Effects of knee extension with different speeds of movement on muscle and cerebral oxygenation

Cerebral and muscle tissue oxygenation during exercise in healthy adults: A systematic review

BACKGROUND

Near-infrared spectroscopy (NIRS) technology has allowed for the measurement of cerebral and skeletal muscle oxygenation simultaneously during exercise. Since this technology has been growing and is now successfully used in laboratory and sports settings, this systematic review aimed to synthesize the evidence and enhance an integrative understanding of blood flow adjustments and oxygen (O2) changes (i.e., the balance between O2 delivery and O2 consumption) within the cerebral and muscle systems during exercise.

METHODS

A systematic review was conducted using PubMed, Embase, Scopus, and Web of Science databases to search for relevant studies that simultaneously investigated cerebral and muscle hemodynamic changes using the near-infrared spectroscopy system during exercise. This review considered manuscripts written in English and available before February 9, 2023. Each step of screening involved evaluation by 2 independent authors, with disagreements resolved by a third author. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the methodological quality of the studies.

RESULTS

Twenty studies were included, of which 80% had good methodological quality, and involved 290 young or middle-aged adults. Different types of exercises were used to assess cerebral and muscle hemodynamic changes, such as cycling (n = 11), treadmill (n = 1), knee extension (n = 5), isometric contraction of biceps brachii (n = 3), and duet swim routines (n = 1). The cerebral hemodynamics analysis was focused on the frontal cortex (n = 20), while in the muscle, the analysis involved vastus lateralis (n = 18), gastrocnemius (n = 3), biceps brachii (n = 5), deltoid (n = 1), and intercostal muscle (n = 1). Overall, muscle deoxygenation increases during exercise, reaching a plateau in voluntary exhaustion, while in the brain, oxyhemoglobin concentration increases with exercise intensity, reaching a plateau or declining at the exhaustion point.

CONCLUSION

Muscle and cerebral oxygenation respond differently to exercise, with muscle increasing O2 utilization and cerebral tissue increasing O2 delivery during exercise. However, at the exhaustion point, both muscle and cerebral oxygenation become compromised. This is characterized by a reduction in blood flow and a decrease in O2 extraction in the muscle, while in the brain, oxygenation reaches a plateau or decline, potentially resulting in motor failure during exercise.

Brain activation associated with low- and high-intensity concentric versus eccentric isokinetic contractions of the biceps brachii: An fNIRS study

Studies have shown that neural responses following concentric (CON) and eccentric (ECC) muscle contractions are different, which suggests differences in motor control associated with CON and ECC contractions. This study aims to determine brain activation of the left primary motor cortex (M1) and left and right dorsolateral prefrontal cortices (DLPFCs) during ECC and CON of the right bicep brachii (BB) muscle at low- and high-contraction intensities. Eighteen young adults (13M/5F, 21-35 years) were recruited to participate in one familiarization and two testing sessions in a randomized crossover design. During each testing session, participants performed either ECC or CON contractions of the BB (3 sets × 8 reps) at low- (25% of maximum ECC/CON, 45°/s) and high-intensity (75% of maximum ECC/CON, 45°/s) on an isokinetic dynamometer. Eleven-channel functional near-infrared spectroscopy was used to measure changes in oxyhemoglobin (O2 Hb) from the left M1, and left and right DLPFC during ECC and CON contractions. Maximum torque for ECC was higher than CON (43.3 ± 14.1 vs. 46.2 ± 15.7 N m, p = 0.025); however, no differences in O2 Hb were observed between contraction types at low or high intensities in measured brain regions. High-intensity ECC and CON contractions resulted in greater increases in O2 Hb of M1 and bilateral DLPFC compared to low-intensity ECC and CON contractions (p = 0.014). Our findings suggest no differences in O2 Hb responses between contraction types at high and low intensities. High-contraction intensities resulted in greater brain activation of the M1 and bilateral DLPFC, which may have implications for neurorehabilitation to increase central adaptations from exercise.

Can Data-Driven Supervised Machine Learning Approaches Applied to Infrared Thermal Imaging Data Estimate Muscular Activity and Fatigue?

Surface electromyography (sEMG) is the acquisition, from the skin, of the electrical signal produced by muscle activation. Usually, sEMG is measured through electrodes with electrolytic gel, which often causes skin irritation. Capacitive contactless electrodes have been developed to overcome this limitation. However, contactless EMG devices are still sensitive to motion artifacts and often not comfortable for long monitoring. In this study, a non-invasive contactless method to estimate parameters indicative of muscular activity and fatigue, as they are assessed by EMG, through infrared thermal imaging (IRI) and cross-validated machine learning (ML) approaches is described. Particularly, 10 healthy participants underwent five series of bodyweight squats until exhaustion interspersed by 1 min of rest. During exercising, the vastus medialis activity and its temperature were measured through sEMG and IRI, respectively. The EMG average rectified value (ARV) and the median frequency of the power spectral density (MDF) of each series were estimated through several ML approaches applied to IRI features, obtaining good estimation performances (r = 0.886, p < 0.001 for ARV, and r = 0.661, p < 0.001 for MDF). Although EMG and IRI measure physiological processes of a different nature and are not interchangeable, these results suggest a potential link between skin temperature and muscle activity and fatigue, fostering the employment of contactless methods to deliver metrics of muscular activity in a non-invasive and comfortable manner in sports and clinical applications.

Central and Peripheral Thermal Signatures of Brain-Derived Fatigue during Unilateral Resistance Exercise: A Preliminary Study

Simple Summary

Fatigue is considered a brain-derived emotion that could impact performance during the execution of physical exercises. Infrared thermography is a valuable technique able to measure the psychophysiological state associated with emotions in a contactless manner. The aim of the study is to test the capability of infrared thermography to evaluate the central and peripheral physiological effect of fatigue through facial skin and muscle temperature modulations collected during the execution of a unilateral resistance exercise of the lower limb. Both time- and frequency-domain analyses were performed on the temperature time course of the face and limbs. Particularly, significant correlations between features extracted from the thermal signals and the perceived exertion were found. These findings confirmed the ability of thermal imaging to detect both peripheral and central effects of fatigue in response to physical exercises. These results could foster the employment of infrared thermography to monitor the psychophysiological state of the athletes during training. The possibility to calibrate the training load in accordance with the psychophysiological conditions could improve the performance of the athletes during the training process and competitions.

Abstract

Infrared thermography (IRT) allows to evaluate the psychophysiological state associated with emotions from facial temperature modulations. As fatigue is a brain-derived emotion, it is possible to hypothesize that facial temperature could provide information regarding the fatigue related to exercise. The aim of this study was to investigate the capability of IRT to assess the central and peripheral physiological effect of fatigue by measuring facial skin and muscle temperature modulations in response to a unilateral knee extension exercise until exhaustion. Rate of perceived exertion (RPE) was recorded at the end of the exercise. Both time- (∆T_ROI: pre–post exercise temperature variation) and frequency-domain (∆PSD: pre–post exercise power spectral density variation of specific frequency bands) analyses were performed to extract features from regions of interest (ROIs) positioned on the exercised and nonexercised leg, nose tip, and corrugator. The ANOVA-RM revealed a significant difference between ∆T_ROI (F_(1.41,9.81) = 15.14; p = 0.0018), and between ∆PSD of myogenic (F_(1.34,9.39) = 15.20; p = 0.0021) and neurogenic bands (F_(1.75,12.26) = 9.96; p = 0.0034) of different ROIs. Moreover, significant correlations between thermal features and RPE were found. These findings suggest that IRT could assess both peripheral and central responses to physical exercise. Its applicability in monitoring the psychophysiological responses to exercise should be further explored

Are mode-specific differences in performance fatigability attributable to muscle oxygenation?

PURPOSE

The purpose of this study was to examine the composite, intra-individual, and inter-individual patterns of responses for deoxygenated hemoglobin and myoglobin (deoxy[heme]), oxygenated hemoglobin and myoglobin (oxy[heme]), total hemoglobin and myoglobin (total[heme]), and tissue saturation index (StO₂%) during fatiguing, maximal, isokinetic, unilateral, and bilateral leg extensions.

METHODS

Nine men (Mean ± SD; age = 21.9 ± 2.4 years; height = 181.8 ± 11.9 cm; body mass = 85.8 ± 6.2 kg) performed 50 unilateral and bilateral maximal, concentric, isokinetic leg extensions at 180° s^-1 on two separate visits. The muscle oxygenation parameters assessed with near-infrared spectroscopy from the dominant leg and isokinetic torque were averaged for 2 consecutive repetitions at 5 repetition intervals. Separate 2 (Condition [Unilateral and Bilateral]) × 10 (Repetition [5-50]) repeated measures ANOVAs were performed to examine mean differences for normalized isokinetic torque and each muscle oxygenation parameter. Intra- and inter-individual differences were examined with polynomial regression analyses.

RESULTS

For normalized isokinetic torque, the unilateral condition (56.3 ± 10.5%) exhibited greater performance fatigability than the bilateral condition (45.0 ± 18.7%). Collapsed across Condition, deoxy[heme] exhibited an increase (p < 0.001), while StO₂% exhibited a decrease (p < 0.001). The bilateral condition exhibited a more sustained decline in oxy[heme] than the unilateral condition (p = 0.005). Deoxy[heme], oxy[heme], and total[heme] exhibited substantial intra- and inter-individual differences for the fatigue-induced patterns of response.

CONCLUSION

The present findings indicated that the greater performance fatigability for unilateral versus bilateral fatiguing, maximal, isokinetic leg extensions was not attributable to differences in muscle oxygenation. Future studies of muscle oxygenation should report individual and composite fatigue-induced patterns of responses due to the substantial intra- and inter-individual variabilities.

Changes in Muscle Oxygen Saturation Measured Using Wireless Near-Infrared Spectroscopy in Resistance Training: A Systematic Review

Background: This study aimed to report, through a systematic review of the literature, the baseline and final reference values obtained by near-infrared spectroscopy (NIRS) of muscle oxygen saturation (SmO₂) during resistance training in healthy adults. Methods: Original research studies were searched from four databases (Scopus, PubMed, WOS, and SportDiscus). Subsequently, three independent reviewers screened the titles and abstracts, followed by full-text reviews to assess the studies’ eligibility. Results: Four studies met the inclusion criteria, data were extracted and methodological quality was assessed using the Downs and Black scale. Muscle oxygen saturation (% SmO2) during reported muscle strength exercises showed a decreasing trend after a muscle strength protocol; that is, before the protocol (range = 68.07–77.9%) and after (range = 9.50–46.09%). Conclusions: The trend of the SmO₂ variables is to decrease after a muscle strength protocol. Studies are lacking that allow expanding the use of these devices during this type of training.

Slow-Speed Resistance Training Increases Skeletal Muscle Contractile Properties and Power Production Capacity in Elite Futsal Players

The purpose of this study was to explore the effects of slow-speed resistance training with low intensity (SRT) on muscle power output in elite futsal players with respect to traditional resistance training. The authors hypothesized that the muscle deoxygenation during SRT causes early recruitment of fast twitch fibers that would positively affect strength and power performance. Thirty male elite futsal players were recruited and randomly assigned either to SRT group or to traditional resistance training (TRT) group. All players underwent an 8-weeks experimental protocol consisting of 2 training sessions per week at both leg curl and leg extension machines. In the SRT, players lifted 50% of one maximum repetition (1RM) involving 3 s for eccentric and concentric actions. In the TRT, players lifted 80% of 1RM involving 1 s for eccentric and concentric actions. All players were tested twice (pre and post) for sprint and jump performances, maximal isometric voluntary contraction (MVC) and maximal isokinetic peak torque (Peak TQ) and total work (TW) at 60 and 120°/s (on knee extensors and flexors). The two groups presented remarkable differences in the within-group changes for all the variables. SRT exhibited greater improvements in both Peak TQ and TW for knee extensors and flexors at 120°/s. Conversely, TRT showed greater improvements in MVC, and in both Peak TQ and TW for knee extensors and flexors at 60°/s, except for Peak TQ of the knee extensors, where no significant difference was found between TRT and SRT. Countermovement jump showed a decrease in eccentric time and an increase in concentric force in SRT group. SRT and TRT resulted effective to enhance the strength performance indices during the 8-weeks experimental protocol. Peak torque at 120°/s explained more of the contractile characteristic effects of SRT training than MVC, suggesting that slow-speed training can cause fast twitch fibers hypertrophy in elite athletes. Since slow-speed training is supposed to produce a decreased exercise-induced muscle damage, SRT method is a suitable option in strength training for futsal and team sports.

Reliability of Low-Cost Near-Infrared Spectroscopy in the Determination of Muscular Oxygen Saturation and Hemoglobin Concentration during Rest, Isometric and Dynamic Strength Activity

Background: The objective of this study was to establish the reliability of the Humon Hex near-infrared reflectance spectroscopy (NIRS) in determining muscle oxygen saturation (SmO₂) and hemoglobin concentration (Hgb) at rest and during isometric and dynamic strength exercises using a functional electromechanical dynamometer (FEMD). Methods: The SmO₂ and Hgb values of sixteen healthy adults (mean ± standard deviation (SD): Age = 36.1 ± 6.4 years) were recorded at rest and during isometry (8 s), dynamic strength I (initial load of 40% of the average isometric load, with 2 kg increments until muscle failure) and dynamic strength II (same as I, but with an initial load of 40% of the maximum isometric load) activity. To evaluate the reliability in the determination of SmO₂ and Hgb of this device, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were obtained. Results: The main results obtained are SmO₂ at rest (CV = 5.76%, SEM = 3.81, ICC = 0.90), isometric strength (CV = 3.03%, SEM = 2.08, ICC = 0.92), dynamic strength I (CV = 10.6, SEM = 7.17, ICC = 0.22) and dynamic strength II (CV = 9.69, SEM = 6.75, ICC = 0.32); Hgb at rest (CV = 1.97%, SEM = 0.24, ICC = 0.65), isometric strength (CV = 0.98%, SEM = 0.12, ICC = 0.96), dynamic strength I (CV = 3.25, SEM = 0.40, ICC = 0.54) and dynamic strength II (CV = 2.74, SEM = 0.34, ICC = 0.65). Conclusions: The study shows that Humon Hex is a reliable device to obtain SmO₂ and Hgb data in healthy adult subjects at rest and during isometric strength, providing precision for measurements made with this device.

The Effect of Resistance Exercise Movement Tempo on Psychophysiological Responses in Novice Men

Tavares, VDdO, Agrícola, PMD, Nascimento, PHD, Oliveira Neto, L, Elsangedy, HM, and Machado, DGS. The effect of resistance exercise movement tempo on psychophysiological responses in novice men. J Strength Cond Res 34(5): 1264-1273, 2020-This study aimed to compare the effects of movement tempo in resistance exercise (RE) on psychophysiological responses in novice men. Seventeen novice men (24.5 ± 3.2 years; 79.3 ± 8.22 kg; 1.76 ± 0.06 m) performed the 10 repetition maximum (10RM) test for bench press and knee extension in 2 sessions (test-retest) and 2 RE training sessions with different movement tempos in a random and counterbalanced order (4 sets of 10 repetitions). The low tempo RE (LTRE) session was performed using 50% 10RM with 3-0-3-0 seconds (concentric, pause, eccentric, and pause, respectively). The moderate tempo RE (MTRE) session was performed using 80% 10RM with 1-0-1-0 seconds (concentric, pause, eccentric, and pause, respectively). Affective valence (Feeling Scale), perceived activation (FAS), attentional focus, and ratings of perceived exertion (Borg 6-20) were reported after each set. A two-way analysis of variance with repeated measures showed only a significant main effect of the set (all ps < 0.05), indicating changes between sets but not between LTRE and MTRE. In addition, a paired-samples t-test did not find significant differences between LTRE and MTRE, on average, in any psychophysiological responses (all ps > 0.16). Thus, for the protocol tested, there is no psychophysiological advantage to using either LTRE or MTRE in novice men. From a practical perspective, for psychophysiological responses, the present results suggest that it is up to the trainer/coach to decide which RE movement tempo to use, which will depend on the purpose of the training period, specificity, client tolerance of and preference for exercise intensity, and movement tempo.

Acute Effect of Exercise on Cognitive Performance in Middle-Aged Adults: Aerobic Versus Balance

BACKGROUND

Recent evidence has suggested that chronic physical activities including balance exercises have positive effects on cognition, but their acute effects are still unknown. In the present study, the authors tested the hypothesis that an acute bout of balance exercise would enhance cognitive performance compared with aerobic activity.

METHODS

A total of 20 healthy middle-aged adults completed 2 acute 30-minute balance and moderate-intensity aerobic exercise sessions on 2 counterbalanced separate occasions. To assess cognitive functions, performance tasks in executive control, perceptual speed, and simple reaction time were tested before and immediately after each exercise session.

RESULTS

Although there were no significant interactions (time × exercise condition, P > .05), the main effects of time were significant in executive control (P < .05), perceptual speed (P < .05), and simple reaction time (P < .001), showing improvements after both exercises.

CONCLUSIONS

These findings highlight that both types of exercise (aerobic, more metabolic and less cognitively demanding; balance, more cognitively and less metabolically demanding) were able to positively affect simple reaction time performance, perceptual speed, and executive control independently of physiological adjustments occurring during aerobic or balance exercise.

New Directions in Exercise Prescription: Is There a Role for Brain-Derived Parameters Obtained by Functional Near-Infrared Spectroscopy?

In the literature, it is well established that regular physical exercise is a powerful strategy to promote brain health and to improve cognitive performance. However, exact knowledge about which exercise prescription would be optimal in the setting of exercise–cognition science is lacking. While there is a strong theoretical rationale for using indicators of internal load (e.g., heart rate) in exercise prescription, the most suitable parameters have yet to be determined. In this perspective article, we discuss the role of brain-derived parameters (e.g., brain activity) as valuable indicators of internal load which can be beneficial for individualizing the exercise prescription in exercise–cognition research. Therefore, we focus on the application of functional near-infrared spectroscopy (fNIRS), since this neuroimaging modality provides specific advantages, making it well suited for monitoring cortical hemodynamics as a proxy of brain activity during physical exercise.

Traditional sets versus rest-redistribution: a laboratory-controlled study of a specific cluster set configuration at fast and slow velocities

This study investigated redistributing long inter-set rest intervals into shorter but more frequent intervals at 2 different concentric velocities. Resistance-trained men performed 4 randomised isokinetic unilateral knee extension protocols, 2 at 60°·s^-1 and 2 at 360°·s^-1. At each speed, subjects performed 40 repetitions with 285 s of rest using traditional sets (TS; 4 sets of 10 with 95 s of inter-set rest) and rest-redistribution (RR; 20 sets of 2 with 15 s inter-set rest). Before and at 2, 5, and 10 min after exercise, tensiomyography (TMG) and oxygenation (near-infrared spectroscopy; NIRS) were measured. NIRS was also measured during exercise, and rating of perceived exertion (RPE) was recorded after every 10 repetitions. At both speeds, RR displayed greater peak torque, total work, and power output during latter repetitions, but there were no differences between TS or RR when averaging all 40 repetitions. The RPE was less during RR at both speeds (p < 0.05). RR increased select muscle oxygen saturation and blood flow at both speeds. There were no effects of protocol on TMG, but effect sizes favoured a quicker recovery after RR. RR was likely beneficial in maintaining performance compared with the latter parts of TS sets and limiting perceived and peripheral fatigue. Novelty Although effective at slow velocities, rest-redistribution was likely more effective during high-velocity movements in this study. Rest-redistribution maintained the ability to produce force throughout an entire range of motion. Rest-redistribution reduced RPE during both high-velocity and high-force movements.

Functional and/or structural brain changes in response to resistance exercises and resistance training lead to cognitive improvements - a systematic review

BACKGROUND

During the aging process, physical capabilities (e.g., muscular strength) and cognitive functions (e.g., memory) gradually decrease. Regarding cognitive functions, substantial functional (e.g., compensatory brain activity) and structural changes (e.g., shrinking of the hippocampus) in the brain cause this decline. Notably, growing evidence points towards a relationship between cognition and measures of muscular strength and muscle mass. Based on this emerging evidence, resistance exercises and/or resistance training, which contributes to the preservation and augmentation of muscular strength and muscle mass, may trigger beneficial neurobiological processes and could be crucial for healthy aging that includes preservation of the brain and cognition. Compared with the multitude of studies that have investigated the influence of endurance exercises and/or endurance training on cognitive performance and brain structure, considerably less work has focused on the effects of resistance exercises and/or resistance training. While the available evidence regarding resistance exercise-induced changes in cognitive functions is pooled, the underlying neurobiological processes, such as functional and structural brain changes, have yet to be summarized. Hence, the purpose of this systematic review is to provide an overview of resistance exercise-induced functional and/or structural brain changes that are related to cognitive functions.

METHODS AND RESULTS

A systematic literature search was conducted by two independent researchers across six electronic databases; 5957 records were returned, of which 18 were considered relevant and were analyzed.

SHORT CONCLUSION

Based on our analyses, resistance exercises and resistance training evoked substantial functional brain changes, especially in the frontal lobe, which were accompanied by improvements in executive functions. Furthermore, resistance training led to lower white matter atrophy and smaller white matter lesion volumes. However, based on the relatively small number of studies available, the findings should be interpreted cautiously. Hence, future studies are required to investigate the underlying neurobiological mechanisms and to verify whether the positive findings can be confirmed and transferred to other needy cohorts, such as older adults with dementia, sarcopenia and/or dynapenia.

Effects on the Profile of Circulating miRNAs after Single Bouts of Resistance Training with and without Blood Flow Restriction-A Three-Arm, Randomized Crossover Trial

BACKGROUND

The effects of blood flow restriction (training) may serve as a model of peripheral artery disease. In both conditions, circulating micro RNAs (miRNAs) are suggested to play a crucial role during exercise-induced arteriogenesis. We aimed to determine whether the profile of circulating miRNAs is altered after acute resistance training during blood flow restriction (BFR) as compared with unrestricted low- and high-volume training, and we hypothesized that miRNA that are relevant for arteriogenesis are affected after resistance training.

METHODS

Eighteen healthy volunteers (aged 25 ± 2 years) were enrolled in this three-arm, randomized-balanced crossover study. The arms were single bouts of leg flexion/extension resistance training at (1) 70% of the individual single-repetition maximum (1RM), (2) at 30% of the 1RM, and (3) at 30% of the 1RM with BFR (artificially applied by a cuff at 300 mm Hg). Before the first exercise intervention, the individual 1RM (N) and the blood flow velocity (m/s) used to validate the BFR application were determined. During each training intervention, load-associated outcomes (fatigue, heart rate, and exhaustion) were monitored. Acute effects (circulating miRNAs, lactate) were determined using pre-and post-intervention measurements.

RESULTS

All training interventions increased lactate concentration and heart rate (p < 0.001). The high-intensity intervention (HI) resulted in a higher lactate concentration than both lower-intensity training protocols with BFR (LI-BFR) and without (LI) (LI, p = 0.003; 30% LI-BFR, p = 0.008). The level of miR-143-3p was down-regulated by LI-BFR, and miR-139-5p, miR-143-3p, miR-195-5p, miR-197-3p, miR-30a-5p, and miR-10b-5p were up-regulated after HI. The lactate concentration and miR-143-3p expression showed a significant positive linear correlation (p = 0.009, r = 0.52). A partial correlation (intervention partialized) showed a systematic impact of the type of training (LI-BFR vs. HI) on the association (r = 0.35 remaining after partialization of training type).

CONCLUSIONS

The strong effects of LI-BFR and HI on lactate- and arteriogenesis-associated miRNA-143-3p in young and healthy athletes are consistent with an important role of this particular miRNA in metabolic processes during (here) artificial blood flow restriction. BFR may be able to mimic the occlusion of a larger artery which leads to increased collateral flow, and it may therefore serve as an external stimulus of arteriogenesis.

Evaluation of 18-Week Whole-Body Vibration Training in Normobaric Hypoxia on Lower Extremity Muscle Strength in an Elderly Population

Therapeutic benefits of hypoxic training have been suggested for clinical populations, such as elderly who could suffer loss of lower limb muscle strength and higher risk of falling. This study investigated the effects of 18 weeks of whole-body vibration (WBV) training in normobaric hypoxia on the strength parameters of an elderly population. Thirty-one healthy elderly participants were randomly assigned to a hypoxic whole-body vibration group (HWBV; n = 10), normoxic whole-body vibration group (NWBV; n = 11), or control group (n = 10). The experimental groups received the same vibration treatment in a hypoxia chamber (HWBV: 16.1% fraction of inspired oxygen [FiO₂]; NWBV: 21.0% FiO₂). Isokinetic leg muscle strength was evaluated using a Biodex System-3 isokinetic dynamometer. Body composition was obtained with dual-energy X-ray absorptiometry. There were no significant differences between groups in either strength or body composition parameters. The NWBV group showed statistically significant improvements in the maximal strength of knee extensors, with a small effect size (p = 0.004; d = 0.54). No significant differences were found in any variable of the HWBV group. The combination of WBV training and exposure to normobaric cyclic hypoxia carried out in the present study did not have an effect on strength parameters in healthy elderly subjects.

Effects of blood flow restriction exercise on hemostasis: a systematic review of randomized and non-randomized trials

Background

Blood flow restriction (BFR) exercise has shown to induce a positive influence on bone metabolism and attenuate muscle strength loss and atrophy in subjects suffering from musculoskeletal weakness. Despite the known benefits of BFR exercise, it remains unclear whether or not the pressurization of blood vessels damages the endothelial cells or increases risk for formation of thrombi. Thus, the effects of BFR exercise on coagulation, fibrinolysis, or hemostasis, remains speculative.

Objective

The aim of the present study was to perform a systematic review of the short and long- term effects of BFR exercise on blood hemostasis in healthy individuals and patients with known disease (ie, hypertension, diabetes, obesity, and ischemic heart disease).

Data Sources

A systematic review of English and non-English articles was conducted across PubMed, Science Direct, and Google Scholar databases, including reference lists of relevant papers. Study quality assessment was evaluated using the modified version of Downs and Black checklist. Search results were limited to exercise training studies investigating the effects of BFR exercise on blood hemostasis in healthy individuals and patients with disease. Level of evidence was determined according to the criteria described by Oxford Center for Evidence-Based Medicine.

Study selection

Only randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) that examined the effects of exercise with BFR exercise vs exercises without BFR on blood hemostasis in healthy individuals and patients were included.

Data extraction

Nine studies were eligible (RCT =4; NRCT =5).

Results

The average score on the Downs and Black checklist was 11.22. All studies were classified as having poor methodological quality wherein the level of evidence provided in all reviewed studies was level IIb only (ie, poor quality RCTs).

Conclusion

Considering the limitations in the available evidence, firm recommendations cannot be provided.