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Hjortshoej MH, Aagaard P, Storgaard CD, Juneja H, Lundbye‐Jensen J, Magnusson SP, Couppé C. Hormonal, immune, and oxidative stress responses to blood flow-restricted exercise. Acta Physiol (Oxf) 2023; 239:e14030. [PMID: 37732509 PMCID: PMC10909497 DOI: 10.1111/apha.14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/12/2023] [Accepted: 07/30/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Heavy-load free-flow resistance exercise (HL-FFRE) is a widely used training modality. Recently, low-load blood-flow restricted resistance exercise (LL-BFRRE) has gained attention in both athletic and clinical settings as an alternative when conventional HL-FFRE is contraindicated or not tolerated. LL-BFRRE has been shown to result in physiological adaptations in muscle and connective tissue that are comparable to those induced by HL-FFRE. The underlying mechanisms remain unclear; however, evidence suggests that LL-BFRRE involves elevated metabolic stress compared to conventional free-flow resistance exercise (FFRE). AIM The aim was to evaluate the initial (<10 min post-exercise), intermediate (10-20 min), and late (>30 min) hormonal, immune, and oxidative stress responses observed following acute sessions of LL-BFRRE compared to FFRE in healthy adults. METHODS A systematic literature search of randomized and non-randomized studies was conducted in PubMed, Embase, Cochrane Central, CINAHL, and SPORTDiscus. The Cochrane Risk of Bias (RoB2, ROBINS-1) and TESTEX were used to evaluate risk of bias and study quality. Data extractions were based on mean change within groups. RESULTS A total of 12525 hits were identified, of which 29 articles were included. LL-BFRRE demonstrated greater acute increases in growth hormone responses when compared to overall FFRE at intermediate (SMD 2.04; 95% CI 0.87, 3.22) and late (SMD 2.64; 95% CI 1.13, 4.16) post-exercise phases. LL-BFRRE also demonstrated greater increase in testosterone responses compared to late LL-FFRE. CONCLUSION These results indicate that LL-BFRRE can induce increased or similar hormone and immune responses compared to LL-FFRE and HL-FFRE along with attenuated oxidative stress responses compared to HL-FFRE.
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Affiliation(s)
- M. H. Hjortshoej
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
- Centre for Health and RehabilitationUniversity College AbsalonSlagelseDenmark
| | - P. Aagaard
- Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
| | - C. D. Storgaard
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Nutrition, Exercise and Sports, Section of Integrative PhysiologyUniversity of CopenhagenCopenhagenDenmark
| | - H. Juneja
- Centre for Health and RehabilitationUniversity College AbsalonSlagelseDenmark
| | - J. Lundbye‐Jensen
- Department of Nutrition, Exercise and Sports, Section of Integrative PhysiologyUniversity of CopenhagenCopenhagenDenmark
| | - S. P. Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
| | - C. Couppé
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
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Song Y, Wang H, Chen L, Shangguan Y, Jia H. Effects of blood flow restriction training on bone turnover markers, microstructure, and biomechanics in rats. Front Endocrinol (Lausanne) 2023; 14:1194364. [PMID: 37680889 PMCID: PMC10482404 DOI: 10.3389/fendo.2023.1194364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/12/2023] [Indexed: 09/09/2023] Open
Abstract
Objective The present study aimed to investigate the effects of blood flow restriction training on muscle strength, bone tissue structure material, and biomechanical properties in rats applying various exercise interventions and to analyze the process by identifying the bone turnover markers, it provides a theoretical basis for the application of BFRT in clinical rehabilitation. Methods A total of 24, 3-month-old male SD (Sprague Dawley) rats were randomly divided into pressurized control group (CON, n=6), low-intensity training group (LIRT, n=6), high-intensity training group (HIRT, n=6), and blood flow restriction training group (LIBFR, n=6) for 8-week ladder-climbing exercises. The pressured control group were given only ischemia treatments and did not undertake any burden. The low-intensity training group was allowed to climb the ladder with 30% of the maximum voluntary carrying capacity (MVCC). The rats in the high-intensity training group were allowed to climb the ladder with 70% MVCC. The blood flow restriction training group climbed the ladder with 30% MVCC while imposing blood flow restriction. Before sampling, the final MVCC was measured using a ladder-climbing protocol with progressively increasing weight loading. The serum, muscle, and bone were removed for sampling. The concentrations of the bone turnover markers PINP, BGP, and CTX in the serum were measured using ELISA. The bone mineral density and microstructure of femur bones were measured using micro-CT. Three-point bending and torsion tests were performed by a universal testing machine to measure the material mechanics and structural mechanics indexes of the femur bone. Results The results of maximum strength test showed that the MVCC in LIRT, HIRT, and LIBFR groups was significantly greater than in the CON group, while the MVCC in the HIRT group was significantly higher than that in the LIRT group (P<0.05). According to the results of the bone turnover marker test, the concentrations of bone formation indexes PINP (amino-terminal extension peptide of type I procollagen) and BGP (bone gla protein) were significantly lower in the CON group than in the HIRT group (P<0.01), while those were significantly higher in the LIRT group compared to the HIRT group (P<0.01). In terms of bone resorption indexes, significant differences were identified only between the HIRT and other groups (P<0.05). The micro-CT examination revealed that the HIRT group had significantly greater bone density index values than the CON and LIRT groups (P<0.05). The results of three-point bending and torsion test by the universal material testing machine showed that the elastic modulus and maximum load indexes of the HIRT group were significantly smaller than those of the LIBFR group (P<0.05). The fracture load indexes in the HIRT group were significantly smaller than in the LIBFR group (P<0.05). Conclusion 1. LIRT, HIRT, LIBFR, and CON all have significant differences, and this training helps to improve maximum strength, with HIRT being the most effective. 2. Blood flow restriction training can improve the expression of bone turnover markers, such as PINP and BGP, which promote bone tissue formation. 3. Blood flow restriction training can improve muscle strength and increase the positive development of bone turnover markers, thereby improving bone biomechanical properties such as bone elastic modulus and maximum load.
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Affiliation(s)
- Yawei Song
- Jiangsu Province "Sports and Health Project" Collaborative Innovation Center, Nanjing Sport Institute, Nanjing, China
- Department of Sports and Health Sciences, Nanjing, China
| | - Hao Wang
- Jiangsu Province "Sports and Health Project" Collaborative Innovation Center, Nanjing Sport Institute, Nanjing, China
- Department of Sports and Health Sciences, Nanjing, China
| | - Liang Chen
- Jiangsu Province "Sports and Health Project" Collaborative Innovation Center, Nanjing Sport Institute, Nanjing, China
- Department of Sports and Health Sciences, Nanjing, China
| | | | - Hu Jia
- Jiangsu Province "Sports and Health Project" Collaborative Innovation Center, Nanjing Sport Institute, Nanjing, China
- Department of Sports and Health Sciences, Nanjing, China
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Maga M, Wachsmann-Maga A, Batko K, Włodarczyk A, Kłapacz P, Krężel J, Szopa N, Sliwka A. Impact of Blood-Flow-Restricted Training on Arterial Functions and Angiogenesis-A Systematic Review with Meta-Analysis. Biomedicines 2023; 11:1601. [PMID: 37371696 DOI: 10.3390/biomedicines11061601] [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: 04/29/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Despite growing evidence of the significant influence of blood-flow-restricted (BFR) training on different body functions, its impact on the vascular system, especially the arteries, is controversial. Therefore, the objective of our study was to analyze how BFR exercise, compared to other types of exercise without the restriction of blood flow, influences arterial functions and angiogenesis in adults. Studies comparing the effect of BFR versus non-BFR training on arterial parameters were divided into three categories: endothelial function, angiogenesis, and other vasculature functions. The search was based on Cochrane Library, PubMed®, and Embase, and 38 studies were included. The meta-analysis revealed a more significant improvement in flow-mediated dilatation (FMD) (p = 0.002) and the production of the primary angiogenesis biomarker vascular endothelial growth factor (VEGF) (p = 0.009) after BFR compared to non-BFR training (p = 0.002). The analysis of the pulse wave velocity, ankle-brachial index, systolic blood pressure, and heart rate did not show significant differences in changes between BFR and non-BFR training. The other parameters examined did not have sufficient data to be included in the meta-analysis. The results obtained present trends that suggest significant impacts of BFR training on endothelial functions and angiogenesis. There is still a lack of multicenter randomized clinical trials including many participants, and such studies are necessary to confirm the advantage of BFR over non-BFR activity.
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Affiliation(s)
- Mikołaj Maga
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Agnieszka Wachsmann-Maga
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Krzysztof Batko
- Department of Research and Design, Medicine Economy Law Society (MELS) Foundation, 30-040 Krakow, Poland
| | - Aleksandra Włodarczyk
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Paulina Kłapacz
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Jakub Krężel
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Natalia Szopa
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Agnieszka Sliwka
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
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Tan Z, Chen P, Zheng Y, Pan Y, Wang B, Zhao Y. Effect of blood flow-restricted resistance training on myocardial fibrosis in early spontaneously hypertensive rats. Front Cardiovasc Med 2023; 10:1101748. [PMID: 36818353 PMCID: PMC9928848 DOI: 10.3389/fcvm.2023.1101748] [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: 11/18/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Objective The purpose of this study was to explore the effect of blood flow-restricted resistance training on myocardial fibrosis in early spontaneously hypertensive rats (SHRs). Methods Four-week-old male Wistar-Kyoto rats and SHRs were randomly divided into the following groups: normal group (WKY), SHR control (SHR-SED) group, high-intensity resistance training (HIRT) group, low- and medium-intensity resistance training (LMIRT) group, and blood flow-restricted low- and medium-resistance training (BFRT) group. Body weight, hemodynamics, cardiac function, myocardial morphology and fibrosis, and the expression levels of transforming growth factor-beta1-Smad (TGFβ-1-Smad) pathway-related proteins in the myocardium were assessed. Results (1) BFRT lowered blood pressure significantly, decreased left ventricular wall thickness, and improved cardiac function. At the same time, BFRT was superior to traditional resistance training in lowering diastolic blood pressure, and was superior to HIRT in improving left ventricular compliance, reducing heart rate, and reducing left ventricular posterior wall and left ventricular mass (P < 0.05). (2) BFRT decreased collagen I and collagen fiber area in the myocardium, increased the collagen III area, and decreased the collagen I/III ratio (P < 0.05). BFRT produced a better proportion of myocardial collagen fibers than did traditional resistance training (P < 0.05). (3) In the myocardium of the BFRT group compared to the traditional resistance training group, the expression of TGFβ-1, Smad2/3/4, p-Smad2/3, CTGF, and TIMP1 was significantly downregulated, MMP2 and TIMP2 were significantly upregulated, the MMP/TIMP ratio significantly increased, and TGFβ-1 expression significantly decreased (P < 0.05). Conclusion BFRT inhibited the TGFβ-1-Smad pathway in the myocardium, downregulated the expression of CTGF, and regulated the balance between MMPs and TIMPs, thereby reducing myocardial fibrosis in SHR, and improving cardiac morphology and function. BFRT also lowered blood pressure, and achieved an effect of early prevention and treatment of hypertension. At the same time, BFRT was superior to traditional resistance training in reducing diastolic blood pressure and adjusting the proportion of myocardial collagen fibers.
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Affiliation(s)
- Zhaowen Tan
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Peiyou Chen
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yuchan Zheng
- Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Ying Pan
- Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Baolong Wang
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yan Zhao
- Nanjing Sport Institute, Nanjing, Jiangsu, China,*Correspondence: Yan Zhao,
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Ferlito JV, Rolnick N, Ferlito MV, De Marchi T, Deminice R, Salvador M. Acute effect of low-load resistance exercise with blood flow restriction on oxidative stress biomarkers: A systematic review and meta-analysis. PLoS One 2023; 18:e0283237. [PMID: 37083560 PMCID: PMC10121002 DOI: 10.1371/journal.pone.0283237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The purpose of this review was to analyze the acute effects of low-load resistance exercise with blood flow restriction (LLE-BFR) on oxidative stress markers in healthy individuals in comparison with LLE or high-load resistance exercise (HLRE) without BFR. MATERIALS AND METHODS A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. These searches were performed in CENTRAL, SPORTDiscus, EMBASE, PubMed, CINAHL and Virtual Health Library- VHL, which includes Lilacs, Medline and SciELO. The risk of bias and quality of evidence were assessed through the PEDro scale and GRADE system, respectively. RESULTS Thirteen randomized clinical trials were included in this review (total n = 158 subjects). Results showed lower post-exercise damage to lipids (SMD = -0.95 CI 95%: -1.49 to -0. 40, I2 = 0%, p = 0.0007), proteins (SMD = -1.39 CI 95%: -2.11 to -0.68, I2 = 51%, p = 0.0001) and redox imbalance (SMD = -0.96 CI 95%: -1.65 to -0.28, I2 = 0%, p = 0.006) in favor of LLRE-BFR compared to HLRE. HLRE presents higher post-exercise superoxide dismutase activity but in the other biomarkers and time points, no significant differences between conditions were observed. For LLRE-BFR and LLRE, we found no difference between the comparisons performed at any time point. CONCLUSIONS Based on the available evidence from randomized trials, providing very low or low certainty of evidence, this review demonstrates that LLRE-BFR promotes less oxidative stress when compared to HLRE but no difference in levels of oxidative damage biomarkers and endogenous antioxidants between LLRE. TRIAL REGISTRATION Register number: PROSPERO number: CRD42020183204.
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Affiliation(s)
- João Vitor Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States of America
| | - Marcos Vinicius Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
| | - Thiago De Marchi
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Rafael Deminice
- Department of Physical Education, State University of Londrina, Londrina, Brazil
| | - Mirian Salvador
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
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Maga M, Schönborn M, Wachsmann-Maga A, Śliwka A, Krężel J, Włodarczyk A, Olszewska M, Nowobilski R. Stimulation of the Vascular Endothelium and Angiogenesis by Blood-Flow-Restricted Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315859. [PMID: 36497934 PMCID: PMC9739167 DOI: 10.3390/ijerph192315859] [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: 11/05/2022] [Revised: 11/26/2022] [Accepted: 11/27/2022] [Indexed: 05/06/2023]
Abstract
Blood-flow-restricted exercise (BFRE) has been gaining constantly increasing interest in rehabilitation, but its influence on endothelial functions has not been well studied yet. Our aim is to examine the influence of low-resistance BFRE on endothelial functions and angiogenesis. This prospective cross-over study involved 35 young healthy adults. They conducted a 21-min low-resistant exercise with blood flow restricted by pressure cuffs placed on arms and tights. They also did the same training but without blood flow restriction. Endothelial parameters and angiogenesis biomarkers were evaluated before and up to 20 min after exercise. Both types of exercise increased Flow-Mediated Dilatation (FMD) but elevation after BFRE was more significant compared to the controls. The stiffness index decreased only after BFRE, while the reflection index decreased significantly after both types of exercise but was higher after BFRE. Platelet endothelial cell adhesion molecule (PECAM-1) and vascular endothelial growth factor receptor 2 (VEGFR-2) concentrations were increased by both exercise types but elevations were higher after BFRE compared to the controls. Only BFRE elevated the mean serum CD34 protein concentration. Based on these results, we can assume that low-resistance BFR exercise stimulates angiogenesis and improves endothelial functions more significantly compared to the same training performed without blood flow restriction.
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Affiliation(s)
- Mikołaj Maga
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Correspondence: ; Tel.: +48-692814418
| | - Martyna Schönborn
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agnieszka Wachsmann-Maga
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agnieszka Śliwka
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland
| | - Jakub Krężel
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Aleksandra Włodarczyk
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Marta Olszewska
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Roman Nowobilski
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland
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Lemos LK, Filho CATT, Santana dos Santos F, Biral TM, Cavina APDS, Junior EP, de Oliveira Damasceno S, Vendrame JW, Pastre CM, Vanderlei FM. Autonomic and cardiovascular responses on post-eccentric exercise recovery with blood flow restriction at different loads: randomized controlled trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tan Z, Zhao Y, Zheng Y, Pan Y. The Effect of Blood Flow-Restricted Low Resistance Training on Microvascular Circulation of Myocardium in Spontaneously Hypertensive Rats. Front Physiol 2022; 13:829718. [PMID: 35535353 PMCID: PMC9076488 DOI: 10.3389/fphys.2022.829718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: The purpose of this study was to explore the effect of blood flow-restricted low resistance training on microvascular rarefaction in the myocardium of spontaneously hypertensive rats (SHRs). Methods: Four-week-old male SHRs were randomly divided into the following groups: Wistar-Kyoto (WKY), SHR control (SHR-SED), high-intensity resistance training (HIRT), low-intensity resistance training (LIRT), and blood flow-restricted low resistance training (BFRT). The exercise groups began to receive exercise intervention for 8 weeks at the age of 7 weeks. Blood pressure (BP), heart rate (HR), cardiac function, capillary density, and Vascular endothelial growth factor -Phosphatidylinositol 3-kinase-Protein kinase B-Endothelial nitric oxide synthetase (VEGF-Pi3k-Akt-eNOS) were assessed. Results: 1) BP and HR of BFRT decreased significantly, Ejection fraction (EF) and Fraction shortening (FS) increased, and the effect of BFRT on lowering BP and HR was better than that of other groups (p < 0.05); 2) The expression of VEGF, VEGFR2, p-VEGFR2, Pi3k, Akt, p-Akt, eNOS and p-eNOS in the myocardium of the BFRT was significantly upregulated, and eNOS expression was significantly higher than other groups (p < 0 05); 3) the expression of VEGF in the blood of the BFRT was significantly upregulated, higher than SHR-SED, lower than HIRT (p < 0.05), and there was no significant difference between BFRT and LIRT(p > 0.05); 4) the capillary density in the myocardium of BFRT was significantly higher than other exercise groups (p < 0 05). Conclusion: Blood flow-restricted low resistance training can activate the VEGF-Pi3k-Akt-eNOS pathway, upregulate the expression of VEGF in blood, improve microvascular rarefaction, and promote myocardial microvascular circulation, thereby improving cardiac function and lowering blood pressure, achieving the preventive effect of early hypertension.
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Affiliation(s)
- Zhaowen Tan
- College of Sports Science, Nanjing Normal University, Nanjing, China
| | - Yan Zhao
- Nanjing Sport Institute, Nanjing, China
| | | | - Ying Pan
- Nanjing Sport Institute, Nanjing, China
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Pereira-Neto EA, Lewthwaite H, Boyle T, Johnston K, Bennett H, Williams MT. Effects of exercise training with blood flow restriction on vascular function in adults: a systematic review and meta-analysis. PeerJ 2021; 9:e11554. [PMID: 34277146 PMCID: PMC8272459 DOI: 10.7717/peerj.11554] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background Blood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE. Methodology Five electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed. Results Twenty-six studies were included in the review (total participants n = 472; n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76; 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24; 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported. Conclusion There is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.
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Affiliation(s)
- Elisio A Pereira-Neto
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Hayley Lewthwaite
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Kylie Johnston
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Hunter Bennett
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Marie T Williams
- Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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EFFECT OF BLOOD FLOW RESTRICTION TRAINING ON MUSCULAR PERFORMANCE, PAIN AND VASCULAR FUNCTION. Int J Sports Phys Ther 2020; 15:892-900. [PMID: 33344005 DOI: 10.26603/ijspt20200892] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Blood flow restriction (BFR) training enhances muscular strength and hypertrophy in several populations including older adults and injured athletes. However, the efficacy of emerging BFR technologies on muscular adaptations, vascular health, and pain is unclear. Purpose The purpose of this study was to examine muscular performance, pain and vascular function in response to eight weeks of BFR compared to traditional resistance training and a control group. Study Design Randomized control trial. Methods Thirty-one overtly healthy participants (age: 23 ± 4y, 65% female) underwent eight weeks of supervised high load resistance training (RES), low load resistance training with BFR (BFR) or no training (control, CON). RES and BFR (with pneumatic bands) performed seven upper and lower body exercises, two to three sessions per week at 60% and 30% of one-repetition maximum (1RM), respectively. Twenty-four hours post-exercise, general muscle soreness was assessed via a visual analog scale (VAS) and present pain intensity (PPI) of the McGill Pain Questionnaire. At baseline and after eight weeks, participants underwent one-repetition maximum (1RM), and flow-mediated dilation (FMD) testing. Results At baseline all groups exhibited similar muscle strength and endurance and vascular function. At the end of training, RES and BFR groups significantly increased muscle strength (1RM) to a similar magnitude as compared to the CON group (p < 0.0001), but did not alter body composition. FMD significantly increased in RES and BFR groups compared to CON group (p = 0.006). VAS and PPI were similar between RES and BFR groups throughout the exercise sessions until VAS decreased in the BFR group after the last session compared to the RES group (p = 0.02). Conclusion Compared to RES, BFR resulted in similar muscular performance (strength and endurance) and vascular improvements at a lower exercise intensity, suggesting BFR is an effective alternative to high load resistance training. Further longitudinal studies may gain greater understanding regarding general muscle pain and soreness when using BFR. Level of Evidence Therapy, Level 2.
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