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Lavigne C, Mons V, Grange M, Blain GM. Acute neuromuscular, cardiovascular, and muscle oxygenation responses to low-intensity aerobic interval exercises with blood flow restriction. Exp Physiol 2024. [PMID: 38875101 DOI: 10.1113/ep091742] [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: 12/25/2023] [Accepted: 05/21/2024] [Indexed: 06/16/2024]
Abstract
We investigated the influence of short- and long-interval cycling exercise with blood flow restriction (BFR) on neuromuscular fatigue, shear stress and muscle oxygenation, potent stimuli to BFR-training adaptations. During separate sessions, eight individuals performed short- (24 × 60 s/30 s; SI) or long-interval (12 × 120 s/60 s; LI) trials on a cycle ergometer, matched for total work. One leg exercised with (BFR-leg) and the other without (CTRL-leg) BFR. Quadriceps fatigue was quantified using pre- to post-interval changes in maximal voluntary contraction (MVC), potentiated twitch force (QT) and voluntary activation (VA). Shear rate was measured by Doppler ultrasound at cuff release post-intervals. Vastus lateralis tissue oxygenation was measured by near-infrared spectroscopy during exercise. Following the initial interval, significant (P < 0.05) declines in MVC and QT were found in both SI and LI, which were more pronounced in the BFR-leg, and accounted for approximately two-thirds of the total reduction at exercise termination. In the BFR-leg, reductions in MVC (-28 ± 15%), QT (-42 ± 17%), and VA (-15 ± 17%) were maximal at exercise termination and persisted up to 8 min post-exercise. Exercise-induced muscle deoxygenation was greater (P < 0.001) in the BFR-leg than CTRL-leg and perceived pain was more in LI than SI (P < 0.014). Cuff release triggered a significant (P < 0.001) shear rate increase which was consistent across trials. Exercise-induced neuromuscular fatigue in the BFR-leg exceeded that in the CTRL-leg and was predominantly of peripheral origin. BFR also resulted in diminished muscle oxygenation and elevated shear stress. Finally, short-interval trials resulted in comparable neuromuscular and haemodynamic responses with reduced perceived pain compared to long-intervals.
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Lisbôa FD, de Aguiar RA, Soares Pereira G, Caputo F. Acute Effects of a Practical Blood Flow Restriction Device During Swimming Exercise. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:466-475. [PMID: 37851855 DOI: 10.1080/02701367.2023.2263050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 09/11/2023] [Indexed: 10/20/2023]
Abstract
Purpose: The present study aimed to analyze: 1) the reliability of the tissue saturation index (TSI) and ratings of perceived discomfort (RPD) responses wearing a neoprene practical cuff (PrC), comparing with the responses from traditional (TrC) pneumatic cuffs (study I); 2) the effects of PrC on metabolic (blood lactate concentration, BLC), perceptual (rate of perceived effort, RPE) and kinematic responses at sub-maximal swimming velocities (study II). Methods: Study I; 1) PrC test-retest at rest and during swimming ergometer exercise; 2) BFR at rest with TrC inflated to different percentages of the minimum arterial occlusion pressure (MAOP; 60, 80, 100, 120 and 140%). Test-retest reliability of TSI and RPD was assessed by the intraclass correlation coefficient (ICC) and comparisons among conditions were analyzed by one-way repeated-measures ANOVA. Study II; 1) 50, 200 and 400 m swimming performances; 2) sub-maximal incremental swimming protocol with and without PrC. Two-way repeated measures ANOVA was used to compare all variables during sub-maximal velocities. Results: TSI (ICC = 0.81; 95%CI 0.62-0.91) and RPD (ICC = 0.97; 95%CI 0.94-0.99) were reliable under restricted exercise using PrC. TSI during restricted exercise was lower (p <.001) compared to unrestricted exercise (6.8 ± 6.1% vs. 21.6 ± 8.2% of physiological normalization). PrC showed higher BLC only at or above 91% of critical velocity (p < .03), while stroke rate and RPE were higher (p < .005), and stroke length was lower (p < .03) during all swimming velocities. Conclusion: This easy-to-handle and affordable practical BFR device increased physiological stress at sub-maximal efforts which could be an additional training tool for swimmers.
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Cockfield BA, Wedig IJ, Vinckier AL, McDaniel J, Elmer SJ. Physiological and perceptual responses to acute arm cranking with blood flow restriction. Eur J Appl Physiol 2024; 124:1509-1521. [PMID: 38142449 DOI: 10.1007/s00421-023-05384-0] [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: 06/08/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Lower-body aerobic exercise with blood flow restriction (BFR) offers a unique approach for stimulating improvements in muscular function and aerobic capacity. While there are more than 40 reports documenting acute and chronic responses to lower-body aerobic exercise with BFR, responses to upper-body aerobic exercise with BFR are not clearly established. PURPOSE We evaluated acute physiological and perceptual responses to arm cranking with and without BFR. METHODS Participants (N = 10) completed 4 arm cranking (6 × 2 min exercise, 1 min recovery) conditions: low-intensity at 40%VO2peak (LI), low-intensity at 40%VO2peak with BFR at 50% of arterial occlusion pressure (BFR50), low-intensity at 40%VO2peak with BFR at 70% of arterial occlusion pressure (BFR70), and high-intensity at 80%VO2peak (HI) while tissue oxygenation, cardiorespiratory, and perceptual responses were assessed. RESULTS During exercise, tissue saturation for BFR50 (54 ± 6%), BFR70 (55 ± 6%), and HI (54 ± 8%) decreased compared to LI (61 ± 5%, all P < 0.01) and changes in deoxyhemoglobin for BFR50 (11 ± 4), BFR70 (15 ± 6), and HI (16 ± 10) increased compared to LI (4 ± 2, all P < 0.01). During recovery intervals, tissue saturation for BFR50 and BFR70 decreased further and deoxyhemoglobin for BFR50 and BFR70 increased further (all P < 0.04). Heart rate for BFR70 and HI increased by 9 ± 9 and 50 ± 15b/min, respectively, compared to LI (both P < 0.02). BFR50 (8 ± 2, 1.0 ± 1.0) and BFR70 (10 ± 2, 2.1 ± 1.4) elicited greater arm-specific perceived exertion (6-20 scale) and pain (0-10 scale) compared to LI (7 ± 1, 0.2 ± 0.5, all P < 0.05) and pain for BFR70 did not differ from HI (1.7 ± 1.9). CONCLUSION Arm cranking with BFR decreased tissue saturation and increased deoxyhemoglobin without causing excessive cardiorespiratory strain and pain.
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Affiliation(s)
- Benjamin A Cockfield
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
- Department of Physical Therapy, Central Michigan University, Mount Pleasant, MI, USA
| | - Isaac J Wedig
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
- Health Research Institute, Michigan Technological University, Houghton, MI, USA
- School of Health and Human Performance, Marquette, MI, USA
| | - Alyssa L Vinckier
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
- Department of Physical Therapy, Central Michigan University, Mount Pleasant, MI, USA
| | - John McDaniel
- Exercise Physiology Program, Kent State University, Kent, OH, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
| | - Steven J Elmer
- Department of Kinesiology and Integrative Physiology, College of Science and Arts, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA.
- Health Research Institute, Michigan Technological University, Houghton, MI, USA.
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de Queiros VS, Rolnick N, Sabag A, Wilde P, Peçanha T, Aniceto RR, Rocha RFC, Delgado DZ, de Araújo Tinôco Cabral BG, Dantas PMS. Effect of High-Intensity Interval Exercise versus Continuous Low-Intensity Aerobic Exercise with Blood Flow Restriction on Psychophysiological Responses: A Randomized Crossover Study. J Sports Sci Med 2024; 23:114-125. [PMID: 38455431 PMCID: PMC10915608 DOI: 10.52082/jssm.2024.114] [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: 12/06/2023] [Accepted: 01/09/2024] [Indexed: 03/09/2024]
Abstract
This study compared the effect of continuous low-intensity aerobic exercise with blood flow restriction (LI-AE-BFR) versus high-intensity interval exercise (HIIE), matching total external mechanical work between conditions, on perceptual (exertion, pain, affective and pleasure) and physiological responses (heart rate [HR], blood lactate [BL] and muscle fatigue). Ten healthy untrained men (25.6 ± 3.78 years old; 75.02 ± 12.02 kg; 172.2 ± 6.76 cm; 24.95 ± 3.16 kg/m²) completed three visits to the laboratory. In visit 1, anthropometry, blood pressure and peak running velocity on the treadmill were measured. In visits 2 and 3, participants were randomly assigned to HIIE or LI-AE-BFR, both in treadmill. HIIE consisted of 10 one-minute stimuli at 80% of peak running velocity interspersed with one-minute of passive recovery. LI-AE-BFR consisted of 20-minutes of continuous walking at 40% of peak running velocity with bilateral cuffs inflated to 50% of arterial occlusion pressure. BL and maximum isometric voluntary contraction (MIVC - fatigue measure) were measured pre- and immediately post-exercise. HR, rating of perceived exertion (RPE), and rating of perceived pain (RPP) were recorded after each stimulus in HIIE and every two minutes in LI-AE-BFR. Affective response to the session, pleasure, and future intention to exercise (FIE) were assessed 10 minutes after the intervention ended. Increases in BL concentrations were greater in HIIE (p = 0.028; r = 0.51). No effects time or condition were reported for MIVC. HR was higher in HIIE at all analyzed time points (p < 0.001; d = 3.1 to 5.2). RPE did not differ between conditions (p > 0.05), while average session RPP was higher in LI-AE-BFR (p = 0.036; r = 0.46). Affective positive response (p = 0.019; d = 0.9) and FIE (p = 0.013; d = 0.97) were significantly higher in HIIE. Therefore, HIIE elicited higher physiological stress, positive affective response, and intention to engage in future exercise bouts compared to LI-AE-BFR.
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Affiliation(s)
- Victor S de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, New York, USA
| | - Angelo Sabag
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Phelipe Wilde
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - Thiago Peçanha
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Rodrigo Ramalho Aniceto
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Currais Novos-RN, Brazil
| | | | - Douglas Z Delgado
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | | | - Paulo Moreira Silva Dantas
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
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Mckee JR, Girard O, Peiffer JJ, Scott BR. Manipulating Internal and External Loads During Repeated Cycling Sprints: A Comparison of Continuous and Intermittent Blood Flow Restriction. J Strength Cond Res 2024; 38:47-54. [PMID: 37889856 DOI: 10.1519/jsc.0000000000004594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
ABSTRACT Mckee, JR, Girard, O, Peiffer, JJ, and Scott, BR. Manipulating internal and external loads during repeated cycling sprints: A comparison of continuous and intermittent blood flow restriction. J Strength Cond Res 38(1): 47-54, 2024-This study examined the impact of blood flow restriction (BFR) application method (continuous vs. intermittent) during repeated-sprint exercise (RSE) on performance, physiological, and perceptual responses. Twelve adult male semi-professional Australian football players completed 4 RSE sessions (3 × [5 × 5-second maximal sprints:25-second passive recovery], 3-minute rest between the sets) with BFR applied continuously (C-BFR; excluding interset rest periods), intermittently during only sprints (I-BFR WORK ), or intraset rest periods (I-BFR REST ) or not at all (Non-BFR). An alpha level of p < 0.05 was used to determine significance. Mean power output was greater for Non-BFR ( p < 0.001, dz = 1.58 ), I-BFR WORK ( p = 0.002, dz = 0.63 ), and I-BFR REST ( p = 0.003, dz = 0.69 ) than for C-BFR and for Non-BFR ( p = 0.043, dz = 0.55 ) compared with I-BFR REST . Blood lactate concentration ( p = 0.166) did not differ between the conditions. Mean oxygen consumption was higher during Non-BFR ( p < 0.001, dz = 1.29 and 2.31; respectively) and I-BFR WORK ( p < 0.001, dz = 0.74 and 1.63; respectively) than during I-BFR REST and C-BFR and for I-BFR REST ( p = 0.002, dz = 0.57) compared with C-BFR. Ratings of perceived exertion were greater for I-BFR REST ( p = 0.042, dz = 0.51) and C-BFR ( p = 0.011, dz = 0.90) than for Non-BFR and during C-BFR ( p = 0.023, dz = 0.54) compared with I-BFR WORK . Applying C-BFR or I-BFR REST reduced mechanical output and cardiorespiratory demands of RSE and were perceived as more difficult. Practitioners should be aware that BFR application method influences internal and external demands during RSE.
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Affiliation(s)
- James R Mckee
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, Australia; and
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Jeremiah J Peiffer
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, Australia; and
| | - Brendan R Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, Australia; and
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Uematsu A, Mizushima Y, Ishizaka H, Hortobágyi T, Mizushima T, Toyoda S, Nakajima T. Blood flow restriction reduces the increases in cardiorespiratory responses and subjective burden without inhibiting muscular activity during cycling at ventilatory threshold in healthy males. PLoS One 2023; 18:e0294524. [PMID: 38064463 PMCID: PMC10707540 DOI: 10.1371/journal.pone.0294524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
Low-intensity endurance exercise with blood flow restriction (KAATSU) is under consideration for use in cardiac rehabilitation. However, the physiological responses to such exercise have not yet been fully characterized. In an initial effort in healthy males (n = 11, age: 26.3±4.6 y), we compared the physiological responses to low-intensity endurance exercise with and without a thigh KAATSU. Participants performed maximal graded exercise testing using a cycle ergometer with or without KAATSU. We examined responses to cycling exercise at ventilatory threshold (VT) in heart rate (HR), oxygen consumption (VO2), dyspnea, ratings of perceived exertion (RPE), blood pressure (BP), and rectus femoris activation. Participants reached VT at a lower mechanical load, HR, VO2, dyspnea, and double product (HR×systolic BP) with KAATSU vs. no-KAATSU. At VT, RPE, and rectus femoris activity did not differ between the two conditions. These results suggest that KAATSU reduced exercise intensity to reach VT and the physiological responses to exercise at VT without changes in knee extensor muscle activation. Results from this pilot study in healthy males suggest that KAATSU aerobic exercise at VT intensity has the potential to be an effective and low-burden adjuvant to cycling in cardiac rehabilitation.
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Affiliation(s)
- Azusa Uematsu
- Faculty of Sociology, Otemon Gakuin University, Nishiai, Ibaraki, Osaka, Japan
| | - Yuta Mizushima
- Department of Rehabilitation, School of Medicine, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - Hayato Ishizaka
- Department of Rehabilitation, School of Medicine, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - Tibor Hortobágyi
- Department of Kinesiology, Hungarian University of Sports Science, Alkotás utca, Budapest, Hungary
- Institute of Sport Sciences and Physical Education, University of Pécs, Ifjúság úutja, Pécs, Hungary
- Somogy Country Kaposi Mór Teaching Hospital, Tallián Gyula utca, Kaposvár, Hungary
- Center for Human Movement Sciences, University of Groningen, A. Deusinglaan, Groningen, The Netherlands
| | - Takashi Mizushima
- Department of Rehabilitation, School of Medicine, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
- Department of Medical KAATSU Training, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
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Chang H, Yan J, Lu G, Chen B, Zhang J. Muscle strength adaptation between high-load resistance training versus low-load blood flow restriction training with different cuff pressure characteristics: a systematic review and meta-analysis. Front Physiol 2023; 14:1244292. [PMID: 37693006 PMCID: PMC10485702 DOI: 10.3389/fphys.2023.1244292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose: In this systematic review and meta-analysis, blood flow restriction (BFR) with low-load resistance training (BFR-RT) was compared with high-load resistance training (HL-RT) on muscle strength in healthy adults. The characteristics of cuff pressure suitable for muscle strength gain were also investigated by analyzing the effects of applying different occlusion pressure prescriptions and cuff inflation patterns on muscle strength gain. Methods: Literature search was conducted using PubMed, Ovid Medline, ProQuest, Cochrane Library, Embase, and Scopus databases to identify literature published until May 2023. Studies reporting the effects of BFR-RT interventions on muscle strength gain were compared with those of HL-RT. The risk of bias in the included trials was assessed using the Cochrane tool, followed by a meta-analysis to calculate the combined effect. Subgroup analysis was performed to explore the beneficial variables. Results: Nineteen articles (42 outcomes), with a total of 458 healthy adults, were included in the meta-analysis. The combined effect showed higher muscle strength gain with HL-RT than with BFR-RT (p = 0.03, SMD = -0.16, 95% CI: -0.30 to -0.01). The results of the subgroup analysis showed that the BFR-RT applied with incremental and individualized pressure achieved muscle strength gain similar to the HL-RT (p = 0.8, SMD = -0.05, 95% CI: -0.44 to 0.34; p = 0.68, SMD = -0.04, 95% CI: -0.23 to 0.15), but muscle strength gain obtained via BFR-RT applied with absolute pressure was lower than that of HL-RT (p < 0.05, SMD = -0.45, 95% CI: -0.71 to -0.19). Furthermore, muscle strength gain obtained by BFR-RT applied with intermittent pressure was similar to that obtained by HL-RT (p = 0.88, SMD = -0.02, 95% CI: -0.27 to 0.23), but muscle strength gain for BFR-RT applied with continuous pressure showed a less prominent increase than that for HL-RT (p < 0.05, SMD = -0.3, 95% CI: -0.48 to -0.11). Conclusion: In general, HL-RT produces superior muscle strength gains than BFR-RT. However, the application of individualized, incremental, and intermittent pressure exercise protocols in BFR-RT elicits comparable muscle strength gains to HL-RT. Our findings indicate that cuff pressure characteristics play a significant role in establishing a BFR-RT intervention program for enhancing muscle strength in healthy adults. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails; Identifier: PROSPERO (CRD42022364934).
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Affiliation(s)
- Hualong Chang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jing Yan
- College of Education, Anyang Normal University, Anyang, China
| | - Guiwei Lu
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Biao Chen
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jianli Zhang
- Exercise and Metabolism Research Center, College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Smith NDW, Abbiss CR, Girard O, Scott BR, Peiffer JJ. Blood-Flow Restriction Is Associated With More Even Pacing During High-Intensity Cycling. Int J Sports Physiol Perform 2023; 18:667-673. [PMID: 37130589 DOI: 10.1123/ijspp.2022-0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/26/2023] [Accepted: 03/13/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE This study examined the influence of blood-flow restriction (BFR) on the distribution of pace, physiological demands, and perceptual responses during self-paced cycling. METHODS On separate days, 12 endurance cyclists/triathletes were instructed to produce the greatest average power output during 8-minute self-paced cycling trials with BFR (60% arterial occlusion pressure) or without restriction (CON). Power output and cardiorespiratory variables were measured continuously. Perceived exertion, muscular discomfort, and cuff pain were recorded every 2 minutes. RESULTS Linear regression analysis of the power output slope was statistically significant (ie, deviated from the intercept) for CON (2.7 [3.2] W·30 s-1; P = .009) but not for BFR (-0.1 [3.1] W·30 s-1; P = .952). Absolute power output was ∼24% (12%) lower at all time points (P < .001) during BFR compared with CON. Oxygen consumption (18% [12%]; P < .001), heart rate (7% [9%]; P < .001), and perceived exertion (8% [21%]; P = .008) were reduced during BFR compared with CON, whereas muscular discomfort (25% [35%]; P = .003) was greater. Cuff pain was rated as "strong" (5.3 [1.8] au; 0-10 scale) for BFR. CONCLUSION Trained cyclists adopted a more even distribution of pace when BFR was applied compared with a negative distribution during CON. By presenting a unique combination of physiological and perceptual responses, BFR is a useful tool to understand how the distribution of pace is self-regulated.
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Affiliation(s)
- Nathan D W Smith
- Exercise Science, Centre for Healthy Ageing, Murdoch University, Perth, WA,Australia
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA,Australia
| | - Chris R Abbiss
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Perth, WA,Australia
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA,Australia
| | - Brendan R Scott
- Exercise Science, Centre for Healthy Ageing, Murdoch University, Perth, WA,Australia
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA,Australia
| | - Jeremiah J Peiffer
- Exercise Science, Centre for Healthy Ageing, Murdoch University, Perth, WA,Australia
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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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Lauver JD, Moran A, Guilkey JP, Johnson KE, Zanchi NE, Rotarius TR. Acute Responses to Cycling Exercise With Blood Flow Restriction During Various Intensities. J Strength Cond Res 2022; 36:3366-3373. [PMID: 34341317 DOI: 10.1519/jsc.0000000000004099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Lauver, JD, Moran, A, Guilkey, JP, Johnson, KE, Zanchi, NE, and Rotarius, TR. Acute responses to cycling exercise with blood flow restriction during various intensities. J Strength Cond Res 36(12): 3366-3373, 2022-The purpose of this study was to investigate the acute physiological responses during cycling at various intensities with blood flow restriction (BFR). Subjects ( N = 9; V̇ o2 peak = 36.09 ± 5.80 ml·kg -1 ·min -1 ) performed 5 protocols: high-intensity (HIGH), control (CON-90), 90% of ventilatory threshold (VT) work rate with BFR (90-BFR), 70% of VT with BFR (70-BFR), and 30% V̇ o2 peak with BFR (30-BFR). Protocols consisted of five 2-minute work intervals interspersed with 1-minute recovery intervals. Blood flow restriction pressure was 80% of limb occlusion pressure. V̇ o2 , muscle excitation, tissue oxygen saturation (StO 2 ), discomfort, and level of perceived exertion (RPE) were assessed. Muscle excitation was higher during HIGH (302.9 ± 159.9 %BSL [baseline]) compared with 70-BFR (99.7 ± 76.4 %BSL) and 30-BFR (98.2 ± 70.5 %BSL). StO 2 was greater during 90-BFR (40.7 ± 12.5 ∆BSL), 70-BFR (34.4 ± 15.2 ∆BSL), and 30-BFR (31.9 ± 18.7 ∆BSL) compared with CON-90 (4.4 ± 11.5 ∆BSL). 90-BFR (39.6 ± 12.0 ∆BSL) resulted in a greater StO 2 -Avg compared with HIGH (20.5 ± 13.8 ∆BSL). Also, HIGH (23.68 ± 5.31 ml·kg -1 ·min -1 ) resulted in a greater V̇ o2 compared with 30-BFR (15.43 ± 3.19 ml·kg -1 ·min -1 ), 70-BFR (16.65 ± 3.26 ml·kg -1 ·min -1 ), and 90-BFR (18.28 ± 3.89 ml·kg -1 ·min -1 ); 90-BFR (intervals: 4 = 15.9 ± 2.3; intervals: 5 = 16.4 ± 2.5) resulted in a greater RPE compared with 30-BFR (intervals: 4 = 13.3 ± 1.4; intervals: 5 = 13.7 ± 1.7) during intervals 4 and 5. These results suggest that when adding BFR to various intensities of aerobic exercise, consideration should be given to peak work and VT to provide a balance between high local physiological stress and perceptual responses.
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Affiliation(s)
- Jakob D Lauver
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Austin Moran
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Justin P Guilkey
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Kelly E Johnson
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina
| | - Nelo E Zanchi
- Department of Physical Education, Federal University of Maranhao (UFMA), Sao Luis, Brazil; and
| | - Timothy R Rotarius
- Department of Exercise Science and Athletic Training, Adrian College, Adrian, Michigan
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11
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Spada JM, Paul RW, Tucker BS. Blood Flow Restriction Training preserves knee flexion and extension torque following anterior cruciate ligament reconstruction: A systematic review. J Orthop 2022; 34:233-239. [PMID: 36120478 PMCID: PMC9478494 DOI: 10.1016/j.jor.2022.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background There is inconsistency in the literature comparing the outcomes of Blood Flow Restriction Training versus Traditional Post-Operative Rehabilitation after anterior cruciate ligament reconstruction. Purpose This study aimed to determine if Blood Flow Restriction Training can limit the loss of knee extension and knee flexion muscle torque during early recovery from anterior cruciate ligament reconstruction better than Traditional Post-Operative Rehabilitation. Methods Three databases (PubMed, Embase, and Scopus) were searched for level 1 randomized controlled trials pertaining to Blood Flow Restriction Training after anterior cruciate ligament reconstruction. To maximize consistency among included studies, only studies which used knee flexion and knee extension muscle torque as the primary outcome measures were included. Search terms included "cruciate + occlusion", "cruciate + blood flow restriction", and "cruciate + occlusion training". Results Two level 1 trials with training protocols of 8 and 16 weeks yielded isokinetic knee flexion torque data in support of Blood Flow Restriction Training. Both trials demonstrated that Blood Flow Restriction Training also yielded significantly increased isokinetic knee extension torque compared to control groups. Conclusion The highest-quality level 1 trials evaluating knee extension and knee extension strength via isokinetic torque agree that Blood Flow Restriction Training limits post-operative losses of knee flexion and extension strength. No adverse events were reported in either study. Except for patients of whom Blood Flow Restriction is contraindicated, clinicians may consider utilizing Blood Flow Restriction Training from week 2 of the post-operative period through the conclusion of outpatient rehabilitation using low intensities, multiple times per week; however, further studies comparing Blood Flow Restriction Training protocols are necessary before an optimal protocol could be confidently recommended.
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Affiliation(s)
- Joshua M. Spada
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Ryan W. Paul
- Rothman Orthopaedic Institute, Philadelphia, PA, USA
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12
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Muscle Fatigue Is Attenuated When Applying Intermittent Compared With Continuous Blood Flow Restriction During Endurance Cycling. Int J Sports Physiol Perform 2022; 17:1126-1131. [PMID: 35551112 DOI: 10.1123/ijspp.2021-0523] [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: 11/22/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to identify a blood-flow-restriction (BFR) endurance exercise protocol that maximizes metabolic strain and minimizes muscle fatigue. METHODS Twelve healthy participants accomplished 5 different interval cycling endurance exercises (2-min work, 1-min rest) in a randomized order: (1) control, low intensity with unrestricted blood flow (CON30); (2) low intensity with intermittent BFR (i-BFR30, ∼150 mm Hg); (3) low intensity with continuous BFR (c-BFR, ∼100 mm Hg); (4) unloaded cycling with i-BFR0 (∼150 mm Hg); and (5) high intensity (HI) with unrestricted blood flow. Force production, creatine kinase activity, antioxidant markers, blood pH, and potassium (K+) were measured in a range of 5 minutes before and after each cycling exercise protocol. RESULTS HI showed the highest reduction (Δ = -0.26 [0.05], d = 5.6) on blood pH. Delta pH for c-BRF30 (Δ = -0.02 [0.03], d = 0.8) and Δ pH for i-BRF30 (Δ = -0.04 [0.03], d = 1.6) were different from each other, and both were higher compared with CON30 (Δ = 0.03 [0.03]). There was significant before-to-after force loss following HI (Δ = 55 [40] N·m-1, d = 1.5) and c-BFR30 (Δ = 27 [21] N·m-1, d = 0.7) protocols only, which were accompanied by significant increases in K+ (HI: Δ = 0.94 [0.65] mmol·L-1, d = 1.8; c-BFR30: Δ = 0.72 [0.85] mmol·L-1, d = 1.2). Moreover, all BFR conditions elicited slight increases in plasma creatine kinase, but not for HI and CON30. Glutathione changes from before to after were significant for all BFR conditions and HI, but not for CON30. CONCLUSIONS The attenuation in fatigue-induced reductions in maximal force suggests that i-BFR exercise could be preferable to c-BFR in improving exercise capacity, with considerably less biologic stress elicited from HI exercises.
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13
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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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14
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Smith NDW, Girard O, Scott BR, Peiffer JJ. Blood flow restriction during self-paced aerobic intervals reduces mechanical and cardiovascular demands without modifying neuromuscular fatigue. Eur J Sport Sci 2022; 23:755-765. [PMID: 35400303 DOI: 10.1080/17461391.2022.2062056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study examined cardiovascular, perceptual, and neuromuscular fatigue characteristics during and after cycling intervals with and without blood flow restriction (BFR). Fourteen endurance cyclists/triathletes completed four 4-minute self-paced aerobic cycling intervals at the highest sustainable intensity, with and without intermittent BFR (60% of arterial occlusion pressure). Rest interval durations were six, four, and four minutes respectively. Power output, cardiovascular demands, and ratings of perceived exertion (RPE) were averaged over each interval. Knee extension torque and vastus lateralis electromyography responses following electrical stimulation of the femoral nerve were recorded pre-exercise, post-interval one (+1, 2, and 4-minutes) and post-interval four (+1, 2, 4, 6 and 8-minutes). Power output during BFR intervals was lower than non-BFR (233 ± 54 vs 282 ± 60W, p < 0.001). Oxygen uptake and heart rate during BFR intervals were lower compared to non-BFR (38.7 ± 4.5 vs 44.7 ± 6.44mL·kg-1·min-1, p < 0.001; 160 ± 14 vs 166 ± 10bpm, p < 0.001), while RPE was not different between conditions. Compared to pre-exercise, maximal voluntary contraction torque and peak twitch torque were reduced after the first interval with further reductions following the fourth interval (p < 0.001) independent of condition (p = 0.992). Voluntary activation (twitch interpolation) did not change between timepoints (p = 0.375). Overall, intermittent BFR reduced the mechanical and cardiovascular demands of self-paced intervals without modifying RPE or knee-extensor neuromuscular characteristics. Therefore, BFR reduced the cardiovascular demands while maintaining the muscular demands associated with self-paced intervals. Self-paced BFR intervals could be used to prevent cardiovascular and perceptual demands being the limiting factor of exercise intensity, thus allowing greater physiological muscular demands compared to intervals without BFR.
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Affiliation(s)
- Nathan D W Smith
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Western Australia.,Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
| | - Olivier Girard
- Exercise and Sport Science Department, School of Human Sciences, The University of Western Australia, Perth, Western Australia
| | - Brendan R Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Western Australia.,Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
| | - Jeremiah J Peiffer
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, Western Australia.,Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
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Silva JCG, Freitas EDS, Aniceto RR, Silva KF, Araújo JP, Bembem MG, Batista GR, Sousa MSC. Aerobic exercise with blood flow restriction: energy expenditure, excess post-exercise oxygen consumption, and respiratory exchange ratio. Clin Physiol Funct Imaging 2022; 42:241-249. [PMID: 35357762 DOI: 10.1111/cpf.12753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
We compared the effects of aerobic exercise with and without blood flow restriction (BFR) to high-intensity aerobic exercise on energy expenditure (EE), excess post-exercise oxygen consumption (EPOC), and respiratory exchange ratio (RER) during and after exercise. Twenty-two recreationally active males randomly completed the following experimental conditions: AE - aerobic exercise without BFR, AE+BFR - aerobic exercise with BFR, HIAE - high-intensity aerobic exercise, CON - non-exercise control condition. EE was significantly (p<0.05) greater during exercise for HIAE compared to all conditions, and for AE+BFR compared to AE and CON during and post-exercise exercise. There were no significant (p>0.05) differences in EPOC between HIAE and AE+BFR at any time point, however, both conditions were significantly (p < 0.05) greater than the AE (d = 1.50 and d = 1.03, respectively) and CON at the first 10 minutes post-exercise. RER during exercise for HIAE was significantly (p<0.05) greater than AE+BFR at the first 6 minutes of exercise (p = 0.003, d = 0.88), however, no significant differences were observed from 9 min up to the end of the exercise. HIAE was also significantly (p<0.05) greater than AE and CON at all time points during exercise, whereas, AE+BFR was significantly (p<0.05) greater than CON at all time points but not significantly (p < 0.05) different than AE (p<0.05); although the overall session RER was significantly (p<0.05) greater during AE+BFR than AE. Altogether, continuous AE+BFR results in greater EE compared to volume matched AE, as well as a similar EPOC compared to HIAE. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Julio C G Silva
- Department of Physical Education, Associate Graduate Program in physical Education UPE-UFPB, João Pessoa, PB, Brazil.,Department of Physical Education, Professional Master's in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, PB, Brazil.,Department of Physical Education, Center for higher education and Development (CESED/UNIFACISA/FCM/ESAC), Campina Grande, PB, Brazil
| | | | - Rodrigo R Aniceto
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Department of Physical Education and Sport, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Currais Novos-RN, Brazil
| | - Kalinne F Silva
- Department of Physical Education, Associate Graduate Program in physical Education UPE-UFPB, João Pessoa, PB, Brazil
| | - Joamira P Araújo
- Department of Physical Education, Associate Graduate Program in physical Education UPE-UFPB, João Pessoa, PB, Brazil
| | - Michael G Bembem
- Neuromuscular Laboratory, Department of health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Gilmário R Batista
- Department of Physical Education, Associate Graduate Program in physical Education UPE-UFPB, João Pessoa, PB, Brazil
| | - Maria S C Sousa
- Department of Physical Education, Associate Graduate Program in physical Education UPE-UFPB, João Pessoa, PB, Brazil
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16
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Kilgas MA, Yoon T, McDaniel J, Phillips KC, Elmer SJ. Physiological Responses to Acute Cycling With Blood Flow Restriction. Front Physiol 2022; 13:800155. [PMID: 35360241 PMCID: PMC8963487 DOI: 10.3389/fphys.2022.800155] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Aerobic exercise with blood flow restriction (BFR) can improve muscular function and aerobic capacity. However, the extent to which cuff pressure influences acute physiological responses to aerobic exercise with BFR is not well documented. We compared blood flow, tissue oxygenation, and neuromuscular responses to acute cycling with and without BFR. Ten participants completed four intermittent cycling (6 × 2 min) conditions: low-load cycling (LL), low-load cycling with BFR at 60% of limb occlusion pressure (BFR60), low-load cycling with BFR at 80% of limb occlusion pressure (BFR80), and high-load cycling (HL). Tissue oxygenation, cardiorespiratory, metabolic, and perceptual responses were assessed during cycling and blood flow was measured during recovery periods. Pre- to post-exercise changes in knee extensor function were also assessed. BFR60 and BFR80 reduced blood flow (~33 and ~ 50%, respectively) and tissue saturation index (~5 and ~15%, respectively) when compared to LL (all p < 0.05). BFR60 resulted in lower VO2, heart rate, ventilation, and perceived exertion compared to HL (all p < 0.05), whereas BFR80 resulted in similar heart rates and exertion to HL (both p > 0.05). BFR60 and BFR80 elicited greater pain compared to LL and HL (all p < 0.05). After exercise, knee extensor torque decreased by ~18 and 40% for BFR60 and BFR80, respectively (both p < 0.05), and was compromised mostly through peripheral mechanisms. Cycling with BFR increased metabolic stress, decreased blood flow, and impaired neuromuscular function. However, only BFR60 did so without causing very severe pain (>8 on pain intensity scale). Cycling with BFR at moderate pressure may serve as a potential alternative to traditional high-intensity aerobic exercise.
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Affiliation(s)
- Matthew A Kilgas
- School of Health and Human Performance, Northern Michigan University, Marquette, MI, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Tejin Yoon
- Department of Physical Education, Kangwon National University, Chuncheon, South Korea
| | - John McDaniel
- Department of Exercise Physiology, Kent State University, Kent, OH, United States
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Kevin C Phillips
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Steven J Elmer
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
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17
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Self-Paced Cycling at the Highest Sustainable Intensity With Blood Flow Restriction Reduces External but Not Internal Training Loads. Int J Sports Physiol Perform 2022; 17:1272-1279. [DOI: 10.1123/ijspp.2022-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022]
Abstract
Purpose: This study compared training loads and internal:external load ratios from an aerobic interval session at the highest perceptually sustainable intensity with and without blood flow restriction (BFR). Methods: On separate days, 14 endurance cyclists/triathletes completed four 4-minute self-paced aerobic cycling intervals at their highest sustainable intensity, with and without BFR (60% of arterial occlusion pressure). Internal training load was quantified using 3 training impulses (TRIMP; Banister, Lucia, and Edwards) and sessional ratings of perceived exertion. External load was assessed using total work done (TWD). Training load ratios between all internal loads were calculated relative to TWD. Results: Lucia TRIMP was lower for the BFR compared with non-BFR session (49 [9] vs 53 [8] arbitrary units [au], P = .020, dz = −0.71). No between-conditions differences were observed for Banister TRIMP (P = .068), Edwards TRIMP (P = .072), and training load in sessional ratings of perceived exertion (P = .134). The TWD was lower for the BFR compared with non-BFR session (223 [52] vs 271 [58] kJ, P < .001, dz = −1.27). Ratios were greater for the BFR session compared with non-BFR for Lucia TRIMP:TWD (0.229 [0.056] vs 0.206 [0.056] au, P < .001, dz = 1.21), Edwards TRIMP:TWD (0.396 [0.105] vs 0.370 [0.088] au, P = .031, dz = 0.66), and training load in sessional ratings of perceived exertion:TWD (1.000 [0.266] vs 0.890 [0.275] au, P = .044, dz = 0.60), but not Banister TRIMP:TWD (P = .306). Conclusions: Practitioners should consider both internal and external loads when monitoring BFR exercise to ensure the demands are appropriately captured. These BFR-induced changes were reflected by the Lucia TRIMP:TWD and Edwards TRIMP:TWD ratio, which could be used to monitor aerobic BFR training loads. The Lucia TRIMP:TWD ratio likely represents BFR-induced changes more appropriately compared with ratios involving either Edwards or Banister TRIMP.
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Hughes L, Grant I, Patterson SD. Aerobic exercise with blood flow restriction causes local and systemic hypoalgesia and increases circulating opioid and endocannabinoid levels. J Appl Physiol (1985) 2021; 131:1460-1468. [PMID: 34498944 DOI: 10.1152/japplphysiol.00543.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study examined the effect of aerobic exercise with and without blood flow restriction (BFR) on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid systems. In a randomized crossover design, pain-free individuals performed 20 min of cycling in four experimental trials: 1) low-intensity aerobic exercise (LI-AE) at 40% V̇o2max; 2) LI-AE with low-pressure BFR (BFR40); 3) LI-AE with high-pressure BFR (BFR80); and 4) high-intensity aerobic exercise (HI-AE) at 70% V̇o2max. Pressure pain thresholds (PPTs) were assessed before and 5 min postexercise. Circulating concentrations of beta-endorphin and 2-arachidonoylglycerol were assessed before and 10 min postexercise. In the exercising legs, postexercise PPTs were increased following BFR40 and BFR80 compared with LI-AE (23-32% vs. 1-2% increase, respectively). The increase in PPTs was comparable to HI-AE (17-20% increase) with BFR40 and greater with BFR80 (30-32% increase). Both BFR80 and HI-AE increased PPTs in remote areas of the body (increase of 26-28% vs. 19-21%, respectively). Postexercise circulating beta-endorphin concentration was increased following BFR40 (11%) and HI-AE (14%), with the greatest change observed following BFR80 (29%). Postexercise circulating 2-arachidonoylglycerol concentration was increased following BFR40 (22%) and BFR80 (20%), with the greatest change observed following HI-AE (57%). Addition of BFR to LI-AE can trigger both local and systemic hypoalgesia that is not observed follow LI-AE alone and activate endogenous opioid and endocannabinoid systems of pain inhibition. Compared with HI-AE, local and systemic hypoalgesia following LI-AE with high-pressure BFR is greater and comparable, respectively. LI-AE with BFR may help pain management in load-compromised individuals.NEW & NOTEWORTHY We have shown that performing blood flow restriction (BFR) during low-intensity aerobic exercise can trigger local and systemic hypoalgesia, which is not typically observed with this intensity of exercise. High-pressure BFR triggers greater and comparable hypoalgesia than high-intensity aerobic exercise in the exercising limbs and remote areas of the body, respectively. Performing BFR during low-intensity aerobic exercise activates the opioid and endocannabinoid systems, providing novel insight into potential mechanisms of hypoalgesia with BFR exercise.
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Affiliation(s)
- Luke Hughes
- Centre for Applied Performance Sciences, Faculty of Sport, Allied Health, and Performance Sciences, St. Mary's University, London, United Kingdom
| | - Ian Grant
- Centre for Applied Performance Sciences, Faculty of Sport, Allied Health, and Performance Sciences, St. Mary's University, London, United Kingdom
| | - Stephen David Patterson
- Centre for Applied Performance Sciences, Faculty of Sport, Allied Health, and Performance Sciences, St. Mary's University, London, United Kingdom
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Sinclair P, Kadhum M, Paton B. Tolerance to Intermittent vs. Continuous Blood Flow Restriction Training: A meta-Analysis. Int J Sports Med 2021; 43:3-10. [PMID: 34535020 DOI: 10.1055/a-1537-9886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The proven beneficial effects of low-load blood flow restriction training on strength gain has led to further exploration into its application during rehabilitation, where the traditional use of heavy loads may not be feasible. With current evidence showing that low-load blood flow restriction training may be less well tolerated than heavy-load resistance training, this review was conducted to decipher whether intermittently deflating the pressure cuff during rest intervals of a training session improves tolerance to exercise, without compromising strength. Four databases were searched for randomized controlled trials that compared the effect of intermittent versus continuous blood flow restriction training on outcomes of exercise tolerance or strength in adults. Nine studies were identified, with six included in the meta-analysis. No significant difference in rate of perceived exertion was found (SMD-0.06, 95% CI-0.41 to 0.29, p=0.73, I 2=80%). Subgroup analysis excluding studies that introduced bias showed a shift towards favoring the use of intermittent blood flow restriction training (SMD-0.42, 95% CI-0.87 to 0.03, p=0.07, I 2=0%). There was no significant difference in strength gain. Intermittent cuff deflations during training intervals does not improve tolerance to exercise during blood flow restriction training.
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Affiliation(s)
- Pierre Sinclair
- Department of Institute of Sports and Exercise Health (ISEH), University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Murtaza Kadhum
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Bruce Paton
- Department of Institute of Sports and Exercise Health (ISEH), University College London, London, United Kingdom of Great Britain and Northern Ireland
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Acute physiological and perceptual responses to moderate intensity cycling with different levels of blood flow restriction. Biol Sport 2021; 38:437-443. [PMID: 34475624 PMCID: PMC8329982 DOI: 10.5114/biolsport.2021.100146] [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: 08/06/2020] [Revised: 09/04/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to compare: i) the physiological and perceptual responses of low-load exercise [(moderate intensity exercise (MI)] with different levels of blood flow restriction (BFR), and ii) MI with BFR on the bike with high intensity (HI) exercise without BFR. The protocol involved large muscle mass exercise at different levels of BFR, and this differentiates our study from others. Twenty-one moderately trained males (age: 24.6 ± 2.4 years; VO2peak: 47.2 ± 7.0 ml.kg-1.min-1, mean ± sd) performed one maximal graded exercise test and seven 5-min constant-load cycling bouts. Six bouts were at MI [40% peak power (Ppeak), 60%VO2peak], one without BFR and five with different levels of BFR (40%, 50%, 60%, 70%, 80% of estimated arterial occlusion pressure). The HI bout (70%Ppeak, 90%VO2peak) was without BFR. Oxygen uptake (VO2), heart rate (HR), blood lactate (BLa), rate of perceived exertion (RPE), and tissue oxygen saturation (TSI) were recorded. Regardless of pressure, HR, BLa and RPE during MI-BFR were higher compared to MI (p < 0.05, ES: moderate to very large), and TSI reduction was greater in MI-BFR than MI (p < 0.05, ES: moderate to large). The responses of VO2, HR, BLa, RPE and TSI induced by the different levels of BFR in MI-BFR were similar. Regardless of pressure, the responses of VO2, HR, BLa and RPE induced by MI-BFR were lower than HI (p < 0.05), except for TSI. TSI change was similar between MI-BFR and HI. It appears that BFR equal to 40% of arterial occlusion pressure is sufficient to reduce TSI when exercising with a large muscle mass.
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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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22
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Hostrup M, Cairns SP, Bangsbo J. Muscle Ionic Shifts During Exercise: Implications for Fatigue and Exercise Performance. Compr Physiol 2021; 11:1895-1959. [PMID: 34190344 DOI: 10.1002/cphy.c190024] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise causes major shifts in multiple ions (e.g., K+ , Na+ , H+ , lactate- , Ca2+ , and Cl- ) during muscle activity that contributes to development of muscle fatigue. Sarcolemmal processes can be impaired by the trans-sarcolemmal rundown of ion gradients for K+ , Na+ , and Ca2+ during fatiguing exercise, while changes in gradients for Cl- and Cl- conductance may exert either protective or detrimental effects on fatigue. Myocellular H+ accumulation may also contribute to fatigue development by lowering glycolytic rate and has been shown to act synergistically with inorganic phosphate (Pi) to compromise cross-bridge function. In addition, sarcoplasmic reticulum Ca2+ release function is severely affected by fatiguing exercise. Skeletal muscle has a multitude of ion transport systems that counter exercise-related ionic shifts of which the Na+ /K+ -ATPase is of major importance. Metabolic perturbations occurring during exercise can exacerbate trans-sarcolemmal ionic shifts, in particular for K+ and Cl- , respectively via metabolic regulation of the ATP-sensitive K+ channel (KATP ) and the chloride channel isoform 1 (ClC-1). Ion transport systems are highly adaptable to exercise training resulting in an enhanced ability to counter ionic disturbances to delay fatigue and improve exercise performance. In this article, we discuss (i) the ionic shifts occurring during exercise, (ii) the role of ion transport systems in skeletal muscle for ionic regulation, (iii) how ionic disturbances affect sarcolemmal processes and muscle fatigue, (iv) how metabolic perturbations exacerbate ionic shifts during exercise, and (v) how pharmacological manipulation and exercise training regulate ion transport systems to influence exercise performance in humans. © 2021 American Physiological Society. Compr Physiol 11:1895-1959, 2021.
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Affiliation(s)
- Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Simeon Peter Cairns
- SPRINZ, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand.,Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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23
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Ferguson RA, Mitchell EA, Taylor CW, Bishop DJ, Christiansen D. Blood-flow-restricted exercise: Strategies for enhancing muscle adaptation and performance in the endurance-trained athlete. Exp Physiol 2021; 106:837-860. [PMID: 33486814 DOI: 10.1113/ep089280] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/19/2021] [Indexed: 12/15/2022]
Abstract
NEW FINDINGS What is the topic of this review? Blood-flow-restricted (BFR) exercise represents a potential approach to augment the adaptive response to training and improve performance in endurance-trained individuals. What advances does it highlight? When combined with low-load resistance exercise, low- and moderate-intensity endurance exercise and sprint interval exercise, BFR can provide an augmented acute stimulus for angiogenesis and mitochondrial biogenesis. These augmented acute responses can translate into enhanced capillary supply and mitochondrial function, and subsequent endurance-type performance, although this might depend on the nature of the exercise stimulus. There is a requirement to clarify whether BFR training interventions can be used by high-performance endurance athletes within their structured training programme. ABSTRACT A key objective of the training programme for an endurance athlete is to optimize the underlying physiological determinants of performance. Training-induced adaptations are governed by physiological and metabolic stressors, which initiate transcriptional and translational signalling cascades to increase the abundance and/or function of proteins to improve physiological function. One important consideration is that training adaptations are reduced as training status increases, which is reflected at the molecular level as a blunting of the acute signalling response to exercise. This review examines blood-flow-restricted (BFR) exercise as a strategy for augmenting exercise-induced stressors and subsequent molecular signalling responses to enhance the physiological characteristics of the endurance athlete. Focus is placed on the processes of capillary growth and mitochondrial biogenesis. Recent evidence supports that BFR exercise presents an intensified training stimulus beyond that of performing the same exercise alone. We suggest that this has the potential to induce enhanced physiological adaptations, including increases in capillary supply and mitochondrial function, which can contribute to an improvement in performance of endurance exercise. There is, however, a lack of consensus regarding the potency of BFR training, which is invariably attributable to the different modes, intensities and durations of exercise and BFR methods. Further studies are needed to confirm its potential in the endurance-trained athlete.
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Affiliation(s)
- Richard A Ferguson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emma A Mitchell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Conor W Taylor
- Ineos Grenadiers Cycling Team, Bollin House, Wilmslow, UK
| | - David J Bishop
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
| | - Danny Christiansen
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
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24
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Sugimoto T, Suga T, Tomoo K, Dora K, Mok E, Tsukamoto H, Takada S, Hashimoto T, Isaka T. Blood Flow Restriction Improves Executive Function after Walking. Med Sci Sports Exerc 2021; 53:131-138. [PMID: 32694372 DOI: 10.1249/mss.0000000000002446] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Blood flow restriction (BFR) walking is recognized as a beneficial strategy for increasing skeletal muscle mass and strength. No study has examined the effect of BFR exercise on cognitive functions, including executive function (EF). In this study, we examined the effect of BFR walking on EF. METHODS We performed two studies, at rest and exercise, with BFR or non-BFR (NBFR) in a crossover design. Sitting rest was performed for 15 min (study 1, n = 8). Exercise was programmed at five sets of 2-min walking at 5 km·h with 1-min rest intervals (study 2, n = 16). The BFR condition was achieved using 200 mm Hg pressure cuffs placed around the proximal region of the thighs. The NBFR condition involved no pressure cuffs. EF was assessed using the color-word Stroop task before and after each condition. RESULTS In study 1, there were no significant effects on EF parameters for both BFR and NBFR conditions, suggesting that BFR alone does not improve EF. In study 2, incongruent reaction time shortened after BFR walking compared with that before walking (P = 0.001). Furthermore, the reverse Stroop interference score decreased after BFR walking compared with that before walking (P < 0.001). CONCLUSION These findings suggest that, even with a mild exercise, BFR walking improves EF independently of the effect of BFR alone or walking alone.
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Affiliation(s)
- Takeshi Sugimoto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
| | - Tadashi Suga
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
| | - Keigo Tomoo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
| | - Kento Dora
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
| | - Ernest Mok
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
| | | | - Shingo Takada
- Faculty of Lifelong Sport, Department of Sports Education, Hokusho University, Ebetsu, Hokkaido, JAPAN
| | - Takeshi Hashimoto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, JAPAN
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25
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Rolnick N, Schoenfeld BJ. Can Blood Flow Restriction Used During Aerobic Training Enhance Body Composition in Physique Athletes? Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Hwang H, Mizuno S, Kasai N, Kojima C, Sumi D, Hayashi N, Goto K. Muscle oxygenation, endocrine and metabolic regulation during low-intensity endurance exercise with blood flow restriction. Phys Act Nutr 2020; 24:30-37. [PMID: 32698259 PMCID: PMC7451842 DOI: 10.20463/pan.2020.0012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 01/19/2023] Open
Abstract
PURPOSE The present study investigated the effect of endurance exercise with blood flow restriction (BFR) performed at either 25% maximal oxygen uptake (V˙O2 max) or 40% V˙O2 max) on muscle oxygenation, energy metabolism, and endocrine responses. METHODS Ten males were recruited in the present study. The subjects performed three trials: (1) endurance exercise at 40% V˙O2 max without BFR (NBFR40), (2) endurance exercise at 25% V˙O2 max with BFR (BFR25), and (3) endurance exercise at 40% V˙O2 max with BFR (BFR40). The exercises were performed for 15 min during which the pedaling frequency was set at 70 rpm. In BFR25 and BFR40, 2 min of pressure phase (equivalent to 160 mmHg) followed by 1 min of release phase were repeated five times (5 × 3 min) throughout 15 minutes of exercise. During exercise, muscle oxygenation and concentration of respiratory gases were measured. The blood samples were collected before exercise, immediately after 15 min of exercise, and at 15, 30, and 60 minutes after completion of exercise. RESULTS Deoxygenated hemoglobin (deoxy-Hb) level during exercise was significantly higher with BFR25 and BFR40 than that with NBFR40. BFR40 showed significantly higher total-hemoglobin (total-Hb) than NBFR40 during 2 min of pressure phase. Moreover, exercise-induced lactate elevation and pH reduction were significantly augmented in BFR40, with concomitant increase in serum cortisol concentration after exercise. Carbohydrate (CHO) oxidation was significantly higher with BFR40 than that with NBFR40 and BFR25, whereas fat oxidation was lower with BFR40. CONCLUSION Deoxy-Hb and total Hb levels were significantly increased during 15 min of pedaling exercise in BFR25 and BFR40, indicating augmented local hypoxia and blood volume (blood perfusion) in the muscle. Moreover, low-and moderate-intensity exercise with BFR facilitated CHO oxidation.
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Affiliation(s)
- Hyejung Hwang
- Graduate school of Sport and Health Science, Ritsumeikan University, ShigaJapan
- Department of Physical Education, Hanyang University, SeoulKorea
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulKorea
| | - Sahiro Mizuno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, NagoyaJapan
| | - Nobukazu Kasai
- Department of Sports Science, Japan Institute of Sports Sciences, TokyoJapan
| | - Chihiro Kojima
- Department of Sports Science, Japan Institute of Sports Sciences, TokyoJapan
| | - Daichi Sumi
- Research Center for Urban Health and Sports, Osaka City University, OsakaJapan
| | - Nanako Hayashi
- Research Center for Urban Health and Sports, Osaka City University, OsakaJapan
| | - Kazushige Goto
- Research Center for Urban Health and Sports, Osaka City University, OsakaJapan
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27
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Insights for Blood Flow Restriction and Hypoxia in Leg Versus Arm Submaximal Exercise. Int J Sports Physiol Perform 2020; 15:714-719. [PMID: 32023543 DOI: 10.1123/ijspp.2019-0168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/08/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess tissue oxygenation, along with metabolic and physiological responses during blood flow restriction (BFR, bilateral vascular occlusion) and systemic hypoxia conditions during submaximal leg- versus arm-cycling exercise. METHODS In both legs and arms, 4 randomized sessions were performed (normoxia 400 m, fraction of inspired oxygen [FIO2] 20.9% and normobaric hypoxia 3800 m, FIO2 13.1% [0.1%]; combined with BFR at 0% and 45% of resting pulse elimination pressure). During each session, a single 6-minute steady-state submaximal exercise was performed to measure physiological changes and oxygenation (near-infrared spectroscopy) of the muscle tissue in both the vastus lateralis (legs) and biceps brachii (arms). RESULTS Total hemoglobin concentration ([tHb]) was 65% higher (P < .001) in arms versus legs, suggesting that arms had a greater blood perfusion capacity than legs. Furthermore, there were greater changes in tissue blood volume [tHb] during BFR compared with control conditions (P = .017, F = 5.45). The arms elicited 7% lower tissue saturation (P < .001) and were thus more sensitive to the hypoxia-induced reduction in oxygen supply than legs, no matter the condition. This indicates that legs and arms may elicit different regulatory hemodynamic mechanisms (ie, greater blood flow in arms) for limiting the decreased oxygen delivery during exercise with altered arterial oxygen content. CONCLUSIONS The combination of BFR and/or hypoxia led to increased [tHb] in both limbs likely due to greater vascular resistance; further, arms were more responsive than legs. This possibly influences the maintenance of oxygen delivery and enhances perfusion pressure, suggesting greater vascular reactivity in arms than in legs.
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28
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Corvino RB, Oliveira MFM, Denadai BS, Rossiter HB, Caputo F. Speeding of oxygen uptake kinetics is not different following low-intensity blood-flow-restricted and high-intensity interval training. Exp Physiol 2019; 104:1858-1867. [PMID: 31613029 DOI: 10.1113/ep087727] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/10/2019] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Can interval blood-flow-restricted (BFR) cycling training, undertaken at a low intensity, promote a similar adaptation to oxygen uptake ( V ̇ O 2 ) kinetics to high-intensity interval training? What is the main finding and its importance? Speeding of pulmonary V ̇ O 2 on-kinetics in healthy young subjects was not different between low-intensity interval BFR training and traditional high-intensity interval training. Given that very low workloads are well tolerated during BFR cycle training and speed V ̇ O 2 on-kinetics, this training method could be used when high mechanical loads are contraindicated. ABSTRACT Low-intensity blood-flow-restricted (BFR) endurance training is effective to increase aerobic capacity. Whether it speeds pulmonary oxygen uptake ( V ̇ O 2 p ), CO2 output ( V ̇ C O 2 p ) and ventilatory ( V ̇ Ep ) kinetics has not been examined. We hypothesized that low-intensity BFR training would reduce the phase 2 time constant (τp ) of V ̇ O 2 p , V ̇ C O 2 p and V ̇ Ep by a similar magnitude to traditional high-intensity interval training (HIT). Low-intensity interval training with BFR served as a control. Twenty-four participants (25 ± 6 years old; maximal V ̇ O 2 46 ± 6 ml kg-1 min-1 ) were assigned to one of the following: low-intensity BFR interval training (BFR; n = 8); low-intensity interval training without BFR (LOW; n = 7); or high-intensity interval training without BFR (HIT; n = 9). Training was 12 sessions of two sets of five to eight × 2 min cycling and 1 min resting intervals. LOW and BFR were conducted at 30% of peak incremental power (Ppeak ), and HIT was at ∼103% Ppeak . For BFR, cuffs were inflated on both thighs (140-200 mmHg) during exercise and deflated during rest intervals. Six moderate-intensity step transitions (30% Ppeak ) were averaged for analysis of pulmonary on-kinetics. Both BFR (pre- versus post-training τp = 18.3 ± 3.2 versus 14.5 ± 3.4 s; effect size = 1.14) and HIT (τp = 20.3 ± 4.0 versus 13.1 ± 2.9 s; effect size = 1.75) reduced the V ̇ O 2 p τp (P < 0.05). As expected, there was no change in LOW ( V ̇ O 2 p τp = 17.9 ± 6.2 versus 17.7 ± 4.3 s; P = 0.9). The kinetics of V ̇ C O 2 p and V ̇ Ep were speeded only after HIT (38.5 ± 10.6%, P < 0.001 and 31.2 ± 24.7%, P = 0.004, respectively). Both HIT and low-intensity BFR training were effective in speeding moderate-intensity V ̇ O 2 p kinetics. These data support the findings of others that low-intensity cycling training with BFR increases muscle oxidative capacity.
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Affiliation(s)
- Rogério B Corvino
- Human Performance Research Group, Center for Health and Exercise Science, Santa Catarina State University, Florianopolis, Brazil
| | - Mariana F M Oliveira
- Human Performance Research Group, Center for Health and Exercise Science, Santa Catarina State University, Florianopolis, Brazil.,Physical Effort Laboratory, Sports Center, Federal University of the State of Santa Catarina, Florianopolis, Brazil
| | - Benedito S Denadai
- Physical Effort Laboratory, Sports Center, Federal University of the State of Santa Catarina, Florianopolis, Brazil.,Human Performance Laboratory, São Paulo State University, Rio Claro, Brazil
| | - Harry B Rossiter
- Division of Pulmonary and Critical Care Physiology and Medicine, Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Center at Harbor-UCLA Medical Center, Torrance, CA, USA.,School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Fabrizio Caputo
- Human Performance Research Group, Center for Health and Exercise Science, Santa Catarina State University, Florianopolis, Brazil
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29
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Silva JCG, Pereira Neto EA, Pfeiffer PAS, Neto GR, Rodrigues AS, Bemben MG, Patterson SD, Batista GR, Cirilo-Sousa MS. Acute and Chronic Responses of Aerobic Exercise With Blood Flow Restriction: A Systematic Review. Front Physiol 2019; 10:1239. [PMID: 31636569 PMCID: PMC6787286 DOI: 10.3389/fphys.2019.01239] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
This study systematically reviewed the available scientific evidence pertaining to the acute and chronic changes promoted by aerobic exercise (AE) combined with blood flow restriction (BFR) on neuromuscular, metabolic and hemodynamic variables. PubMed, Web of ScienceTM and Scopus databases were searched for the period from January 2000 to June 2019 and the analysis involved a critical content review. A total of 313 articles were identified, of which 271 were excluded and 35 satisfied the inclusion criteria. Twelve studies evaluated the acute effects and eight studies evaluated the chronic metabolic effects of AE + BFR. For the neuromuscular variables, three studies analyzed the acute effects of AE + BFR and nine studies analyzed the chronic effects. Only 15 studies were identified that evaluated the hemodynamic acute effects of AE + BFR. The analysis provided evidence that AE combined with BFR promotes positive acute and chronic changes in neuromuscular and metabolic variables, a greater elevation in hemodynamic variables than exercise alone, and a higher energy demand during and after exercise. Since these alterations were all well-tolerated, this method can be considered to be safe and feasible for populations of athletes, healthy young, obese, and elderly individuals.
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Affiliation(s)
- Júlio Cesar Gomes Silva
- Associate Graduate Program in Physical Education, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Faculty Nova Esperança (FAMENE/FACENE), Coordination of Physical Education, Nursing and Medical Schools, João Pessoa, Brazil.,Coordination of Physical Education, University Center for Higher Education and Development (CESED/UNIFACISA/FCM/ESAC), Campina Grande, Brazil
| | - Elísio Alves Pereira Neto
- Associate Graduate Program in Physical Education, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Patrick Alan Souza Pfeiffer
- Associate Graduate Program in Physical Education, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil
| | - Gabriel Rodrigues Neto
- Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Faculty Nova Esperança (FAMENE/FACENE), Coordination of Physical Education, Nursing and Medical Schools, João Pessoa, Brazil.,Coordination of Physical Education, University Center for Higher Education and Development (CESED/UNIFACISA/FCM/ESAC), Campina Grande, Brazil
| | - Amanda Santos Rodrigues
- Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil
| | - Michael G Bemben
- Department of Health and Exercise Science, Norman, OK, United States
| | - Stephen D Patterson
- Faculty of Sport, Health and Applied Science, St Marys' University, London, United Kingdom
| | - Gilmário Ricarte Batista
- Associate Graduate Program in Physical Education, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil
| | - Maria S Cirilo-Sousa
- Associate Graduate Program in Physical Education, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.,Laboratory of Kinanthropometry and Human Performance, Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil
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30
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Willis SJ, Peyrard A, Rupp T, Borrani F, Millet GP. Vascular and oxygenation responses of local ischemia and systemic hypoxia during arm cycling repeated sprints. J Sci Med Sport 2019; 22:1151-1156. [PMID: 31104973 DOI: 10.1016/j.jsams.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/26/2019] [Accepted: 05/07/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the acute vascular and oxygenation responses to repeated sprint exercise during arm cycling with either blood flow restriction (BFR) or systemic hypoxia alone or in combination. DESIGN The study design was a single-blinded repeated-measures assessment of four conditions with two levels of normobaric hypoxia (400 m and 3800 m) and two levels of BFR (0% and 45% of total occlusion). METHODS Sixteen active participants (eleven men and five women; mean ± SD; 26.4 ± 4.0 years old; 73.8 ± 9.8 kg; 1.79 ± 0.07 m) completed 5 sessions (1 familiarization, 4 conditions). During each test visit, participants performed a repeated sprint arm cycling test to exhaustion (10 s maximal sprints with 20 s recovery until exhaustion) to measure power output, metabolic equivalents, blood flow, as well as oxygenation (near-infrared spectroscopy) of the biceps brachii muscle tissue. RESULTS Repeated sprint performance was decreased with both BFR and systemic hypoxia conditions. Greater changes between minimum-maximum of sprints in total hemoglobin concentration (Δ[tHb]) were demonstrated with BFR (400 m, 45% and 3800 m, 45%) than without (400 m, 0% and 3800 m, 0%) (p < 0.001 for both). Additionally, delta tissue saturation index (ΔTSI) decreased more with both BFR conditions than without (p < 0.001 for both). The absolute maximum TSI was progressively reduced with both BFR and systemic hypoxia (p < 0.001). CONCLUSIONS By combining high-intensity, repeated sprint exercise with BFR and/or systemic hypoxia, there is a robust stimulus detected by increased changes in blood perfusion placed on specific vascular mechanisms, which were more prominent in BFR conditions.
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Affiliation(s)
- Sarah J Willis
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland.
| | - Arthur Peyrard
- Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424 LIBM Chambéry), Université Savoie Mont Blanc, Campus Scientifique Technolac, France
| | - Thomas Rupp
- Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424 LIBM Chambéry), Université Savoie Mont Blanc, Campus Scientifique Technolac, France
| | - Fabio Borrani
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland
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31
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Christiansen D, Eibye KH, Rasmussen V, Voldbye HM, Thomassen M, Nyberg M, Gunnarsson TGP, Skovgaard C, Lindskrog MS, Bishop DJ, Hostrup M, Bangsbo J. Cycling with blood flow restriction improves performance and muscle K + regulation and alters the effect of anti-oxidant infusion in humans. J Physiol 2019; 597:2421-2444. [PMID: 30843602 DOI: 10.1113/jp277657] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022] Open
Abstract
KEY POINTS Training with blood flow restriction (BFR) is a well-recognized strategy for promoting muscle hypertrophy and strength. However, its potential to enhance muscle function during sustained, intense exercise remains largely unexplored. In the present study, we report that interval training with BFR augments improvements in performance and reduces net K+ release from contracting muscles during high-intensity exercise in active men. A better K+ regulation after BFR-training is associated with an elevated blood flow to exercising muscles and altered muscle anti-oxidant function, as indicated by a higher reduced to oxidized glutathione (GSH:GSSG) ratio, compared to control, as well as an increased thigh net K+ release during intense exercise with concomitant anti-oxidant infusion. Training with BFR also invoked fibre type-specific adaptations in the abundance of Na+ ,K+ -ATPase isoforms (α1 , β1 , phospholemman/FXYD1). Thus, BFR-training enhances performance and K+ regulation during intense exercise, which may be a result of adaptations in anti-oxidant function, blood flow and Na+ ,K+ -ATPase-isoform abundance at the fibre-type level. ABSTRACT We examined whether blood flow restriction (BFR) augments training-induced improvements in K+ regulation and performance during intense exercise in men, and also whether these adaptations are associated with an altered muscle anti-oxidant function, blood flow and/or with fibre type-dependent changes in Na+ ,K+ -ATPase-isoform abundance. Ten recreationally-active men (25 ± 4 years, 49.7 ± 5.3 mL kg-1 min-1 ) performed 6 weeks of interval cycling, where one leg trained without BFR (control; CON-leg) and the other trained with BFR (BFR-leg, pressure: ∼180 mmHg). Before and after training, femoral arterial and venous K+ concentrations and artery blood flow were measured during single-leg knee-extensor exercise at 25% (Ex1) and 90% of thigh incremental peak power (Ex2) with i.v. infusion of N-acetylcysteine (NAC) or placebo (saline) and a resting muscle biopsy was collected. After training, performance increased more in BFR-leg (23%) than in CON-leg (12%, P < 0.05), whereas K+ release during Ex2 was attenuated only from BFR-leg (P < 0.05). The muscle GSH:GSSG ratio at rest and blood flow during exercise was higher in BFR-leg than in CON-leg after training (P < 0.05). After training, NAC increased resting muscle GSH concentration and thigh net K+ release during Ex2 only in BFR-leg (P < 0.05), whereas the abundance of Na+ ,K+ -ATPase-isoform α1 in type II (51%), β1 in type I (33%), and FXYD1 in type I (108%) and type II (60%) fibres was higher in BFR-leg than in CON-leg (P < 0.05). Thus, training with BFR elicited greater improvements in performance and reduced thigh K+ release during intense exercise, which were associated with adaptations in muscle anti-oxidant function, blood flow and Na+ ,K+ -ATPase-isoform abundance at the fibre-type level.
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Affiliation(s)
- Danny Christiansen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark.,Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Kasper H Eibye
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Villads Rasmussen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Hans M Voldbye
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Martin Thomassen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Thomas G P Gunnarsson
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Casper Skovgaard
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Mads S Lindskrog
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - David J Bishop
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
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Limb blood flow and tissue perfusion during exercise with blood flow restriction. Eur J Appl Physiol 2018; 119:377-387. [DOI: 10.1007/s00421-018-4029-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/30/2018] [Indexed: 10/27/2022]
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33
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Acute physiological responses to low-intensity blood flow restriction cycling. J Sci Med Sport 2018; 21:969-974. [DOI: 10.1016/j.jsams.2018.01.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 11/18/2022]
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Blood Flow Restriction Training in Rehabilitation Following Anterior Cruciate Ligament Reconstructive Surgery: A Review. Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bertuzzi R, Gáspari AF, Trojbicz LR, Silva-Cavalcante MD, Lima-Silva AE, Billaut F, Girard O, Millet GP, Bossi AH, Hopker J, Pandeló DR, Fulton TJ, Paris HL, Chapman RF, Grosicki GJ, Murach KA, Hureau TJ, Dufour SP, Favret F, Kruse NT, Nicolò A, Sacchetti M, Pedralli M, Pinheiro FA, Tricoli V, Brietzke C, Pires FO, Sandford GN, Pearson S, Kilding AE, Ross A, Laursen PB, da Silveira ALB, Olivares EL, de Azevedo Cruz Seara F, Miguel-dos-Santos R, Mesquita TRR, Nelatury S, Vagula M. Commentaries on Viewpoint: Resistance training and exercise tolerance during high-intensity exercise: moving beyond just running economy and muscle strength. J Appl Physiol (1985) 2018; 124:529-535. [PMID: 29480788 DOI: 10.1152/japplphysiol.01064.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Romulo Bertuzzi
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil
| | - Arthur F. Gáspari
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil
| | - Lucas R. Trojbicz
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil
| | - Marcos D. Silva-Cavalcante
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil,Sport Science Research Group, Federal University of Pernambuco, Pernambuco, Brazil
| | - Adriano E. Lima-Silva
- Sport Science Research Group, Federal University of Pernambuco, Pernambuco, Brazil,Human Performance Research Group, Technological Federal University of Parana, Parana, Brazil
| | | | - Oliver Girard
- Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Grégoire P. Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Arthur Henrique Bossi
- School of Sport and Exercise Sciences University of Kent, Chatham Maritime, Chatham, Kent, England
| | - James Hopker
- School of Sport and Exercise Sciences University of Kent, Chatham Maritime, Chatham, Kent, England
| | - Domingos R. Pandeló
- Federal University of São Paulo Centro de Alta Performance (High Performance Center)
| | | | | | | | - Gregory J. Grosicki
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Kevin A. Murach
- Department of Rehabilitation Sciences and Center for Muscle Biology, University of Kentucky, Lexington, KY
| | - Thomas J. Hureau
- University of Strasbourg Faculty of Medicine, Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Strasbourg, France
| | - Stéphane P. Dufour
- University of Strasbourg Faculty of Medicine, Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Strasbourg, France
| | - Fabrice Favret
- University of Strasbourg Faculty of Medicine, Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Strasbourg, France
| | - Nicholas T. Kruse
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa
| | - Andrea Nicolò
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Marinei Pedralli
- Department of Kinesiology & Health Education, Cardiovascular Aging Research Laboratory, The University of Texas at Austin, Austin, TX
| | - Fabiano A. Pinheiro
- Laboratory of Adaptation to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil,Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Valmor Tricoli
- Laboratory of Adaptation to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Cayque Brietzke
- Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Flávio Oliveira Pires
- Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Gareth N. Sandford
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand,High Performance Sport New Zealand, Auckland, New Zealand,Athletics New Zealand, Auckland, New Zealand
| | - Simon Pearson
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand,Queensland Academy of Sport, Nathan, Australia
| | - Andrew E. Kilding
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Angus Ross
- High Performance Sport New Zealand, Auckland, New Zealand,Athletics New Zealand, Auckland, New Zealand
| | - Paul B. Laursen
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand,High Performance Sport New Zealand, Auckland, New Zealand
| | - Anderson Luiz B. da Silveira
- Laboratory of Physiology and Human Performance, Department of Physical Education and Sports, Federal Rural University of Rio de Janeiro, Brazil
| | - Emerson Lopes Olivares
- Laboratory of Cardiovascular Physiology and Pharmacology, Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Brazil
| | - Fernando de Azevedo Cruz Seara
- Laboratory of Cardiac Electrophysiology, Carlos Chagas Filho Department of Biophysics, Federal University of Rio de Janeiro, Brazil
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Sprick JD, Rickards CA. Combining remote ischemic preconditioning and aerobic exercise: a novel adaptation of blood flow restriction exercise. Am J Physiol Regul Integr Comp Physiol 2017; 313:R497-R506. [PMID: 28835447 PMCID: PMC5792145 DOI: 10.1152/ajpregu.00111.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 11/22/2022]
Abstract
Remote ischemic preconditioning (RIPC) can attenuate tissue damage sustained by ischemia-reperfusion injury. Blood flow restriction exercise (BFRE) restricts blood flow to exercising muscles. We implemented a novel approach to BFRE with cyclical bouts of blood flow restriction-reperfusion, reflecting the RIPC model. A concern about BFRE, however, is potential amplification of the exercise pressor reflex, which could be unsafe in at-risk populations. We hypothesized that cyclical BFRE would elicit greater increases in sympathetic outflow and arterial pressure than conventional exercise (CE) when performed at the same relative intensity. We also assessed the cerebrovascular responses due to potential implementation of BFRE in stroke rehabilitation. Fourteen subjects performed treadmill exercise at 65-70% maximal heart rate with and without intermittent BFR (4 × 5-min intervals of bilateral thigh-cuff pressure followed by 5-min reperfusion periods). Mean arterial pressure (MAP), plasma norepinephrine (NE), and middle and posterior cerebral artery velocities (MCAv and PCAv) were compared between trials. As expected, BFRE elicited higher concentration NE compared with CE (1249 ± 170 vs. 962 ± 114 pg/ml; P = 0.06). Unexpectedly, however, there were no differences in MAP between conditions (overall P = 0.33), and MAP was 4-5 mmHg lower with BFRE versus CE during the reperfusion periods (P ≤ 0.05 for reperfusion periods 3 and 4). There were no differences in MCAv or PCAv between trials (P ≥ 0.22), suggesting equivalent cerebrometabolic demand. The exaggerated sympathoexcitatory response with BFRE was not accompanied by higher MAP, likely because of the cyclical reperfusions. This cyclical BFRE paradigm could be adapted to cardiac or stroke rehabilitation, where exercising patients could benefit from the cardio and cerebro protection associated with RIPC.
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Affiliation(s)
- Justin D Sprick
- Institute for Cardiovascular and Metabolic Diseases, University of North Texas Health Science Center, Fort Worth, Texas
| | - Caroline A Rickards
- Institute for Cardiovascular and Metabolic Diseases, University of North Texas Health Science Center, Fort Worth, Texas
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