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de Castro FMP, Oliveira LDP, Aquino R, Tourinho Filho H, Puggina EF. Impact of Complete Intermittent Blood Flow Restriction in Upper Limbs Strength and Neural Function. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:635-645. [PMID: 38306672 DOI: 10.1080/02701367.2023.2294092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Abstract
Purpose: We aimed to investigate the chronic effects of low-load strength training (LT) with complete intermittent blood flow restriction (IBFR) on neural adaptations and strength in biceps brachii. Methods: Nineteen volunteers were randomly assigned into two different 9-week training protocols consisting of three assessment weeks and six training weeks: (a) LT with complete IBFR (LT-IBFR; n = 10) and (b) LT without complete IBFR (LT; n = 9). Strength was evaluated by predicted 1 repetition maximum (1RM) at weeks 1, 5, and 9 and neural function by root mean square (RMS) and median frequency (MDF) at sessions 1, 7, and 12 during the first three and last three repetitions. Both groups performed three sets of Scott curl with 20% of predicted 1RM interspersed with 90s rest twice a week. Results: No changes were found in predicted 1RM throughout the training protocols nor between groups. LT-IBFR group showed lower RMS in the first set than LT for the first three repetitions and higher RMS in all sets for the last three repetitions with decreases in this value across the sets with no longitudinal changes for both groups. MDF in the first three repetitions did not differentiate between groups, however, in the last three repetitions, MDF were lower for LTIBFR group in all sets and it increased across the sets for this condition with no chronical changes for both groups in both repetitions zones. These results suggest that LT-IBFR may be ineffective for increasing Q5 strength and it did not promote chronic neural adaptations.
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Zhang WY, Zhuang SC, Chen YM, Wang HN. Validity and reliability of a wearable blood flow restriction training device for arterial occlusion pressure assessment. Front Physiol 2024; 15:1404247. [PMID: 38911327 PMCID: PMC11191424 DOI: 10.3389/fphys.2024.1404247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose The blood flow restriction (BFR) training is an effective approach to promoting muscle strength, muscle hypertrophy, and regulating the peripheral vascular system. It is recommended to use to the percentage of individual arterial occlusion pressure (AOP) to ensure safety and effectiveness. The gold standard method for assessing arterial occlusive disease is typically measured using Doppler ultrasound. However, its high cost and limited accessibility restrict its use in clinical and practical applications. A novel wearable BFR training device (Airbands) with automatic AOP assessment provides an alternative solution. This study aims to examine the reliability and validity of the wearable BFR training device. Methods Ninety-two participants (46 female and 46 male) were recruited for this study. Participants were positioned in the supine position with the wearable BFR training device placed on the proximal portion of the right thigh. AOP was measured automatically by the software program and manually by gradually increasing the pressure until the pulse was no longer detected by color Doppler ultrasound, respectively. Validity, inter-rater reliability, and test-retest reliability were assessed by intraclass correlation coefficients (ICC) and Bland-Altman analysis. Results The wearable BFR training device demonstrated good validity (ICC = 0.85, mean difference = 4.1 ± 13.8 mmHg [95% CI: -23.0 to 31.2]), excellent inter-rater reliability (ICC = 0.97, mean difference = -1.4 ± 6.7 mmHg [95% CI: -14.4 to 11.7]), and excellent test-retest reliability (ICC = 0.94, mean difference = 0.6 ± 8.6 mmHg [95% CI: -16.3 to 17.5]) for the assessment of AOP. These results were robust in both male and female subgroups. Conclusion The wearable BFR training device can be used as a valid and reliable tool to assess the AOP of the lower limb in the supine position during BFR training.
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Affiliation(s)
- Wei-Yang Zhang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
- Sports Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Shu-Can Zhuang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Yuan-Ming Chen
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Hao-Nan Wang
- Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Wong V, Spitz RW, Song JS, Yamada Y, Kataoka R, Hammert WB, Kang A, Seffrin A, Bell ZW, Loenneke JP. Blood flow restriction augments the cross-education effect of isometric handgrip training. Eur J Appl Physiol 2024; 124:1575-1585. [PMID: 38168713 DOI: 10.1007/s00421-023-05386-y] [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: 09/03/2023] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION The application of blood flow restriction (BFR) to low-intensity exercise may be able to increase strength not only in the trained limb but also in the homologous untrained limb. Whether this effect is repeatable and how that change compares to that observed with higher intensity exercise is unknown. PURPOSE Examine whether low-intensity training with BFR enhances the cross-education of strength compared to exercise without BFR and maximal efforts. METHODS A total of 179 participants completed the 6-week study, with 135 individuals performing isometric handgrip training over 18 sessions. Participants were randomly assigned to one of four groups: 1) low-intensity (4 × 2 min of 30% MVC; LI, n = 47), 2) low-intensity with blood flow restriction (LI + 50% arterial occlusion pressure; LI-BFR, n = 41), 3) maximal effort (4 × 5 s of 100% MVC; MAX, n = 47), and 4) non-exercise control (CON, n = 44). RESULTS LI-BFR was the only group that observed a cross-education in strength (CON: 0.64 SD 2.9 kg, LI: 0.95 SD 3.6 kg, BFR-LI: 2.7 SD 3.3 kg, MAX: 0.80 SD 3.1 kg). In the trained hand, MAX observed the greatest change in strength (4.8 SD 3.3 kg) followed by LI-BFR (2.8 SD 4.0 kg). LI was not different from CON. Muscle thickness did not change in the untrained arm, but ulna muscle thickness was increased within the trained arm of the LI-BFR group (0.06 SD 0.11 cm). CONCLUSION Incorporating BFR into low-intensity isometric training led to a cross-education effect on strength that was greater than all other groups (including high-intensity training).
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Affiliation(s)
- Vickie Wong
- Department of Sport and Health, Solent University, Southampton, Hampshire, SO14 0YN, UK
| | - Robert W Spitz
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - William B Hammert
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Anna Kang
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Aldo Seffrin
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA
| | - Zachary W Bell
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, P.O. Box 1848, University, MS, USA.
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Hu C, Zhu B, Wang Y, Yang F, Zhang J, Zhong W, Lu S, Luo C. Effectiveness of blood flow restriction versus traditional weight-bearing training in rehabilitation of knee osteoarthritis patients with MASLD: a multicenter randomized controlled trial. Front Endocrinol (Lausanne) 2023; 14:1220758. [PMID: 38155949 PMCID: PMC10753484 DOI: 10.3389/fendo.2023.1220758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
To compare the reliability and effectiveness of blood blow restriction resistance training (BFR) versus traditional weight-bearing training (WB) in knee osteoarthritis (KOA) patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Methods This multicenter randomized controlled trial was conducted from January 2021 to June 2022 at Shanghai Jiao Tong University affiliated Sixth People's Hospital and The People's Hospital of Mengla County. A total of 120 outpatients were recruited and randomized to perform WB (n=60) or BFR (n=60) resistance training protocols in accordance with standard recommended protocols for 12 weeks. Demographic data and Kellgren and Lawrence grading system scores were collected. Pain, range of motion (ROM), scaled maximal isotonic strength (10RM), self-reported function (KOOS), and 30-s chair sit-to-stand test results were assessed at weeks 1, 4, and 12. Results 112 patients (57 in the WB group, 55 in the BFR group) completed the training programs and assessments. No significant intergroup demographic differences were noted. ROM and scaled 10RM significantly increased at the 4- and 12-week assessments and differed significantly between groups. The pain, ability of daily living and quality of life subscale in KOOS increased significantly at the 12-week assessment and differed significantly between groups, adjusted for baseline value. Significant and comparable increases in 30-s chair sit-to-stand test results were observed within and between study groups. Conclusion BFR training enhanced muscle strength, reduced pain, and improved daily living and sports activities in patients with KOA, compared to WB training alone. BFR should be recommended for rehabilitation in KOA individuals with MASLD. Clinical trial registration number ChiCTR2100042872.
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Affiliation(s)
- Chengfang Hu
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zhu
- Department of Orthopedics, The People’s Hospital of Mengla County, Mengla, China
| | - Yanmao Wang
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Yang
- Department of Orthopedics, The People’s Hospital of Mengla County, Mengla, China
| | - Jun Zhang
- Department of Orthopedics, The People’s Hospital of Mengla County, Mengla, China
| | - Wanrun Zhong
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengdi Lu
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congfeng Luo
- Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Piepoli A, Miras-Moreno S, Janicijevic D, Martínez-Amat A, García-Ramos A. Differences in Various Strength Manifestations Between the Flat and Retracted Bench Press Variants: Are They Affected by Subjects' Experience or Strength Levels? J Strength Cond Res 2023; 37:2339-2345. [PMID: 37815255 DOI: 10.1519/jsc.0000000000004561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Piepoli, A, Miras-Moreno, S, Janicijevic, D, Martínez-Amat, A, and García-Ramos, A. Differences in various strength manifestations between the flat and retracted bench press variants: are they affected by subjects' experience or strength levels? J Strength Cond Res 37(12): 2339-2345, 2023. The objective of this study was to explore the effect of retracting the scapulae during the free-weight bench press (BP) exercise on various strength manifestations and perceptual variables. Twenty-eight recreationally trained male lifters (BP 1-repetition maximum [1RM] = 96.1 ± 20.8 kg) randomly performed in 2 different sessions: the flat BP (scapulae free to move during the movement) and retracted BP (shoulders retracted during the movement). Three strength manifestations were evaluated: (a) explosive strength -mean velocity (MV) achieved against 3 submaximal loads (40, 60, and 80%1RM); (b) maximal strength -1RM; and (c) endurance strength -number of repetitions completed to failure against the 70%1RM. Discomfort and ratings of perceived exertion (RPE) values were also recorded immediately after completing each test. The upward displacement of the barbell was lower for the retracted BP compared with the flat BP at the 3 submaximal loads ( p ≤ 0.024), but no significant differences between the BP variants were observed for the MV at submaximal loads ( p ≥ 0.473), 1RM ( p = 0.147), number of repetitions completed to failure ( p = 0.447), RPE at submaximal loads ( p ≥ 0.363), or discomfort during any test ( p ≥ 0.611). Subjects always demonstrated a greater strength performance with the BP variant most used in their training programs, but the differences between the flat and retracted BP were not affected by subjects' maximal strength values ( p ≥ 0.162). These results suggest that retracting the scapulae during the BP exercise presents minor effects on different strength manifestations and perceptual measures of effort and discomfort.
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Affiliation(s)
- Antonio Piepoli
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Sergio Miras-Moreno
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Danica Janicijevic
- University of Belgrade, Faculty of Sport and Physical Education, The Research Centre, Belgrade, Serbia
- Research Academy of Human Biomechanics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo University, Ningbo, China
- Faculty of Sports Science, Ningbo University, Ningbo, China; and
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, Concepción, Chile
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de Queiros VS, Rolnick N, dos Santos ÍK, de França IM, Lima RJ, Vieira JG, Aniceto RR, Neto GR, de Medeiros JA, Vianna JM, de Araújo Tinôco Cabral BG, Silva Dantas PM. Acute Effect of Resistance Training With Blood Flow Restriction on Perceptual Responses: A Systematic Review and Meta-Analysis. Sports Health 2023; 15:673-688. [PMID: 36415041 PMCID: PMC10467469 DOI: 10.1177/19417381221131533] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory. OBJECTIVES To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses. DATA SOURCES CINAHL, Cochrane Library, PubMed®, Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022. STUDY SELECTION Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 2. DATA EXTRACTION All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer. RESULTS Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar. CONCLUSION In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.
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Affiliation(s)
- Victor Sabino de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, Bronx, New York, USA
| | - Ísis Kelly dos Santos
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil; Graduate Program in Physical Education, State University of Rio Grande do Norte (UERN), Mossoró-RN, Brazil
| | - Ingrid Martins de França
- Graduate Program in Physiotherapy, Federal University of Rio Grande do Rio Grande Norte (UFRN), Natal-RN, Brazil
| | - Rony Jerônimo Lima
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - João Guilherme Vieira
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil; Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil
| | - Rodrigo Ramalho Aniceto
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Currais Novos-RN, Brazil
| | - Gabriel Rodrigues Neto
- 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
| | - Jason Azevedo de Medeiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
| | - Jeferson Macedo Vianna
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil; Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil
| | - Breno Guilherme de Araújo Tinôco Cabral
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil)
| | - Paulo Moreira Silva Dantas
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil)
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Parkington T, Maden-Wilkinson T, Klonizakis M, Broom D. Comparative Perceptual, Affective, and Cardiovascular Responses between Resistance Exercise with and without Blood Flow Restriction in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16000. [PMID: 36498075 PMCID: PMC9737453 DOI: 10.3390/ijerph192316000] [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: 10/27/2022] [Revised: 11/20/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Older adults and patients with chronic disease presenting with muscle weakness or musculoskeletal disorders may benefit from low-load resistance exercise (LLRE) with blood flow restriction (BFR). LLRE-BFR has been shown to increase muscle size, strength, and endurance comparable to traditional resistance exercise but without the use of heavy loads. However, potential negative effects from LLRE-BFR present as a barrier to participation and limit its wider use. This study examined the perceptual, affective, and cardiovascular responses to a bout of LLRE-BFR and compared the responses to LLRE and moderate-load resistance exercise (MLRE). Twenty older adults (64.3 ± 4.2 years) performed LLRE-BFR, LLRE and MLRE consisting of 4 sets of leg press and knee extension, in a randomised crossover design. LLRE-BFR was more demanding than LLRE and MLRE through increased pain (p ≤ 0.024, d = 0.8-1.4) and reduced affect (p ≤ 0.048, d = -0.5--0.9). Despite this, LLRE-BFR was enjoyed and promoted a positive affective response (p ≤ 0.035, d = 0.5-0.9) following exercise comparable to MLRE. This study supports the use of LLRE-BFR for older adults and encourages future research to examine the safety, acceptability, and efficacy of LLRE-BFR in patients with chronic disease.
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Affiliation(s)
- Thomas Parkington
- Physical Activity, Wellness and Public Health Research Group, Department of Sport and Physical Activity, Sheffield Hallam University, Sheffield S1 1WB, UK
- Lifestyle, Exercise and Nutrition Improvement Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Thomas Maden-Wilkinson
- Physical Activity, Wellness and Public Health Research Group, Department of Sport and Physical Activity, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Markos Klonizakis
- Lifestyle, Exercise and Nutrition Improvement Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - David Broom
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
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Sandbach PJ, Carvajal MS, Uygur M, Dankel SJ. The impact of post-exercise blood flow restriction on local muscle endurance of a remote limb. Clin Physiol Funct Imaging 2022; 42:356-361. [PMID: 35778804 DOI: 10.1111/cpf.12776] [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: 04/19/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies have examined the influence of post-exercise blood flow restriction as a mechanism to activate muscle afferents and assess non-local muscle fatigue. While these studies have assessed fatigue during maximal contractions, less is known on how these afferents may impact submaximal local muscle endurance which was the purpose of the present study. METHODS Individuals completed two testing visits which involved completing a set of elbow flexion exercises to volitional failure on the non-dominant followed by the dominant arm. During both trials, a pneumatic cuff was placed at the top of the non-dominant arm prior to exercise. This cuff was inflated to either 0% (control) or 70% (experimental) of the individual's arterial occlusion pressure immediately after the set was completed. We then evaluated how this impacted local muscle endurance of the dominant arm using a Bayesian paired samples t-test with an uninformed prior width of 0.707 centered on 0. RESULTS A total of 36 individuals completed the study (18 females). There was a greater discomfort present in the experimental trial when compared to the control trial [control: 4.5 (SD: 2.4), experimental: 5.8 (SD: 1.9); BF10 =61.46], but there were no differences in repetitions completed on the dominant arm [control: 43 (SD: 9), experimental: 43 (SD: 10); BF10 = 0.179]. CONCLUSION Applying blood flow restriction post-exercise induced sensations of discomfort but did not alter local muscle endurance of the contralateral limb. These results suggest that increasing the activation of muscle afferents does not appear to alter submaximal muscle endurance of a remote limb. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Paul J Sandbach
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Marlon S Carvajal
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Mehmet Uygur
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
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Bradley KM, Bunn JA, Feito Y, Myers BJ. Effects of Blood Flow Restriction Training on Muscle Size, Power, and V̇O2max in Active Adults. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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GARCIA NÁDIAF, MORAES CAMILADE, REBELO MACÁRIOA, PETERS SAVANAHMARIAG, CASTRO FÁBIOMDE, PUGGINA ENRICOF. Strength training with and without arteriovenous blood flow restriction improves performance, regardless of changes in muscle hypertrophy, in Wistar rats. AN ACAD BRAS CIENC 2022; 94:e20201147. [DOI: 10.1590/0001-3765202220201147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/13/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | - ENRICO F. PUGGINA
- University of São Paulo (USP), Brazil; University of São Paulo (USP), Brazil
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Miller BC, Tirko AW, Shipe JM, Sumeriski OR, Moran K. The Systemic Effects of Blood Flow Restriction Training: A Systematic Review. Int J Sports Phys Ther 2021; 16:978-990. [PMID: 34386277 PMCID: PMC8329318 DOI: 10.26603/001c.25791] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Blood flow restriction (BFR) training has been reported to have significant benefits on local skeletal muscle including increasing local muscle mass, strength, and endurance while exercising with lower resistance. As a result, patients unable to perform traditional resistance training may benefit from this technique. However, it is unclear what effects BFR may have on other body systems, such as the cardiovascular and pulmonary systems. It is important to explore the systemic effects of BFR training to ensure it is safe for use in physical therapy. PURPOSE The purpose of this study was to systematically review the systemic effects of blood flow restriction training when combined with exercise intervention. STUDY DESIGN Systematic review. METHODS Three literature searches were performed: June 2019, September 2019, and January 2020; using MedLine, ScienceDirect, PubMed, Cochrane Reviews and CINAHL Complete. Inclusion criteria included: at least one outcome measure addressing a cardiovascular, endocrinological, systemic or proximal musculoskeletal, or psychosocial outcome, use of clinically available blood flow restriction equipment, use of either resistance or aerobic training in combination with BFR, and use of quantitative measures. Exclusion criteria for articles included only measuring local or distal musculoskeletal changes due to BFR training, examining only passive BFR or ischemic preconditioning, articles not originating from a scholarly peer-reviewed journal, CEBM level of evidence less than two, or PEDro score less than four. Articles included in this review were analyzed with the CEBM levels of evidence hierarchy and PEDro scale. RESULTS Thirty-five articles were included in the review. PEDro scores ranged between 4 and 8, and had CEBM levels of evidence of 1 and 2. Common systems studied included cardiovascular, musculoskeletal, endocrine, and psychosocial. This review found positive or neutral effects of blood flow restriction training on cardiovascular, endocrinological, musculoskeletal, and psychosocial outcomes. CONCLUSIONS Although BFR prescription parameters and exercise interventions varied, the majority of included articles reported BFR training to produce favorable or non-detrimental effects to the cardiovascular, endocrine, and musculoskeletal systems. This review also found mixed effects on psychosocial outcomes when using BFR. Additionally, this review found no detrimental outcomes directly attributed to blood flow restriction training on the test subjects or outcomes tested. Thus, BFR training may be an effective intervention for patient populations that are unable to perform traditional exercise training with positive effects other than traditional distal muscle hypertrophy and strength and without significant drawbacks to the individual. LEVEL OF EVIDENCE 1b.
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Rolnick N, Kimbrell K, Cerqueira MS, Weatherford B, Brandner C. Perceived Barriers to Blood Flow Restriction Training. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:697082. [PMID: 36188864 PMCID: PMC9397924 DOI: 10.3389/fresc.2021.697082] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/11/2021] [Indexed: 12/13/2022]
Abstract
Blood flow restriction (BFR) training is increasing in popularity in the fitness and rehabilitation settings due to its role in optimizing muscle mass and strength as well as cardiovascular capacity, function, and a host of other benefits. However, despite the interest in this area of research, there are likely some perceived barriers that practitioners must overcome to effectively implement this modality into practice. These barriers include determining BFR training pressures, access to appropriate BFR training technologies for relevant demographics based on the current evidence, a comprehensive and systematic approach to medical screening for safe practice and strategies to mitigate excessive perceptual demands of BFR training to foster long-term compliance. This manuscript attempts to discuss each of these barriers and provides evidence-based strategies and direction to guide clinical practice and future research.
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Affiliation(s)
- Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States
- *Correspondence: Nicholas Rolnick
| | - Kyle Kimbrell
- Owens Recovery Science, San Antonio, TX, United States
| | - Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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13
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Cerqueira MS, Costa EC, Santos Oliveira R, Pereira R, Brito Vieira WH. Blood Flow Restriction Training: To Adjust or Not Adjust the Cuff Pressure Over an Intervention Period? Front Physiol 2021; 12:678407. [PMID: 34262476 PMCID: PMC8273389 DOI: 10.3389/fphys.2021.678407] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
Blood flow restriction (BFR) training combines exercise and partial reduction of muscular blood flow using a pressured cuff. BFR training has been used to increase strength and muscle mass in healthy and clinical populations. A major methodological concern of BFR training is blood flow restriction pressure (BFRP) delivered during an exercise bout. Although some studies increase BFRP throughout a training intervention, it is unclear whether BFRP adjustments are pivotal to maintain an adequate BFR during a training period. While neuromuscular adaptations induced by BFR are widely studied, cardiovascular changes throughout training intervention with BFR and their possible relationship with BFRP are less understood. This study aimed to discuss the need for BFRP adjustment based on cardiovascular outcomes and provide directions for future researches. We conducted a literature review and analyzed 29 studies investigating cardiovascular adaptations following BFR training. Participants in the studies were healthy, middle-aged adults, older adults and clinical patients. Cuff pressure, when adjusted, was increased during the training period. However, cardiovascular outcomes did not provide a plausible rationale for cuff pressure increase. In contrast, avoiding increments in cuff pressure may minimize discomfort, pain and risks associated with BFR interventions, particularly in clinical populations. Given that cardiovascular adaptations induced by BFR training are conflicting, it is challenging to indicate whether increases or decreases in BFRP are needed. Based on the available evidence, we suggest that future studies investigate if maintaining or decreasing cuff pressure makes BFR training safer and/or more comfortable with similar physiological adaptation.
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Affiliation(s)
- Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Eduardo Caldas Costa
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequié, Brazil
| | - Wouber Hérickson Brito Vieira
- Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
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14
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Song JS, Spitz RW, Yamada Y, Bell ZW, Wong V, Abe T, Loenneke JP. Exercise-induced hypoalgesia and pain reduction following blood flow restriction: A brief review. Phys Ther Sport 2021; 50:89-96. [PMID: 33940556 DOI: 10.1016/j.ptsp.2021.04.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To review past literature regarding exercise-induced hypoalgesia and pain reduction following blood flow restriction interventions, and to discuss potential mechanisms as well as future considerations towards the efficacy of blood flow restriction in pain reduction following exercise. METHODS To be eligible for inclusion, studies had to include acute exercise, or long-term training interventions, with blood flow restriction, along with including pre and post intervention pain measurements. RESULTS A total of 13 studies met the inclusion criteria. Among these 13 studies, 3 studies examined exercise-induced hypoalgesia after an acute bout of resistance exercise with blood flow restriction, and 10 studies investigated pain reduction following long-term blood flow restriction training. CONCLUSIONS Existing literature suggests that low load resistance exercise with blood flow restriction may serve as an effective pain management method for those who are unable or unwilling to train with high loads. Several potential mechanisms have been suggested, however, the roles of these mechanisms are still unclear and require further clarification. Future research should consider implementing different methods of blood flow restriction application, and research study design to clarify the utility and efficacy of blood flow restriction as a pain management tool, by itself or in combination with exercise.
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Affiliation(s)
- Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, United States.
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15
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Keller JL, Hill EC, Housh TJ, Smith CM, Anders JPV, Schmidt RJ, Johnson GO. The acute and early phase effects of blood flow restriction training on ratings of perceived exertion, performance fatigability, and muscular strength in women. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-204198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Blood flow restriction (BFR) resistance training (RT) has garnered recent interest, but female-specific data remains scarce. OBJECTIVE: The purpose was to examine the effects of 2-wks of low-load concentric, isokinetic, reciprocal forearm flexion and extension training, with and without BFR on perceptual responses, performance fatigability, and muscular strength. METHODS: Twenty women were assigned to a BFRT or a non-BFRT group. Each group trained at 30% of concentric peak moment. Each session consisted of 75 concentric, isokinetic, reciprocal forearm flexion extension muscle actions. RPEs were recorded following each set. Pretest and posttest maximal voluntary isometric contraction (MVIC) force was measured, and percent decline was defined as performance fatigability. RESULTS: The RPE values (p< 0.05) increased across sets. Strength (collapsed across muscle action) increased (p< 0.05) from 0-wk (23.7 ± 3.2 Nm) to 2-wk (26.8 ± 2.7 Nm). Independent of group and muscle action, performance fatigability (p< 0.05) increased from 0-wk (10.9 ± 5.0%) to 2-wk (14.1 ± 4.4%). CONCLUSIONS: 2-wks of low-load concentric, reciprocal forearm flexion and extension training resulted in similar training-induced changes in perceptual responses, performance fatigability, and muscular strength between BFRT and non-BFRT. These findings may reduce concerns of increased perceptual responses following BFRRT compared to non-BFRRT.
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Affiliation(s)
- Joshua L. Keller
- Department of Health, Kinesiology and Sport, College of Education, University of South Alabama, AL, USA
| | - Ethan C. Hill
- Division of Kinesiology, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, USA
| | - Terry J. Housh
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
| | - Cory M. Smith
- Human and Environmental Physiology Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA
| | - John Paul V. Anders
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
| | - Richard J. Schmidt
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
| | - Glen O. Johnson
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Sciences, University of Nebraska – Lincoln, Lincoln, NE, USA
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Saatmann N, Zaharia OP, Loenneke JP, Roden M, Pesta DH. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab 2021; 32:106-117. [PMID: 33358931 DOI: 10.1016/j.tem.2020.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/15/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
Blood flow restriction resistance training (BFRT) employs partial vascular occlusion of exercising muscles via inflation cuffs. Compared with high-load resistance training, mechanical load is markedly reduced with BFRT, but induces similar gains in muscle mass and strength. BFRT is thus an effective training strategy for people with physical limitations. Recent research indicates that BFRT has beneficial effects on glucose and mitochondrial metabolism. BFRT may therefore qualify as a valuable exercise alternative for individuals with type 2 diabetes (T2D), a disorder characterized by impaired glucose metabolism, musculoskeletal decline, and exacerbated progression of sarcopenia. This review covers the effects of BFRT in healthy populations and in persons with impaired physical fitness, the mechanisms of action of this novel training modality, and possible applications for individuals with T2D.
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Affiliation(s)
- Nina Saatmann
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Michael Roden
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | - Dominik H Pesta
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany; Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Centre for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, Cologne, Germany.
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Teixeira EL, Painelli VDS, Schoenfeld BJ, Silva-Batista C, Longo AR, Aihara AY, Cardoso FN, Peres BDA, Tricoli V. Perceptual and Neuromuscular Responses Adapt Similarly Between High-Load Resistance Training and Low-Load Resistance Training With Blood Flow Restriction. J Strength Cond Res 2020; 36:2410-2416. [PMID: 33306591 DOI: 10.1519/jsc.0000000000003879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Teixeira, EL, Painelli, VdS, Schoenfeld, BJ, Silva-Batista, C, Longo, AR, Aihara, AY, Cardoso, FN, Peres, BdA, and Tricoli, V. Perceptual and neuromuscular responses adapt similarly between high-load resistance training and low-load resistance training with blood flow restriction. J Strength Cond Res XX(X): 000-000, 2020-This study compared the effects of 8 weeks of low-load resistance training with blood flow restriction (LL-BFR) and high-load resistance training (HL-RT) on perceptual responses (rating of perceived exertion [RPE] and pain), quadriceps cross-sectional area (QCSA), and muscle strength (1 repetition maximum [RM]). Sixteen physically active men trained twice per week, for 8 weeks. One leg performed LL-BFR (3 sets of 15 repetitions, 20% 1RM), whereas the contralateral leg performed HL-RT (3 sets of 8 repetitions, 70% 1RM). Rating of perceived exertion and pain were evaluated immediately after the first and last training sessions, whereas QCSA and 1RM were assessed at baseline and after training. Rating of perceived exertion was significantly lower (6.8 ± 1.1 vs. 8.1 ± 0.8, p = 0.001) and pain significantly higher (7.1 ± 1.2 vs. 5.8 ± 1.8, p = 0.02) for LL-BFR than that for HL-RT before training. Significant reductions in RPE and pain were shown for both protocols after training (both p < 0.0001), although no between-protocol differences were shown in absolute changes (p = 0.10 and p = 0.48, respectively). Both LL-BFR and HL-RT were similarly effective in increasing QCSA (7.0 ± 3.8% and 6.3 ± 4.1%, respectively; both p < 0.0001) and 1RM (6.9 ± 4.1% and 13.7 ± 5.9%, respectively; both P < 0.0001), although absolute changes for 1RM in HL-RT were greater than LL-BFR (p = 0.001). In conclusion, LL-BFR produces lower RPE values and a higher pain perception than HL-RT. However, consistent application of these approaches result in chronic adaptations so that there are no differences in perceptual responses over the course of time. In addition, muscle strength is optimized with HL-RT despite similar increases in muscle hypertrophy between conditions.
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Affiliation(s)
- Emerson Luiz Teixeira
- Strength Training Study and Research Group, Paulista University, UNIP, São Paulo, SP, Brazil.,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.,School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | | | - Carla Silva-Batista
- School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil.,School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Ariel Roberth Longo
- Strength Training Study and Research Group, Paulista University, UNIP, São Paulo, SP, Brazil
| | | | | | | | - Valmor Tricoli
- School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
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18
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Rolnick N, Schoenfeld BJ. Can Blood Flow Restriction Used During Aerobic Training Enhance Body Composition in Physique Athletes? Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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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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20
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Bell ZW, Spitz RW, Wong V, Yamada Y, Chatakondi RN, Abe T, Dankel SJ, Loenneke JP. Conditioning participants to a relative pressure: implications for practical blood flow restriction. Physiol Meas 2020; 41:08NT01. [PMID: 32886653 DOI: 10.1088/1361-6579/aba810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To develop a valid method of applying blood flow restriction when the pressure cannot be known. This method involves conditioning the individual to what the goal pressure should be, such that the participant is able to recognize the sensation associated with that specific pressure. APPROACH Participants were conditioned to 40% of their arterial occlusion pressure (AOP) by oscillating between pressures that were too high (60%) and pressures that were too low (20%). Incorrect pressures were used to highlight pressure sensations surrounding the correct pressure that participants would be asked to later identify. Participants made attempts to estimate pressures at 5 min and 24 h following the conditioning stimulus. MAIN RESULTS A total of 40 participants completed this study. Estimated pressures at 5 min post conditioning were similar to the target pressure (-2 (-7, 3) mmHg; probability of H0: 0.675). However, pressures at 24 h post conditioning were underestimated as compared to the target pressure (-7 (-13, -2) mmHg). Additionally, pressures at 24 h appeared to be less than that at 5 min (-4.7 (-8.6, 0.9) mmHg; probability of H1: 0.84). The average absolute error was 11.2 mmHg (7.4% AOP) for 5 min and 14.0 mmHg (9.2% AOP) at 24 h. SIGNIFICANCE Although pressure estimations were underestimated at 24 h post conditioning, the majority of estimated pressures were between the upper and lower pressures used for the conditioning stimulus. Future research is needed to clarify and potentially refine what appears to be a promising method of estimation.
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Affiliation(s)
- Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, United States of America
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21
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Spitz RW, Chatakondi RN, Bell ZW, Wong V, Viana RB, Dankel SJ, Abe T, Yamada Y, Loenneke JP. Blood Flow Restriction Exercise: Effects of Sex, Cuff Width, and Cuff Pressure on Perceived Lower Body Discomfort. Percept Mot Skills 2020; 128:353-374. [PMID: 32777996 DOI: 10.1177/0031512520948295] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Narrow cuffs cause less discomfort than wide cuffs immediately following elbow flexion exercise in combination with blood flow restriction, possibly due to a balling up effect of the bicep underneath the cuff. In this study, we sought to examine the impact of cuff width, sex, and pressure on perceived discomfort in the quadriceps, following knee extensions. One hundred participants completed three separate experiments. In Experiment 1, we compared participants' discomfort at rest after using a 5 and a 12 cm cuff. In Experiment 2, we compared the discomfort from these two cuffs after four sets of exercise. In Experiment 3, we used the same exercise protocol as in Experiment 2, but we compared the discomfort between a 12 cm cuff inflated to an inappropriate pressure and a 12 cm cuff inflated to the recommended pressure. We found no sex differences in Experiments 1 and 3. In Experiment 1, the narrow cuff had higher discomfort (16 vs 12 AU). In Experiment 2, men reported higher discomfort than women, with no discomfort differences related to cuff width, though narrow cuffs were most preferred. In Experiment 3, cuffs inflated to a pressure intended for narrow cuffs were associated with higher discomfort, and participants preferred to use it less. In summary, we found no strong evidence for discomfort differences due to cuff width. There was some indication that participants preferred narrow cuffs with pressures inflated to the recommended relative pressure. Muscle shape may influence how cuff width affects discomfort.
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Affiliation(s)
- Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
| | - Raksha N Chatakondi
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
| | - Ricardo B Viana
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi.,Faculty of Physical Education and Dance, Federal University of Goiás
| | - Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, New Jersey, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi
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Mok E, Suga T, Sugimoto T, Tomoo K, Dora K, Takada S, Hashimoto T, Isaka T. Negative effects of blood flow restriction on perceptual responses to walking in healthy young adults: A pilot study. Heliyon 2020; 6:e04745. [PMID: 32885079 PMCID: PMC7452548 DOI: 10.1016/j.heliyon.2020.e04745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 11/02/2022] Open
Abstract
Background Methods Results Conclusions
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23
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Korkmaz E, Dönmez G, Uzuner K, Babayeva N, Torgutalp ŞŞ, Özçakar L. Effects of Blood Flow Restriction Training on Muscle Strength and Architecture. J Strength Cond Res 2020; 36:1396-1403. [PMID: 32287091 DOI: 10.1519/jsc.0000000000003612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Korkmaz, E, Dönmez, G, Uzuner, K, BabayevaŞerife Şeyma Torgutalp, N, and Özçakar, L. Effects of blood flow restriction training on muscle strength and architecture. J Strength Cond Res XX(X): 000-000, 2020-The aim of this study was to compare the effect of the traditional resistance (RES) training and low-intensity resistance training with blood flow restriction (BFR) protocols on quadriceps and hamstring muscle strength, and rectus femoris (RF) and vastus lateralis architecture, in youth team soccer players. Twenty-three young trained soccer team players were divided into 2 groups: the RES group that practiced traditional high-intensity resistance training (80% 1 repetition maximum [1RM], 4 sets, 12 rep.) (n = 12) and the BFR group that performed low-intensity resistance exercise with BFR (30% 1RM, 4 sets, 30-15-15-15 rep) (n = 11)-unilateral knee extension exercise-twice a week for 6 weeks. Muscle strength (isokinetic concentric peak torque of the quadriceps and hamstring muscles) and ultrasonographic parameters (muscle thickness, pennation angle, and fascicle length) were assessed. Bilateral knee flexor and extensor strength was increased in both groups compared with pre-exercise. The increase in dominant side extensor muscle strength (60°·s p = 0.02, ηp = 0.256, 180°·s p = 0.019, ηp = 0.271) and RF thickness (p = 0.002, ηp = 0.361) was statistically higher in the BFR group than in the RES group. These findings support that occlusion training can provide better benefits than traditional strength training to improve muscle hypertrophy. In addition, the novelty of our study is that BFR training may affect the muscle structure measured by ultrasonography.
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Affiliation(s)
| | - Gürhan Dönmez
- Gençlerbirliği Sports Club, Ankara, Turkey.,Department of Sports Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Kubilay Uzuner
- Department of Physiology, Eskişehir Osmangazi University, School of Medicine, Eskişehir, Turkey
| | - Naila Babayeva
- Department of Sports Medicine, Hacettepe University Medical School, Ankara, Turkey
| | | | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Spitz RW, Wong V, Bell ZW, Viana RB, Chatakondi RN, Abe T, Loenneke JP. Blood Flow Restricted Exercise and Discomfort: A Review. J Strength Cond Res 2020; 36:871-879. [PMID: 32058360 DOI: 10.1519/jsc.0000000000003525] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Spitz, RW, Wong, V, Bell, ZW, Viana, RB, Chatakondi, RN, Abe, T, and Loenneke, JP. Blood flow restricted exercise and discomfort: A Review. J Strength Cond Res XX(X): 000-000, 2020-Blood flow restriction exercise involves using a pneumatic cuff or elastic band to restrict arterial inflow into the muscle and block venous return out of the muscle during the exercise bout. The resultant ischemia in conjunction with low-load exercise has shown to be beneficial with increasing muscle size and strength. However, a limitation of using blood flow restriction (BFR) is the accompanying discomfort associated with this type of exercise. Factors that may influence discomfort are applied pressure, width of the cuff, cuff material, sex, and training to failure. The goal of this review was to evaluate the existing literature and elucidate how these factors can be manipulated to reduce discomfort during exercise as well as provide possible directions for future research. Thirty-eight different studies were located investigating BFR and discomfort. It was found that BFR training causes more discomfort than exercise without BFR. However, chronic use of BFR may increase tolerability, but discomfort may still be elevated over traditional non-blood flow restricted exercise. Discomfort can be attenuated by the application of lower applied pressures and stopping short of task failure. Finally, in the upper body, wider cuffs seem to increase ratings of discomfort compared with more narrow cuffs. In conclusion, applying the proper-sized cuff and making the applied pressure relative to both the individual and the cuff applied may attenuate discomfort. Reducing discomfort during exercise may help increase adherence to exercise and rehabilitation programs.
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Affiliation(s)
- Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Ricardo B Viana
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi.,Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Raksha N Chatakondi
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, Mississippi
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25
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Spitz RW, Bell ZW, Wong V, Viana RB, Chatakondi RN, Abe T, Loenneke JP. The position of the cuff bladder has a large impact on the pressure needed for blood flow restriction. Physiol Meas 2020; 41:01NT01. [DOI: 10.1088/1361-6579/ab64b8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Buckner SL, Jessee MB, Dankel SJ, Mattocks KT, Mouser JG, Bell ZW, Abe T, Bentley JP, Loenneke JP. Blood flow restriction does not augment low force contractions taken to or near task failure. Eur J Sport Sci 2019; 20:650-659. [DOI: 10.1080/17461391.2019.1664640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Samuel L. Buckner
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Matthew B. Jessee
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, MS, USA
| | - Scott J. Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ, USA
| | - Kevin T. Mattocks
- Department of Exercise Science, Lindenwood University, Belleville, IL, USA
| | - J. Grant Mouser
- Department of Kinesiology and Health Promotion, Troy University, Troy, AL, USA
| | - Zachary W. Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - John P. Bentley
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - Jeremy P. Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
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