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Pişkin NE, Yavuz G, Aktuğ ZB, Aldhahi MI, Al-Mhanna SB, Gülü M. The Effect of Combining Blood Flow Restriction with the Nordic Hamstring Exercise on Hamstring Strength: Randomized Controlled Trial. J Clin Med 2024; 13:2035. [PMID: 38610800 PMCID: PMC11012977 DOI: 10.3390/jcm13072035] [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: 02/06/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: It is a matter of curiosity what effect the blood flow restriction (BFR) method, which is usually combined with low-intensity resistance exercises, will have when used with high-intensity eccentric exercises. (2) Methods: The present study examined the effects of combining BFR with nordic hamstring exercises (NHEs) on hamstring muscle strength, bilateral deficit (BLD), and training volume. Thirty young female volleyball players, who trained three times a week, participated voluntarily in the study. These players were stratified into three groups, each comprising ten individuals: a control group (CG), an NHE group, and an NHE + BFR group. Hamstring muscle strength and BLD values were determined using an H-BORD device, while training volume was measured in terms of sets and repetitions. (3) Results: Statistical analysis revealed that there were no statistically significant differences in non-dominant and dominant leg peak torque parameters in the exercise groups (F = 2.65; p = 0.097; ηp2 = 0.17; F = 1.15; p = 0.0334; ηp2 = 0.084), while the total training volume was lower in the NHE + BFR group. (4) Conclusions: As a result, it was seen that adding the BFR method to NHE did not provide additional gains. However, due to the low training volume of BFR + NHE, it may be recommended to apply BFR together with NHE to athlete groups.
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Affiliation(s)
- Necdet Eray Pişkin
- Department of Movement and Training Sciences, Faculty of Sports Sciences, Nigde Omer Halisdemir University, Niğde 51240, Türkiye;
| | - Gönül Yavuz
- Department of Physical Education and Sports, Faculty of Sports Sciences, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Türkiye;
| | - Zait Burak Aktuğ
- Department of Physical Education and Sports, Faculty of Sports Sciences, Nigde Omer Halisdemir University, Niğde 51240, Türkiye;
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Sameer Badri Al-Mhanna
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale 71450, Türkiye
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Hammert WB, Moreno EN, Martin CC, Jessee MB, Buckner SL. Skeletal Muscle Adaptations to High-Load Resistance Training With Pre-Exercise Blood Flow Restriction. J Strength Cond Res 2023; 37:2381-2388. [PMID: 37535935 DOI: 10.1519/jsc.0000000000004553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
ABSTRACT Hammert, WB, Moreno, EN, Martin, CC, Jessee, MB, and Buckner, SL. Skeletal muscle adaptations to high-load resistance training with pre-exercise blood flow restriction. J Strength Cond Res 37(12): 2381-2388, 2023-This study aimed to determine if blood flow restriction (BFR) could augment adaptations to a high-load training protocol that was inadequate for muscle growth. Forty nontrained individuals had each arm assigned to 1 of 3 elbow flexion protocols: (a) high-load resistance training [TRAD; 4 sets to muscular failure at 70% 1 repetition maximum (1RM)], (b) low repetition high-load resistance training with pre-exercise BFR (PreBFR; 4 sets of 3 repetitions at 70% 1RM + 3 min of pre-exercise BFR), and (c) low repetition high-load resistance training (LRTRAD); 4 sets of 3 repetitions at 70% 1RM). Muscle thickness (MT), 1RM strength, and local muscular endurance (LME) of the elbow flexors were measured before and after 8 weeks. An alpha level of 0.05 was used for all comparisons. For the 50% site, MT increased for TRAD (0.211 cm, 95% confidence interval [95% CI]: 0.143-0.280), PreBFR (0.105 cm, 95% CI: 0.034-0.175), and LRTRAD (0.073 cm, 95% CI: 0.000-0.146). The change for TRAD was greater than PreBFR and LRTRAD. For the 60% site, MT increased for TRAD (0.235 cm, 95% CI: 0.153-0.317), PreBFR (0.097 cm, 95% CI: 0.014-0.180), and LRTRAD (0.082 cm, 95% CI: 0.000-0.164). The change for TRAD was greater than PreBFR and LRTRAD. For the 70% site MT increased for TRAD (0.308 cm, 95% CI: 0.247-0.369), PreBFR (0.103 cm, 95% CI: 0.041-0.166), and LRTRAD (0.070 cm, 95% CI: 0.004-0.137). The change for TRAD was greater than PreBFR and LRTRAD. One repetition maximum and LME significantly increased for each condition, with no differences between conditions. Collapsed across conditions 1RM strength increased 2.094 kg (95% CI: 1.771-2.416) and LME increased 7.0 repetitions (95% CI: 5.7-8.3). In conclusion, the application of BFR to low-repetition, high-load training did not enhance the adaptative response.
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Affiliation(s)
- William B Hammert
- Department of Educational and Psychological Studies, USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida; and
| | - Enrique N Moreno
- Department of Educational and Psychological Studies, USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida; and
| | - Cole C Martin
- Department of Educational and Psychological Studies, USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida; and
| | - Matthew B Jessee
- Department of Health, Exercise Science and Recreation Management, Applied Human Health and Physical Function Laboratory, University of Mississippi, Oxford, Mississippi
| | - Samuel L Buckner
- Department of Educational and Psychological Studies, USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida; and
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Scott BR, Girard O, Rolnick N, McKee JR, Goods PSR. An Updated Panorama of Blood-Flow-Restriction Methods. Int J Sports Physiol Perform 2023; 18:1461-1465. [PMID: 37777193 DOI: 10.1123/ijspp.2023-0135] [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: 04/06/2023] [Revised: 08/04/2023] [Accepted: 09/01/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Exercise with blood-flow restriction (BFR) is being increasingly used by practitioners working with athletic and clinical populations alike. Most early research combined BFR with low-load resistance training and consistently reported increased muscle size and strength without requiring the heavier loads that are traditionally used for unrestricted resistance training. However, this field has evolved with several different active and passive BFR methods emerging in recent research. PURPOSE This commentary aims to synthesize the evolving BFR methods for cohorts ranging from healthy athletes to clinical or load-compromised populations. In addition, real-world considerations for practitioners are highlighted, along with areas requiring further research. CONCLUSIONS The BFR literature now incorporates several active and passive methods, reflecting a growing implementation of BFR in sport and allied health fields. In addition to low-load resistance training, BFR is being combined with high-load resistance exercise, aerobic and anaerobic energy systems training of varying intensities, and sport-specific activities. BFR is also being applied passively in the absence of physical activity during periods of muscle disuse or rehabilitation or prior to exercise as a preconditioning or performance-enhancement technique. These various methods have been reported to improve muscular development; cardiorespiratory fitness; functional capacities; tendon, bone, and vascular adaptations; and physical and sport-specific performance and to reduce pain sensations. However, in emerging BFR fields, many unanswered questions remain to refine best practice.
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Affiliation(s)
- Brendan R Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Center for Healthy Aging, Murdoch University, Perth, WA, Australia
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, New York, NY, USA
| | - James R McKee
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Paul S R Goods
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Center for Healthy Aging, Murdoch University, Perth, WA, Australia
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Wang Y, Li Z, Tongtong C, Zhang W, Li X. Effect of continuous and intermittent blood flow restriction deep-squat training on thigh muscle activation and fatigue levels in male handball players. Sci Rep 2023; 13:19152. [PMID: 37932313 PMCID: PMC10628241 DOI: 10.1038/s41598-023-44523-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023] Open
Abstract
We aimed to investigate acute changes before and after low-intensity continuous and intermittent blood flow restriction (BFR) deep-squat training on thigh muscle activation characteristics and fatigue level under suitable individual arterial occlusion pressure (AOP). Twelve elite male handball players were recruited. Continuous (Program 1) and intermittent (Program 2) BFR deep-squat training was performed with 30% one-repetition maximum load. Program 1 did not include decompression during the intervals, while Program 2 contained decompression during each interval. Electromyography (EMG) was performed before and after two BFR training programs in each period. EMG signals of the quadriceps femoris, posterior femoral muscles, and gluteus maximus, including the root mean square (RMS) and normalized RMS and median frequency (MF) values of each muscle group under maximum voluntary contraction (MVC), before and after training were calculated. The RMS value under MVC (RMSMVC) of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and gluteus maximus (GM) decreased after continuous and intermittent BFR training programs, and those of the biceps femoris (BF) and semitendinosus (SEM) increased; The RMS standard values of the VL, BF, and SEM were significantly increased after continuous and intermittent BFR training (P < 0.05), The RMS value of GM significantly decreased after cuff inflating (P < 0.05). The MF values of RF, VM, VL, and GM decreased significantly after continuous BFR training (P < 0.05). Continuous BFR deep-squat training applied at 50% AOP was more effective than the intermittent BFR training program. Continuous application of BFR induces greater levels of acute fatigue than intermittent BFR that may translate into greater muscular training adaptations over time.
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Affiliation(s)
- Yan Wang
- Department of Physical Education Teaching and Research, Fuzhou University, Fuzhou, 350108, Fujian, China
| | - Zhiyuan Li
- Department of Public Physical and Art Education, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
| | - Che Tongtong
- School of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Wenjuan Zhang
- Department of Military Theory, Fuzhou University, Fuzhou, 350108, Fujian, China.
| | - Xiaoxiao Li
- Department of Military Theory, Fuzhou University, Fuzhou, 350108, Fujian, China
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Vehrs PR, Johnson AW. Commentary: Is there a minimum effective dose for vascular occlusion during blood flow restriction training? Front Physiol 2023; 14:1279435. [PMID: 37849976 PMCID: PMC10577197 DOI: 10.3389/fphys.2023.1279435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Pat R. Vehrs
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
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García-Sillero M, Maroto-Izquierdo S, Galván-García M, Benitez-Porres J, Vargas-Molina S, Jurado-Castro JM. Acute Effects of Blood Flow Restriction Training on Movement Velocity and Neuromuscular Signal during the Back Squat Exercise. J Clin Med 2023; 12:4824. [PMID: 37510938 PMCID: PMC10381307 DOI: 10.3390/jcm12144824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/30/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back squat exercise. METHODS Twenty-four university students participated in this study. In two randomized sessions 72 h apart, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity (MPV), peak concentric velocity (Vmax), and the effort index (EI)). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. RESULTS The BFR condition showed higher (p < 0.05) EI, peak, and rooted mean square normalized EMG in Set 1 compared to Set 2. Similar MPV and Vmax were observed in each set for both the BFR and control conditions. No significant differences were observed between conditions in any set. CONCLUSIONS BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less excitation of the muscles involved.
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Affiliation(s)
- Manuel García-Sillero
- Physical Education and Sport, Faculty of Medicine, EADE-University of Wales Trinity Saint David, 29018 Malaga, Spain
| | - Sergio Maroto-Izquierdo
- Department of Health Sciences, European University Miguel de Cervantes (UEMC), 47012 Valladolid, Spain
| | - María Galván-García
- Physical Education and Sport, Faculty of Medicine, EADE-University of Wales Trinity Saint David, 29018 Malaga, Spain
| | - Javier Benitez-Porres
- Physical Education and Sport, Faculty of Medicine, University of Málaga, 29016 Málaga, Spain
| | - Salvador Vargas-Molina
- Physical Education and Sport, Faculty of Medicine, EADE-University of Wales Trinity Saint David, 29018 Malaga, Spain
| | - Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Ciencias De La Actividad Física y El Deporte, Escuela Universitaria de Osuna (Centro Adscrito a la Universidad de Sevilla), 41640 Osuna, Spain
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Rolnick N, Kamis O. Important Methodological Concern Regarding the Article "Effect of Leg Half-Squat Training With Blood Flow Restriction Under Different External Loads on Strength and Vertical Jumping Performance in Well-Trained Volleyball Players": A Letter to the Editor. Dose Response 2023; 21:15593258231173494. [PMID: 37123605 PMCID: PMC10141283 DOI: 10.1177/15593258231173494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/14/2023] [Indexed: 05/02/2023] Open
Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, USA
- Nicholas Rolnick, Department of Health Sciences,
250 Bedford Park Boulevard W, Bronx, NY 10468, USA.
| | - Okan Kamis
- Institute of Health Sciences, Gazi University Ankara, Ankara, Türkiye
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Li S, Wang P, Xin X, Zhou X, Wang J, Zhao J, Wang X. The Effect of Low Intensity Resistance Training with Blood Flow Restriction on Fall Resistance in Middle-Aged and Older Adults: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4723. [PMID: 36981632 PMCID: PMC10049074 DOI: 10.3390/ijerph20064723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To systematically evaluate the effect of low intensity resistance training with blood flow restriction on fall resistance in middle-aged and older adults. METHODS PubMed, The Cochrane Library, Web of Science, Embase, EBSCO host, CNKI Database, VIP, Wanfang Database and CBMdisc were searched, and the retrieval period was from the beginning of each database to 25 July 2022. Randomized controlled trials were collected concerning the intervention of low intensity resistance training with blood flow restriction on lower limb muscle strength, muscle mass, muscle function, balance, walking and other fall resistance indicators in middle-aged and older adults. Cochrane Risk of Bias Tool was used for methodological quality assessment of the included literature. Statistical analysis was performed using RevMan 5.4 software and Stata 15.1. RESULTS A total of 14 randomized controlled trials (419 participants in total) were included in the study. Meta-analysis results revealed that low intensity resistance training with blood flow restriction significantly improved lower limb muscle strength (SMD = 0.51, 95%CI: [0.28, 0.74], p < 0.0001), lower limb muscle mass (MD = 1.99, 95%CI: [0.77, 3.22], p = 0.001) and walking ability (SMD = -0.89, 95% CI. [-1.71, -0.06], p = 0.03), while there was no apparent intervention effect on lower limb muscle function (SMD = 0.25, 95%CI: [-0.23, 0.73], p = 0.31) and balance (SMD = 0.22, 95%CI: [-0.08, 0.52], p = 0.15). The results of subgroup analysis showed that the intervention effect of low intensity resistance training with blood flow restriction on lower limb muscle strength was more significant in subjects aged 55-64 years, with exercise cycles of 4-8 weeks, exercise frequency of three times per week, exercise intensity of 20-30% 1RM, and vascular flow blocking pressure ≥ 120 mmHg. CONCLUSION Low intensity resistance training with blood flow restriction can effectively improve lower limb muscle strength, muscle mass and walking ability in middle-aged and older adults, and can serve as an important form of fall resistance training for the older adults.
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Affiliation(s)
- Shufan Li
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Peng Wang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Xin Xin
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Xiaojing Zhou
- Department of Sports and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Jing Wang
- Department of Sports and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Jinlei Zhao
- Department of Sports and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Xing Wang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
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9
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Moreno EN, Hammert WB, Martin CC, Buckner SL. Acute muscular and cardiovascular responses to high load training with pre-exercise blood flow restriction. Clin Physiol Funct Imaging 2023; 43:109-119. [PMID: 36401343 DOI: 10.1111/cpf.12799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study is to examine the acute muscular and cardiovascular responses to applying blood flow restriction (BFR) before high-load training. METHODS Forty trained individuals visited the lab on three occasions. On Visit 1, participants completed paperwork and performed strength assessments. During Visits 2 and 3, participants completed four exercise conditions (one in each arm during each visit) as follows: (1) traditional resistance training (TRAD), (2) low load training with BFR (LLBFR), (3) low repetition high load training with pre-exercise BFR (PreBFR), and (4) low repetition traditional training (LRTRAD). Blood pressure, muscle thickness (MT), and isometric strength (ISO) were measured before and after exercise. RESULTS Data are displayed as means (SD). Immediately following exercise, MT in TRAD was greater compared with PreBFR (mean difference = 0.18[0.30] cm, p < 0.001) and LRTRAD (mean difference = 0.28[0.30] cm, p < 0.001). In addition, LLBFR demonstrated greater MT compared with PreBFR (mean difference = 0.24[0.30] cm, p < 0.001]. Immediately following exercise, ISO was lower in TRAD compared with PreBFR (mean difference = 33.8[46.9]N, p < 0.001) and the LRTRAD condition (mean difference = 32.8[50.4]N, p < 0.001). In addition, ISO was lower in LLBFR compared with PreBFR (mean difference = 43.9 [47.4]N, p < 0.001) and LRTRAD (mean difference = 42.9 [43.8]N, p < 0.001). Immediately following exercise, systolic blood pressure was greater in TRAD compared with PreBFR and LRTRAD. CONCLUSION The application of BFR before engaging in high-load training does not seem to augment the muscular responses to exercise when compared with traditional high loads alone; however, it may pose less demand on the cardiovascular system.
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Affiliation(s)
- Enrique N Moreno
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - William B Hammert
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - Cole C Martin
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
| | - Samuel L Buckner
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, Florida, USA
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Rolnick N, Kimbrell K, de Queiros V. Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice-A review of the current state of the research. Front Physiol 2023; 14:1089065. [PMID: 37064884 PMCID: PMC10099250 DOI: 10.3389/fphys.2023.1089065] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Training with blood flow restriction (BFR) has been shown to be a useful technique to improve muscle hypertrophy, muscle strength and a host of other physiological benefits in both healthy and clinical populations using low intensities [20%-30% 1-repetition maximum (1RM) or <50% maximum oxygen uptake (VO2max)]. However, as BFR training is gaining popularity in both practice and research, there is a lack of awareness for potentially important design characteristics and features associated with BFR cuff application that may impact the acute and longitudinal responses to training as well as the safety profile of BFR exercise. While cuff width and cuff material have been somewhat addressed in the literature, other cuff design and features have received less attention. This manuscript highlights additional cuff design and features and hypothesizes on their potential to impact the response and safety profile of BFR. Features including the presence of autoregulation during exercise, the type of bladder system used, the shape of the cuff, the set pressure versus the interface pressure, and the bladder length will be addressed as these variables have the potential to alter the responses to BFR training. As more devices enter the marketplace for consumer purchase, investigations specifically looking at their impact is warranted. We propose numerous avenues for future research to help shape the practice of BFR that may ultimately enhance efficacy and safety using a variety of BFR technologies.
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Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, NY, United States
- *Correspondence: Nicholas Rolnick,
| | - Kyle Kimbrell
- Owens Recovery Science, San Antonio, TX, United States
| | - Victor de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), NatalRN, Brazil
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11
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Yang Q, He XJ, Li YD, Zhang YZ, Ding CS, Li GX, Sun J. Dose-response relationship of blood flow restriction training on isometric muscle strength, maximum strength and lower limb extensor strength: A meta-analysis. Front Physiol 2022; 13:1046625. [PMID: 36589415 PMCID: PMC9800008 DOI: 10.3389/fphys.2022.1046625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
Objective: To perform a meta-analysis on the efficacy and dose-response relationship of blood flow restriction training on muscle strength reported worldwide. Methods: Thirty-four eligible articles with a total sample size of 549 participants were included in the meta-analysis. This study was performed using the method recommended by the Cochrane Handbook (https://training.cochrane.org/handbook), and the effect size was estimated using the standardized mean difference (SMD) and using RevMan 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014). Results: The meta-analysis showed that blood flow restriction training increased the lower limb extensor muscle strength [SMD = 0.72, 95%; confidence interval (CI): 0.43 to 1.00, p < 0.01], knee extensor isokinetic torque SMD = 0.48 [95% CI: 0.24 to 0.73, p < 0.01], knee flexor isokinetic torque SMD = 0.39 [95% CI: 0.11 to 0.67, p < 0.01], and squat one-repetition maximum [SMD = 0.28, 95% CI: 0.01 to 0.55, p < 0.01]. There was no publication bias. Evaluation of dose-response relationship showed that the training load, mode, frequency, duration, and maximum cuff pressure affected the muscle function. Conclusion: blood flow restriction training. 16 significantly improved lower limb muscle strength, and the optimal training conditions consisted of a weight load smaller or equal to 30% of one-repetition maximum, training duration longer than 4 weeks, frequency of more than 3 times/week, and maximum cuff pressure lower than 200 mmHg. Systematic Review Registration: website, identifier registration number.
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Affiliation(s)
| | | | | | | | | | | | - Jian Sun
- *Correspondence: Guo Xing Li, ; Jian Sun,
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12
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Effects of Blood Flow Restriction Therapy for Muscular Strength, Hypertrophy, and Endurance in Healthy and Special Populations: A Systematic Review and Meta-Analysis. Clin J Sport Med 2022; 32:531-545. [PMID: 36083329 DOI: 10.1097/jsm.0000000000000991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Blood flow restriction (BFR) training is an increasingly applied tool with potential benefits in muscular hypertrophy, strength, and endurance. This study investigates the effectiveness of BFR training relative to other forms of training on muscle strength, hypertrophy, and endurance. DATA SOURCES We performed systematic searches of MEDLINE, Embase, and PubMed and assessed the methodological quality of included studies using the Cochrane risk of bias tool. MAIN RESULTS We included 53 randomized controlled trials with 31 included in meta-analyses. For muscular strength comparing low-intensity BFR (LI-BFR) training with high-intensity resistance training (HIRT), the pooled mean difference (MD) for 1 repetition maximum was 5.34 kg (95% CI, 2.58-8.09; P < 0.01) favoring HIRT. When comparing LI-BFR training with HIRT for torque, the MD was 6.35 N·m (95% CI, 0.5-12.3; P = 0.04) also favoring HIRT. However, comparing LI-BFR with low-intensity resistance training (LIRT) for torque, there was a MD of 9.94 N·m (95% CI, 5.43-14.45; P < 0.01) favoring BFR training. Assessing muscle hypertrophy, the MD in cross-sectional area was 0.96 cm2 (95% CI, 0.21-1.7; P = 0.01) favoring pooled BFR training compared with nonocclusive training. Assessing endurance, V̇o2 maximum demonstrated a greater mean increase of 0.37 mL/kg/min (95% CI, -0.97 to 3.17; P = 0.64) in BFR endurance training compared with endurance training alone. CONCLUSION Blood flow restriction training produced increases in muscular strength, hypertrophy, and endurance. Comparing LI-BFR training with HIRT, HIRT was a significantly better training modality for increasing muscle hypertrophy and strength. However, LI-BFR was superior when compared with a similar low-intensity protocol. Blood flow restriction training is potentially beneficial to those unable to tolerate the high loads of HIRT; however, better understanding of its risk to benefit ratio is needed before clinical application. LEVEL OF EVIDENCE Level 1.
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Ganzarolli Stevanatto L, Venturini Ferreira M, Bonganha V, de Souza G, Cavaglieri C, Chacon Mikahil M. Acute cardiac autonomic responses to resistance exercise with and without blood flow restriction. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Girardi FM, Guenka LC. Quadriceps strengthening by the Kaatsu Training method in women with patellofemoral pain. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22001529022022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT This is a cross-sectional, comparative, and randomized study aimed to evaluate the effects of the partial vascular occlusion technique (Kaatsu Training) associated with low load exercises in the muscle strengthening of quadriceps in women with patellofemoral pain. We evaluated 18 women with patellofemoral pain, aged from 18 to 35 years, allocated into two groups. The experimental group performed the strengthening with blood flow reduction with the aid of a sphygmomanometer, associated with low load (≅20% RM). Whereas the control group performed exercises with the same load, but without blood flow reduction. The treatment was performed three times a week for six weeks, totaling 18 sessions. We used the numerical pain rating scale (NPRS) and the anterior knee pain scale (AKPS) questionnaire for evaluation; we evaluated the muscle strength of knee extensors by the digital dynamometer. The results showed that the partial vascular occlusion technique significantly improved the values of quadriceps strength gain in the right, 6.22kg (p=0.03) and left limb, 6.98kg (p=0.04), in women with patellofemoral pain. Therefore, training with partial vascular occlusion can be useful for strengthening of the knee extensor musculature in women with patellofemoral pain who, because of the pain, have low tolerance to high load exercises for muscle strengthening. An effective, safe and cost-effective technique, which does not require an investment in a leg extension machine, since, with a cuff, low load exercises can offer significant results.
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15
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Lemos LK, Toledo Teixeira Filho CA, Biral TM, de Souza Cavina AP, Junior EP, Oliveira Damasceno SD, Vanderlei FM. Acute effects of resistance exercise with blood flow restriction on cardiovascular response: a meta-analysis. J Comp Eff Res 2022; 11:829-842. [PMID: 35712965 DOI: 10.2217/cer-2021-0272] [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: 11/21/2022] Open
Abstract
Aim: To compare the acute effects of low-load resistance training associated with blood flow restriction (LLRT-BFR) with low-load resistance training (LLRT) and high-load resistance training (HLRT) on cardiovascular outcomes in healthy individuals. Methods: This review was registered and the studies were selected using seven databases. Randomized controlled clinical trials were included that evaluated LLRT-BFR compared with LLRT and HLRT in young individuals for the cardiovascular outcomes. Results: 19 studies were included. In the comparison of LLRT-BFR with HLRT, there were significant differences for cardiac output and heart rate - with reduced values and in favor of LLRT-BFR. Conclusion: There are no greater acute effects of the addition of blood flow restriction, with the exception of the reduction in cardiac output and heart rate for LLRT-BFR compared with HLRT.
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Affiliation(s)
- Leonardo Kesrouani Lemos
- Postgraduate Program in Physiotherapy, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | | | - Taíse Mendes Biral
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | | | - Eduardo Pizzo Junior
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | - Silas de Oliveira Damasceno
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
| | - Franciele Marques Vanderlei
- Postgraduate Program in Movement Sciences, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil.,Department of Physiotherapy, Universidade Estadual Paulista (FCT/UNESP), Presidente Prudente, SP, Brazil
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16
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Girardi FM, Guenka LC. Fortalecimento do quadríceps através do método Kaatsu Training em mulheres com dor femoropatelar. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22001529022022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Este é um estudo transversal, comparativo e randomizado, cujo objetivo foi avaliar os efeitos da técnica de oclusão vascular parcial (Kaatsu Training) associada a exercícios de baixa carga no fortalecimento muscular de quadríceps em mulheres com dor femoropatelar. Foram avaliadas 18 mulheres com dor femoropatelar, com idade entre 18 e 35 anos, que foram alocadas em dois grupos. O grupo experimental realizou fortalecimento com redução do fluxo sanguíneo por meio de um esfigmomanômetro, associado com baixa carga (≅20% RM). Enquanto o grupo-controle realizou exercícios com a mesma carga, porém sem redução do fluxo sanguíneo. O tratamento foi realizado três vezes na semana, em um período de seis semanas, totalizando 18 sessões. Para avaliação foram utilizadas a escala numérica de avaliação da dor (NPRS) e o questionário anterior knee pain scale (AKPS); a força muscular de extensores do joelho foi avaliada através do dinamômetro digital. Os resultados mostraram que a técnica de oclusão vascular parcial provocou melhorias significativas nos valores de ganho de força do quadríceps no membro direito, 6,22kg (p=0,03), e esquerdo, 6,98kg (p=0,04), em mulheres com dor femoropatelar. Portanto, treinamento com oclusão vascular parcial pode ser uma alternativa útil para ganho de força da musculatura extensora do joelho em mulheres com dor femoropatelar que, devido à dor, tenham baixa tolerância a exercícios de alta carga para fortalecimento muscular, sendo uma técnica eficaz, segura e com boa relação de custo-benefício, não necessitando a compra de uma cadeira extensora, uma vez que utilizando um manguito é possível obter resultados significativos associados a exercícios de baixa carga.
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17
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Wang J, Fu H, QiangZhang, Zhang M, Fan Y. Effect of Leg Half-Squat Training With Blood Flow Restriction Under Different External Loads on Strength and Vertical Jumping Performance in Well-Trained Volleyball Players. Dose Response 2022; 20:15593258221123673. [PMID: 36158741 PMCID: PMC9500279 DOI: 10.1177/15593258221123673] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/16/2022] [Indexed: 12/04/2022]
Abstract
Purpose To examine the effect of blood flow restriction resistance training under different external loads on the muscle strength and vertical jumping performance in volleyball players. Methods 18 well-trained collegiate male volleyball players were randomly divided into 3 groups: high-load resistance training group (HL-RT, 70% 1RM, n = 6), low-load blood flow restriction resistance training group (LL-BFR-RT, 30% 1RM, 50% arterial occlusion, n = 6), and high-load blood flow restriction resistance training group (HL-BFR-RT, 70% 1RM, 50% arterial occlusion, n = 6). Participants performed leg half-squat exercise 3 times per week for 8 weeks. Measurements of Isokinetic peak torque of knee extension and flexion, 1RM leg half-squat, squat jump, and 3 footed take-off were obtained before and after training. A two-way repeated-measures analysis of variance was used to examine differences among the 3 groups and between the 2 testing time (pre-test vs post-test). Results (1) The HL-RT group was significantly greater in muscle strength than that in the LL-BFR-RT group (P < .05), but no improvement in vertical jumping performance (P >.05). (2) Improvement in muscle strength and vertical jumping performance was significantly greater in the HL-BFR-RT group than that in the LL-BFR-RT group (P <.05). (3) The HL-BFR-RT group had greater but not significant improvement in muscle strength and vertical jumping performance than that in the HL-RT group. Conclusions Although increases in muscle strength were observed between training groups, HL-BFR-RT increased not only muscle strength but vertical jumping performance to a greater extent compared to LL-BFR-RT and HL-RT.
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Affiliation(s)
- Jiaoqin Wang
- Capital University of Physical Education and Sports, Beijing, China
| | - Honghao Fu
- School of Physical Education, Huazhong University of Science and Technology, Wuhan, China
| | - QiangZhang
- Capital University of Physical Education and Sports, Beijing, China
| | - Ming Zhang
- Beijing Sport University, Beijing, China
| | - Yongzhao Fan
- Capital University of Physical Education and Sports, Beijing, China
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18
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Das A, Paton B. Is There a Minimum Effective Dose for Vascular Occlusion During Blood Flow Restriction Training? Front Physiol 2022; 13:838115. [PMID: 35464074 PMCID: PMC9024204 DOI: 10.3389/fphys.2022.838115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background Blood flow restriction (BFR) training at lower exercise intensities has a range of applications, allowing subjects to achieve strength and hypertrophy gains matching those training at high intensity. However, there is no clear consensus on the percentage of limb occlusion pressure [%LOP, expressed as a % of the pressure required to occlude systolic blood pressure (SBP)] and percentage of one repetition max weight (%1RM) required to achieve these results. This review aims to explore what the optimal and minimal combination of LOP and 1RM is for significant results using BFR. Method A literature search using PubMed, Scopus, Wiley Online, Springer Link, and relevant citations from review papers was performed, and articles assessed for suitability. Original studies using BFR with a resistance training exercise intervention, who chose a set %LOP and %1RM and compared to a non-BFR control were included in this review. Result Twenty-one studies met the inclusion criteria. %LOP ranged from 40 to 150%. %1RM used ranged from 15 to 80%. Training at 1RM ≤20%, or ≥ 80% did not produce significant strength results compared to controls. Applying %LOP of ≤50% and ≥ 80% did not produce significant strength improvement compared to controls. This may be due to a mechanism mediated by lactate accumulation, which is facilitated by increased training volume and a moderate exercise intensity. Conclusion Training at a minimum of 30 %1RM with BFR is required for strength gains matching non-BFR high intensity training. Moderate intensity training (40-60%1RM) with BFR may produce results exceeding non-BFR high intensity however the literature is sparse. A %LOP of 50-80% is optimal for BFR training.
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Affiliation(s)
- Arpan Das
- Institute of Sports, Exercise and Health, Department of Medical Sciences, University College of London, London, United Kingdom
| | - Bruce Paton
- Institute of Sports, Exercise and Health, Department of Medical Sciences, University College of London, London, United Kingdom
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19
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Freitas EDS, Karabulut M, Bemben MG. The Evolution of Blood Flow Restricted Exercise. Front Physiol 2021; 12:747759. [PMID: 34925056 PMCID: PMC8674694 DOI: 10.3389/fphys.2021.747759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022] Open
Abstract
The use of blood flow restricted (BFR) exercise has become an accepted alternative approach to improve skeletal muscle mass and function and improve cardiovascular function in individuals that are not able to or do not wish to use traditional exercise protocols that rely on heavy loads and high training volumes. BFR exercise involves the reduction of blood flow to working skeletal muscle by applying a flexible cuff to the most proximal portions of a person’s arms or legs that results in decreased arterial flow to the exercising muscle and occluded venous return back to the central circulation. Safety concerns, especially related to the cardiovascular system, have not been consistently reported with a few exceptions; however, most researchers agree that BFR exercise can be a relatively safe technique for most people that are free from serious cardiovascular disease, as well as those with coronary artery disease, and also for people suffering from chronic conditions, such as multiple sclerosis, Parkinson’s, and osteoarthritis. Potential mechanisms to explain the benefits of BFR exercise are still mostly speculative and may require more invasive studies or the use of animal models to fully explore mechanisms of adaptation. The setting of absolute resistive pressures has evolved, from being based on an individual’s systolic blood pressure to a relative measure that is based on various percentages of the pressures needed to totally occlude blood flow in the exercising limb. However, since several other issues remain unresolved, such as the actual external loads used in combination with BFR, the type of cuff used to induce the blood flow restriction, and whether the restriction is continuous or intermittent, this paper will attempt to address these additional concerns.
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Affiliation(s)
- Eduardo D S Freitas
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Murat Karabulut
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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20
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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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21
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Scarpelli MC, Bergamasco JGA, Arruda EADB, Cook SB, Libardi CA. Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report. Front Sports Act Living 2021; 3:671764. [PMID: 34240050 PMCID: PMC8257955 DOI: 10.3389/fspor.2021.671764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022] Open
Abstract
In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.
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Affiliation(s)
- Maíra Camargo Scarpelli
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - João Guilherme Almeida Bergamasco
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Estevan A de Barros Arruda
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Summer B Cook
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | - Cleiton Augusto Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
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22
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de Queiros VS, Dantas M, Neto GR, da Silva LF, Assis MG, Almeida-Neto PF, Dantas PMS, Cabral BGDAT. Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals. Medicine (Baltimore) 2021; 100:e25794. [PMID: 33950976 PMCID: PMC8104249 DOI: 10.1097/md.0000000000025794] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/15/2021] [Indexed: 01/04/2023] Open
Abstract
The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings.To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique.This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique.Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60-80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively).Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.
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Affiliation(s)
- Victor Sabino de Queiros
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Matheus Dantas
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Gabriel Rodrigues Neto
- Professional Master's in Family Health/Physical Education Coordination/Physiotherapy Coordination, Faculties of Nursing and Medicine Nova Esperança (FACENE/FAMENE), João Pessoa
| | - Luiz Felipe da Silva
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Marina Gonçalves Assis
- Bachelor of Science in Physical Education, Unifacisa University Center (UNIFACISA), Campina Grande, Paraíba, Brazil
| | - Paulo Francisco Almeida-Neto
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
| | - Paulo Moreira Silva Dantas
- Master of Science in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte
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23
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Teixeira EL, Ugrinowitsch C, de Salles Painelli V, Silva-Batista C, Aihara AY, Cardoso FN, Roschel H, Tricoli V. Blood Flow Restriction Does Not Promote Additional Effects on Muscle Adaptations When Combined With High-Load Resistance Training Regardless of Blood Flow Restriction Protocol. J Strength Cond Res 2021; 35:1194-1200. [PMID: 33900254 DOI: 10.1519/jsc.0000000000003965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Teixeira, EL, Ugrinowitsch, C, de Salles Painelli, V, Silva-Batista, C, Aihara, AY, Cardoso, FN, Roschel, H, and Tricoli, V. Blood flow restriction does not promote additional effects on muscle adaptations when combined with high-load resistance training regardless of blood flow restriction protocol. J Strength Cond Res 35(5): 1194-1200, 2021-The aim of this study was to investigate, during high-load resistance training (HL-RT), the effect of blood flow restriction (BFR) applied during rest intervals (BFR-I) and muscle contractions (BFR-C) compared with HL-RT alone (no BFR), on maximum voluntary isometric contraction (MVIC), maximum dynamic strength (one repetition maximum [1RM]), quadriceps cross-sectional area (QCSA), blood lactate concentration ([La]), and root mean square of the surface electromyography (RMS-EMG) responses. Forty-nine healthy and untrained men (25 ± 6.2 years, 178.1 ± 5.3 cm and 78.8 ± 11.6 kg) trained twice per week, for 8 weeks. One leg of each subject performed HL-RT without BFR (HL-RT), whereas the contralateral leg was randomly allocated to 1 of 2 unilateral knee extension protocols: BFR-I or BFR-C (for all protocols, 3 × 8 repetitions, 70% 1RM). Maximum voluntary isometric contraction, 1RM, QCSA, and acute changes in [La] and RMS-EMG were assessed before and after training. The measurement of [La] and RMS-EMG was performed during the control sessions with the same relative load obtained after the 1RM test, before and after training. Similar increases in MVIC, 1RM, and QCSA were demonstrated among all conditions, with no significant difference between them. [La] increased for all protocols in pre-training and post-training, but it was higher for BFR-I compared with the remaining protocols. Increases in RMS-EMG occurred for all protocols in pre-training and post-training, with no significant difference between them. In conclusion, despite of a greater metabolic stress, BFR inclusion to HL-RT during rest intervals or muscle contraction did not promote any additive effect on muscle strength and hypertrophy.
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Affiliation(s)
- Emerson Luiz Teixeira
- School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil.,Strength Training Study and Research Group, Paulista University, UNIP, São Paulo, SP, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
| | - Vitor de Salles Painelli
- Strength Training Study and Research Group, Paulista University, UNIP, São Paulo, SP, Brazil.,Exercise Neuroscience Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil; and
| | - Carla Silva-Batista
- Strength Training Study and Research Group, Paulista University, UNIP, São Paulo, SP, Brazil.,Exercise Neuroscience Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil; and
| | | | | | - Hamilton Roschel
- School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
| | - Valmor Tricoli
- School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
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24
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Linero C, Choi SJ. Effect of blood flow restriction during low-intensity resistance training on bone markers and physical functions in postmenopausal women. J Exerc Sci Fit 2021; 19:57-65. [PMID: 33293983 PMCID: PMC7683332 DOI: 10.1016/j.jesf.2020.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/20/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effects of 12-week low intensity resistance training (RT) with blood flow restriction on bone mineral density (BMD), bone turnover markers (BTM), physical functions, and blood lactate concentration in postmenopausal women with osteoporosis or osteopenia. METHODS 26 study participants (56 ± 1.8yrs, T-score: -2.5 ± 0.7) were randomly assigned into Moderate to High-Intensity RT (MHIRT, n = 7), BFR combined with Low-Intensity RT (LIBFR, n = 7), Low-Intensity RT (LIRT, n = 6), or Control group (CON, n = 6). Exercise group performed leg press, leg extension, biceps curl, and triceps extension 3 times a week for 12 weeks. Training intensity were set at 60% of 1-repetition maximum (1-RM) for MHIRT, and at 30% of 1-RM for LIBFR and LIRT, and reset every 4 weeks for increasing intensity. RESULTS Lower, and upper limb 1-RM only increased in MHIRT (65%, p < 0.001), and LIBFR (40%, p < 0.05), while LIRT only showed increment on lower limb 1-RM (28%, p < 0.05). All exercise groups demonstrated significant increment on blood lactate concentration after training session (p < 0.001). However, LIBFR showed 2.7 folds higher increment than LIRT (p < 0.001). Although no changes were observed in MHIRT, LIBFR, and LIRT, CON showed significant decrease in BMD (p < 0.05). While, LIRT showed no responses on BTM, LIBFR significantly increased bone formation markers (P1NP) about 7.05 ng/ml (p < 0.05). Lastly, balance improvement was only found in MHIRT, and LIBFR (p < 0.05). CONCLUSION 12-week LIBFR can be implied as a safe, and effective method to improve muscle strength, P1NP, and balance similar to MHIRT in postmenopausal women with osteoporosis or osteopenia.
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Affiliation(s)
- Christian Linero
- Department of Sport and Health Sciences, Kyungsung University, Busan, South Korea
| | - Seung-Jun Choi
- Department of Sport and Health Sciences, Kyungsung University, Busan, South Korea
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Rolnick N, Schoenfeld BJ. Blood Flow Restriction Training and the Physique Athlete: A Practical Research-Based Guide to Maximizing Muscle Size. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Alves TC, Santos AP, Abdalla PP, Venturini ACR, Angelotti PS, Borges FG, Reis HDO, Bollela VR, Mota J, Machado DRL. Resistance training with blood flow restriction: Impact on the muscle strength and body composition in people living with HIV/AIDS. Eur J Sport Sci 2020; 21:450-459. [PMID: 32349629 DOI: 10.1080/17461391.2020.1757765] [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] [Indexed: 10/24/2022]
Abstract
The aim of the study was to compare the impact of 12-week resistance training with blood flow restriction (GRTBFR) versus, traditional resistance training (GTRT) and non-training on the muscle strength and body composition HIV/AIDS participants. Muscle strength was tested at baseline, and on the 6th, 21st and 36th training sessions, using maximal repetition test. Pre- and post-intervention body composition changes were measured by dual-energy X-ray absorptiometry. Resistance training was undertaken three times a week comprising bilateral elbow extension and flexion exercises, unilateral flexion and bilateral knee extension. Changes in strength and body composition (pre- and post-intervention) between groups were evaluated by mixed models of repeated measures, and by paired and unpaired comparisons, considering the Effect Size. All groups were similar at baseline for muscle strength and body composition. Post-intervention, the training groups showed similar, statistically significant increases in muscle strength (GRTBFR=25.7-57.4%; GTRT=24.5-52.3%) and skeletal muscle tissue (GRTBFR=8.4%; GTRT=8.3%). There was also a significant change in body fat (p=0.023-0.043), with significant effect sizes for strength and skeletal muscle tissue (0.41-2.27), respectively. These results suggest that both resistance training interventions promoted muscle hypertrophy, body fat reduction and positive impact on muscle strength in people living with HIV/AIDS. Resistance training with blood flow restriction proved to be an effective alternative to include patients with marked physical weakness, unable to engage in regular strength training programme.ClinicalTrials.gov identifier: NCT02783417.
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Affiliation(s)
- Thiago Cândido Alves
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group.,Minas Gerais State University
| | - André P Santos
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Pedro P Abdalla
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Ana Cláudia R Venturini
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | | | - Franciane Góes Borges
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Henrique D O Reis
- Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Valdes R Bollela
- Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Dalmo R L Machado
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group.,Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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Rodrigues R, Ferraz RB, Kurimori CO, Guedes LK, Lima FR, de Sá-Pinto AL, Gualano B, Roschel H. Low-Load Resistance Training With Blood-Flow Restriction in Relation to Muscle Function, Mass, and Functionality in Women With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2020; 72:787-797. [PMID: 31033228 DOI: 10.1002/acr.23911] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/23/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate the effects of a low-load resistance training program associated with partial blood-flow restriction in patients with rheumatoid arthritis (RA). METHODS Forty-eight women with RA were randomized into 1 of 3 groups: high-load resistance training (HL-RT; 70% 1 repetition maximum [1RM]), low-load resistance training (30% 1RM) with partial blood-flow restriction training (BFRT), and a control group. Patients completed a 12-week supervised training program and were assessed for lower-extremity 1RM, quadriceps cross-sectional area (CSA), physical function (timed-stands test [TST], timed-up-and-go test [TUG], and Health Assessment Questionnaire [HAQ]), and quality of life (Short Form 36 health survey [SF-36]) at baseline and after the intervention. RESULTS BFRT and HL-RT were similarly effective in increasing maximum dynamic strength in both leg press (22.8% and 24.2%, respectively; P < 0.0001 for all) and knee extension (19.7% and 23.8%, respectively; P < 0.0001 for all). Quadriceps CSA was also significantly increased in both BFRT and HL-RT (9.5% and 10.8%, respectively; P < 0.0001 for all). Comparable improvements in TST (11.2% and 14.7%; P < 0.0001 for all) and TUG (-6.8% [P < 0.0053] and -8.7% [P < 0.0001]) were also observed in BFRT and HL-RT, respectively. Improvements in both groups were significantly greater than those of the control group (P < 0.05 for all). SF-36 role physical and bodily pain and HAQ scores were improved only in BFRT (45.7%, 22.5%, and -55.9%, respectively; P < 0.05 for all). HL-RT resulted in 1 case of withdrawal and several cases of exercise-induced pain, which did not occur in BFRT. CONCLUSION BFRT was effective in improving muscle strength, mass, function, and health-related quality of life in patients with RA, emerging as a viable therapeutic modality in RA management.
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Mendonca GV, Mouro M, Vila-Chã C, Pezarat-Correia P. Nerve conduction during acute blood-flow restriction with and without low-intensity exercise Nerve conduction and blood-flow restriction. Sci Rep 2020; 10:7380. [PMID: 32355236 PMCID: PMC7193597 DOI: 10.1038/s41598-020-64379-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/07/2020] [Indexed: 11/09/2022] Open
Abstract
Despite being apparently safe for most individuals, the impact of low intensity (LI) blood-flow restricted (BFR) exercise on nerve function and integrity is still obscure. We explored whether BFR (with and without exercise) alters the properties of nerve conduction measured at the level of the restricted limb. Thirteen healthy, young men (22.0 ± 1.7 years) were included in this study. Arterial occlusion pressure was taken at rest. Soleus M- and H-recruitment curves were constructed for all participants. H-wave latencies and amplitudes were obtained in three testing conditions (non-BFR vs. 60 vs. 80% BFR) at four different time points: [#1] non-restricted baseline, [#2] time control either with or without BFR, [#3] non-restricted pre-exercise, [#4] LI exercise either with or without BFR. Nerve conduction was estimated using the difference between the latency of H and M wave. BFR did not affect H-wave amplitude, either with or without exercise. The changes in the difference between H- and M-wave latency of over time were similar between all conditions (condition-by-time interaction: F = 0.7, p = 0.47). In conclusion, our data indicate that performing LI exercise with BFR, set at 60 or 80% BFR, does not exert a negative impact on sciatic-tibial nerve function. Thus, from a neurological standpoint, we provide preliminary evidence that LI BFR exercise may be regarded as a safe mode of resistance training in healthy young men.
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Affiliation(s)
- Goncalo V Mendonca
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal. .,CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal.
| | - Miguel Mouro
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal
| | - Carolina Vila-Chã
- Polytechnic Institute of Guarda, Av. Dr. Francisco Sá Carneiro, n. 50, Guarda, 6300-559, Portugal.,Research Center in Sports Sciences, Health and Human Development (CIDESD), Vila-Real, Portugal
| | - Pedro Pezarat-Correia
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal.,CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal
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Lima-Soares F, Pessoa KA, Torres Cabido CE, Lauver J, Cholewa J, Rossi F, Zanchi NE. Determining the Arterial Occlusion Pressure for Blood Flow Restriction: Pulse Oximeter as a New Method Compared With a Handheld Doppler. J Strength Cond Res 2020; 36:1120-1124. [PMID: 32379239 DOI: 10.1519/jsc.0000000000003628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Lima-Soares, F, Pessoa, KA, Torres Cabido, CE, Lauver, J, Cholewa, J, Rossi, FE, and Zanchi, NE. Determining the arterial occlusion pressure for blood flow restriction: pulse oximeter as a new method compared with a handheld Doppler. J Strength Cond Res XX(X): 000-000, 2020-In laboratorial and clinical settings, the use of Doppler ultrasound equipment has been considered the gold standard method to determine arterial occlusion pressure (AOP). However, the use of Doppler equipment is inherently limited to the technical expertise needed to perform AOP measurements. To overcome the technical difficulties of the use of Doppler equipment use in the determination of AOP, a simpler and less subjective methodology would be helpful for blood flow restriction (BFR) practitioners. In this regard, portable pulse oximetry has been largely used in clinical practice for measuring systolic pressures, as well as loss or recovery of pulse, with results similar to those observed with the use of Doppler equipment. For such purposes, the AOP from young male and female subjects was evaluated after different body positions (standing, seated, and supine positions). Loss of capillary blood flow or AOP was readily determined by simple visual inspection for the pulse oximeter and loss of sound for the Doppler equipment. The results presented herein strongly suggest the use of the portable pulse oximetry equipment as reliable, when compared with the handheld Doppler (seated K = 0.962, standing K = 0.845, and supine K = 0.963 and seated rs = 0.980, standing rs = 0.958, and supine rs = 0.955). Because AOP measurement by pulse oximetry is relatively easier to perform and financially more accessible than handheld Doppler equipment, BFR practitioners may benefit from this new methodology to measure AOP, thus determining individualized restriction pressures.
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Affiliation(s)
- Fernanda Lima-Soares
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Laboratory of Cellular and Molecular Biology of Skeletal Muscle (LABCEMME), São Luís, Brazil
| | - Kassiana A Pessoa
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Laboratory of Cellular and Molecular Biology of Skeletal Muscle (LABCEMME), São Luís, Brazil
| | - Christian E Torres Cabido
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Physical Exercise, Health and Human Performance Research Group, Federal University of Maranhão (UFMA), São Luís, Brazil
| | - Jakob Lauver
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina, United States
| | - Jason Cholewa
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina, United States
| | - Fabrício Rossi
- Immunometabolism of Skeletal Muscle and Exercise Research Group, Department of Physical Education, Federal University of Piauí (UFPI), Teresina-PI, Brazil
| | - Nelo E Zanchi
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Laboratory of Cellular and Molecular Biology of Skeletal Muscle (LABCEMME), São Luís, Brazil
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30
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Clarkson MJ, May AK, Warmington SA. Is there rationale for the cuff pressures prescribed for blood flow restriction exercise? A systematic review. Scand J Med Sci Sports 2020; 30:1318-1336. [PMID: 32279391 DOI: 10.1111/sms.13676] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/12/2020] [Accepted: 03/27/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Blood flow restriction exercise has increasingly broad applications among healthy and clinical populations. Ensuring the technique is applied in a safe, controlled, and beneficial way for target populations is essential. Individualized cuff pressures are a favored method for achieving this. However, there remains marked inconsistency in how individualized cuff pressures are applied. OBJECTIVES To quantify the cuff pressures used in the broader blood flow restriction exercise literature, and determine whether there is clear justification for the choice of pressure prescribed. METHODS Studies were included in this review from database searches if they employed an experimental design using original data, involved either acute or chronic exercise using blood flow restriction, and they assessed limb or arterial occlusion pressure to determine an individualized cuff pressure. Methodologies of the studies were evaluated using a bespoke quality assessment tool. RESULTS Fifty-one studies met the inclusion criteria. Individualized cuff pressures ranged from 30% to 100% arterial occlusion pressure. Only 7 out of 52 studies attempted to justify the individualized cuff pressure applied during exercise. The mean quality rating for all studies was 11.1 ± 1.2 out of 13. CONCLUSIONS The broader blood flow restriction exercise literature uses markedly heterogeneous prescription variables despite using individualized cuff pressures. This is problematic in the absence of any clear justification for the individualized cuff pressures selected. Systematically measuring and reporting all relevant acute responses and training adaptations to the full spectrum of BFR pressures alongside increased clarity around the methodology used during blood flow restriction exercise is paramount.
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Affiliation(s)
- Matthew J Clarkson
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Anthony K May
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Stuart A Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
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31
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Clarkson MJ, Brumby C, Fraser SF, McMahon LP, Bennett PN, Warmington SA. Hemodynamic and perceptual responses to blood flow-restricted exercise among patients undergoing dialysis. Am J Physiol Renal Physiol 2020; 318:F843-F850. [PMID: 32068463 DOI: 10.1152/ajprenal.00576.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
End-stage kidney disease is associated with reduced exercise capacity, muscle atrophy, and impaired muscle function. While these may be improved with exercise, single modalities of exercise do not traditionally elicit improvements across all required physiological domains. Blood flow-restricted exercise may improve all of these physiological domains with low intensities traditionally considered insufficient for these adaptions. Investigation of this technique appeals, but is yet to be evaluated, in patients undergoing dialysis. With the use of a progressive crossover design, 10 satellite patients undergoing hemodialysis underwent three exercise conditions over 2 wk: two bouts (10 min) of unrestricted cycling during two consecutive hemodialysis sessions (condition 1), two bouts of cycling with blood flow restriction while off hemodialysis on 2 separate days (condition 2), and two bouts of cycling with blood flow restriction during two hemodialysis sessions (condition 3). Outcomes included hemodynamic responses (heart rate and blood pressure) throughout all sessions, participant-perceived exertion and discomfort on a Borg scale, and evaluation of ultrafiltration rates and dialysis adequacy (Kt/V) obtained post hoc. Hemodynamic responses were consistent regardless of condition. Significant increases in heart rate, systolic blood pressure, and mean arterial blood pressure (P < 0.05) were observed postexercise followed by a reduction in blood pressures during the 60-min recovery (12, 5, and 11 mmHg for systolic, diastolic, and mean arterial pressures, respectively). Blood pressures returned to predialysis ranges following the recovery period. Blood flow restriction did not affect ultrafiltration achieved or Kt/V. Hemodynamic safety and tolerability of blood flow restriction during aerobic exercise on hemodialysis is comparable to standard aerobic exercise.
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Affiliation(s)
- Matthew J Clarkson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Catherine Brumby
- Department of Renal Medicine, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Lawrence P McMahon
- Department of Renal Medicine, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Paul N Bennett
- Medical and Clinical Affairs, Satellite Healthcare, Adelaide, South Australia, Australia.,School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Stuart A Warmington
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Hwang PS, Willoughby DS. Mechanisms Behind Blood Flow-Restricted Training and its Effect Toward Muscle Growth. J Strength Cond Res 2019; 33 Suppl 1:S167-S179. [PMID: 30011262 DOI: 10.1519/jsc.0000000000002384] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hwang, P and Willoughby, DS. Mechanisms behind blood flow-restricted training and its effect toward muscle growth. J Strength Cond Res 33(7S): S167-S179, 2019-It is widely established throughout the literature that skeletal muscle can induce hypertrophic adaptations after progressive overload of moderate-to-high-intensity resistance training. However, there has recently been a growing body of research that shows that the combination of blood flow-restricted (BFR) training with low-intensity resistance exercise can induce similar gains in muscular strength and hypertrophic adaptations. The implementation of external pressure cuffs over the most proximal position of the limb extremities with the occlusion of venous outflow of blood distal to the occlusion site defines the BFR training protocol. There are various mechanisms through which BFR training may cause the stimulations for skeletal muscle hypertrophy and increases in strength. These may include increases in hormonal concentrations, increases within the components of the intracellular signaling pathways for muscle protein synthesis such as the mTOR pathway, increases within biomarkers denoting satellite cell activity and apparent patterns in fiber type recruitment. There have also been scientific findings demonstrating hypertrophic effects within both BFR limbs and non-BFR muscles during BFR training programs. The purpose behind this critical review will be to provide a comprehensive discussion on relevant literature that can help elucidate the potential underlying mechanisms leading to hypertrophic adaptations after BFR training programs. This review will also explicate the various findings within the literature that focalizes on both BFR limb and non-BFR muscle hypertrophy after bouts of BFR training. Furthermore, this critical review will also address the various needs for future research in the many components underlying the novel modality of BFR training.
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Affiliation(s)
- Paul S Hwang
- Department of Health, Human Performance, and Recreation, Exercise and Biochemical Nutrition Laboratory, Baylor University, Waco, Texas
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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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Crossley KW, Porter DA, Ellsworth J, Caldwell T, Feland JB, Mitchell U, Johnson AW, Egget D, Gifford JR. Effect of Cuff Pressure on Blood Flow during Blood Flow-restricted Rest and Exercise. Med Sci Sports Exerc 2019; 52:746-753. [PMID: 31568024 DOI: 10.1249/mss.0000000000002156] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE This study investigated the relationship between blood flow restriction (BFR) cuff pressure and blood flow at rest and during exercise, with the aim of determining if lower cuff pressures will provide an ischemic stimulus comparable to higher pressures. METHODS The relationship between blood flow and cuff pressure at rest was determined by measuring blood flow (Doppler Ultrasound) through the superficial femoral artery (SFA) in 23 adults across a range of pressures (0%-100% Arterial Occlusion Pressure at rest [rAOP]). The interplay between cuff pressure, blood flow and exercise was assessed by determining AOP at rest and during plantar flexion exercise (eAOP) and subsequently measuring the blood flow response to plantar flexion exercise with BFR cuff pressure set to either 40% rAOP or 40% eAOP. RESULTS At rest, a nonlinear relationship between cuff pressure and blood flow through the SFA exhibited a plateau at moderate pressures, with nonsignificant differences in blood flow (~9%, P = 1.0) appearing between pressures ranging from 40% to 80% rAOP. While eAOP was greater than rAOP (229 ± 1.5 mm Hg vs 202 ± 1.5 mm Hg, P < 0.01), blood flow during plantar flexion exercise did not significantly differ (P = 0.49) when applying 40% rAOP or 40% eAOP. CONCLUSIONS Blood flow through the SFA exhibits a nonlinear relationship with cuff pressure, such that cuff pressures in the range of 40% to 80% rAOP reduce blood flow to approximately the same degree. The BFR interventions opting for lower (e.g., 40% AOP), more comfortable pressures will likely provide an ischemic stimulus comparable to that of higher (80% AOP), less-comfortable pressures.
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Affiliation(s)
- Kent W Crossley
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - Doran A Porter
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - Joshua Ellsworth
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - Tabitha Caldwell
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | | | | | | | - Dennis Egget
- Department of Statistics, Brigham Young University, Provo, UT
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da Silva JCG, Silva KF, Domingos-Gomes JR, Batista GR, da Silva Freitas ED, Torres VBC, do Socorro Cirilo-Sousa M. Aerobic exercise with blood flow restriction affects mood state in a similar fashion to high intensity interval exercise. Physiol Behav 2019; 211:112677. [PMID: 31499050 DOI: 10.1016/j.physbeh.2019.112677] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/25/2019] [Accepted: 09/05/2019] [Indexed: 11/19/2022]
Abstract
We investigated the acute effects of aerobic exercise with blood flow restriction (BFR) on mood state in American football athletes. Twenty-two male American football athletes were randomly assigned to three experimental conditions: 1) aerobic exercise (AE: 40% VO2max), 2) aerobic exercise with BRF (AE + BFR: 40% VO2 max), and 3) high-intensity interval exercise (HIIE: 80% and 40% VO2max during exercise and the active intervals, respectively). Mood state and total mood disturbance (TMD) were assessed before, immediately post, and 1 h post-exerciser. Ratings of perceived exertion (RPE) were measured 30 min post-exercise. AE + BFR and HIIE significantly (p < 0.05) increased fatigue and tension compared to baseline immediately post-exercise, whereas vigor significantly (p < 0.05) decreased at the same time point for both conditions. TMD increased significantly (p < 0.05) for AE + BFR and HIIE immediately post-exercise and it remained elevated up to 1 h post-exercise for AE + BFR. AE did not significantly (p > 0.05) affect mood state or TMD and it was significantly (p < 0.05) lower than AE + BFR and HIIE. AE + BFR and HIIE also elicited significantly (p < 0.05) greater RPE levels than AE 30 min post-exercise. Therefore, AE + BFR induces acute impairments in mood state and RPE levels in a similar fashion to HIIE.
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Affiliation(s)
- Julio Cesar Gomes da Silva
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Paraíba, Brazil; Coordination of Physical Education/Professional Master's in Family Health, Nursing and Medical Schools, (FAMENE/FACENE), João Pessoa, Nova Esperança, Paraíba, Brazil; Coordination of Physical Education, Center for Higher Education and Development (CESED/UNIFACISA/FCM/ESAC), Campina Grande, Paraíba, Brazil.
| | - Kalinne Fernandes Silva
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Paraíba, Brazil
| | - Jarbas Ralison Domingos-Gomes
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Paraíba, Brazil
| | - Gilmário Ricarte Batista
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Paraíba, Brazil
| | | | - Vitor Bruno Cavalcanti Torres
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Paraíba, Brazil; Coordination of Physical Education, Center for Higher Education and Development (CESED/UNIFACISA/FCM/ESAC), Campina Grande, Paraíba, Brazil
| | - Maria do Socorro Cirilo-Sousa
- Department of Physical Education, Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Paraíba, Brazil
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Girard O, Willis SJ, Purnelle M, Scott BR, Millet GP. Separate and combined effects of local and systemic hypoxia in resistance exercise. Eur J Appl Physiol 2019; 119:2313-2325. [PMID: 31468172 DOI: 10.1007/s00421-019-04217-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/21/2019] [Indexed: 12/31/2022]
Abstract
PURPOSES This study quantified performance, physiological, and perceptual responses during resistance exercise to task failure with blood flow restriction (BFR), in systemic hypoxia, and with these stimuli combined. METHODS Fourteen young men were tested for 1-repetition maximum (1RM) in the barbell biceps curl and lying triceps extension exercises. On separate visits, subjects performed exercise trials (4 sets to failure at 70% 1RM with 90 s between sets) in six separate randomized conditions, i.e., in normoxia or hypoxia (fraction of inspired oxygen = 20.9% and 12.9%, respectively) combined with three different levels of BFR (0%, 45%, or 60% of resting arterial occlusion pressure). Muscle activation and oxygenation were monitored via surface electromyography and near-infrared spectroscopy, respectively. Arterial oxygen saturation, heart rate, and perceptual responses were assessed following each set. RESULTS Compared to set 1, the number of repetitions before failure decreased in sets 2, 3, and 4 for both exercises (all P < 0.001), independently of the condition (P > 0.065). Arterial oxygen saturation was lower with systemic hypoxia (P < 0.001), but not BFR, while heart rate did not differ between conditions (P > 0.341). Muscle oxygenation and activation during exercise trials remained unaffected by the different conditions (all P ≥ 0.206). A significant main effect of time, but not condition, was observed for overall perceived discomfort, difficulty breathing, and limb discomfort (all P < 0.001). CONCLUSION Local and systemic hypoxic stimuli, or a combination of both, did not modify the fatigue-induced change in performance, trends of muscle activation or oxygenation, nor exercise-related sensations during a multi-set resistance exercise to task failure.
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Affiliation(s)
- Olivier Girard
- Murdoch Applied Sports Science (MASS) Laboratory, Murdoch University, Perth, Australia. .,Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Sarah J Willis
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Marin Purnelle
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Brendan R Scott
- Murdoch Applied Sports Science (MASS) Laboratory, Murdoch University, Perth, Australia
| | - Grégoire P Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Shorter E, Sannicandro AJ, Poulet B, Goljanek-Whysall K. Skeletal Muscle Wasting and Its Relationship With Osteoarthritis: a Mini-Review of Mechanisms and Current Interventions. Curr Rheumatol Rep 2019; 21:40. [PMID: 31203463 PMCID: PMC6571089 DOI: 10.1007/s11926-019-0839-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose of Review Osteoarthritis (OA) is a subset of joint disorders resulting in degeneration of synovial joints. This leads to pain, disability and loss of independence. Knee and hip OA are extremely prevalent, and their occurrence increases with ageing. Similarly, loss of muscle mass and function, sarcopenia, occurs during ageing. Recent Findings Little is known about the impact of muscle wasting on OA progression; nevertheless, it has been suggested that muscle wasting directly affects the stability of the joints and loss of mobility leads to gradual degeneration of articular cartilage. The molecular mechanisms underlying muscle wasting in OA are not well understood; however, these are probably related to changes in gene expression, as well as epigenetic modifications. Summary It is becoming clear that skeletal muscle wasting plays an important role in OA development and/or progression. Here, we discuss mechanisms, current interventions, such as exercise, and potentially novel approaches, such as modulation of microRNAs, aiming at ameliorating OA symptoms through maintaining muscle mass and function.
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Affiliation(s)
- Emily Shorter
- Institute of Ageing and Chronic Disease, University of Liverpool, William Henry Duncan Building, West Derby Road, Liverpool, L7 8TX UK
| | - Anthony J Sannicandro
- Department of Physiology, School of Medicine, REMEDI, NUI Galway, Human Biology Building, University Road, Galway, Ireland
| | - Blandine Poulet
- Institute of Ageing and Chronic Disease, University of Liverpool, William Henry Duncan Building, West Derby Road, Liverpool, L7 8TX UK
| | - Katarzyna Goljanek-Whysall
- Institute of Ageing and Chronic Disease, University of Liverpool, William Henry Duncan Building, West Derby Road, Liverpool, L7 8TX UK
- Department of Physiology, School of Medicine, REMEDI, NUI Galway, Human Biology Building, University Road, Galway, Ireland
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Amani-Shalamzari S, Farhani F, Rajabi H, Abbasi A, Sarikhani A, Paton C, Bayati M, Berdejo-Del-Fresno D, Rosemann T, Nikolaidis PT, Knechtle B. Blood Flow Restriction During Futsal Training Increases Muscle Activation and Strength. Front Physiol 2019; 10:614. [PMID: 31178752 PMCID: PMC6538690 DOI: 10.3389/fphys.2019.00614] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 05/01/2019] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to investigate the effect of leg blood flow restriction (BFR) applied during a 3-a-side futsal game on strength-related parameters. Twelve male futsal players were randomly assigned into two groups (n = 6 for each group) during 10 training sessions either with or without leg BFR. Prior to and post-training sessions, participants completed a series of tests to assess anabolic hormones and leg strength. Pneumatic cuffs were initially inflated to 110% of leg systolic blood pressure and further increased by 10% after every two completed sessions. In comparison with baseline, the resting post-training levels of myostatin (p = 0.002) and IGF-1/MSTN ratio (p = 0.006) in the BFR group changed, whereas no change in the acute level of IGF-1 and myostatin after exercise was observed. Peak torque of knee extension and flexion increased in both groups (p < 0.05). A trend of increased neural activation of all heads of the quadriceps was observed in both groups, however, it was statistically significant only for rectus femoris in BFR (p = 0.02). These findings indicated that the addition of BFR to normal futsal training might induce greater neuromuscular benefits by increasing muscle activation and augmenting the hormonal response.
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Affiliation(s)
- Sadegh Amani-Shalamzari
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Farid Farhani
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Hamid Rajabi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Ali Abbasi
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Science, Kharazmi University, Tehran, Iran
| | - Ali Sarikhani
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Carl Paton
- Faculty of Health and Sport Science, Eastern Institute of Technology, Napier, New Zealand
| | - Mahdi Bayati
- Department of Exercise Physiology, Sports Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.,Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
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Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2019; 10:533. [PMID: 31156448 PMCID: PMC6530612 DOI: 10.3389/fphys.2019.00533] [Citation(s) in RCA: 287] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
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Affiliation(s)
- Stephen D. Patterson
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Luke Hughes
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jamie Burr
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada
| | - Brendan R. Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Cleiton Augusto Libardi
- MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gabriel Rodrigues Neto
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, Brazil
| | | | - Juan Martin-Hernandez
- I+HeALTH Research Group, Department of Health Sciences, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
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Biazon TMPC, Ugrinowitsch C, Soligon SD, Oliveira RM, Bergamasco JG, Borghi-Silva A, Libardi CA. The Association Between Muscle Deoxygenation and Muscle Hypertrophy to Blood Flow Restricted Training Performed at High and Low Loads. Front Physiol 2019; 10:446. [PMID: 31057426 PMCID: PMC6479177 DOI: 10.3389/fphys.2019.00446] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/01/2019] [Indexed: 01/19/2023] Open
Abstract
The metabolic stress induced by blood flow restriction (BFR) during resistance training (RT) might maximize muscle growth. However, it is currently unknown whether metabolic stress are associated with muscle hypertrophy after RT protocols with high- or low load. Therefore, the aim of the study was to compare the effect of high load RT (HL-RT), high load BFR (HL-BFR), and low load BFR (LL-BFR) on deoxyhemoglobin concentration [HHb] (proxy marker of metabolic stress), muscle cross-sectional area (CSA), activation, strength, architecture and edema before (T1), after 5 (T2), and 10 weeks (T3) of training with these protocols. Additionally, we analyzed the occurrence of association between muscle deoxygenation and muscle hypertrophy. Thirty young men were selected and each of participants’ legs was allocated to one of the three experimental protocols in a randomized and balanced way according to quartiles of the baseline CSA and leg extension 1-RM values of the dominant leg. The dynamic maximum strength was measured by 1-RM test and vastus lateralis (VL) muscle cross-sectional area CSA echo intensity (CSAecho) and pennation angle (PA) were performed through ultrasound images. The measurement of muscle activation by surface electromyography (EMG) and [HHb] through near-infrared spectroscopy (NIRS) of VL were performed during the training session with relative load obtained after the 1-RM, before (T1), after 5 (T2), and 10 weeks (T3) training. The training total volume (TTV) was greater for HL-RT and HL-BFR compared to LL-BFR. There was no difference in 1-RM, CSA, CSAecho, CSAecho/CSA, and PA increases between protocols. Regarding the magnitude of the EMG, the HL-RT and HL-BFR groups showed higher values than and LL-BFR. On the other hand, [HHb] was higher for HL-BFR and LL-BFR. In conclusion, our results suggest that the addition of BFR to exercise contributes to neuromuscular adaptations only when RT is performed with low-load. Furthermore, we found a significant association between the changes in [HHb] (i.e., metabolic stress) and increases in muscle CSA from T2 to T3 only for the LL-BFR, when muscle edema was attenuated.
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Affiliation(s)
- Thaís M P C Biazon
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Carlos Ugrinowitsch
- Escola de Educação Física e Esporte, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Samuel D Soligon
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Ramon M Oliveira
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - João G Bergamasco
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physical Therapy Department, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Cleiton A Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, Brazil
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Bjørnsen T, Wernbom M, Løvstad A, Paulsen G, D’Souza RF, Cameron-Smith D, Flesche A, Hisdal J, Berntsen S, Raastad T. Delayed myonuclear addition, myofiber hypertrophy, and increases in strength with high-frequency low-load blood flow restricted training to volitional failure. J Appl Physiol (1985) 2019; 126:578-592. [DOI: 10.1152/japplphysiol.00397.2018] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of the present study was to investigate muscle hypertrophy, strength, and myonuclear and satellite cell (SC) responses to high-frequency blood flow-restricted resistance exercise (BFRRE). Thirteen individuals [24 ± 2 yr (mean ± SD), 9 men] completed two 5-day blocks of 7 BFRRE sessions, separated by a 10-day rest period. Four sets of unilateral knee extensions to voluntary failure at 20% of one repetition maximum (1RM) were conducted with partial blood flow restriction (90–100 mmHg). Muscle samples obtained before, during, 3 days, and 10 days after training were analyzed for muscle fiber area (MFA), myonuclei, SC, and mRNA and miRNA expression. Muscle size was measured by ultrasonography and magnetic resonance imaging and strength with 1RM knee extension. With the first block of BFRRE, SC number increased in both fiber types (70%–80%, P < 0.05), whereas type I and II MFA decreased by 6 ± 7% and 15 ± 11% ( P < 0.05), respectively. With the second block of training, muscle size increased by 6%–8%, whereas the number of SCs (type I: 80 ± 63%, type II: 147 ± 95%), myonuclei (type I: 30 ± 24%, type II: 31 ± 28%), and MFA (type I: 19 ± 19%, type II: 11 ± 19%) peaked 10 days after the second block of BFRRE, whereas strength peaked after 20 days of detraining (6 ± 6%, P < 0.05). Pax7- and p21 mRNA expression were elevated during the intervention, whereas myostatin, IGF1R, MyoD, myogenin, cyclinD1 and -D2 mRNA did not change until 3–10 days postintervention. High-frequency low-load BFRRE induced robust increases in SC, myonuclei, and muscle size but modest strength gains. Intriguingly, the responses were delayed and peaked 10–20 days after the training intervention, indicating overreaching. NEW & NOTEWORTHY In line with previous studies, we demonstrate that high-frequency low-load blood flow-restricted resistance exercise (HF-BFRRE) can elicit robust increases in satellite cell and myonuclei numbers, along with gains in muscle size and strength. However, our results also suggest that these processes can be delayed and that with very strenuous HF-BFRRE, there may even be transient muscle fiber atrophy, presumably because of accumulated stress responses. Our findings have implications for the prescription of BFR exercise.
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Affiliation(s)
- Thomas Bjørnsen
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Mathias Wernbom
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Sweden
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Amund Løvstad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | | | | | - David Cameron-Smith
- Liggins Institute, University of Auckland, New Zealand
- Food & Bio-based Products Group, AgResearch, Palmerston North, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Alexander Flesche
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jonny Hisdal
- Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
| | - Sveinung Berntsen
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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Schamne JC, Ferreira Junior A, Araújo ACD, Lima-Silva AE, Bertuzzi RCDM, Okuno NM. Cardiac autonomic responses during and after a single session of aerobic exercise with and without blood flow restriction. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900030015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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43
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Borges A, Teodósio C, Matos P, Mil-Homens P, Pezarat-Correia P, Fahs C, Mendonca GV. Sexual Dimorphism in the Estimation of Upper-Limb Blood Flow Restriction in the Seated Position. J Strength Cond Res 2018; 32:2096-2102. [PMID: 29570573 DOI: 10.1519/jsc.0000000000002582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Borges, A, Teodósio, C, Matos, P, Mil-Homens, P, Pezarat-Correia, P, Fahs, C, and Mendonca, GV. Sexual dimorphism in the estimation of upper-limb blood flow restriction in the seated position. J Strength Cond Res 32(7): 2096-2102, 2018-Arterial occlusion pressure (AOP) is typically used to normalize blood flow restriction (BFR) during low-intensity BFR exercise. Despite strong evidence for sexual dimorphism in muscle blood flow, sex-related differences in AOP estimation remain a controversial topic. We aimed at determining whether the relationship of upper-limb AOP with arm circumference and systolic blood pressure (BP) differs between men and women resting in the seated position. Sixty-two healthy young participants (31 men: 21.7 ± 2.3; 31 women: 22.0 ± 2.0 years) were included in this study. Arm circumference, resting BP, and AOP were taken in the seated position. Multiple linear regression analysis was used to determine whether the relationship of AOP with arm circumference and resting BP differed between sexes. Prediction accuracy was assessed with the mean absolute percent error and Bland-Altman plots. Men had higher systolic BP and larger arm circumference than women (p < 0.05). Nevertheless, AOP was similar between sexes. Arm circumference, systolic BP, and sex were all significant predictors of AOP (p < 0.05), explaining 42% of its variance. The absolute percent error was similar in both sexes (men: -0.55 ± 7.12; women: -0.39 ± 6.31%, p > 0.05). Bland-Altman plots showed that the mean difference between actual and estimated AOP was nearly zero in both groups, with no systematic overestimation or underestimation. In conclusion, arm circumference, systolic BP, and sex are all significant predictors of upper-limb-seated AOP. Their measurement allows for the indirect estimation of BFR pressure within the context of exercise training.
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Affiliation(s)
- Afonso Borges
- Laboratory of Neuromuscular Function, Faculty of Human Motricity, University of Lisbon, Lisboa, Portugal
| | - Carolina Teodósio
- Laboratory of Neuromuscular Function, Faculty of Human Motricity, University of Lisbon, Lisboa, Portugal
| | - Pedro Matos
- Laboratory of Neuromuscular Function, Faculty of Human Motricity, University of Lisbon, Lisboa, Portugal
| | - Pedro Mil-Homens
- Laboratory of Neuromuscular Function, Faculty of Human Motricity, University of Lisbon, Lisboa, Portugal.,CIPER, Faculty of Human Motricity, University of Lisbon, Portugal, Portugal
| | - Pedro Pezarat-Correia
- Laboratory of Neuromuscular Function, Faculty of Human Motricity, University of Lisbon, Lisboa, Portugal.,CIPER, Faculty of Human Motricity, University of Lisbon, Portugal, Portugal
| | | | - Goncalo V Mendonca
- Laboratory of Neuromuscular Function, Faculty of Human Motricity, University of Lisbon, Lisboa, Portugal.,CIPER, Faculty of Human Motricity, University of Lisbon, Portugal, Portugal
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Fatela P, Reis JF, Mendonca GV, Freitas T, Valamatos MJ, Avela J, Mil-Homens P. Acute Neuromuscular Adaptations in Response to Low-Intensity Blood-Flow Restricted Exercise and High-Intensity Resistance Exercise: Are There Any Differences? J Strength Cond Res 2018; 32:902-910. [PMID: 29570594 DOI: 10.1519/jsc.0000000000002022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fatela, P, Reis, JF, Mendonca, GV, Freitas, T, Valamatos, MJ, Avela, J, and Mil-Homens, P. Acute neuromuscular adaptations in response to low-intensity blood flow restricted exercise and high-intensity resistance exercise: are there any differences? J Strength Cond Res 32(4): 902-910, 2018-Numerous studies have reported similar neuromuscular adaptations between low-intensity (LI) blood-flow restricted exercise (BFRE) and high-intensity (HI) resistance training. Unfortunately, none of these experimental designs individualized blood flow restriction (BFR) levels to each participant. Thus, their findings are difficult to interpret. We aimed at comparing the acute effects of LI BFR (80% of absolute vascular occlusion pressure) with LI non-BFR and HI training on muscle torque, activation, and neuromuscular fatigue. Ten men (23.8 ± 5.4 years) exercised at 20 and 75% of 1 repetition maximum with and without BFR (for LI). Blood flow restriction pressure was determined individually using resting blood-flow measurements. Torque was determined during maximal voluntary contractions (MVCs) at pre-exercise and postexercise time points. Surface electromyographic activity (root mean square [RMS] and median frequency [MF]) was recorded for the rectus femoris (RF) and vastus medialis (VM) muscles, before and after each session of training, during isometric contractions at 20% MVC. Torque decreased post-HI and LI BFR (-9.5 and -7.8%, respectively; p < 0.01), but not after LI non-BFR. The MF was reduced following HI training in the VM and the RF muscles (-5.3 and -12.5%, respectively; p ≤ 0.05). Conversely, the impact of LI BFR on reducing MF was limited to the RF muscle (-10.7%, p ≤ 0.05). Finally, when compared to all other conditions, RMS values were consistently higher during submaximal contractions performed after HI training (p ≤ 0.05). Thus, we conclude that, despite enhancing the acute magnitude of muscular activation and fatigue, LI BFR exercise exerts a less profound impact on neuromuscular function than HI resistance training.
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Affiliation(s)
- Pedro Fatela
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Joana F Reis
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,European University, Laureate International Universities, Lisbon, Portugal
| | - Goncalo V Mendonca
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Tomás Freitas
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Maria J Valamatos
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Janne Avela
- European University, Laureate International Universities, Lisbon, Portugal.,Neuromuscular Research Center, Department of Biology and Physical Activity, University of Jyvaskyla, Jyvaskyla, Finland
| | - Pedro Mil-Homens
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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Mendonca GV, Borges A, Teodósio C, Matos P, Correia J, Vila-Chã C, Mil-Homens P, Pezarat-Correia P. Muscle fatigue in response to low-load blood flow-restricted elbow-flexion exercise: are there any sex differences? Eur J Appl Physiol 2018; 118:2089-2096. [PMID: 30006670 DOI: 10.1007/s00421-018-3940-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/10/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to determine whether men and women display a different magnitude of muscle fatigue in response to high-load (HL) and low-load blood flow-restricted (LLBFR) elbow-flexion exercise. We also explored to which extent both exercise protocols induce similar levels of muscle fatigue (i.e., torque decrement). METHODS Sixty-two young participants (31 men and 31 women) performed dynamic elbow flexions at 20 and 75% of one-repetition maximum for LLBFR and HL exercise, respectively. Maximum voluntary isometric contractions were performed before and after exercise to quantify muscle fatigue. RESULTS Men and women exhibited similar magnitude of relative torque decrement after both exercise protocols (p > 0.05). HL was more fatiguing (∆ torque output: 11.9 and 23 N.m in women and men, respectively) than LLBFR resistance exercise (∆ torque output: 8.3 and 15.4 N.m in women and men, respectively) in both sexes, but this was largely attenuated after controlling for the differences in volume load between protocols (p > 0.05). CONCLUSIONS These data show that torque decrement in response to LLBFR and HL dynamic elbow-flexion exercise does not follow a sexually dimorphic pattern. Our data also indicate that, if performed in a multiple-set fashion and prescribed for a given volume load, elbow-flexion LLBFR exercise induces similar levels of fatigue as HL acute training. Importantly, this occurs similarly in both sexes.
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Affiliation(s)
- Goncalo V Mendonca
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal. .,CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal.
| | - Afonso Borges
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal
| | - Carolina Teodósio
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal
| | - Pedro Matos
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal
| | - Joana Correia
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal
| | - Carolina Vila-Chã
- Polytechnic Institute of Guarda, Av. Dr. Francisco Sá Carneiro, n. 50, 6300-559, Guarda, Portugal.,Research Center in Sports Sciences, Health and Human Development (CIDESD), Vila Real, Portugal
| | - Pedro Mil-Homens
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal.,CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal
| | - Pedro Pezarat-Correia
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal.,CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada Dafundo, 1499-002, Lisbon, Portugal
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Raji-amirhasani A, Joukar S, Naderi-Boldaji V, Bejeshk MA. Mild exercise along with limb blood-flow restriction modulates the electrocardiogram, angiotensin, and apelin receptors of the heart in aging rats. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2018; 21:558-563. [PMID: 29942444 PMCID: PMC6015241 DOI: 10.22038/ijbms.2018.24796.6165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/28/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Considering the lack of information, the effects of mild endurance exercise plus blood flow restriction (BFR) on electrocardiographic parameters, hypertrophy index, and expression of angiotensin II receptors type 1 (AT1R) and type 2 (AT2R) and apelin receptor (APJ) were assessed in hearts of old male rats. MATERIALS AND METHODS Animal were grouped as control (CTL), Sham (Sh), lower extremities blood flow restriction (BFR), exercise (Ex), Sham + exercise (Sh + Ex), and blood flow restriction + exercise (BFR + Ex). RESULTS Exercise plus BFR significantly decreased the corrected QT (QTc) interval (P<0.01 vs CTL and Sh groups) and increased the heart hypertrophy index (P<0.05 vs CTL and BFR groups). Exercise alone increased expression of the APJ (P<0.01, vs CTL, Sh, and BFR groups) and AT2 receptors (P<0.001, vs Sh, CTL, BFR, and BFR + exercise groups), whereas it reduced expression of AT1R (P<0.01 in comparison with CTL, Sh, and BFR groups). Exercise plus BFR caused a significant increase in APJ (P<0.05 vs Ex, Sh+Ex and P<0.001 vs CTL, Sh, and BFR groups) and also expression of AT1R (P<0.001 vs Ex, Sh + Ex, CTL, Sh, and P<0.01 vs BFR groups). Accompaniment of exercise with BFR destroyed the effect of exercise on the expression of AT2R. CONCLUSION Mild endurance exercise plus BFR can alter the expression of angiotensin II and apelin receptors that leads to cardiac hypertrophy and improves the ventricular conductivity of aging rats.
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Affiliation(s)
- Alireza Raji-amirhasani
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Siyavash Joukar
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Science, Kerman, Iran
| | - Vida Naderi-Boldaji
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad-Abbas Bejeshk
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
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Jørgensen AN, Aagaard P, Frandsen U, Boyle E, Diederichsen LP. Blood-flow restricted resistance training in patients with sporadic inclusion body myositis: a randomized controlled trial. Scand J Rheumatol 2018; 47:400-409. [PMID: 29775118 DOI: 10.1080/03009742.2017.1423109] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the effect of 12 weeks of low-load blood-flow restricted resistance (BFR) training on self-reported and objective physical function, and maximal muscle strength in patients with sporadic inclusion body myositis (sIBM). METHOD Twenty-two patients with sIBM were randomized into a training group (BFR group) or a non-exercising control group, according to CONsolidated Standards Of Reporting Trials (CONSORT) guidelines. The BFR group performed 12 weeks of BFR training twice per week. The primary outcome was the physical function domain of the 36-item Short Form Health Survey (pf-SF-36), which was used to measure self-reported physical function. All patients performed physical function tests (2-Minute Walk Test, Timed Up and Go, and 30-Second Chair Stand), completed the Inclusion Body Myositis Functional Rating Scale (IBMFRS), and were tested for isolated knee extensor muscle strength. RESULTS No effects of the training intervention were observed for pf-SF-36 or the objective physical function tests. Leg muscle strength decreased in controls (-9.2%, p = 0.02), but was unaltered in the BFR group (+0.9%, p = 0.87), resulting in a between-group difference in the per-protocol analysis (p = 0.026). Between-group differences in baseline to follow-up changes emerged for IBMFRS, in favour of the BFR group (p = 0.018). CONCLUSION Twelve weeks of BFR training did not improve self-reported or objective physical function in these sIBM patients. However, the training protocol had a preventive (retaining) effect on the disease-related decline in leg muscle strength, which may aid the long-term preservation of physical function and postpone the need for healthcare assistance.
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Affiliation(s)
- A N Jørgensen
- a Department of Sports Science and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC) , University of Southern Denmark , Odense , Denmark.,b Department of Clinical Research , University of Southern Denmark , Odense , Denmark
| | - P Aagaard
- a Department of Sports Science and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC) , University of Southern Denmark , Odense , Denmark
| | - U Frandsen
- a Department of Sports Science and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC) , University of Southern Denmark , Odense , Denmark
| | - E Boyle
- a Department of Sports Science and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC) , University of Southern Denmark , Odense , Denmark.,c Division of Epidemiology, Dalla Lana School of Public Health , University of Toronto , Toronto , ON , Canada
| | - L P Diederichsen
- b Department of Clinical Research , University of Southern Denmark , Odense , Denmark.,d Department of Rheumatology , Odense University Hospital , Odense , Denmark
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Silva JCG, Aniceto RR, Oliota-Ribeiro LS, Neto GR, Leandro LS, Cirilo-Sousa MS. Mood Effects of Blood Flow Restriction Resistance Exercise Among Basketball Players. Percept Mot Skills 2018; 125:788-801. [PMID: 29768966 DOI: 10.1177/0031512518776847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study compared the acute effects of resistance exercise with and without blood flow restriction (BFR) on basketball players' mood states. A total of 11 male basketball players (M age = 19.9, SD = 2.8 years; M height = 180.8, SD = 7.8 cm; M weight = 71.1, SD = 9.1 kg; M body mass index = 22.1, SD = 1.9 kg/m2) were randomly assigned to two experimental conditions: (a) low-load resistance exercise with BFR (LLRE + BFR) and high-load resistance exercise (HLRE) without BFR. We measured mood state with the Brunel Mood Scale before and after each session. There was a significant interaction effect such that there was increased fatigue over time with LLRE + BFR ( p = .001, Δ% = 169.2). Regarding total mood disorder, there were significant pre and postexercise differences between athletes exposed to both the LLRE + BFR and HLRE conditions ( p = .048) and a decharacterization of the iceberg mood profile in the post-training LLRE + BFR condition. LLRE + BFR, compared to HLRE, promoted an acute negative effect on mood state, decharacterization of the iceberg profile, total mood disturbance, and increased participant fatigue, suggesting that this method of strength training should be avoided before sports competitions.
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Affiliation(s)
- Júlio C G Silva
- 1 Associate Program of Graduate Studies in Physical Education, University of Pernambuco/Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,2 Department of Physical Education, Laboratory of Kinanthropometry and Human Performance, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,3 Coordination of Physical Education, Center for Higher Education and Development, Campina Grande, Paraíba, Brazil
| | - Rodrigo R Aniceto
- 1 Associate Program of Graduate Studies in Physical Education, University of Pernambuco/Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,2 Department of Physical Education, Laboratory of Kinanthropometry and Human Performance, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,4 Study and Research Group in Biomechanics and Psychophysiology of Exercise, Department of Physical Education, Instituto Federal de Educação, Ciência e Tecnologia, Camocim, Ceará, Brazil
| | - Leandro S Oliota-Ribeiro
- 1 Associate Program of Graduate Studies in Physical Education, University of Pernambuco/Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,2 Department of Physical Education, Laboratory of Kinanthropometry and Human Performance, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Gabriel R Neto
- 1 Associate Program of Graduate Studies in Physical Education, University of Pernambuco/Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,2 Department of Physical Education, Laboratory of Kinanthropometry and Human Performance, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,3 Coordination of Physical Education, Center for Higher Education and Development, Campina Grande, Paraíba, Brazil.,5 Coordination of Physical Education/Professional Master's in Family Health, Nursing and Medical Schools, Nova Esperança, João Pessoa, Paraíba, Brazil
| | - Leonardo S Leandro
- 2 Department of Physical Education, Laboratory of Kinanthropometry and Human Performance, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,4 Study and Research Group in Biomechanics and Psychophysiology of Exercise, Department of Physical Education, Instituto Federal de Educação, Ciência e Tecnologia, Camocim, Ceará, Brazil
| | - Maria S Cirilo-Sousa
- 1 Associate Program of Graduate Studies in Physical Education, University of Pernambuco/Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,2 Department of Physical Education, Laboratory of Kinanthropometry and Human Performance, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.,4 Study and Research Group in Biomechanics and Psychophysiology of Exercise, Department of Physical Education, Instituto Federal de Educação, Ciência e Tecnologia, Camocim, Ceará, Brazil
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Pereira Neto EA, Bittar ST, Silva JCGD, Pfeiffer PAS, Santos HHD, Sousa MDSCD. WALKING WITH BLOOD FLOW RESTRICTION IMPROVES THE DYNAMIC STRENGTH OF WOMEN WITH OSTEOPOROSIS. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182402175290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT Introduction: Improving strength levels is important to women with osteoporosis. Resistance and aerobic exercise are effective means of reaching this goal; however, the use of low-load exercises with blood flow restriction is an alternative to traditional methods of exercise to achieve the same strength gains in this population. Objective: To analyze the chronic effects of aerobic and resistance training combined with blood flow restriction on the maximal dynamic strength (MDS) of women with osteoporosis. Methods: Twenty women (61.40±4.63 years of age, 61.82±12.54 kg, 1.51±0.05 m, 27.16±5.55 kg/m²) were randomly assigned to four groups: 1 - high-intensity resistance training (HI); 2 - low-intensity resistance training with blood flow restriction (LI-BFR); 3 - aerobic training with blood flow restriction (ABFR); and 4 - control group (CG). Unilateral knee extension MDS was assessed using the one-repetition maximum (1RM) strength test before and after the 6th and 12th weeks of intervention. The data were analyzed using repeated measures analysis of variance (ANOVA) with a Bonferroni post-hoc test performed using SPSS (version 21.0), considering a significance level of P<0.05 for all tests. Results: Baseline comparisons showed that HI and CG had lower strength levels than LI-BFR and ABFR groups (P<0.05). The ABFR group exhibited a significant increase in MDS between the 1st and the 6th week (9%, P=0.001) and between the 1st and the 12th week (21.6%, P=0.008). The LI-BFR group exhibited increased MDS between the 1st and the 6th week (10.1%, P=0.001), between the 1st and the 12th week (24.2%, P=0.003) and between the 6th and 12th week (12.8%, P=0.030). The HI group exhibited a significant difference between the 1st and the 6th week (38.7%, P<0.001), between the 1st and the 12th week (62%, P<0.001) and between the 6th and 12th weeks (17.4%, P=0.020), whereas the CG had no significant differences between the timepoints (P>0.05). Conclusions: ABFR and LI-BFR effectively increased the MDS of women with osteoporosis.
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