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Olmos AA, Montgomery TR, Sears KN, Dinyer TK, Hammer SM, Bergstrom HC, Hill EC, Succi PJ, Lawson J, Trevino MA. Blood flow restriction increases necessary muscle excitation of the elbow flexors during a single high-load contraction. Eur J Appl Physiol 2024; 124:1807-1820. [PMID: 38236301 DOI: 10.1007/s00421-023-05405-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: 07/03/2023] [Accepted: 12/09/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE To investigate the effects of blood flow restriction (BFR) on electromyographic amplitude (EMGRMS)-force relationships of the biceps brachii (BB) during a single high-load muscle action. METHODS Twelve recreationally active males and eleven recreationally active females performed maximal voluntary contractions (MVCs), followed by an isometric trapezoidal muscle action of the elbow flexors at 70% MVC. Surface EMG was recorded from the BB during BFR and control (CON) visits. For BFR, cuff pressure was 60% of the pressure required to completely occlude blood at rest. Individual b (slope) and a terms (gain) were calculated from the log-transformed EMGRMS-force relationships during the linearly increasing and decreasing segments of the trapezoid. EMGRMS during the steady force segment was normalized to MVC EMGRMS. RESULTS For BFR, the b terms were greater during the linearly increasing segment than the linearly decreasing segment (p < 0.001), and compared to the linearly increasing segment for CON (p < 0.001). The a terms for BFR were greater during the linearly decreasing than linearly increasing segment (p = 0.028). Steady force N-EMGRMS was greater for BFR than CON collapsed across sex (p = 0.041). CONCLUSION BFR likely elicited additional recruitment of higher threshold motor units during the linearly increasing- and steady force-segment. The differences between activation and deactivation strategies were only observed with BFR, such as the b terms decreased and the a terms increased for the linearly decreasing segment in comparison to the increasing segment. However, EMGRMS-force relationships during the linearly increasing- and decreasing-segments were not different between sexes during BFR and CON.
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Affiliation(s)
- Alex A Olmos
- Applied Neuromuscular Physiology Laboratory, Department of Health and Human Performance, Oklahoma State University, 191 CRC, Stillwater, OK, 74074, USA
| | - Tony R Montgomery
- Applied Neuromuscular Physiology Laboratory, Department of Health and Human Performance, Oklahoma State University, 191 CRC, Stillwater, OK, 74074, USA
| | - Kylie N Sears
- Applied Neuromuscular Physiology Laboratory, Department of Health and Human Performance, Oklahoma State University, 191 CRC, Stillwater, OK, 74074, USA
| | - Taylor K Dinyer
- Applied Neuromuscular Physiology Laboratory, Department of Health and Human Performance, Oklahoma State University, 191 CRC, Stillwater, OK, 74074, USA
| | - Shane M Hammer
- Applied Neuromuscular Physiology Laboratory, Department of Health and Human Performance, Oklahoma State University, 191 CRC, Stillwater, OK, 74074, USA
| | - Haley C Bergstrom
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, 40506, USA
| | - Ethan C Hill
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, 32816, USA
| | - Pasquale J Succi
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, 40506, USA
| | - John Lawson
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, 32816, USA
| | - Michael A Trevino
- Applied Neuromuscular Physiology Laboratory, Department of Health and Human Performance, Oklahoma State University, 191 CRC, Stillwater, OK, 74074, USA.
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Ogrezeanu DC, López-Bueno L, Sanchís-Sánchez E, Carrasco JJ, Cuenca-Martínez F, Suso-Martí L, López-Bueno R, Cruz-Montecinos C, Martinez-Valdes E, Casaña J, Calatayud J. Neuromuscular Responses and Perceptions of Health Status and Pain-Related Constructs in End-Stage Knee Osteoarthritis During Resistance Training With Blood Flow Restriction. J Strength Cond Res 2024; 38:762-772. [PMID: 38090743 DOI: 10.1519/jsc.0000000000004680] [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: 03/23/2024]
Abstract
ABSTRACT Ogrezeanu, DC, López-Bueno, L, Sanchís-Sánchez, E, Carrasco, JJ, Cuenca-Martínez, F, Suso-Martí, L, López-Bueno, R, Cruz-Montecinos, C, Martinez-Valdes, E, Casaña, J, and Calatayud, J. Neuromuscular responses and perceptions of health status and pain-related constructs in end-stage knee osteoarthritis during resistance training with blood flow restriction. J Strength Cond Res 38(4): 762-772, 2024-We aimed to evaluate the neuromuscular responses and their relationship with health status, kinesiophobia, pain catastrophizing, and chronic pain self-efficacy in patients with end-stage knee osteoarthritis during acute resistance training with different levels of blood flow restriction (BFR). Seventeen patients with end-stage knee osteoarthritis participated in 3 experimental sessions separated by 3 days, performing 4 sets of knee extensions with low load and 3 levels of concurrent BFR performed in a random order: control (no BFR), BFR at 40% arterial occlusion pressure (AOP), and BFR at 80% AOP. Normalized root-mean-square (nRMS), nRMS spatial distribution (centroid displacement, modified entropy, and coefficient of variation), and normalized median frequency (nFmed) were calculated from the vastus medialis (VM) and lateralis (VL) using high-density surface electromyography. Subjects were asked to report adverse effects after the sessions. In the VM, nRMS was higher with 80% AOP than with 40% AOP ( p = 0.008) and control ( p < 0.001), whereas there were no differences between conditions in the VL. Normalized root-mean-square also showed an association with pain catastrophizing, chronic pain self-efficacy, and health status (VM: -0.50, 0.49, -0.42; VL: -0.39, 0.27, -0.33). Spatial distribution varied between conditions but mostly in the VL. Overall, nFmed did not vary, with only a slight increase in the VL with 40% AOP, between set 3 and 4. BFR during knee extensions at 80% AOP increases VM activity and VL amplitude distribution more than 40% AOP and control. Importantly, muscle activity increases are modulated by pain catastrophizing, chronic pain self-efficacy, and health status in these patients, and kinesiophobia seems to especially modulate entropy.
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Affiliation(s)
- Daniel C Ogrezeanu
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Laura López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Enrique Sanchís-Sánchez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Juan J Carrasco
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; and
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Lin TY, Chueh TY, Hung TM. Preferred Reporting Items for Resistance Exercise Studies (PRIRES): A Checklist Developed Using an Umbrella Review of Systematic Reviews. SPORTS MEDICINE - OPEN 2023; 9:114. [PMID: 38040927 PMCID: PMC10692055 DOI: 10.1186/s40798-023-00640-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 09/26/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The issues of replication and scientific transparency have been raised in exercise and sports science research. A potential means to address the replication crisis and enhance research reliability is to improve reporting quality and transparency. This study aims to formulate a reporting checklist as a supplement to the existing reporting guidelines, specifically for resistance exercise studies. METHODS PubMed (which covers Medline) and Scopus (which covers Medline, EMBASE, Ei Compendex, World Textile Index, Fluidex, Geobase, Biobase, and most journals in Web of Science) were searched for systematic reviews that comprised the primary studies directly comparing different resistance training methods. Basic data on the selected reviews, including on authors, publication years, and objectives, were summarized. The reporting items for the checklist were identified based on the objective of the reviews. Additional items from an existing checklist, namely the Consensus on Exercise Reporting Template, a National Strength and Conditioning Association handbook, and an article from the EQUATOR library were incorporated into the final reporting checklist. RESULTS Our database search retrieved 3595 relevant records. After automatic duplicate removal, the titles and abstracts of the remaining 2254 records were screened. The full texts of 137 records were then reviewed, and 88 systematic reviews that met the criteria were included in the umbrella review. CONCLUSION Developed primarily by an umbrella review method, this checklist covers the research questions which have been systematically studied and is expected to improve the reporting completeness of future resistance exercise studies. The PRIRES checklist comprises 26 reporting items (39 subitems) that cover four major topics in resistance exercise intervention: 1) exercise selection, performance, and training parameters, 2) training program and progression, 3) exercise setting, and 4) planned vs actual training. The PRIRES checklist was designed specifically for reporting resistance exercise intervention. It is expected to be used with other reporting guidelines such as Consolidated Standards of Reporting Trials and Standard Protocol Items: Recommendations for Interventional Trials. This article presents only the development process and resulting items of the checklist. An accompanying article detailing the rationale for, the importance of, and examples of each item is being prepared. REGISTRATION This study is registered with the EQUATOR Network under the title "Preferred Reporting Items for Resistance Exercise Studies (PRIRES)." PROSPERO registration number: CRD42021235259.
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Affiliation(s)
- Ting-Yu Lin
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da'an District, Taipei City, 106, Taiwan
| | - Ting-Yu Chueh
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da'an District, Taipei City, 106, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da'an District, Taipei City, 106, Taiwan.
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Davids CJ, Roberts LA, Bjørnsen T, Peake JM, Coombes JS, Raastad T. Where Does Blood Flow Restriction Fit in the Toolbox of Athletic Development? A Narrative Review of the Proposed Mechanisms and Potential Applications. Sports Med 2023; 53:2077-2093. [PMID: 37578669 PMCID: PMC10587223 DOI: 10.1007/s40279-023-01900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
Blood flow-restricted exercise is currently used as a low-intensity time-efficient approach to reap many of the benefits of typical high-intensity training. Evidence continues to lend support to the notion that even highly trained individuals, such as athletes, still benefit from this mode of training. Both resistance and endurance exercise may be combined with blood flow restriction to provide a spectrum of adaptations in skeletal muscle, spanning from myofibrillar to mitochondrial adjustments. Such diverse adaptations would benefit both muscular strength and endurance qualities concurrently, which are demanded in athletic performance, most notably in team sports. Moreover, recent work indicates that when traditional high-load resistance training is supplemented with low-load, blood flow-restricted exercise, either in the same session or as a separate training block in a periodised programme, a synergistic and complementary effect on training adaptations may occur. Transient reductions in mechanical loading of tissues afforded by low-load, blood flow-restricted exercise may also serve a purpose during de-loading, tapering or rehabilitation of musculoskeletal injury. This narrative review aims to expand on the current scientific and practical understanding of how blood flow restriction methods may be applied by coaches and practitioners to enhance current athletic development models.
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Affiliation(s)
- Charlie J Davids
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia.
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Thomas Bjørnsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Jonathan M Peake
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Truls Raastad
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
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Castilla-López C, Romero-Franco N. Low-load strength resistance training with blood flow restriction compared with high-load strength resistance training on performance of professional soccer players: a randomized controlled trial. J Sports Med Phys Fitness 2023; 63:1146-1154. [PMID: 37535339 DOI: 10.23736/s0022-4707.23.14974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
BACKGROUND The aim of this study is to evaluate the effectiveness of low-load blood flow restriction strength resistance training (LL-BFR) compared to high load strength resistance training (HL) on performance of professional soccer players. METHODS Eighteen male players from National Soccer Professional League were randomly allocated into two groups: LL-BFR, who performed a 6-weeks strength training program with low load (20-35% of one-repetition maximum-[1RM]), or HL, who performed a 6-week resistance training program with high load (70-85% 1RM). Before and after, thigh girth, vertical jump, lower limb strength, vertical force-velocity profile (F-v), and 30-m sprint were evaluated. RESULTS After the training program, both LL-BFR and HL induced significant increases compared to baseline in thigh girth (+3.3% for LL-BFR and +3.1% for HL) and maximal velocity during sprinting (+6.0 and +6.2%, respectively), without between-group differences. In reference to FV, only HL players improved imbalance (-54.4%), maximal theoretical force production (+10.4%) and decreased extension velocity (-20.5%) compared to baseline, without between-group differences. Only LL-BFR induced increases in maximum voluntary contraction of left hamstring compared to baseline (+13.8%), without between-group differences. No differences were shown for the rest of variables (P>0.05). CONCLUSIONS Although LL-BFR may increase muscle circumference and sprint ability, these results are similar to those induced with HL in male professional soccer. In terms of F-v, only HL induced improvements, but these changes were not greater than those observed after LL-BFR.
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Affiliation(s)
| | - Natalia Romero-Franco
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IIdISBa), Palma, Spain
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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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Keller M, Faude O, Gollhofer A, Centner C. Can We Make Blood Flow Restriction Training More Accessible? Validity of a Low-Cost Blood Flow Restriction Device to Estimate Arterial Occlusion Pressure. J Strength Cond Res 2023; 37:1581-1587. [PMID: 36728035 DOI: 10.1519/jsc.0000000000004434] [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: 02/03/2023]
Abstract
ABSTRACT Keller, M, Faude, O, Gollhofer, A, and Centner, C. Can we make blood flow restriction training more accessible? Validity of a low-cost blood flow restriction device to estimate arterial occlusion pressure. J Strength Cond Res 37(8): 1581-1587, 2023-Evidence indicates that low-load resistance training with blood flow restriction (BFR) results in comparable gains in muscle mass and muscle strength as high-load resistance training without BFR. Low-load BFR training is a promising tool for areas such as rehabilitation because individuals are exposed to low mechanical stress. However, BFR training is only safe and effective when the cuff pressure is individually adjusted to the arterial occlusion pressure (AOP). Generally, thresholds for AOP are typically determined with sophisticated laboratory material, including Doppler ultrasound and tourniquet systems. Therefore, this study investigated the validity of a low-cost BFR product with automatic AOP assessment (AirBands International) compared with the gold standard for determining the individual AOP. Valid measurements were obtained at the arms and legs in 104 healthy volunteers. For the arms ( n = 49), a Bland-Altman analysis revealed a mean difference of 7 ± 13 mm Hg between the 2 methods, with slightly higher pressure levels for the gold standard (131 ± 14 mm Hg) than for the low-cost device (125 ± 17 mm Hg). For the legs ( n = 55), the low-cost device reached its maximum pressure capacity in 70% of subjects during AOP identification, making the results on the legs unreliable. Although the low-cost device is a valid tool for identifying the individual AOP in the arms, the device cannot be recommended for use at the legs because of its limited pressure capacity. When using the low-cost device for BFR training at the arms, it is recommended to apply the cuff pressure to 60% of the individual AOP to meet current BFR training guidelines.
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Affiliation(s)
- Martin Keller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany; and
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany; and
- Praxisklinik Rennbahn, Muttenz, Switzerland
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Reina-Ruiz ÁJ, Martínez-Cal J, Molina-Torres G, Romero-Galisteo RP, Galán-Mercant A, Carrasco-Vega E, González-Sánchez M. Effectiveness of Blood Flow Restriction on Functionality, Quality of Life and Pain in Patients with Neuromusculoskeletal Pathologies: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1401. [PMID: 36674158 PMCID: PMC9858892 DOI: 10.3390/ijerph20021401] [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: 11/29/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Blood flow restriction is characterized as a method used during exercise at low loads of around 20-40% of a repetition maximum, or at a low-moderate intensity of aerobic exercise, in which cuffs that occlude the proximal part of the extremities can partially reduce arterial flow and fully restrict the venous flow of the musculature in order to achieve the same benefits as high-load exercise. OBJECTIVE The main objective of this systematic literature review was to analyze the effects of BFR intervention on pain, functionality, and quality of life in subjects with neuromusculoskeletal pathologies. METHODS The search to carry out was performed in PubMed, Cochrane, EMBASE, PEDro, CINHAL, SPORTDiscus, Trip Medical Database, and Scopus: "kaatsu" OR "ischemic training" OR "blood flow restriction" OR "occlusion resistance training" OR "vascular occlusion" OR "vascular restriction". RESULTS After identifying 486 papers and eliminating 175 of them due to duplication and 261 after reading the title and abstract, 50 papers were selected. Of all the selected articles, 28 were excluded for not presenting a score equal to or higher than 6 points on the PEDro scale and 8 for not analyzing the target outcome variables. Finally, 14 papers were selected for this systematic review. CONCLUSIONS The data collected indicate that the blood flow restriction tool is a therapeutic alternative due to its effectiveness under different exercise modalities. The benefits found include decreases in pain thresholds and improvement in the functionality and quality of life of the neuro-musculoskeletal patient during the first six weeks. However, the results provided by this tool are still not clear for medium- and long-term interventions.
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Affiliation(s)
- Álvaro Jesús Reina-Ruiz
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
| | - Jesús Martínez-Cal
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain
| | - Guadalupe Molina-Torres
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain
| | - Rita-Pilar Romero-Galisteo
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain
| | - Alejandro Galán-Mercant
- Institute of Biomedicine of Cádiz (INIBICA), 11009 Cádiz, Spain
- MOVE-IT Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of Cádiz, 11009 Cádiz, Spain
| | - Elio Carrasco-Vega
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain
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9
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Rodrigues S, Forte P, Dewaele E, Branquinho L, Teixeira JE, Ferraz R, Barbosa TM, Monteiro AM. Effect of Blood Flow Restriction Technique on Delayed Onset Muscle Soreness: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58091154. [PMID: 36143831 PMCID: PMC9505400 DOI: 10.3390/medicina58091154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The effect of the blood flow restriction technique (BFR) on delayed onset muscular soreness (DOMS) symptoms remains unclear. Since there is no consensus in the literature, the aim of the present study is to systematically identify and appraise the available evidence on the effects of the BFR technique on DOMS, in healthy subjects. Materials and Methods: Computerized literature search in the databases Pubmed, Google Scholar, EBSCO, Cochrane and PEDro to identify randomized controlled trials that assessed the effects of blood flow restriction on delayed onset muscular soreness symptoms. Results: Eight trials met the eligibility criteria and were included in this review, presenting the results of 118 participants, with a mean methodological rating of 6/10 on the PEDro scale. Conclusions: So far, there is not enough evidence to confirm or refute the influence of BFR on DOMS, and more studies with a good methodological basis are needed, in larger samples, to establish protocols and parameters of exercise and intervention. Data analysis suggests a tendency toward the proinflammatory effect of BFR during high restrictive pressures combined with eccentric exercises, while postconditioning BFR seems to have a protective effect on DOMS. Prospero ID record: 345457, title registration: “Effect of Blood Flow Restriction Technique on the Prevention of Delayed Onset Muscle Soreness: A Systematic Review”.
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Affiliation(s)
- Sandra Rodrigues
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Rua Delfim Maia, 334, 4200-253 Porto, Portugal
- Correspondence:
| | - Pedro Forte
- Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - Eva Dewaele
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Rua Delfim Maia, 334, 4200-253 Porto, Portugal
| | - Luís Branquinho
- Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - José E. Teixeira
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - Ricardo Ferraz
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
- Department of Sports Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal
| | - Tiago M. Barbosa
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - António M. Monteiro
- Department of Sports Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
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10
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Hill EC, Rivera PM, Proppe CE, Gonzalez Rojas DH, Wizenberg AM, Keller JL. Greater Neuromuscular Fatigue Following Low Load Blood Flow Restriction than Non Blood Flow Restriction Resistance Exercise Among Recreationally Active Men. J Neurophysiol 2022; 128:73-85. [PMID: 35704398 DOI: 10.1152/jn.00028.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the acute effects of low-load blood flow restriction (LLBFR) and low-load non-BFR (LL) on neuromuscular function following a bout of standardized, fatiguing leg extension muscle actions. METHODS Fourteen men (mean age ± SD = 23±4 yrs) volunteered to participate in this investigation and randomly performed LLBFR and LL on separate days. Resistance exercise consisted of 75 isotonic, unilateral leg extension muscle actions performed at 30% of one-repetition maximum. Prior to (pretest) and after (posttest) performing each bout of exercise, strength and neural assessments were determined. RESULTS There was no pretest to posttest differences between LLBFR and LL for maximal voluntary isometric contraction (MVIC) torque or V-wave/M-wave responses (muscle compound action potentials assessed during a superimposed MVIC muscle action) which exhibited decreases (collapsed across condition) of 41.2% and 26.2%, respectively. There were pretest to posttest decreases in peak twitch torque (36.0%) and sEMG (29.5%) for LLBFR but not LL, and larger decreases in voluntary activation for LLBFR (11.3%) than LL (4.5%). CONCLUSIONS These findings suggested that LLBFR elicited greater fatigue-induced decreases in several indices of neuromuscular function relative to LL. Despite this, both LLBFR and LL resulted in similar decrements in performance as assessed by maximal strength.
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Affiliation(s)
- Ethan C Hill
- School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florida, Orlando, FL, United States.,Florida Space Institute, University of Central Florida, Orlando, FL, United States
| | - Paola M Rivera
- School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florida, Orlando, FL, United States
| | - Christopher E Proppe
- School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florida, Orlando, FL, United States
| | - David H Gonzalez Rojas
- School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florida, Orlando, FL, United States
| | - Aaron M Wizenberg
- School of Kinesiology & Physical Therapy, Division of Kinesiology, University of Central Florida, Orlando, FL, United States
| | - Joshua L Keller
- College of Education and Professional Studies, Department of Health, Kinesiology and Sport Integrated Laboratory of Exercise and Applied Physiology, University of South Alabama, Mobile, AL, United States
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11
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Yang S, Zhang P, Sevilla-Sanchez M, Zhou D, Cao J, He J, Gao B, Carballeira E. Low-Load Blood Flow Restriction Squat as Conditioning Activity Within a Contrast Training Sequence in High-Level Preadolescent Trampoline Gymnasts. Front Physiol 2022; 13:852693. [PMID: 35770193 PMCID: PMC9234321 DOI: 10.3389/fphys.2022.852693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
To investigate the effects of implementing low-load blood flow restriction exercises (LL-BFRE) instead of high-load exercises (HL-RE) in a contrast training program on strength and power performance of high-level young gymnasts. Fifteen high-level pre-pubescent trampoline gymnasts (national level, Tanner Stage II, intermediate experience in strength training) were divided into two groups to complete the same structure of a ten-week contrast strength training program differing only in the configuration of the first resistance exercise of the contrast sequence. The LL-BFRE group (n = 7, four girls, 13.9 ± 0.4 y) performed the first resistance exercise of the contrast with LL-BFRE (20%–30% 1RM, perceived pressure of 7 on a scale from 0 to 10). The HL-RE group (n = 8, four girls, 13.8 ± 0.5 y) trained the first resistance exercise of the contrast sequence with moderate-to-high load (60%–85% 1RM). Before and after the training period, isometric mid-thigh pull (IMTP), squat jump (SJ), counter movement jump (CMJ), and drop-jump (DJ) were performed to evaluate the effect of the intervention on strength and power capacities as primary outcomes. Changes in participants’ anthropometric measures, muscle mass, left and right thigh girth, IMTP relative to bodyweight (IMTP-R), eccentric utilization ratio (EUR), and reactive strength index (RSI) were assessed as secondary outcomes. There was no significant interaction (p > 0.05) between group x time in any power and strength outcome, although SJ and EUR showed a trend to significant interaction (p = 0.06 and p = 0.065, respectively). There was an overall effect of time (p < 0.05) in all power and strength variables (CMJ, SJ, EUR, DJ, RSI, IMTP, and IMTP-R). There was a significant interaction in muscle mass (MM) [β = 0.57 kg, 95% CI = (0.15; 0.98), t13 = 2.67, p = 0.019], revealing that participants in LL-BFRE increased their muscle mass (6.6 ± 3.1%) compared to HL-RE (3.6 ± 2.0%). Anthropometric variables did not present any group or interaction effect. However, there was a time effect (p < 0.05). Implementing LL-BFRE in place of HL-RE as a conditioning activity in a contrast training sequence might be equally effective in improving lower-body strength and power in preadolescent trampoline gymnasts.
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Affiliation(s)
- Shengtao Yang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, China
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Peng Zhang
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Marta Sevilla-Sanchez
- Department of Physical Education and Sport, Faculty of Sport Sciences and Physical Education, Campus Bastiagueiro, University of A Coruna, Oleiros, Spain
| | - Dong Zhou
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Jie Cao
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Jiajian He
- Professional Sports Research Center, Shanghai Research Institute of Sports Science, Shanghai, China
| | - Binghong Gao
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, China
- *Correspondence: Binghong Gao, ; Eduardo Carballeira,
| | - Eduardo Carballeira
- Department of Physical Education and Sport, Faculty of Sport Sciences and Physical Education, Campus Bastiagueiro, University of A Coruna, Oleiros, Spain
- *Correspondence: Binghong Gao, ; Eduardo Carballeira,
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12
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Reina-Ruiz ÁJ, Galán-Mercant A, Molina-Torres G, Merchán-Baeza JA, Romero-Galisteo RP, González-Sánchez M. Effect of Blood Flow Restriction on Functional, Physiological and Structural Variables of Muscle in Patients with Chronic Pathologies: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031160. [PMID: 35162182 PMCID: PMC8835162 DOI: 10.3390/ijerph19031160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 02/01/2023]
Abstract
The main objective of this systematic review of the current literature is to analyze the changes that blood flow restriction (BFR) causes in subjects with neuro-musculoskeletal and/or systemic pathologies focusing on the following variables: strength, physiological changes, structural changes and cardiocirculatory variables. The search was carried out in seven databases, including randomized clinical trials in which therapeutic exercise was combined with the blood flow restriction tool in populations with musculoskeletal pathologies. Outcome variables are strength, structural changes, physiological changes and cardiocirculatory variables. Twenty studies were included in the present study. Although there is a lot of heterogeneity between the interventions and evaluation instruments, we observed how the restriction of blood flow presents significant differences in the vast majority of the variables analyzed. In addition, we observed how BFR can become a supplement that provides benefits when performed with low intensity, similar to those obtained through high-intensity muscular efforts. The application of the BFR technique can provide benefits in the short and medium term to increase strength, muscle thickness and cardiovascular endurance, even improving the physiological level of the cardiovascular system. In addition, BFR combined with low-load exercises also achieves benefits comparable to high-intensity exercises without the application of BFR, benefiting patients who are unable to lift high loads.
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Affiliation(s)
- Álvaro Jesús Reina-Ruiz
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain; (Á.J.R.-R.); (R.P.R.-G.); (M.G.-S.)
| | - Alejandro Galán-Mercant
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education, Sciences University of Cádiz, 11002 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11002 Cádiz, Spain
- Correspondence: (A.G.-M.); (G.M.-T.)
| | - Guadalupe Molina-Torres
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Nursing and Physiotherapy, University of Almeria, 04120 Almeria, Spain
- Correspondence: (A.G.-M.); (G.M.-T.)
| | - Jose Antonio Merchán-Baeza
- Centre for Health and Social Care Research (CESS), Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain;
| | - Rita Pilar Romero-Galisteo
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain; (Á.J.R.-R.); (R.P.R.-G.); (M.G.-S.)
- Instituto de Investigación Biomédica de Málaga, IBIMA, Calle Doctor Miguel Díaz Recio, 28, 29010 Málaga, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain; (Á.J.R.-R.); (R.P.R.-G.); (M.G.-S.)
- Instituto de Investigación Biomédica de Málaga, IBIMA, Calle Doctor Miguel Díaz Recio, 28, 29010 Málaga, Spain
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Fleming JD, Ritzmann R, Centner C. Effect of an Anterior Cruciate Ligament Rupture on Knee Proprioception Within 2 Years After Conservative and Operative Treatment: A Systematic Review with Meta-Analysis. Sports Med 2021; 52:1091-1102. [PMID: 34854058 PMCID: PMC9023382 DOI: 10.1007/s40279-021-01600-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The anterior cruciate ligament (ACL) plays a major role in knee proprioception and is thus responsible for maintaining knee joint stability and functionality. The available evidence suggests that ACL reconstruction diminishes somatosensory feedback and proprioceptive functioning, which are vital for adequate joint positioning and movement control. OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the effect of an ACL rupture on knee proprioception after arthroscopic ACL repair surgery or conservative treatment. METHODS A systematic review with meta-analysis was conducted according to the Preferred Reporting Guidelines for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was performed in the following databases from inception to 10th October 2020: PubMed, Web of Science, SPORTDiscus, Cochrane Library and Scopus. Randomized and non-randomized studies that evaluated proprioception using the joint position sense (JPS) and threshold to detection of passive motion (TTDPM) techniques at 15°-30° knee flexion with an external healthy control group in a time period between 6 and 24 months post injury or operation were included in the analysis. RESULTS In total, 4857 studies were identified, from which 11 were included in the final quantitative analysis. The results demonstrated that proprioception after arthroscopic ACL repair surgery was significantly lower than in the healthy control group (JPS: standardized mean difference [SMD] 0.57, 95% confidence interval [CI] 0.27-0.87, p < 0.01, n = 6 studies; TTDPM: SMD 0.77, 95% CI 0.20-1.34, p < 0.01, n = 4 studies). There were no significant differences in proprioception between the conservative treatment group and the healthy control group (JPS: SMD 0.57, 95% CI - 0.69 to 1.84, p = 0.37, n = 4 studies; TTDPM: SMD 0.82, 95% CI - 0.02 to 1.65, p = 0.05, n = 2 studies), although measures for TTDPM were close to statistical significance. CONCLUSION The findings of the present systematic review and meta-analysis revealed that knee proprioception is persistently compromised 6-24 months following surgical treatment of ACL tears compared with healthy controls. The reduced kinesthetic awareness after ACL surgery is of high relevance for optimizing individual treatment plans in these patients. As the current literature is still scarce about the exact underlying mechanisms, further research is needed. TRIAL REGISTRATION The present systematic review was registered in PROSPERO (CRD42021198617).
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Affiliation(s)
- John Dick Fleming
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany
| | | | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany. .,Praxisklinik Rennbahn, Muttenz, Switzerland.
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14
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Bielitzki R, Behrendt T, Behrens M, Schega L. Time to Save Time: Beneficial Effects of Blood Flow Restriction Training and the Need to Quantify the Time Potentially Saved by Its Application During Musculoskeletal Rehabilitation. Phys Ther 2021; 101:6315163. [PMID: 34228788 DOI: 10.1093/ptj/pzab172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/14/2021] [Accepted: 06/06/2021] [Indexed: 11/14/2022]
Abstract
The main goal of musculoskeletal rehabilitation is to achieve the pre-injury and/or pre-surgery physical function level with a low risk of re-injury. Blood flow restriction (BFR) training is a promising alternative to conventional therapy approaches during musculoskeletal rehabilitation because various studies support its beneficial effects on muscle mass, strength, aerobic capacity, and pain perception. In this perspective article, we used an evidence-based progressive model of a rehabilitative program that integrated BFR in 4 rehabilitation phases: (1) passive BFR, (2) BFR combined with aerobic training, (3) BFR combined with low-load resistance training, and (4) BFR combined with low-load resistance training and traditional high-load resistance training. Considering the current research, we propose that a BFR-assisted rehabilitation has the potential to shorten the time course of therapy to reach the stage where the patient is able to tolerate resistance training with high loads. The information and arguments presented are intended to stimulate future research, which compares the time to achieve rehabilitative milestones and their physiological bases in each stage of the musculoskeletal rehabilitation process. This requires the quantification of BFR training-induced adaptations (eg, muscle mass, strength, capillary-to-muscle-area ratio, hypoalgesia, molecular changes) and the associated changes in performance with a high measurement frequency (≤1 week) to test our hypothesis. This information will help to quantify the time saved by BFR-assisted musculoskeletal rehabilitation. This is of particular importance for patients, because the potentially accelerated recovery of physical functioning would allow them to return to their work and/or social life earlier. Furthermore, other stakeholders in the health care system (eg, physicians, nurses, physical therapists, insurance companies) might benefit from that with regard to work and financial burden.
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Affiliation(s)
- Robert Bielitzki
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tom Behrendt
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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15
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de Lima FR, Marin DP, Ferreira LT, Sousa Filho CPB, Astorino TA, Prestes J, Marquezi ML, Otton R. Effect of Resistance Training With Total and Partial Blood Flow Restriction on Biomarkers of Oxidative Stress and Apoptosis in Untrained Men. Front Physiol 2021; 12:720773. [PMID: 34566685 PMCID: PMC8458755 DOI: 10.3389/fphys.2021.720773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: The characterization of immune and oxidative stress responses to acute and chronic exercise training is important because it may aid in the safety and dose–response prescription of resistance training (RT) in many populations. Purpose: The present study compared changes in acute oxidative stress and markers of apoptosis in immune cells before and after 8 weeks of low-load RT with total or partial blood flow restriction (BFR) versus high-load traditional RT. Methods: Twenty-seven untrained men were randomly divided into three groups: traditional RT [75% one-repetition maximum (1-RM)], RT with partial (20% 1-RM), and total BFR (20% 1-RM). Over an 8-week period, participants performed six sets of arm curls until failure with 90 seconds of recovery for 3 days/week. Blood samples were obtained before and after the first and last training sessions. Results: Data indicated that all training groups showed similar increases in muscular strength (p < 0.001), reduction in mitochondrial membrane potential (MMP) after exercise in neutrophils (p < 0.001), and increase in caspase-3 activity after exercise (p < 0.001). Traditional RT and total BFR showed increased plasma lipid peroxidation (p < 0.001) and protein carbonyls (p < 0.001) and lower levels of reduced glutathione (GSH) (p < 0.001) after exercise. No change was observed in oxidative stress biomarkers in response to partial BFR (p > 0.05). Conclusion: Data show that RT with partial BFR can increase muscular strength but still does not augment biomarkers of oxidative stress in untrained men. In addition, RT with total BFR promoted similar responses of oxidative stress and markers of immune cell apoptosis versus traditional RT.
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Affiliation(s)
- Fabio Rocha de Lima
- Interdisciplinary Post-graduate Programme in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Douglas Popp Marin
- Interdisciplinary Post-graduate Programme in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Letícia Torres Ferreira
- Interdisciplinary Post-graduate Programme in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | | | - Todd Anthony Astorino
- Department of Kinesiology, California State University San Marcos, San Marcos, CA, United States
| | - Jonato Prestes
- Graduation Program on Physical Education, Catholic University of Brasilia, Brazilia, Brazil
| | - Marcelo Luis Marquezi
- Physical Education Research Laboratory, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Rosemari Otton
- Interdisciplinary Post-graduate Programme in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
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16
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Editorial Commentary: Blood Flow Restriction Therapy Continues to Prove Effective. Arthroscopy 2021; 37:2870-2872. [PMID: 34481627 DOI: 10.1016/j.arthro.2021.04.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 04/30/2021] [Indexed: 02/02/2023]
Abstract
Blood flow restriction (BFR) training continues to look promising to try and maintain muscle mass or to rebuild muscle mass and strength after injury or surgery. Because additional potential benefits include pain control, increased gene expression (leading to atrophy reduction), and muscle excitation, our use of the modality favors earlier over middle- or late-phase postoperative use. We initiate BFR therapy 2-14 days postoperatively, often with reduced cuff pressure in the first several sessions before increasing to the recommended therapeutic occlusion level. We have observed the greatest benefit for individuals who are non-weight-bearing for 6 to 8 weeks and who may have more postoperative restrictions due to the nature of the surgery. Compared with the opposite thigh, we have seen instances in which quadriceps girth has been preserved, although not increased, following the non-weight-bearing period. Ideally, we use 1 to 3 low-load resistance training exercises per session at least 2 times per week for 6 weeks. We also employ BFR following osteotomy or any procedure where bone drilling is used, as researchers have observed improved bone health. Additional benefits relevant to the early postoperative phase, such as effusion and pain reduction, have not been clearly established. Anecdotally, we have seen effusion levels temporarily increase during treatment but then resolve to baseline within 30 to 60 minutes of tourniquet deflation. Further high-level research is necessary to objectively validate BFR use and which patients may best benefit from it.
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17
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Cerqueira MS, Maciel DG, Barboza JAM, Centner C, Lira M, Pereira R, De Brito Vieira WH. Effects of low-load blood flow restriction exercise to failure and non-failure on myoelectric activity: a meta-analysis. J Athl Train 2021; 57:402-417. [PMID: 34038945 DOI: 10.4085/1062-6050-0603.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To compare the short- and long-term effects of low load blood flow restriction (LL-BFR) versus low- (LL-RT) or high-load (HL-RT) resistance training with free blood flow on myoelectric activity, and investigate the differences between failure and non-failure protocols. DATA SOURCE We identified sources by searching the MEDLINE/PUBMED, CINAHL, WEB OF SCIENCE, CENTRAL, SCOPUS, SPORTDiscus, and PEDro electronic databases. STUDY SELECTION We screened titles and abstracts of 1048 articles using our inclusion criteria. A total of 39 articles were selected for further analysis. DATA EXTRACTION Two reviewers independently assessed the methodological quality of each study and extracted data from studies. A meta-analytic approach was used to compute standardized mean differences (SMD ± 95% confidence intervals (CI)). Subgroup analyses were conducted for both failure or non-failure protocols. DATA SYNTHESIS The search identified n = 39 articles that met the inclusion criteria. Regarding the short-term effects, LL-BFR increased muscle excitability compared with LL-RT during non-failure exercises (SMD 0.61, 95% CI 0.34 to 0.88), whereas HL-RT increased muscle excitability compared with LL-BFR regardless of voluntary failure (SMD -0.61, 95% CI -1.01 to 0.21) or not (SMD -1.13, CI -1.94 to -0.33). Concerning the long-term effects, LL-BFR increased muscle excitability compared with LL-RT during exercises performed to failure (SMD 1.09, CI 0.39 to 1.79). CONCLUSIONS Greater short-term muscle excitability levels are observed in LL-BFR than LL-RT during non-failure protocols. Conversely, greater muscle excitability is present during HL-RT compared with LL-BFR, regardless of volitional failure. Furthermore, LL-BFR performed to failure increases muscle excitability in the long-term compared with LL-RT.
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Affiliation(s)
- Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Daniel Germano Maciel
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Jean Artur Mendonça Barboza
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany; Praxisklinik Rennbahn, Muttenz, Switzerland,
| | - Maria Lira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil,
| | - Wouber Hérickson De Brito Vieira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
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Pignanelli C, Christiansen D, Burr JF. Blood flow restriction training and the high-performance athlete: science to application. J Appl Physiol (1985) 2021; 130:1163-1170. [PMID: 33600282 DOI: 10.1152/japplphysiol.00982.2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The manipulation of blood flow in conjunction with skeletal muscle contraction has greatly informed the physiological understanding of muscle fatigue, blood pressure reflexes, and metabolism in humans. Recent interest in using intentional blood flow restriction (BFR) has focused on elucidating how exercise during periods of reduced blood flow affects typical training adaptations. A large initial appeal for BFR training was driven by studies demonstrating rapid increases in muscle size, strength, and endurance capacity, even when notably low intensities and resistances, which would typically be incapable of stimulating change in healthy populations, were used. The incorporation of BFR exercise into the training of strength- and endurance-trained athletes has recently been shown to provide additive training effects that augment skeletal muscle and cardiovascular adaptations. Recent observations suggest BFR exercise alters acute physiological stressors such as local muscle oxygen availability and vascular shear stress, which may lead to adaptations that are not easily attained with conventional training. This review explores these concepts and summarizes both the evidence base and knowledge gaps regarding the application of BFR training for athletes.
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Affiliation(s)
- Christopher Pignanelli
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Danny Christiansen
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jamie F Burr
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Torma F, Bakonyi P, Regdon Z, Gombos Z, Jokai M, Babszki G, Fridvalszki M, Virág L, Naito H, Iftikhar Bukhari S, Radak Z. Blood flow restriction during the resting periods of high-intensity resistance training does not alter performance but decreases MIR-1 and MIR-133A levels in human skeletal muscle. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:40-45. [PMID: 35782677 PMCID: PMC9219274 DOI: 10.1016/j.smhs.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ferenc Torma
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Peter Bakonyi
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Zsolt Regdon
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Hungary
| | - Zoltan Gombos
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Matyas Jokai
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Gergely Babszki
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Marcell Fridvalszki
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Laszló Virág
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Hungary
| | - Hisashi Naito
- Department of Exercise Physiology, Graduate School of Health and Sports Science & Medicine, Juntendo University, Japan
| | | | - Zsolt Radak
- Research Center of Molecular Exercise Science, University of Physical Education, Budapest, Hungary
- Faculty of Sport Sciences, Waseda University, Japan
- Corresponding author. Research Center for Molecular Exercise Science, University of Physical Education, Alkotas u. 44, Budapest, H-1123, Hungary.
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20
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Lauber B, König D, Gollhofer A, Centner C. Isometric blood flow restriction exercise: acute physiological and neuromuscular responses. BMC Sports Sci Med Rehabil 2021; 13:12. [PMID: 33579336 PMCID: PMC7881598 DOI: 10.1186/s13102-021-00239-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/02/2021] [Indexed: 12/15/2022]
Abstract
Background Numerous studies have demonstrated that the addition of blood flow restriction (BFR) to low-load (LL) resistance exercise leads to elevated levels of muscle hypertrophy and strength gains. In terms of main underlying mechanisms, metabolic accumulation and increased neuromuscular adaptations seem to play a primary role. However, this evidence is largely based on dynamic exercise conditions. Therefore, the main objective was to investigate the acute physiological adaptations following isometric LL-BFR exercise. Methods Fifteen males participated in this cross-over trial and completed the following sessions in a random and counterbalanced order: isometric LL-BFR exercise (20% maximum voluntary contraction, MVC) and load matched LL exercise without BFR. Lactate levels, muscle activation as well as muscle swelling were recorded during the whole exercise and until 15 min post completion. Additionally, changes in maximal voluntary torque and ratings of perceived exertion (RPE) were monitored. Results During exercise, EMG amplitudes (72.5 ± 12.7% vs. 46.3 ± 6.7% of maximal EMG activity), muscle swelling and RPE were significantly higher during LL-BFR compared to LL (p < 0.05). Lactate levels did not show significant group differences during exercise but revealed higher increases 15 min after completion in the LL-BFR condition (LL-BFR: + 69%, LL: + 22%) (p < 0.05). Additionally, MVC torque significantly decreased immediately post exercise only in LL-BFR (~ − 11%) (p < 0.05) but recovered after 15 min. Conclusions The present results demonstrate that isometric LL-BFR causes increased metabolic, neuromuscular as well as perceptual responses compared to LL alone. These adaptations are similar to dynamic exercise and therefore LL-BFR represents a valuable type of exercise where large joint movements are contraindicated (e.g. rehabilitation after orthopedic injuries).
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Affiliation(s)
- Benedikt Lauber
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland.,Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany
| | - Daniel König
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany. .,Praxisklinik Rennbahn, Muttenz, Switzerland.
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