratory, Troy University, Troy, AL, USA
| | - Matthew A Chatlaong
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - Matthew B Jessee
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
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Pereira-Neto EA, Lewthwaite H, Boyle T, Johnston K, Bennett H, Williams MT. Effects of exercise training with blood flow restriction on vascular function in adults: a systematic review and meta-analysis. PeerJ 2021; 9:e11554. [PMID: 34277146 PMCID: PMC8272459 DOI: 10.7717/peerj.11554] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background Blood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE. Methodology Five electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed. Results Twenty-six studies were included in the review (total participants n = 472; n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76; 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24; 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported. Conclusion There is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.
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Affiliation(s)
- Elisio A Pereira-Neto
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Hayley Lewthwaite
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Kylie Johnston
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Hunter Bennett
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Marie T Williams
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Liu Y, Jiang N, Pang F, Chen T. Resistance Training with Blood Flow Restriction on Vascular Function: A Meta-analysis. Int J Sports Med 2021; 42:577-587. [PMID: 33735919 DOI: 10.1055/a-1386-4846] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In this meta-analysis, the aims were to examine the effects of resistance training with and without blood flow restriction on vascular function. Five databases were searched up to June 2020 for papers about resistance training with blood flow restriction influence on vascular function. The quality of each identified study was evaluated. Effect sizes were estimated in terms of the standardized mean difference. A subgroup analysis was conducted according to participants' age, training duration, and cuff pressure. The results of six studies on arterial compliance and five on vascular function were highly homogenous regarding responses to resistance training with or without blood flow restriction. Resistance training with blood flow restriction had a more positive effect for regulating arterial compliance than resistance training without blood flow restriction, but not for vascular function. Resistance training with blood flow restriction leads to a more positive effect on vascular function than resistance training when training for no longer than four weeks.
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Affiliation(s)
- Yujia Liu
- Department of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Ning Jiang
- Department of Orthopedics, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Fangfang Pang
- Department of Emergency, Haigang Hospital of Yantai City, Yantai, China
| | - Tong Chen
- Department of Marxism Studies, Jiangsu Normal University, Xuzhou, China
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da Cunha Nascimento D, Schoenfeld BJ, Prestes J. Potential Implications of Blood Flow Restriction Exercise on Vascular Health: A Brief Review. Sports Med 2020; 50:73-81. [PMID: 31559565 DOI: 10.1007/s40279-019-01196-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Blood flow restriction (BFR) exercise (a.k.a. occlusion training) has emerged as a viable surrogate to traditional heavy-load strength rehabilitation training for a broad range of clinical populations including elderly subjects and rehabilitating athletes. A particular benefit of BFR exercise is the lower stress upon the joints as compared to traditional heavy resistance training, with similar gains in muscle strength and size. The application of an inflatable cuff to the proximal portion of the limbs increases the pressure required for venous return, leading to changes in venous compliance and wall tension. However, it is not known if long-term benefits of BFR exercise on muscle strength and size outweigh potential short and long-term complications on vascular health. BFR exercise could lead to clinical deterioration of the vasculature along with sympathetic overactivity and decreased vascular function associated with retrograde shear stress. This raises a fundamental question: Given the concern that excessive restriction could cause injury to endothelial cells and might cause detrimental effects on endothelial function, even in healthy individuals, should we critically re-evaluate the safety of this method for the general population? From this perspective, the purpose of this manuscript is to review the effects of BFR exercise on vascular function, and to provide relevant insights for training practice as well as future directions for research.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Department of Physical Education, Catholic University of Brasilia (UCB), Q.S. 07, Lote 01, EPTC-Bloco G. Código Postal, Distrito Federal, Brasilia, 71966-700, Brazil. .,Department of Physical Education, University Center of the Federal District (UDF), Brasilia, Brazil.
| | | | - Jonato Prestes
- Department of Physical Education, Catholic University of Brasilia (UCB), Q.S. 07, Lote 01, EPTC-Bloco G. Código Postal, Distrito Federal, Brasilia, 71966-700, Brazil
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Blood Flow Restriction Therapy for Stimulating Skeletal Muscle Growth: Practical Considerations for Maximizing Recovery in Clinical Rehabilitation Settings. Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000275] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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