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Feng Y, Wen F, Ahmad I, Chen Y, Ye W, Jiang H, Li H, Dai J, Li L, Hu R, Teng C, Yin Y. Does exercise training combined with blood flow restriction improve muscle mass, lower extremity function, and walking capacity in hemiplegic patients? A randomized clinical trial. Top Stroke Rehabil 2025:1-10. [PMID: 40159947 DOI: 10.1080/10749357.2025.2482390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 03/17/2025] [Indexed: 04/02/2025]
Abstract
BACKGROUND Blood flow restriction creates a state with increased motor function that permits treatment modalities to induce muscle hypertrophy. Blood flow-restricted exercise training (BFRET) may induce motor learning and boost the facilitatory effect of exercise training (ET). OBJECTIVE This study investigated the effects of BFRET on post-stroke hemi paretic lower extremity function and walking capacity recovery. METHODOLOGY This randomized clinical trial was conducted from September 2021 to October 2022 at the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Chongqing Medical University in China. Participants were randomized 1:1 to BFRET or ET, each involving 30 minutes of training twice per day for 4 weeks. MAIN OUTCOMES MEASURES The main outcomes were manual muscle testing (MMT) and Fugl-Meyer assessment scale-lower extremity (FMA-LE), the timed up and go test (TUGT), Outcomes were assessed by blinded raters after 4 weeks of training. RESULTS 40 participants mean [SD] age 48.79[12.58] years, 30 males [75%], 20 were randomized to BFRET and 20 to ET. The mean (SD) time since stroke was 2.5 (1.3) years. The MMT scores showed greater strength by within-group comparisons and superior changes in hip flexion and plantar flexion in the BFRET group. CONCLUSIONS BFRET is superior to ET alone in enhancing muscle mass and strength in the lower extremities. BFRET may improve the function of the lower extremities through physiological adaptations for muscle hypertrophy. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: ChiCTR2100050206.
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Affiliation(s)
- Yali Feng
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fanglin Wen
- Department of Rehabilitation Medicine, the Chongqing Medical University, Chongqing, China
| | - Irfan Ahmad
- Department of Rehabilitation Medicine, the Chongqing Medical University, Chongqing, China
| | - Yuanyuan Chen
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenwen Ye
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hang Jiang
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Li
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinshan Dai
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Le Li
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Hu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Can Teng
- Department of Pain Rehabilitation, The Second Affiliated Hospital of the Chinese People's Liberation Army Army Medical University, Chongqing, China
| | - Ying Yin
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Liu X, Xiao J, Chen H. Effects of Blood Flow Restriction Training on Cognitive Flexibility in Adolescent Volleyball Players. Percept Mot Skills 2025:315125251328726. [PMID: 40113583 DOI: 10.1177/00315125251328726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2025]
Abstract
Cognitive flexibility is crucial for volleyball athletes, enabling swift adaptation to dynamic game situations. While blood flow restriction (BFR) training has been suggested to enhance working memory, its specific effects on cognitive flexibility in volleyball players are not well understood. Therefore, this study investigates the effects of BFR combined with low-intensity aerobic exercise on cognitive flexibility in adolescent athletes, with a focus on the role of peripheral catecholamines. A randomized balanced crossover design was employed, involving 20 participants who completed four intervention conditions: sedentary rest, low-intensity aerobic exercise, moderate-intensity aerobic exercise, and BFR with low-intensity aerobic exercise. Post-intervention assessments included measurements of peripheral catecholamine levels and cognitive flexibility, specifically examining shifting costs. The results revealed significant differences in shifting costs across intervention conditions (p < .001). BFR training was associated with significantly higher shifting costs compared to sedentary rest (p < .001), lowintensity aerobic exercise (p < .001), and moderate-intensity aerobic exercise (p = .003). Correlation analysis demonstrated significant negative associations between post-BFR norepinephrine (R = -0.46) and epinephrine (R = -0.48) levels and shifting costs. These findings highlight the potential of BFR training to improve cognitive flexibility in adolescent volleyball players beyond the effects of moderate-intensity aerobic exercise, with practical implications for optimizing training regimens in this population. Additionally, the observed correlations between norepinephrine and epinephrine levels and cognitive performance offer novel insights into the physiological mechanisms underpinning cognitive function in sports contexts.
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Affiliation(s)
- Xinge Liu
- China Volleyball College Beijing Sport University, Beijing, China
| | - Jingzhe Xiao
- China Ice Sports College Beijing Sport University, Beijing, China
| | - Huawei Chen
- China Volleyball College Beijing Sport University, Beijing, China
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Kong H, Zhang Y, Yin M, Xu K, Sun Q, Xie Y, Girard O. Effects of blood flow restriction training on cardiometabolic health and body composition in adults with overweight and obesity: a meta-analysis. Front Physiol 2025; 15:1521995. [PMID: 39896196 PMCID: PMC11782172 DOI: 10.3389/fphys.2024.1521995] [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: 11/03/2024] [Accepted: 12/23/2024] [Indexed: 02/04/2025] Open
Abstract
Objective This meta-analysis aims to evaluate the effects of blood flow restriction (BFR) training on cardiometabolic health and body composition in adults with overweight and obesity. Method Following PRISMA guidelines, a systematic search of PubMed (MEDLINE), EMBASE, Web of Science, Cochrane, and Scopus databases was conducted on 15 March 2024. Pooled effects for each outcome were summarized using Hedge's g (g) through meta-analysis-based random effects models, and subgroup analyses were used to explore moderators. Results A total of 11 studies with 242 participants (Age:32.6 ± 3.6, BMI:27.2 ± 3.5) were included. Regarding cardiometabolic health, BFR training significantly reduced systolic blood pressure (g = 0.62 [0.08, 1.16], p = 0.02), while no significant differences were observed in maximal oxygen uptake (g = 0.48 [-0.21, 1.17], p = 0.17) or diastolic blood pressure (g = 0.31 [-0.22, 0.84], p = 0.25). Regarding body composition, BFR training significantly reduced body fat percentage (g = 0.30 [0.01, 0.58]; p = 0.04), while no significant differences (p > 0.05) were observed in body weight (g = 0.14 [-0.14, 0.42]), body mass index (g = 0.08 [-0.21, 0.38]), waist circumference (g = 0.13 [-0.28, 0.53]), or waist-to-hip ratio (g = 0.48 [-0.19, 1.15]). Subgroup analysis revealed no significant difference in improving systolic blood pressure (g = 0.57 [-0.10, 1.24] vs. g = 0.70 [-0.18, 1.59]) and body fat percentage (g = 0.20 [-0.20, 0.61] vs. g = 0.45 [-0.05, 0.95]) between BFR resistance training and BFR aerobic training. In all selected studies, the overall risk of bias was categorized as "some concern". The certainty of evidence for the BFR outcomes was low. Conclusion BFR training shows promise in improving cardiometabolic health and body composition, indicating that it may serve as a beneficial, individualized exercise prescription for improving cardiovascular disease risk and fat loss in adults with excess body weight and obesity. Systematic Review Registration https://archive.org/details/osf-registrations-uv6jx-v1.
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Affiliation(s)
- Hao Kong
- Athletic Training Institute, Tianjin University of Sport, Tianjin, China
| | - Yilin Zhang
- Athletic Training Institute, Tianjin University of Sport, Tianjin, China
| | - Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Kai Xu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - QingGuo Sun
- Athletic Training Institute, Tianjin University of Sport, Tianjin, China
| | - Yun Xie
- Athletic Training Institute, Tianjin University of Sport, Tianjin, China
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
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Serrano-Ramón JM, García-Luna MA, Hernández-Sánchez S, Cortell-Tormo JM, García-Jaén M. Effects of Blood flow Restriction and Load on Mean Propulsive Velocity and Subjective Perceived Exertion During Squat and Bench Press Exercises. Sports Health 2025; 17:135-143. [PMID: 38544405 PMCID: PMC11569684 DOI: 10.1177/19417381241236808] [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] [Indexed: 11/19/2024] Open
Abstract
BACKGROUND The aim of this study was to determine the influence of different percentages of blood flow restriction (BFR) and loads on mean propulsive velocity (MPV) and subjective perceived exertion during squat (SQ) and bench press (BP) exercises. HYPOTHESIS Higher percentages of BFR will positively affect dependent variables, increasing MPV and reducing perceived exertion. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Eight healthy young male athletes took part. Two sets of 6 repetitions at 70% 1-repetition maximum (1RM), 2 sets of 4 repetitions at 80% 1RM, and 2 sets of 2 repetitions at 90% 1RM were performed randomly; 5-minute recoveries were applied in all sets. The varying arterial occlusion pressure (AOP) applied randomly was 0% (Control [CON]), 80%, and 100%. RESULTS No statistically significant differences in MPV were found during the BP exercise at any percentage of BFR at any percentage 1RM. During the SQ exercise, MPV results showed statistically significant increases of 5.46% (P = 0.04; ηp2 = 0.31) between CON and 100% AOP at 90% 1RM. The perceived exertion results for the BP exercise showed statistically significant reductions of -8.66% (P < 0.01; ηp2 = 0.06) between CON and 100% AOP at 90% 1RM. During the SQ exercise, the perceived exertion results showed significant reductions of -10.04% (P = 0.04; ηp2 = 0.40) between CON and 100% AOP at 80% 1RM; -5.47% (P = 0.02; ηp2 = 0.48) between CON and 80% AOP at 90% 1RM; and -11.83% (P < 0.01; ηp2 = 0.66) between CON and 100% AOP at 90% 1RM. CONCLUSION BFR percentages ~100% AOP at 90% 1RM improved acutely MPV (only in SQ exercises) and reduced acutely perceived exertion (in both exercises). These findings are important to consider when prescribing resistance training for healthy male athletes.
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Affiliation(s)
| | - Marco A. García-Luna
- Area of Physical Education and Sports, Faculty of Education, University of Alicante, Alicante, Spain
| | - Sergio Hernández-Sánchez
- Translational Research Center of Physiotherapy, Department of Pathology and Surgery, Physiotherapy Area, Miguel Hernández University, Alicante, Spain
| | - Juan M. Cortell-Tormo
- Area of Physical Education and Sports, Faculty of Education, University of Alicante, Alicante, Spain
| | - Miguel García-Jaén
- Area of Physical Education and Sports, Faculty of Education, University of Alicante, Alicante, Spain
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Chang H, Yang X, Chen B, Zhang J. Effects of Different Blood Flow Restriction Training Modes on Body Composition and Maximal Strength of Untrained Individuals. Life (Basel) 2024; 14:1666. [PMID: 39768373 PMCID: PMC11678457 DOI: 10.3390/life14121666] [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: 11/18/2024] [Revised: 12/13/2024] [Accepted: 12/14/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND The objective of this study was to examine the impacts of absolute cuff pressure blood flow restriction (A-BFR) training and incremental cuff pressure blood flow restriction (I-BFR) training, under equal cuff pressures, on body composition and maximal strength among untrained adults. Additionally, we aimed to compare these effects with those observed in high-load resistance training (HL-RT). METHODS Thirty-three adults without prior professional sports or resistance training experience were recruited and randomly assigned to three groups (n = 11 per group) for an 8-week training program, held three times weekly. The A-BFR group trained with a 20% 1RM load and a cuff occlusion pressure set at 190 mmHg. The I-BFR group initiated training with an occlusion pressure of 160 mmHg, which incrementally increased by 20 mmHg every two weeks, with other conditions mirroring those of the A-BFR group. The HL-RT group trained with a 70% 1RM load. RESULTS All three groups demonstrated a statistically significant improvement in lower-body maximal strength (p < 0.01), with no significant differences observed among the groups (p > 0.05). A notable increase in left-leg muscle mass was seen across all groups (p < 0.05). However, total muscle mass, right-leg muscle mass, fat-free mass, BMI, bone mineral density, and bone mineral content remained relatively unchanged (p > 0.05), with no significant differences among the groups (p > 0.05). Only the HL-RT group exhibited a significant increase in left-leg thigh circumference (p < 0.05), while right-leg thigh circumference remained stable (p > 0.05), with no significant intergroup differences (p > 0.05). CONCLUSIONS While A-BFR and I-BFR did not yield statistically significant differences in overall training outcomes, A-BFR demonstrated a slightly stronger potential. A-BFR and I-BFR achieved comparable gains in muscle strength and improvements in body composition to those seen with HL-RT. However, HL-RT demonstrated more significant improvements in leg circumference.
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Affiliation(s)
- Hualong Chang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China
| | - Xudong Yang
- Department of Sports Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Biao Chen
- Renji College, Wenzhou Medical University, Wenzhou 325035, China
| | - Jianli Zhang
- Exercise and Metabolism Research Center, College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China
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Bergamasco JGA, Bittencourt D, Silva DG, Biazon TMPDC, Soligon SD, Oliveira RM, Libardi CA. Individual muscle hypertrophy in high-load resistance training with and without blood flow restriction: A near-infrared spectroscopy approach. J Sports Sci 2024:1-7. [PMID: 39675016 DOI: 10.1080/02640414.2024.2437588] [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: 08/02/2024] [Accepted: 11/27/2024] [Indexed: 12/17/2024]
Abstract
We aimed to compare individual hypertrophic responses to high-load resistance training (HL-RT) or high-load with blood flow restriction (HL-BFR). Furthermore, we investigated whether greater responsiveness to one of the protocols could be explained by acute changes in blood deoxyhemoglobin concentration (HHb) and total hemoglobin concentration (tHb) (proxy markers of metabolic stress). Ten untrained participants had their legs randomized into both HL-RT and HL-BFR and underwent 10 weeks of training. Muscle cross-sectional area (mCSA) was measured at baseline and post training, while HHb and tHb during the final session. Using a threshold of 2 × typical errors (3.24%) to compare protocols, five participants showed greater mCSA increases after HL-RT (16.44 ± 7.90%) compared to HL-BFR (10.74 ± 7.12%, p = 0.0054) and five did not respond better to HL-RT (8.95 ± 10.83%) compared to HL-BFR (13.33 ± 8.59%) (p = 0.3105). Additionally, HL-RT induced lower HHb (5855.78 ± 12905.99; p = 0.0101) and tHb (-43169.70 ± 37793.17; p = 0.0030) AUC values compared to HL-BFR (HHb: 39254.80 ± 27020.15; tHb: 46309.40 ± 31613.97). In conclusion, despite the higher levels of metabolic stress markers, most participants did not present greater muscle hypertrophy by combining blood flow restriction with HL-RT.
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Affiliation(s)
- João Guilherme Almeida Bergamasco
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Diego Bittencourt
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Deivid Gomes Silva
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Thaís Marina Pires de Campos Biazon
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Samuel Domingos Soligon
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ramon Martins Oliveira
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Cleiton Augusto Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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Colombo V, Valenčič T, Steiner K, Škarabot J, Folland J, O’Sullivan O, Kluzek S. Comparison of Blood Flow Restriction Interventions to Standard Rehabilitation After an Anterior Cruciate Ligament Injury: A Systematic Review. Am J Sports Med 2024; 52:3641-3650. [PMID: 38591459 PMCID: PMC11608515 DOI: 10.1177/03635465241232002] [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: 05/28/2023] [Accepted: 12/12/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Blood flow restriction training (BFR-t) data are heterogeneous. It is unclear whether rehabilitation with BFR-t after an anterior cruciate ligament (ACL) injury is more effective in improving muscle strength and muscle size than standard rehabilitation. PURPOSE To review outcomes after an ACL injury and subsequent reconstruction in studies comparing rehabilitation with and without BFR-t. STUDY DESIGN Systematic review. Level of evidence, 3. METHODS A search of English-language human clinical studies published in the past 20 years (2002-2022) was carried out in 5 health sciences databases, involving participants aged 18-65 undergoing rehabilitation for an ACL injury. Outcomes associated with muscle strength, muscle size, and knee-specific patient-reported outcome measures (PROMs) were extracted from studies meeting inclusion criteria and compared. RESULTS The literature search identified 279 studies, of which 5 met the selection criteria. Two studies suggested that BFR-t rehabilitation after an ACL injury improved knee or thigh muscle strength and muscle size compared with rehabilitation consisting of comparable and higher load resistance training, with two studies suggesting the opposite. The single study measuring PROMs showed improvement compared to traditional rehabilitation, with no difference in muscle strength or size. CONCLUSION BFR-t after an ACL injury seems to benefit muscle strength, muscle size, and PROM scores compared with standard rehabilitation alone. However, only 1 large study included all these outcomes, which has yet to be replicated in other settings. Further studies utilizing similar methods with a common set of outcome measures are required to confirm the effects of BFR-t on ACL rehabilitation.
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Affiliation(s)
- Valentina Colombo
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tamara Valenčič
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Kat Steiner
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Jakob Škarabot
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jonathan Folland
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Oliver O’Sullivan
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Loughborough, UK
| | - Stefan Kluzek
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
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Clarkson MJ, McMahon B, Warmington SA. Comparing adaptations from blood flow restriction exercise training using regulated or unregulated pressure systems: A systematic review and meta-analysis. Clin Rehabil 2024; 38:1446-1465. [PMID: 39105331 PMCID: PMC11528959 DOI: 10.1177/02692155241271040] [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: 07/31/2023] [Accepted: 07/01/2024] [Indexed: 08/07/2024]
Abstract
OBJECTIVE No study has examined outcomes derived from blood flow restriction exercise training interventions using regulated compared with unregulated blood flow restriction pressure systems. Therefore, we used a systematic review and meta-analyses to compare the chronic adaptations to blood flow restriction exercise training achieved with regulated and unregulated blood flow restriction pressure systems. DATA SOURCES The electronic database search included using the tool EBSCOhost and other online database search engines. The search included Medline, SPORTDiscus, CINAHL, Embase and SpringerLink. METHODS Included studies utilised chronic blood flow restriction exercise training interventions greater than two weeks duration, where blood flow restriction was applied using a regulated or unregulated blood flow restriction pressure system, and where outcome measures such as muscle strength, muscle size or physical function were measured both pre- and post-training. Studies included in the meta-analyses used an equivalent non-blood flow restriction exercise comparison group. RESULTS Eighty-one studies were included in the systematic review. Data showed that regulated (n = 47) and unregulated (n = 34) blood flow restriction pressure systems yield similar training adaptations for all outcome measures post-intervention. For muscle strength and muscle size, this was reaffirmed in the included meta-analyses. CONCLUSION This review indicates that practitioners may achieve comparable training adaptations with blood flow restriction exercise training using either regulated or unregulated blood flow restriction pressure systems. Therefore, additional factors such as device quality, participant comfort and safety, cost and convenience are important factors to consider when deciding on appropriate equipment to use when prescribing blood flow restriction exercise training.
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Affiliation(s)
- Matthew J. Clarkson
- Institute for Health & Sport (IHES), Victoria University, Melbourne, Victoria, Australia
| | - Breanna McMahon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Stuart A. Warmington
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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de Queiros VS, Aniceto RR, Rolnick N, Formiga MF, Vieira JG, Cabral BGDAT, Dantas PMS. Commentary: Blood flow restriction combined with resistance training on muscle strength and thickness improvement in young adults: a systematic review, meta-analysis, and meta-regression. Front Physiol 2024; 15:1486727. [PMID: 39483750 PMCID: PMC11524815 DOI: 10.3389/fphys.2024.1486727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 10/07/2024] [Indexed: 11/03/2024] Open
Affiliation(s)
- Victor S. de Queiros
- Graduate Program in Healthy Science, Federal University of Rio Grande do Norte, Natal-RN, Brazil
| | - Rodrigo R. Aniceto
- Study and Research Group in Biomechanics and Psychophysiology of Exercise, Federal Institute of Education, Science and Technology of Rio Grande do Norte, Nova Cruz-RN, Brazil
- Graduate Program in Cognitive Neuroscience and Behavior, Federal University of Paraiba, João Pessoa, Brazil
| | - Nicholas Rolnick
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY, United States
- The Human Performance Mechanic, Bronx, NY, United States
| | - Magno F. Formiga
- Graduate Program in Physiotherapy and Functioning, Department of Physiotherapy, Federal University of Ceará, Fortaleza, Brazil
| | - João G. Vieira
- Graduate Program in Physical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Breno Guilherme de Araújo Tinôco Cabral
- Graduate Program in Healthy Science, Federal University of Rio Grande do Norte, Natal-RN, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal-RN, Brazil
| | - Paulo Moreira Silva Dantas
- Graduate Program in Healthy Science, Federal University of Rio Grande do Norte, Natal-RN, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal-RN, Brazil
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Dong J, Chi J, Lei EF, Wang D. Effects of blood flow restriction training on aerobic capacity, lower limb muscle strength and mass in healthy adults: a meta-analysis. J Sports Med Phys Fitness 2024; 64:1060-1070. [PMID: 38888563 DOI: 10.23736/s0022-4707.24.15905-1] [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: 06/20/2024]
Abstract
INTRODUCTION The aim of this study was to systematically evaluate the effects of blood flow restriction combined with aerobic exercise on aerobic capacity, lower limb muscle strength and mass in healthy adults. EVIDENCE ACQUISITION According to PRISMA's statement, we searched Web of science, Medline, Embase, Cochrane library, CNKI, Wan fang, and VIP databases to collect randomized controlled trials on the effects of aerobic exercise with blood flow restriction on improving aerobic capacity, lower limb muscle strength, and muscle mass in healthy adults. The studies were published from the establishment of the database to November 2023. A supplementary search has been conducted on March 8, 2024. Review Manager5.3 and Stata17 were used for statistical analysis. EVIDENCE SYNTHESIS A total of 16 RCTs with 388 participants were included. The results of meta-analysis showed: Aerobic exercise with BFR significantly affected aerobic capacity (MD and 95%CI 1.06[0.29,1.83], P<0.05), lower limb muscle strength (MD and 95%CI 7.56[5.80,9.33], P<0.05) and lower limb muscle mass (MD and 95%CI were 3.02[1.63,4.42], P<0.05) in healthy adults. The results of subgroup analysis showed that intermittent pressure was better than continuous pressure (P<0.05). Compared with the elderly, the effect of young and middle-aged was better (P<0.05). At the same time, the training form using power bikes is better than walking or running. Finally, 2-6 weeks, 2-3 sessions per week, 10-45 minutes per session can effectively improve the aerobic capacity of healthy adults. CONCLUSIONS Aerobic exercise with BFR can significantly improve aerobic capacity, lower limb muscle strength and mass in healthy adults. In the future, the effects of blood flow restriction training on healthy adults should be further studied, and the form of pressure, intervention cycle, frequency, time, intensity and other variables should be further controlled.
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Affiliation(s)
- Jin Dong
- Physical Education Institute, Shanxi University, Taiyuan, China
| | - Jinjin Chi
- Physical Education Institute, Shanxi University, Taiyuan, China -
| | - Evander F Lei
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Desheng Wang
- Physical Education Institute, Shanxi University, Taiyuan, China
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Geng Y, Wu X, Zhang Y, Zhang M. Potential Moderators of the Effects of Blood Flow Restriction Training on Muscle Strength and Hypertrophy: A Meta-analysis Based on a Comparison with High-Load Resistance Training. SPORTS MEDICINE - OPEN 2024; 10:58. [PMID: 38773002 PMCID: PMC11109065 DOI: 10.1186/s40798-024-00719-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/21/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND While it has been examined whether there are similar magnitudes of muscle strength and hypertrophy adaptations between low-load resistance training combined with blood-flow restriction training (BFR-RT) and high-load resistance training (HL-RT), some important potential moderators (e.g., age, sex, upper and lower limbs, frequency and duration etc.) have yet to be analyzed further. Furthermore, training status, specificity of muscle strength tests (dynamic versus isometric or isokinetic) and specificity of muscle mass assessments (locations of muscle hypertrophy assessments) seem to exhibit different effects on the results of the analysis. The role of these influencing factors, therefore, remains to be elucidated. OBJECTIVES The aim of this meta-analysis was to compare the effects of BFR- versus HL-RT on muscle adaptations, when considering the influence of population characteristics (training status, sex and age), protocol characteristics (upper or lower limbs, duration and frequency) and test specificity. METHODS Studies were identified through database searches based on the following inclusion criteria: (1) pre- and post-training assessment of muscular strength; (2) pre- and post-training assessment of muscular hypertrophy; (3) comparison of BFR-RT vs. HL-RT; (4) score ≥ 4 on PEDro scale; (5) means and standard deviations (or standard errors) are reported or allow estimation from graphs. In cases where the fifth criterion was not met, the data were requested directly from the authors. RESULTS The main finding of the present study was that training status was an important influencing factor in the effects of BFR-RT. The trained individuals may gain greater muscle strength and hypertrophy with BFR-RT as compared to HL-RT. However, the results showed that the untrained individuals experienced similar muscle mass gains and superior muscle strength gains in with HL-RT compared to BFR-RT. CONCLUSION Compared to HL-RT, training status is an important factor influencing the effects of the BFR-RT, in which trained can obtain greater muscle strength and hypertrophy gains in BFR-RT, while untrained individuals can obtain greater strength gains and similar hypertrophy in HL-RT.
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Affiliation(s)
- Yu Geng
- Department of Physical Education, Jiyang College of Zhejiang A&F University, Zhuji, 311800, People's Republic of China.
| | - Xueping Wu
- School of Physical Education, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Yong Zhang
- Department of Rehabilitation Medicine, School of Medicine, Shaoxing University, Zhejiang, People's Republic of China
| | - Meng Zhang
- School of Physical Education, Huzhou University, Zhejiang, People's Republic of China
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Pişkin NE, Yavuz G, Aktuğ ZB, Aldhahi MI, Al-Mhanna SB, Gülü M. The Effect of Combining Blood Flow Restriction with the Nordic Hamstring Exercise on Hamstring Strength: Randomized Controlled Trial. J Clin Med 2024; 13:2035. [PMID: 38610800 PMCID: PMC11012977 DOI: 10.3390/jcm13072035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: It is a matter of curiosity what effect the blood flow restriction (BFR) method, which is usually combined with low-intensity resistance exercises, will have when used with high-intensity eccentric exercises. (2) Methods: The present study examined the effects of combining BFR with nordic hamstring exercises (NHEs) on hamstring muscle strength, bilateral deficit (BLD), and training volume. Thirty young female volleyball players, who trained three times a week, participated voluntarily in the study. These players were stratified into three groups, each comprising ten individuals: a control group (CG), an NHE group, and an NHE + BFR group. Hamstring muscle strength and BLD values were determined using an H-BORD device, while training volume was measured in terms of sets and repetitions. (3) Results: Statistical analysis revealed that there were no statistically significant differences in non-dominant and dominant leg peak torque parameters in the exercise groups (F = 2.65; p = 0.097; ηp2 = 0.17; F = 1.15; p = 0.0334; ηp2 = 0.084), while the total training volume was lower in the NHE + BFR group. (4) Conclusions: As a result, it was seen that adding the BFR method to NHE did not provide additional gains. However, due to the low training volume of BFR + NHE, it may be recommended to apply BFR together with NHE to athlete groups.
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Affiliation(s)
- Necdet Eray Pişkin
- Department of Movement and Training Sciences, Faculty of Sports Sciences, Nigde Omer Halisdemir University, Niğde 51240, Türkiye;
| | - Gönül Yavuz
- Department of Physical Education and Sports, Faculty of Sports Sciences, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Türkiye;
| | - Zait Burak Aktuğ
- Department of Physical Education and Sports, Faculty of Sports Sciences, Nigde Omer Halisdemir University, Niğde 51240, Türkiye;
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Sameer Badri Al-Mhanna
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale 71450, Türkiye
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Li S, Guo R, Wang J, Zheng X, Zhao S, Zhang Z, Yu W, Li S, Zheng P. The effect of blood flow restriction exercise on N-lactoylphenylalanine and appetite regulation in obese adults: a cross-design study. Front Endocrinol (Lausanne) 2023; 14:1289574. [PMID: 38116312 PMCID: PMC10728722 DOI: 10.3389/fendo.2023.1289574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Background N-lactoylphenylalanine (Lac-Phe) is a new form of "exerkines" closely related to lactate (La), which may be able to inhibit appetite. Blood flow restriction (BFR) can lead to local tissue hypoxia and increase lactate accumulation. Therefore, this study investigated the effects of combining Moderate-intensity Continuous Exercise (MICE) with BFR on Lac-Phe and appetite regulation in obese adults. Methods This study employed the cross-design study and recruited 14 obese adults aged 18-24 years. The participants were randomly divided into three groups and performed several tests with specific experimental conditions: (1) M group (MICE without BFR, 60%VO2max, 200 kJ); (2) B group (MICE with BFR, 60%VO2max, 200 kJ); and (3) C group (control session without exercise). Participants were given a standardized meal 60 min before exercise and a ad libitum 60 min after exercise. In addition, blood and Visual Analogue Scale (VAS) were collected before, immediately after, and 1 hour after performing the exercise. Results No significant difference in each index was detected before exercise. After exercise, the primary differential metabolites detected in the M and B groups were xanthine, La, succinate, Lac-Phe, citrate, urocanic acid, and myristic acid. Apart from that, the major enrichment pathways include the citrate cycle, alanine, aspartate, and glutamate metabolism. The enhanced Lac-Phe and La level in the B group was higher than M and C groups. Hunger of the B group immediately after exercise substantially differed from M group. The total ghrelin, glucagon-like peptide-1 and hunger in the B group 1 hour after exercise differed substantially from M group. The results of calorie intake showed no significant difference among the indexes in each group. Conclusions In conclusion, this cross-design study demonstrated that the combined MICE and BFR exercise reduced the appetite of obese adults by promoting the secretion of Lac-Phe and ghrelin. However, the exercise did not considerably affect the subsequent ad libitum intake.
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Affiliation(s)
- Shuoqi Li
- School of Sports Science, Nantong University, Nantong, China
| | - Rong Guo
- School of Foreign Languages, Ludong University, Yantai, China
| | - Juncheng Wang
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Xinyu Zheng
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Shuo Zhao
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Zhiru Zhang
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Wenbing Yu
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Shiming Li
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Peng Zheng
- Department of Physical Education, Ocean University of China, Qingdao, China
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Kong J, Li Z, Zhu L, Li L, Chen S. Comparison of blood flow restriction training and conventional resistance training for the improvement of sarcopenia in the older adults: A systematic review and meta-analysis. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:269-276. [PMID: 38314044 PMCID: PMC10831374 DOI: 10.1016/j.smhs.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/16/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Age-related sarcopenia places a tremendous burden on healthcare providers and patients' families. Blood flow restriction (BFR) training may be a promising treatment to bring sarcopenia down, and it offers numerous advantages over traditional resistance training. The purpose of this review was to compare the effects of BFR training and conventional resistance training on clinically delayed sarcopenia in the elderly. Databases such as PubMed, Web of Science, Embase, and Science Direct were searched to identify eligible studies; blinded data extraction was performed to assess study quality, and conflicts were submitted to third parties. Someone made the decision. One author used Review Manager (RevMan) 5.4 and compared it with data obtained by another author for this purpose. A total of 14 studies met the inclusion criteria for this review. The funnel plots of the studies did not show any substantial publication bias. Low-load blood flow restriction (LL-BFR) had no significant effect on muscle mass compared with high-load resistance training (HL-RT) (p = 0.74, SMD = 0.07, 95% CI: 0.33 to 0. 46) and LL-BFR had a significant effect on muscle strength compared with HL-RT (p = 0.03, Z = 2.16, SMD = -0.34, 95% CI: 0.65 to -0.03). LL-BFR showed a slight effect on mass compared to LL-RT (p = 0.26, SMD = 0.25, 95% CI: 0.19 to 0.69). Sensitivity analysis produced a nonsignificant change, suggesting that the results of this study are reasonable. In conclusion, the data suggest the possibility that BFR training improves age-related sarcopenia.
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Affiliation(s)
| | | | - Lei Zhu
- Qufu Normal University, China
| | - Lin Li
- Qufu Normal University, China
| | - Si Chen
- Qufu Normal University, China
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Chang H, Yan J, Lu G, Chen B, Zhang J. Muscle strength adaptation between high-load resistance training versus low-load blood flow restriction training with different cuff pressure characteristics: a systematic review and meta-analysis. Front Physiol 2023; 14:1244292. [PMID: 37693006 PMCID: PMC10485702 DOI: 10.3389/fphys.2023.1244292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose: In this systematic review and meta-analysis, blood flow restriction (BFR) with low-load resistance training (BFR-RT) was compared with high-load resistance training (HL-RT) on muscle strength in healthy adults. The characteristics of cuff pressure suitable for muscle strength gain were also investigated by analyzing the effects of applying different occlusion pressure prescriptions and cuff inflation patterns on muscle strength gain. Methods: Literature search was conducted using PubMed, Ovid Medline, ProQuest, Cochrane Library, Embase, and Scopus databases to identify literature published until May 2023. Studies reporting the effects of BFR-RT interventions on muscle strength gain were compared with those of HL-RT. The risk of bias in the included trials was assessed using the Cochrane tool, followed by a meta-analysis to calculate the combined effect. Subgroup analysis was performed to explore the beneficial variables. Results: Nineteen articles (42 outcomes), with a total of 458 healthy adults, were included in the meta-analysis. The combined effect showed higher muscle strength gain with HL-RT than with BFR-RT (p = 0.03, SMD = -0.16, 95% CI: -0.30 to -0.01). The results of the subgroup analysis showed that the BFR-RT applied with incremental and individualized pressure achieved muscle strength gain similar to the HL-RT (p = 0.8, SMD = -0.05, 95% CI: -0.44 to 0.34; p = 0.68, SMD = -0.04, 95% CI: -0.23 to 0.15), but muscle strength gain obtained via BFR-RT applied with absolute pressure was lower than that of HL-RT (p < 0.05, SMD = -0.45, 95% CI: -0.71 to -0.19). Furthermore, muscle strength gain obtained by BFR-RT applied with intermittent pressure was similar to that obtained by HL-RT (p = 0.88, SMD = -0.02, 95% CI: -0.27 to 0.23), but muscle strength gain for BFR-RT applied with continuous pressure showed a less prominent increase than that for HL-RT (p < 0.05, SMD = -0.3, 95% CI: -0.48 to -0.11). Conclusion: In general, HL-RT produces superior muscle strength gains than BFR-RT. However, the application of individualized, incremental, and intermittent pressure exercise protocols in BFR-RT elicits comparable muscle strength gains to HL-RT. Our findings indicate that cuff pressure characteristics play a significant role in establishing a BFR-RT intervention program for enhancing muscle strength in healthy adults. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails; Identifier: PROSPERO (CRD42022364934).
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Affiliation(s)
- Hualong Chang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jing Yan
- College of Education, Anyang Normal University, Anyang, China
| | - Guiwei Lu
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Biao Chen
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Jianli Zhang
- Exercise and Metabolism Research Center, College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Castle JP, Tramer JS, Turner EH, Cotter D, McGee A, Abbas MJ, Gasparro MA, Lynch TS, Moutzouros V. Survey of blood flow restriction therapy for rehabilitation in Sports Medicine patients. J Orthop 2023; 38:47-52. [PMID: 36969302 PMCID: PMC10030811 DOI: 10.1016/j.jor.2023.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/12/2023] [Indexed: 03/23/2023] Open
Abstract
Background Blood flow restriction (BFR) therapy has demonstrated benefits across a spectrum of musculoskeletal injuries, including improved strength, endurance, function, and reduction in pain perception. There is, however, no standardized application of BFR therapy among orthopaedic surgeons within the United States (US). Hypothesis The indication and protocol for BFR therapy vary significantly across providers in the US. Methods An online survey of 21 multiple-choice questions was sent to 3,281 surgeons listed on a large orthopaedic registry. A cross-sectional study was performed on all surgeons who successfully completed the questionnaire. Surgeons were queried on current or planned use of BFR, indications, contraindications, and peri-operative and non-operative management of sports-related injuries. Results Overall, 250 physicians completed the survey, with 149 (59.8%) reporting current BFR use and 75.2% initiating use in the last 1-5 years. Most protocols (78.8%) utilize the modality 2-3 times per week while 15.9% use it only once weekly. Anterior cruciate ligament reconstruction (ACLR) rehabilitation was the most reported indication for initiating BFR therapy (95.7%) along with medial patellofemoral ligament reconstruction (70.2%), multiligamentous knee reconstruction (68.8%), meniscus repair (62.4%), collateral ligament reconstruction (50.4%), Achilles tendon repairs (30.5%), and meniscectomy (27%). Only 36.5% reported using BFR after upper extremity procedures, such as distal biceps repair (19.7%), ulnar collateral ligament elbow reconstruction (17%), rotator cuff (16.8%), and shoulder labrum repair (15.3%). For non-operative injuries, 65.8% of surgeons utilized BFR. Of those not currently using BFR therapy, 33.3% intended to implement its use in the future. Conclusion BFR therapy has increased in popularity with most physicians implementing its use in the last 5 years. BFR was commonly utilized after ACLR. Clinical relevance BFR allows light-load resistance to simulate high-intensity resistance training. This study describes US orthopaedic surgeons' common practice patterns and patient populations that utilize BFR therapy.
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Affiliation(s)
- Joshua P. Castle
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Joseph S. Tramer
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Elizabeth H.G. Turner
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Daniel Cotter
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Anna McGee
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Muhammad J. Abbas
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Matthew A. Gasparro
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - T. Sean Lynch
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
| | - Vasilios Moutzouros
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA
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Wang J, Mogensen AMG, Thybo F, Brandbyge M, Brorson J, van Hall G, Agergaard J, de Paoli FV, Miller BF, Bøtker HE, Farup J, Vissing K. Low-load blood flow-restricted resistance exercise produces fiber type-independent hypertrophy and improves muscle functional capacity in older individuals. J Appl Physiol (1985) 2023; 134:1047-1062. [PMID: 36825645 PMCID: PMC11684990 DOI: 10.1152/japplphysiol.00789.2022] [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: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023] Open
Abstract
Low-load blood flow-restricted resistance exercise (BFRRE) constitutes an effective means to produce skeletal muscle hypertrophy. Nonetheless, its applicability to counteract the age-related skeletal muscle decay at a cellular level, is not clear. Therefore, we investigated the effect of BFRRE on muscle fiber morphology, integrated muscle protein synthesis, muscle stem cells (MuSCs), myonuclear content, and muscle functional capacity in healthy older individuals. Twenty-three participants with a mean age of 66 yr (56-75 yr) were randomized to 6 wk of supervised BFRRE (3 sessions per week) or non-exercise control (CON). Biopsies were collected from the vastus lateralis before and after the intervention. Immunofluorescent microscopy was utilized to assess muscle fiber type-specific cross-sectional area (CSA) as well as MuSC and myonuclear content. Deuterium oxide was orally administered throughout the intervention period, enabling assessment of integrated myofibrillar and connective tissue protein fractional synthesis rate (FSR). BFRRE produced uniform ∼20% increases in the fiber CSA of both type I and type II fibers (P < 0.05). This occurred concomitantly with improvements in both maximal muscle strength and strength-endurance capacity but in the absence of increased MuSC content and myonuclear addition. The observed muscle fiber hypertrophy was not mirrored by increases in either myofibrillar or connective tissue FSR. In conclusion, BFRRE proved effective in stimulating skeletal muscle growth and increased muscle function in older individuals, which advocates for the use of BFRRE as a countermeasure of age-related deterioration of skeletal muscle mass and function.NEW & NOTEWORTHY We provide novel insight, that as little as 6 wk of low-load blood flow-restricted resistance exercise (BFRRE) produces pronounced fiber type-independent hypertrophy, alongside improvements across a broad range of muscle functional capacity in older individuals. Notably, since these results were obtained with a modest exercise volume and in a very time-efficient manner, BFRRE may represent a potent exercise strategy to counteract age-related muscle decay.
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Affiliation(s)
- Jakob Wang
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Frederik Thybo
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Jonas Brorson
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Gerrit van Hall
- Clinical Metabolomics Core Facility, Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health & Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Agergaard
- Center for Healthy Aging, Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Benjamin F Miller
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States
- Oklahoma City VA, Oklahoma City, Oklahoma, United States
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jean Farup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
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Markov A, Hauser L, Chaabene H. Effects of Concurrent Strength and Endurance Training on Measures of Physical Fitness in Healthy Middle-Aged and Older Adults: A Systematic Review with Meta-Analysis. Sports Med 2023; 53:437-455. [PMID: 36222981 PMCID: PMC9876872 DOI: 10.1007/s40279-022-01764-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is evidence that in older adults the combination of strength training (ST) and endurance training (ET) (i.e., concurrent training [CT]) has similar effects on measures of muscle strength and cardiorespiratory endurance (CRE) compared with single-mode ST or ET, respectively. Therefore, CT seems to be an effective method to target broad aspects of physical fitness in older adults. OBJECTIVES The aim was to examine the effects of CT on measures of physical fitness (i.e., muscle strength, power, balance and CRE) in healthy middle-aged and older adults aged between 50 and 73 years. We also aimed to identify key moderating variables to guide training prescription. STUDY DESIGN We conducted a systematic review with meta-analysis of randomized controlled trials. DATA SOURCES The electronic databases PubMed, Web of Science Core Collection, MEDLINE and Google Scholar were systematically searched until February 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomized controlled trials that examined the effects of CT versus passive controls on measures of physical fitness in healthy middle-aged and older adults aged between 50 and 73 years. RESULTS Fifteen studies were eligible, including a total of 566 participants. CT induced moderate positive effects on muscle strength (standardized mean difference [SMD] = 0.74) and power (SMD = 0.50), with a small effect on CRE (SMD = 0.48). However, no significant effects were detected for balance (p > 0.05). Older adults > 65 years (SMD = 1.04) and females (SMD = 1.05) displayed larger improvements in muscle strength compared with adults ≤ 65 years old (SMD = 0.60) and males (SMD = 0.38), respectively. For CRE, moderate positive effects (SMD = 0.52) were reported in those ≤ 65 years old only, with relatively larger gains in females (SMD = 0.55) compared with males (SMD = 0.45). However, no significant differences between all subgroups were detected. Independent single training factor analysis indicated larger positive effects of 12 weeks (SMD = 0.87 and 0.88) compared with 21 weeks (SMD = 0.47 and 0.29) of CT on muscle strength and power, respectively, while for CRE, 21 weeks of CT resulted in larger gains (SMD = 0.62) than 12 weeks (SMD = 0.40). For CT frequency, three sessions per week produced larger beneficial effects (SMD = 0.91) on muscle strength compared with four sessions (SMD = 0.55), whereas for CRE, moderate positive effects were only noted after four sessions per week (SMD = 0.58). A session duration of > 30-60 min generated larger improvements in muscle strength (SMD = 0.99) and power (SMD = 0.88) compared with > 60-90 min (SMD = 0.40 and 0.29, respectively). However, for CRE, longer session durations (i.e., > 60-90 min) seem to be more effective (SMD = 0.61) than shorter ones (i.e., > 30-60 min) (SMD = 0.34). ET at moderate-to-near maximal intensities produced moderate (SMD = 0.64) and small positive effects (SMD = 0.49) on muscle strength and CRE, respectively, with no effects at low intensity ET (p > 0.05). Finally, intra-session ST before ET produced larger gains in muscle strength (SMD = 1.00) compared with separate sessions (SMD = 0.55), whereas ET and ST carried out separately induced larger improvements in CRE (SMD = 0.58) compared with intra-session ET before ST (SMD = 0.49). CONCLUSIONS CT is an effective method to improve measures of physical fitness (i.e., muscle strength, power, and CRE) in healthy middle-aged and older adults aged between 50 and 73 years, regardless of sex. Results of independent single training factor analysis indicated that the largest effects on muscle strength were observed after 12 weeks of training, > 30-60 min per session, three sessions per week, higher ET intensities and when ST preceded ET within the same session. For CRE, the largest effects were noted after 21 weeks of training, four sessions per week, > 60-90 min per session, higher ET intensities and when ET and ST sessions were performed separately. Regarding muscle power, the largest effects were observed after 12 weeks of training and > 30-60 min per session.
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Affiliation(s)
- Adrian Markov
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Am Neuen Palais 10, Bldg. 12, 14469, Potsdam, Germany.
| | - Lukas Hauser
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Am Neuen Palais 10, Bldg. 12, 14469, Potsdam, Germany
| | - Helmi Chaabene
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of Potsdam, 14469, Potsdam, Germany
- High Institute of Sports and Physical Education of Kef, University of Jendouba, 7100, Kef, Tunisia
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Vinolo-Gil MJ, Rodríguez-Huguet M, Martin-Vega FJ, Garcia-Munoz C, Lagares-Franco C, Garcia-Campanario I. Effectiveness of Blood Flow Restriction in Neurological Disorders: A Systematic Review. Healthcare (Basel) 2022; 10:2407. [PMID: 36553931 PMCID: PMC9778162 DOI: 10.3390/healthcare10122407] [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: 10/04/2022] [Revised: 11/02/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022] Open
Abstract
There is scientific evidence that Blood Flow Restriction (BFR) is beneficial in healthy people, the elderly and patients with musculoskeletal disorders. A systematic review was conducted to evaluate the effectiveness of BFR in patients with neurological disorders. The literature search was conducted up until July 2022 in the following databases: PubMed, Web of Science (WOS), Physiotherapy Evidence Database (PEDro), LILACS, Scopus, Cumulative Index of Nursing and Allied Literature Complete (CINAHL), the Cochrane Library and Scientific Electronic Library Online (SciELO). The PEDro scale was used to analyze the methodological quality of the studies, and the Cochrane Collaboration's tool was employed to evaluate the risk of bias. A total of seven articles were included. BFR seems to be beneficial in neurological disorders. Improvements have been found in sensorimotor function, frequency and step length symmetry, perceived exertion, heart rate and gait speed, walking endurance, fatigue, quality of life, muscles thickness, gluteus density and muscle edema. No improvements were found in lower limb strength or balance. However, results must be taken with caution due to the small number of articles and to the large heterogeneity. More clinical trials are needed. These studies should homogenize the protocols used in larger samples, as well as improve their methodological quality.
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Affiliation(s)
- Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
- Institute for Biomedical Research and Innovation of Cádiz, 11009 Cadiz, Spain
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cadiz Bay-La Janda Health District, 11006 Cadiz, Spain
| | | | | | | | - Carolina Lagares-Franco
- Department of Statistics and Operations Research, University of Cadiz, 11510 Cadiz, Spain
- PAIDI UCA Group: CTS553, INiBICA Group CO15 Population and Health, Determinants and Interventions, Faculty of Medicine, University of Cadiz, 11003 Cadiz, Spain
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20
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Chang H, Yao M, Chen B, Qi Y, Zhang J. Effects of Blood Flow Restriction Combined with Low-Intensity Resistance Training on Lower-Limb Muscle Strength and Mass in Post-Middle-Aged Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15691. [PMID: 36497769 PMCID: PMC9735845 DOI: 10.3390/ijerph192315691] [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: 09/29/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
We studied the effect of blood flow restriction (BFR) combined with low-intensity resistance training (LIRT) on lower-limb muscle strength and mass in post-middle-aged adults. The PubMed, OVID, ProQuest, Cochrane Library, EMBASE, Web of Science, and Scopus databases were used to obtain randomized controlled trials, and the effects of BFR and LIRT (BFRt) on muscle strength and mass in adults were examined. The Cochrane risk of bias tool assessed bias in the included trials. The combined effects of BFR and LIRT (BFRt) were calculated by meta-analysis, the association between muscle strength/mass and interventions was determined by meta-regression, and beneficial variables of intervention were explored by subgroup analysis. A total of 11 articles were included in the meta-analysis. The combined effects showed that BFRt significantly improved lower extremity muscle strength but not muscle mass gain. Meta-regression analysis indicated that the effect of BFRt on changes in muscle strength was correlated with frequency of the intervention. Subgroup analysis revealed that BFRt achieved greater muscle strength gains than normal activity, LIRT, and similar muscle strength gains compared to high-intensity resistance training. The increased muscle strength after BFRt was noticed with a frequency of three times a week, but not with a frequency of two times a week, and the difference between these subgroups was statistically significant. Our findings indicate that BFRt can increase lower-limb muscle strength in post-middle-aged adults. Frequency of intervention is a key variable; particularly, a schedule of three times a week is effective in improving muscle strength.
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Affiliation(s)
- Hualong Chang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China
| | - Mengxing Yao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China
| | - Biao Chen
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China
| | - Yongle Qi
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China
| | - Jianli Zhang
- Institute of Human Movement and Sports Engineering, Zhejiang Normal University, Jinhua 321004, China
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21
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Alves TC, Pugliesi Abdalla P, Bohn L, Da Silva LSL, dos Santos AP, Tasinafo Júnior MF, Rossini Venturini AC, Mota J, Lopes Machado DR. Acute and chronic cardiometabolic responses induced by resistance training with blood flow restriction in HIV patients. Sci Rep 2022; 12:16989. [PMID: 36216952 PMCID: PMC9550823 DOI: 10.1038/s41598-022-19857-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 09/06/2022] [Indexed: 12/29/2022] Open
Abstract
Resistance training with blood flow restriction (RTBFR) allows physically impaired people living with HIV (PWH) to exercise at lower intensities than traditional resistance training (TRT). But the acute and chronic cardiac and metabolic responses of PWH following an RTBFR protocol are unknown. The objective was to compare the safety of acute and chronic effects on hemodynamic and lipid profiles between TRT or RTBFR in PWH. In this randomized control trial, 14 PWH were allocated in RTBFR (GRTBFR; n = 7) or TRT (GTRT; n = 7). Both resistance training protocols had 36 sessions (12 weeks, three times per week). Protocol intensity was 30% (GRTBFR) and 80% (GTRT). Hemodynamic (heart rate, blood pressure) and lipid profile were acutely (rest and post exercise 7th, 22nd, and 35th sessions) and chronically (pre and post-program) recorded. General linear models were applied to determine group * time interaction. In the comparisons between groups, the resistance training program showed acute adaptations: hemodynamic responses were not different (p > 0.05), regardless of the assessment session; and chronicles: changes in lipidic profile favors GRTBFR, which significantly lower level of total cholesterol (p = 0.024), triglycerides (p = 0.002) and LDL (p = 0.030) compared to GTRT. RTBFR and TRT induced a similar hemodynamic adaptation in PWH, with no significant risks of increased cardiovascular stress. Additionally, RTBFR promoted better chronic adequacy of lipid profile than TRT. Therefore, RTBFR presents a safe resistance training alternative for PWH.Trial registration: ClinicalTrials.gov ID: NCT02783417; Date of registration: 26/05/2016.
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Affiliation(s)
- Thiago Cândido Alves
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Pedro Pugliesi Abdalla
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil ,grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal
| | - Lucimere Bohn
- grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal ,grid.410936.90000 0001 2199 9085Universidade Lusófona do Porto, Porto, Portugal
| | - Leonardo Santos Lopes Da Silva
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - André Pereira dos Santos
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Márcio Fernando Tasinafo Júnior
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Ana Cláudia Rossini Venturini
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil
| | - Jorge Mota
- grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- grid.11899.380000 0004 1937 0722Universidade de São Paulo, Avenue of Bandeirantes no 3900, University Campus-Monte Alegre, Ribeirão Preto, SP 14040-902 Brazil ,grid.5808.50000 0001 1503 7226Universidade do Porto, Porto, Portugal
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22
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Li S, Guo R, Yu T, Li S, Han T, Yu W. Effect of High-Intensity Interval Training Combined with Blood Flow Restriction at Different Phases on Abdominal Visceral Fat among Obese Adults: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11936. [PMID: 36231251 PMCID: PMC9565218 DOI: 10.3390/ijerph191911936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND High-intensity interval training (HIIT) and blood flow restriction (BFR) represent a critical nonpharmacological strategy to reduce the excess deposition of visceral fat, as well as relevant complications, among obese populations. Applying BFR at diverse phases may have different effects. Therefore, the exercise program of this study combined HIIT with BFR, so as to explore the effect of BFR on abdominal visceral fat area and its mechanism in different periods of HIIT. The aim is to provide a more effective exercise prescription for obese people who want to reduce visceral fat quickly. METHODS This study was a randomized controlled trial involving 72 obese adults. One week before intervention, both regional and whole-body fat masses, abdominal subcutaneous and visceral fat areas, variables of blood metabolism, and VO2max were recorded. Additionally, subjects with a matched fat percentage were randomized as a no-training control (C), HIIT (H), HIIT with BFR during interval (I), and HIIT with BFR during exercise (E) groups for 24 sessions within a 12-week period, using a cycle ergometer. During session one, this study recorded blood lactate, specific serum lipolytic hormones, rating of perceived exertion (RPE), and exercise heart rate (HR) and compared them among three groups. The baseline tests were repeated at 1 week after intervention. RESULTS There was no significant statistical difference in the indicators of each group at baseline (p > 0.05). The improvement of trunk fat mass and fat percentage of the I and E groups markedly increased relative to the H group (p < 0.05). Meanwhile, the I group had improved android fat mass and whole-body fat mass relative to group H (p < 0.05). Those exercise groups had markedly improved indices compared with the C group (p < 0.05). Additionally, the reduction in the I group had remarkably superior abdominal visceral fat areas (AVFA) to the H and E groups (p < 0.05). Immediately and 30 min following exercise, the E and I groups had remarkably increased growth hormone (GH) compared with the H group (p < 0.05). After exercise, the I group showed markedly increased epinephrine (EPI) compared with the H group (p < 0.05). The LA level in the I group evidently increased relative to the E group (p < 0.05), while that in the E group evidently increased compared with the H group (p < 0.05). CONCLUSION Compared with HIIT alone, HIIT with BFR can better improve the body-fat level and glucose metabolism. HIIT with BFR in the interval phase better reduces the abdominal visceral-fat level than in the exercise phase, which may be due to the increase in lipolytic hormone level caused by the higher physiological load.
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Affiliation(s)
- Shuoqi Li
- College of Physical Education, Yangzhou University, Yangzhou 225009, China
| | - Rong Guo
- School of Foreign Languages, Ludong University, Yantai 264025, China
| | - Tao Yu
- Department of Physical Education, Shandong Weihai Sports Training Center, Weihai 264400, China
| | - Shiming Li
- Department of Physical Education, Ocean University of China, Qingdao 266100, China
| | - Tenghai Han
- Department of Physical Education, Weifang Medical University, Weifang 261053, China
| | - Wenbing Yu
- Department of Physical Education, Ocean University of China, Qingdao 266100, China
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23
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Qin L, Cui J, Li J. Sympathetic Nerve Activity and Blood Pressure Response to Exercise in Peripheral Artery Disease: From Molecular Mechanisms, Human Studies, to Intervention Strategy Development. Int J Mol Sci 2022; 23:ijms231810622. [PMID: 36142521 PMCID: PMC9505475 DOI: 10.3390/ijms231810622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Sympathetic nerve activity (SNA) regulates the contraction of vascular smooth muscle and leads to a change in arterial blood pressure (BP). It was observed that SNA, vascular contractility, and BP are heightened in patients with peripheral artery disease (PAD) during exercise. The exercise pressor reflex (EPR), a neural mechanism responsible for BP response to activation of muscle afferent nerve, is a determinant of the exaggerated exercise-induced BP rise in PAD. Based on recent results obtained from a series of studies in PAD patients and a rat model of PAD, this review will shed light on SNA-driven BP response and the underlying mechanisms by which receptors and molecular mediators in muscle afferent nerves mediate the abnormalities in autonomic activities of PAD. Intervention strategies, particularly non-pharmacological strategies, improving the deleterious exercise-induced SNA and BP in PAD, and enhancing tolerance and performance during exercise will also be discussed.
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24
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Burtscher J, Strasser B, Burtscher M, Millet GP. The Impact of Training on the Loss of Cardiorespiratory Fitness in Aging Masters Endurance Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11050. [PMID: 36078762 PMCID: PMC9517884 DOI: 10.3390/ijerph191711050] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 05/16/2023]
Abstract
Elite masters endurance athletes are considered models of optimal healthy aging due to the maintenance of high cardiorespiratory fitness (CRF) until old age. Whereas a drop in VO2max in masters athletes has been broadly investigated, the modifying impact of training still remains a matter of debate. Longitudinal observations in masters endurance athletes demonstrated VO2max declines between -5% and -46% per decade that were closely related to changes in training volume. Here, using regression analyses, we show that 54% and 39% of the variance in observed VO2max decline in male and female athletes, respectively is explained by changes in training volume. An almost linear VO2max decrease was observed in studies on young and older athletes, as well as non-athletes, starting a few days after training cessation, with a decline of as much as -20% after 12 weeks. Besides a decline in stroke volume and cardiac output, training cessation was accompanied by considerable reductions in citrate synthase and succinate dehydrogenase activity (reduction in mitochondrial content and oxidative capacity). This reduction could largely be rescued within similar time periods of training (re)uptake. It is evident that training reduction or cessation leads to a considerably accelerated VO2max drop, as compared to the gradual aging-related VO2max decline, which can rapidly nullify many of the benefits of preceding long-term training efforts.
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Affiliation(s)
- Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland
| | - Barbara Strasser
- Medical Faculty, Sigmund Freud Private University, A-1020 Vienna, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
| | - Gregoire P. Millet
- Department of Biomedical Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland
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25
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Effects of Blood Flow Restriction Therapy for Muscular Strength, Hypertrophy, and Endurance in Healthy and Special Populations: A Systematic Review and Meta-Analysis. Clin J Sport Med 2022; 32:531-545. [PMID: 36083329 DOI: 10.1097/jsm.0000000000000991] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Blood flow restriction (BFR) training is an increasingly applied tool with potential benefits in muscular hypertrophy, strength, and endurance. This study investigates the effectiveness of BFR training relative to other forms of training on muscle strength, hypertrophy, and endurance. DATA SOURCES We performed systematic searches of MEDLINE, Embase, and PubMed and assessed the methodological quality of included studies using the Cochrane risk of bias tool. MAIN RESULTS We included 53 randomized controlled trials with 31 included in meta-analyses. For muscular strength comparing low-intensity BFR (LI-BFR) training with high-intensity resistance training (HIRT), the pooled mean difference (MD) for 1 repetition maximum was 5.34 kg (95% CI, 2.58-8.09; P < 0.01) favoring HIRT. When comparing LI-BFR training with HIRT for torque, the MD was 6.35 N·m (95% CI, 0.5-12.3; P = 0.04) also favoring HIRT. However, comparing LI-BFR with low-intensity resistance training (LIRT) for torque, there was a MD of 9.94 N·m (95% CI, 5.43-14.45; P < 0.01) favoring BFR training. Assessing muscle hypertrophy, the MD in cross-sectional area was 0.96 cm2 (95% CI, 0.21-1.7; P = 0.01) favoring pooled BFR training compared with nonocclusive training. Assessing endurance, V̇o2 maximum demonstrated a greater mean increase of 0.37 mL/kg/min (95% CI, -0.97 to 3.17; P = 0.64) in BFR endurance training compared with endurance training alone. CONCLUSION Blood flow restriction training produced increases in muscular strength, hypertrophy, and endurance. Comparing LI-BFR training with HIRT, HIRT was a significantly better training modality for increasing muscle hypertrophy and strength. However, LI-BFR was superior when compared with a similar low-intensity protocol. Blood flow restriction training is potentially beneficial to those unable to tolerate the high loads of HIRT; however, better understanding of its risk to benefit ratio is needed before clinical application. LEVEL OF EVIDENCE Level 1.
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26
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Chhetri I, Hunt JEA, Mendis JR, Forni LG, Kirk-Bayley J, White I, Cooper J, Somasundaram K, Shah N, Patterson SD, Puthucheary ZA, Montgomery HE, Creagh-Brown BC. Safety and Feasibility Assessment of Repetitive Vascular Occlusion Stimulus (RVOS) Application to Multi-Organ Failure Critically Ill Patients: A Pilot Randomised Controlled Trial. J Clin Med 2022; 11:3938. [PMID: 35887701 PMCID: PMC9316533 DOI: 10.3390/jcm11143938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022] Open
Abstract
Muscle wasting is implicated in the pathogenesis of intensive care unit acquired weakness (ICU-AW), affecting 40% of patients and causing long-term physical disability. A repetitive vascular occlusion stimulus (RVOS) limits muscle atrophy in healthy and orthopaedic subjects, thus, we explored its application to ICU patients. Adult multi-organ failure patients received standard care +/- twice daily RVOS {4 cycles of 5 min tourniquet inflation to 50 mmHg supra-systolic blood pressure, and 5 min complete deflation} for 10 days. Serious adverse events (SAEs), tolerability, feasibility, acceptability, and exploratory outcomes of the rectus femoris cross-sectional area (RFCSA), echogenicity, clinical outcomes, and blood biomarkers were assessed. Only 12 of the intended 32 participants were recruited. RVOS sessions (76.1%) were delivered to five participants and two could not tolerate it. No SAEs occurred; 75% of participants and 82% of clinical staff strongly agreed or agreed that RVOS is an acceptable treatment. RFCSA fell significantly and echogenicity increased in controls (n = 5) and intervention subjects (n = 4). The intervention group was associated with less frequent acute kidney injury (AKI), a greater decrease in the total sequential organ failure assessment score (SOFA) score, and increased insulin-like growth factor-1 (IGF-1), and reduced syndecan-1, interleukin-4 (IL-4) and Tumor necrosis factor receptor type II (TNF-RII) levels. RVOS application appears safe and acceptable, but protocol modifications are required to improve tolerability and recruitment. There were signals of possible clinical benefit relating to RVOS application.
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Affiliation(s)
- Ismita Chhetri
- Intensive Care Unit, Royal Surrey County Hospital, NHS Foundation Trust, Guildford GU2 7XX, UK; (I.C.); (L.G.F.); (J.K.-B.)
- Faculty of Health and Medical Sciences, School of Biosciences & Medicine, University of Surrey, Guildford GU2 7XH, UK; (J.E.A.H.); (J.R.M.)
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London SW7 2BX, UK
| | - Julie E. A. Hunt
- Faculty of Health and Medical Sciences, School of Biosciences & Medicine, University of Surrey, Guildford GU2 7XH, UK; (J.E.A.H.); (J.R.M.)
| | - Jeewaka R. Mendis
- Faculty of Health and Medical Sciences, School of Biosciences & Medicine, University of Surrey, Guildford GU2 7XH, UK; (J.E.A.H.); (J.R.M.)
| | - Lui G. Forni
- Intensive Care Unit, Royal Surrey County Hospital, NHS Foundation Trust, Guildford GU2 7XX, UK; (I.C.); (L.G.F.); (J.K.-B.)
- Faculty of Health and Medical Sciences, School of Biosciences & Medicine, University of Surrey, Guildford GU2 7XH, UK; (J.E.A.H.); (J.R.M.)
| | - Justin Kirk-Bayley
- Intensive Care Unit, Royal Surrey County Hospital, NHS Foundation Trust, Guildford GU2 7XX, UK; (I.C.); (L.G.F.); (J.K.-B.)
| | - Ian White
- Intensive Care Unit, Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, UK; (I.W.); (J.C.); (K.S.); (N.S.)
| | - Jonathan Cooper
- Intensive Care Unit, Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, UK; (I.W.); (J.C.); (K.S.); (N.S.)
| | - Karthik Somasundaram
- Intensive Care Unit, Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, UK; (I.W.); (J.C.); (K.S.); (N.S.)
| | - Nikunj Shah
- Intensive Care Unit, Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, UK; (I.W.); (J.C.); (K.S.); (N.S.)
| | - Stephen D. Patterson
- Faculty of Sport, Allied Health & Performance Sciences, St Mary’s University, London TW1 4SX, UK;
| | - Zudin A. Puthucheary
- William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London E1 4NS, UK;
- Institute for Sport, Exercise and Health, University College London, London W1T 7HA, UK
- Centre for Human Health and Performance, Department of Medicine, University College London, London W1T 7HA, UK;
- Intensive Care Unit, Royal Free London NHS Foundation Trust, London NW3 2QG, UK
- Centre for Human and Applied Physiological Sciences, King’s College London, London WC2R 2LS, UK
| | - Hugh E. Montgomery
- Centre for Human Health and Performance, Department of Medicine, University College London, London W1T 7HA, UK;
| | - Benedict C. Creagh-Brown
- Intensive Care Unit, Royal Surrey County Hospital, NHS Foundation Trust, Guildford GU2 7XX, UK; (I.C.); (L.G.F.); (J.K.-B.)
- Faculty of Health and Medical Sciences, School of Biosciences & Medicine, University of Surrey, Guildford GU2 7XH, UK; (J.E.A.H.); (J.R.M.)
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Lim ZX, Goh J. Effects of blood flow restriction (BFR) with resistance exercise on musculoskeletal health in older adults: a narrative review. Eur Rev Aging Phys Act 2022; 19:15. [PMID: 35725379 PMCID: PMC9208167 DOI: 10.1186/s11556-022-00294-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background Aging leads to a number of structural and physiological deficits such as loss of muscle mass and strength. Strength training at ~ 70% of 1 repetition max (RM) is recommended to prevent age-related loss of muscle mass and strength. However, most older adults may not be able to perform 70% of 1RM or higher intensity. An alternative exercise training program combining low intensity resistance exercise with blood flow restriction (BFR) can result in similar acute and chronic benefits to skeletal muscles in older adults. Main body and short conclusion The potential mechanisms involved are discussed, and include reactive hyperaemia, metabolic stress, and hypoxia. Key issues and safety with the use of BFR in older adults, especially those with chronic conditions are also discussed. Although there has been no reported evidence to suggest that BFR elevates the risk of clinical complications any more than high intensity exercise, it is recommended for individuals to be medically cleared of any cardiovascular risks, prior to engaging in BFR exercise.
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Affiliation(s)
- Zi Xiang Lim
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore.,Centre for Healthy Longevity, National University Health System (NUHS), Singapore, 117456, Singapore
| | - Jorming Goh
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore. .,Centre for Healthy Longevity, National University Health System (NUHS), Singapore, 117456, Singapore. .,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, 117456, Singapore.
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28
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Effects of blood flow restriction training on aerobic capacity: a systematic review and meta-analysis. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00944-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Lack of muscle stem cell proliferation and myocellular hypertrophy in sIBM patients following blood-flow restricted resistance training. Neuromuscul Disord 2022; 32:493-502. [DOI: 10.1016/j.nmd.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/22/2022] [Accepted: 04/22/2022] [Indexed: 11/24/2022]
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30
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Amorim S, Gaspar AP, Degens H, Cendoroglo MS, de Mello Franco FG, Ritti-Dias RM, Cucato GG, Rolnick N, de Matos LDNJ. The Effect of a Single Bout of Resistance Exercise with Blood Flow Restriction on Arterial Stiffness in Older People with Slow Gait Speed: A Pilot Randomized Study. J Cardiovasc Dev Dis 2022; 9:jcdd9030085. [PMID: 35323633 PMCID: PMC8950238 DOI: 10.3390/jcdd9030085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose: Low-intensity resistance exercise with moderate blood-flow restriction (LIRE-BFR) is a new trending form of exercises worldwide. The purpose of this study was to compare the acute effect of a single bout of traditional resistance exercise (TRE) and LIRE-BFR on arterial stiffness in older people with slow gait speeds. Methods: This was a randomized, controlled clinical study. Seventeen older adults (3 men; 14 women; 82 ± 5 years old) completed a session of TRE (n = 7) or LIRE-BFR (n = 10). At baseline and after 60 min post-exercise, participants were subject to blood pressure measurement, heart rate measurements and a determination of arterial stiffness parameters. Results: There was no significant difference between the TRE and LIRE-BFR group at baseline. Pulse-wave velocity increased in both groups (p < 0.05) post-exercise with no between-group differences. Both exercise modalities did not produce any adverse events. The increase in systolic blood pressure, pulse pressure, augmentation pressure and pulse wave velocity (all p > 0.05) were similar after both TRE and LIRE-BFR. Conclusion: TRE and LIRE-BFR had similar responses regarding hemodynamic parameters and pulse-wave velocity in older people with slow gait speed. Long-term studies should assess the cardiovascular risk and safety of LIRE-BFR training in this population.
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Affiliation(s)
- Samuel Amorim
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (S.A.); (A.P.G.); (F.G.d.M.F.)
| | - Alexandra Passos Gaspar
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (S.A.); (A.P.G.); (F.G.d.M.F.)
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester M1 5GD, UK;
| | - Maysa Seabra Cendoroglo
- Division of Geriatrics, Paulista Medical School, The Federal University, Sao Paulo 04020-050, Brazil;
| | | | - Raphael Mendes Ritti-Dias
- Postgraduate Program in Rehabilitation Science, Universidade Nove de Julho, Sao Paulo 01525-000, Brazil;
| | | | - Nicholas Rolnick
- Department of Health Sciences, Lehman College, City University of New York (CUNY), New York, NY 10468, USA;
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Hughes L, Hackney KJ, Patterson SD. Optimization of Exercise Countermeasures to Spaceflight Using Blood Flow Restriction. Aerosp Med Hum Perform 2022; 93:32-45. [PMID: 35063054 DOI: 10.3357/amhp.5855.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION: During spaceflight missions, astronauts work in an extreme environment with several hazards to physical health and performance. Exposure to microgravity results in remarkable deconditioning of several physiological systems, leading to impaired physical condition and human performance, posing a major risk to overall mission success and crew safety. Physical exercise is the cornerstone of strategies to mitigate physical deconditioning during spaceflight. Decades of research have enabled development of more optimal exercise strategies and equipment onboard the International Space Station. However, the effects of microgravity cannot be completely ameliorated with current exercise countermeasures. Moreover, future spaceflight missions deeper into space require a new generation of spacecraft, which will place yet more constraints on the use of exercise by limiting the amount, size, and weight of exercise equipment and the time available for exercise. Space agencies are exploring ways to optimize exercise countermeasures for spaceflight, specifically exercise strategies that are more efficient, require less equipment, and are less time-consuming. Blood flow restriction exercise is a low intensity exercise strategy that requires minimal equipment and can elicit positive training benefits across multiple physiological systems. This method of exercise training has potential as a strategy to optimize exercise countermeasures during spaceflight and reconditioning in terrestrial and partial gravity environments. The possible applications of blood flow restriction exercise during spaceflight are discussed herein.Hughes L, Hackney KJ, Patterson SD. Optimization of exercise countermeasures to spaceflight using blood flow restriction. Aerosp Med Hum Perform. 2021; 93(1):32-45.
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Effectiveness of Blood Flow Restriction Training on Muscle Strength and Physical Performance in Older Adults: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2022; 103:1848-1857. [DOI: 10.1016/j.apmr.2021.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/03/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022]
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Chen Y, Ma C, Wang J, Gu Y, Gao Y. Effects of 40% of Maximum Oxygen Uptake Intensity Cycling Combined with Blood Flow Restriction Training on Body Composition and Serum Biomarkers of Chinese College Students with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:168. [PMID: 35010428 PMCID: PMC8750492 DOI: 10.3390/ijerph19010168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Blood flow restriction training (BFRT) is a new method for promoting muscle growth and improving muscle function, even with relatively low-intensity exercise. BFRT on patients with obesity has not been extensively studied. This study aimed to analyze the effects of cycling at 40% of maximum oxygen uptake (VO2max) combined with BFRT on body composition and serum biomarkers among college students with obesity. This pilot study included thirty-seven male college students with obesity aged 18-22 years (experimental group (EG): n = 18; control group (CG): n = 19). The EG conducted 40% VO2max cycling combined with BFRT activities and the CG conducted 40% VO2max cycling without BFRT two times per week for 12 weeks. Our results showed that in EG, there were significant differences in weight, thigh skinfold thickness (TS), waist circumference, abdominal skinfold thickness, fat mass, body fat percentage, body mass index and glucose (GLU), total cholesterol (TC), triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels before and after the experiment (p < 0.05, p < 0.01, and p < 0.001). After the experiment, TS, GLU, TC, HDL-C, and LDL-C in EG were significantly different than those of the CG (p < 0.05, p < 0.01, and p < 0.001). Together, our results demonstrate that cycling at 40% VO2max combined with BFRT may improve body composition and blood lipid profile of male college students with obesity. Our findings have important implications for those who cannot perform moderate- and high-intensity exercises.
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Affiliation(s)
- Yong Chen
- Department of Physical Education, Huaiyin Normal University, Huaian 223300, China; (Y.C.); (C.M.); (J.W.)
| | - Chunlin Ma
- Department of Physical Education, Huaiyin Normal University, Huaian 223300, China; (Y.C.); (C.M.); (J.W.)
| | - Junmin Wang
- Department of Physical Education, Huaiyin Normal University, Huaian 223300, China; (Y.C.); (C.M.); (J.W.)
| | - Ying Gu
- College of Sports Science, Shenyang Normal University, Shenyang 110034, China
| | - Yan Gao
- School of Foreign Languages, Shenyang Normal University, Shenyang 110034, China;
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Effects of Blood Flow Restriction Combined With Resistance Training or Neuromuscular Electrostimulation on Muscle Cross-Sectional Area. J Sport Rehabil 2021; 31:319-324. [PMID: 34929663 DOI: 10.1123/jsr.2021-0101] [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: 03/23/2021] [Revised: 08/16/2021] [Accepted: 10/10/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Low-load resistance training (LL) and neuromuscular electrostimulation (NES), both combined with blood flow restriction (BFR), emerge as effective strategies to maintain or increase muscle mass. It is well established that LL-BFR promotes similar increases in muscle cross-sectional area (CSA) and lower rating of perceived exertion (RPE) and pain compared with traditional resistance training protocols. On the other hand, only 2 studies with conflicting results have investigated the effects of NES-BFR on CSA, RPE, and pain. In addition, no study directly compared LL-BFR and NES-BFR. OBJECTIVE The aim of the study was to compare the effects of LL-BFR and NES-BFR on vastus lateralis CSA, RPE, and pain. Individual response for muscle hypertrophy was also compared between protocols. DESIGN Intrasubject longitudinal study. SETTING University research laboratory. INTERVENTION Fifteen healthy young males (age = 23 [5] y; weight = 77.6 [11.3] kg; height = 1.76 [0.08] m). MAIN OUTCOME MEASURES Vastus lateralis CSA was measured through ultrasound at baseline (pre) and after 20 training sessions (post). The RPE and pain responses were obtained through modified 10-point scales, handled during all training sessions. RESULTS Both protocols demonstrated significant increases in muscle CSA (P < .0001). However, the LL-BFR demonstrated significantly greater CSA changes compared with NES-BFR (LL-BFR = 11.2%, NES-BFR = 4.6%; P < .0001). Comparing individual increases in CSA, 12 subjects (85.7% of the sample) presented greater muscle hypertrophy for LL-BFR than for the NES-BFR protocol. In addition, LL-BFR produced significantly lower RPE and pain responses (P < .0001). CONCLUSIONS The LL-BFR produced significantly greater increases in CSA with significant less RPE and pain than NES-BFR. In addition, LL-BFR resulted in greater individual muscle hypertrophy responses for most subjects compared with NES-BFR.
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Centner C, Jerger S, Lauber B, Seynnes O, Friedrich T, Lolli D, Gollhofer A, König D. Low-Load Blood Flow Restriction and High-Load Resistance Training Induce Comparable Changes in Patellar Tendon Properties. Med Sci Sports Exerc 2021; 54:582-589. [PMID: 34772900 DOI: 10.1249/mss.0000000000002824] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Low-load resistance training with blood flow restriction (LL-BFR) has emerged as a viable alternative to conventional high-load (HL) resistance training regimens. Despite increasing evidence confirming comparable muscle adaptations between LL-BFR and HL resistance exercise, only very little is known about tendinous mechanical and morphological adaptations following LL-BFR. Therefore, the aim of the present study was to examine the effects of 14 weeks of LL-BFR and HL training on patellar tendon adaptations. METHODS N = 29 recreationally active male participants were randomly allocated into the following two groups: LL-BFR resistance training (20-35% one repetition maximum/1RM) or HL resistance training (70-85% 1RM). Both groups trained three times per week for 14 weeks. One week before and after the intervention, patellar tendon mechanical and morphological properties were assessed via ultrasound and magnetic resonance imaging (MRI). Additionally, changes in muscle cross-sectional area (CSA) were quantified by MRI and muscle strength via dynamic 1RM measurements. RESULTS The findings demonstrated that both LL-BFR and HL training resulted in comparable changes in patellar tendon stiffness (LL-BFR: + 25.2%, p = 0.003; HL: + 22.5%, p = 0.024) without significant differences between groups. Similar increases in tendon CSA were observed in HL and LL-BFR. Muscle mass and strength also significantly increased in both groups but were not statistically different between HL (+ 38%) and LL-BFR (+ 34%), except for knee extension 1RM where higher changes were seen in LL-BFR. CONCLUSION The present results support the notion that both HL and LL-BFR cause substantial changes in patellar tendon properties and the magnitude of changes are not significantly different between conditions. Further studies are needed which examine the physiological mechanisms underlying the altered tendon properties following LL-BFR training.
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Affiliation(s)
- Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Germany Praxisklinik Rennbahn, Muttenz, Switzerland Department of Neurosciences and Movement Sciences, Université de Fribourg, Switzerland Department of Physical Performance, Norwegian School of Sport Sciences, Norway Department of Sports Science, Institute for Nutrition, Sports and Health, University of Vienna, Vienna, Austria
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Rodrigo-Mallorca D, Loaiza-Betancur AF, Monteagudo P, Blasco-Lafarga C, Chulvi-Medrano I. Resistance Training with Blood Flow Restriction Compared to Traditional Resistance Training on Strength and Muscle Mass in Non-Active Older Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111441. [PMID: 34769957 PMCID: PMC8583588 DOI: 10.3390/ijerph182111441] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Low-intensity training with blood flow restriction (LI-BFR) has been suggested as an alternative to high-intensity resistance training for the improvement of strength and muscle mass, becoming advisable for individuals who cannot assume such a load. The systematic review aimed to determine the effectiveness of the LI-BFR compared to dynamic high-intensity resistance training on strength and muscle mass in non-active older adults. A systematic review was conducted according to the Cochrane Handbook and reportedly followed the PRISMA statement. MEDLINE, EMBASE, Web of Science Core Collection, and Scopus databases were searched between September and October 2020. Two reviewers independently selected the studies, extracted data, assessed the risk of bias and the quality of evidence using the GRADE approach. Twelve studies were included in the qualitative synthesis. Meta-analysis pointed out significant differences in maximal voluntary contraction (MVC): SMD 0.61, 95% CI [0.10, 1.11], p = 0.02, I2 71% p < 0.0001; but not in the repetition maximum (RM): SMD 0.07, 95% CI [−0.25, 0.40], p = 0.66, I2 0% p < 0.53; neither in the muscle mass: SMD 0.62, 95% CI [−0.09, 1.34], p = 0.09, I2 59% p = 0.05. Despite important limitations such as scarce literature regarding LI-BFR in older adults, the small sample size in most studies, the still differences in methodology and poor quality in many of them, this systematic review and meta-analysis revealed a positive benefit in non-active older adults. LI- BFR may induce increased muscular strength and muscle mass, at least at a similar extent to that in the traditional high-intensity resistance training.
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Affiliation(s)
- Darío Rodrigo-Mallorca
- UIRFIDE (Sport Performance and Physical Fitness Research Group), Department of Physical and Sports Education, Faculty of Physical Activity and Sports Science, University of Valencia, 46010 Valencia, Spain; (D.R.-M.); (P.M.); (I.C.-M.)
| | - Andrés Felipe Loaiza-Betancur
- Department of Physical Education and Sports, Institute of Physical Education, University of Antioquia, Medellín 050010, Colombia;
| | - Pablo Monteagudo
- UIRFIDE (Sport Performance and Physical Fitness Research Group), Department of Physical and Sports Education, Faculty of Physical Activity and Sports Science, University of Valencia, 46010 Valencia, Spain; (D.R.-M.); (P.M.); (I.C.-M.)
- Department of Education and Specific Didactics, Jaume I University, 12071 Castellon, Spain
| | - Cristina Blasco-Lafarga
- UIRFIDE (Sport Performance and Physical Fitness Research Group), Department of Physical and Sports Education, Faculty of Physical Activity and Sports Science, University of Valencia, 46010 Valencia, Spain; (D.R.-M.); (P.M.); (I.C.-M.)
- Correspondence:
| | - Iván Chulvi-Medrano
- UIRFIDE (Sport Performance and Physical Fitness Research Group), Department of Physical and Sports Education, Faculty of Physical Activity and Sports Science, University of Valencia, 46010 Valencia, Spain; (D.R.-M.); (P.M.); (I.C.-M.)
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Lima KR, Schmidt HL, Daré LR, Soares CB, Lopes LF, Carpes FP, Mello-Carpes PB. Concurrent exercise does not prevent recognition memory deficits induced by beta-amyloid in rats. Physiol Behav 2021; 243:113631. [PMID: 34715093 DOI: 10.1016/j.physbeh.2021.113631] [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: 03/23/2021] [Revised: 10/07/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
Alzheimer's disease affects thousands of people worldwide. Alternatives aiming to prevent the disease or reduce its symptoms include different physical exercise configurations. Here we investigate the potential of concurrent exercise to prevent recognition memory deficits in an Alzheimer's disease-like model induced by the hippocampal beta-amyloid (Aβ) injection in Wistar rats. We demonstrate that the concurrent exercise, which included running and strength exercises performed in the same exercise session, is ineffective in preventing recognition memory deficits in the Aβ rats. Besides, higher levels of reactive oxygen species were found in the concurrent exercise group's hippocampus. The running exercise administrated alone prevented recognition memory impairments.
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Affiliation(s)
- Karine Ramires Lima
- Physiology Research Group, Stress, Memory and Behavior Lab, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Helen Lidiane Schmidt
- Physiology Research Group, Stress, Memory and Behavior Lab, Federal University of Pampa, Uruguaiana, RS, Brazil; Applied Neuromechanics Group, Laboratory of Neuromechanics, Universidade Federal do Pampa, Uruguaiana, RS, Brazil
| | - Leticia Rossi Daré
- Physiology Research Group, Stress, Memory and Behavior Lab, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Caroline Bitencourt Soares
- Physiology Research Group, Stress, Memory and Behavior Lab, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Luiza Freitas Lopes
- Physiology Research Group, Stress, Memory and Behavior Lab, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Felipe P Carpes
- Applied Neuromechanics Group, Laboratory of Neuromechanics, Universidade Federal do Pampa, Uruguaiana, RS, Brazil
| | - Pâmela Billig Mello-Carpes
- Physiology Research Group, Stress, Memory and Behavior Lab, Federal University of Pampa, Uruguaiana, RS, Brazil.
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Chen N, He X, Zhao G, Lu L, Ainsworth BE, Liu Y, Wu X. Efficacy of low-load resistance training combined with blood flow restriction vs. high-load resistance training on sarcopenia among community-dwelling older Chinese people: study protocol for a 3-arm randomized controlled trial. Trials 2021; 22:518. [PMID: 34348792 PMCID: PMC8336391 DOI: 10.1186/s13063-021-05495-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/27/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sarcopenia is accompanied by a decline in muscle mass, muscle strength, and muscle function. Resistance training is the most potential training method for the prevention and treatment of sarcopenia. However, the conventional high-load resistance training (CRT) recommended by the American College of Sports Medicine is a challenge for older people with sarcopenia. As a novel training method, low-load resistance training combined with blood flow restriction (LRT-BFR) may elicit similar muscle mass and muscle strength gains as CRT but with less effort. The objectives of this study are to assess and compare the efficacy and safety of 12-week LRT-BFR and CRT on muscle strength, muscle performance, body composition, pulmonary function, blood biomarkers, CVD risk factors, and quality of life in community-dwelling older Chinese people with sarcopenia. METHOD This is a 12-week, assessor-blinded, 3-arm randomized controlled trial with a non-exercise control group. Community-dwelling people over 65 years will be screened for sarcopenia according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Fifty-one subjects will be randomized into a LRT-BFR group (n = 17), a CRT group (n = 17), and a no-strength training control group (n = 17). The primary outcome is lower limb muscle strength. The secondary outcomes are body composition, upper limb muscle strength, pulmonary function, blood biomarkers, CVD risk factors, and quality of life. Post-intervention follow-up will be performed for 12 weeks. These indicators will be assessed at baseline (0 week), after the 12-week intervention (12 weeks), and at follow-up (24 weeks). The adverse events will also be reported. Data will be analyzed for all participants in an intent-to-treat plan. DISCUSSION This study is the first RCT that will systematically measure and compare the efficacy and safety of LRT-BFR and CRT in older people with sarcopenia on muscle strength, body composition, pulmonary function, blood biomarkers (inflammatory biomarkers, hormone, and growth factors), CVD risk factors, and quality of life. This study can provide an efficient and safe method to prevent the progression of sarcopenia in older people. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100042803 . Registered on 28 January 2021.
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Affiliation(s)
- Nan Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Guoyun Zhao
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Linqian Lu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | | | - Yu Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China.
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China.
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Miller BC, Tirko AW, Shipe JM, Sumeriski OR, Moran K. The Systemic Effects of Blood Flow Restriction Training: A Systematic Review. Int J Sports Phys Ther 2021; 16:978-990. [PMID: 34386277 PMCID: PMC8329318 DOI: 10.26603/001c.25791] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Blood flow restriction (BFR) training has been reported to have significant benefits on local skeletal muscle including increasing local muscle mass, strength, and endurance while exercising with lower resistance. As a result, patients unable to perform traditional resistance training may benefit from this technique. However, it is unclear what effects BFR may have on other body systems, such as the cardiovascular and pulmonary systems. It is important to explore the systemic effects of BFR training to ensure it is safe for use in physical therapy. PURPOSE The purpose of this study was to systematically review the systemic effects of blood flow restriction training when combined with exercise intervention. STUDY DESIGN Systematic review. METHODS Three literature searches were performed: June 2019, September 2019, and January 2020; using MedLine, ScienceDirect, PubMed, Cochrane Reviews and CINAHL Complete. Inclusion criteria included: at least one outcome measure addressing a cardiovascular, endocrinological, systemic or proximal musculoskeletal, or psychosocial outcome, use of clinically available blood flow restriction equipment, use of either resistance or aerobic training in combination with BFR, and use of quantitative measures. Exclusion criteria for articles included only measuring local or distal musculoskeletal changes due to BFR training, examining only passive BFR or ischemic preconditioning, articles not originating from a scholarly peer-reviewed journal, CEBM level of evidence less than two, or PEDro score less than four. Articles included in this review were analyzed with the CEBM levels of evidence hierarchy and PEDro scale. RESULTS Thirty-five articles were included in the review. PEDro scores ranged between 4 and 8, and had CEBM levels of evidence of 1 and 2. Common systems studied included cardiovascular, musculoskeletal, endocrine, and psychosocial. This review found positive or neutral effects of blood flow restriction training on cardiovascular, endocrinological, musculoskeletal, and psychosocial outcomes. CONCLUSIONS Although BFR prescription parameters and exercise interventions varied, the majority of included articles reported BFR training to produce favorable or non-detrimental effects to the cardiovascular, endocrine, and musculoskeletal systems. This review also found mixed effects on psychosocial outcomes when using BFR. Additionally, this review found no detrimental outcomes directly attributed to blood flow restriction training on the test subjects or outcomes tested. Thus, BFR training may be an effective intervention for patient populations that are unable to perform traditional exercise training with positive effects other than traditional distal muscle hypertrophy and strength and without significant drawbacks to the individual. LEVEL OF EVIDENCE 1b.
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Scarpelli MC, Bergamasco JGA, Arruda EADB, Cook SB, Libardi CA. Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report. Front Sports Act Living 2021; 3:671764. [PMID: 34240050 PMCID: PMC8257955 DOI: 10.3389/fspor.2021.671764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022] Open
Abstract
In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.
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Affiliation(s)
- Maíra Camargo Scarpelli
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - João Guilherme Almeida Bergamasco
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Estevan A de Barros Arruda
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Summer B Cook
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | - Cleiton Augusto Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
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Emílio Lixandrão M, Ugrinowitsch C, Roschel H. Commentaries on "Effect of blood-flow restricted vs heavy-load strength training on muscle strength: Systematic review and meta-analysis". Scand J Med Sci Sports 2021; 31:489-492. [PMID: 33483976 DOI: 10.1111/sms.13875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/27/2020] [Accepted: 11/04/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Manoel Emílio Lixandrão
- Applied Physiology and Nutrition Research Group, Faculdade de Medicina FMUSP, School of Physical Education and Sport, Universidade de Sao Paulo, Sao Paulo, Brazil.,Laboratory of Strength Training, School of Physical Education and Sport, University of Sao Paulo, Brazil
| | - Carlos Ugrinowitsch
- Laboratory of Strength Training, School of Physical Education and Sport, University of Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, Faculdade de Medicina FMUSP, School of Physical Education and Sport, Universidade de Sao Paulo, Sao Paulo, Brazil.,Laboratory of Strength Training, School of Physical Education and Sport, University of Sao Paulo, Brazil.,Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
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Vechin FC, Conceição MS, Telles GD, Libardi CA, Ugrinowitsch C. Interference Phenomenon with Concurrent Strength and High-Intensity Interval Training-Based Aerobic Training: An Updated Model. Sports Med 2021; 51:599-605. [PMID: 33405189 DOI: 10.1007/s40279-020-01421-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 01/22/2023]
Abstract
Previous research has suggested that concurrent training (CT) may attenuate resistance training (RT)-induced gains in muscle strength and mass, i.e.' the interference effect. In 2000, a seminal theoretical model indicated that the interference effect should occur when high-intensity interval training (HIIT) (repeated bouts at 95-100% of the aerobic power) and RT (multiple sets at ~ 10 repetition maximum;10 RM) were performed in the same training routine. However, there was a paucity of data regarding the likelihood of other HIIT-based CT protocols to induce the interference effect at the time. Thus, based on current HIIT-based CT literature and HIIT nomenclature and framework, the present manuscript updates the theoretical model of the interference phenomenon previously proposed. We suggest that very intense HIIT protocols [i.e., resisted sprint training (RST), and sprint interval training (SIT)] can greatly minimize the odds of occurring the interference effect on muscle strength and mass. Thus, very intensive HIIT protocols should be implemented when performing CT to avoid the interference effect. Long and short HIIT-based CT protocols may induce the interference effect on muscle strength when HIIT bout is performed before RT with no rest interval between them.
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Affiliation(s)
- Felipe C Vechin
- School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65, Cidade Universitária, Sao Paulo, SP, 05508-030, Brazil.
- MUSCULAB, Laboratory of Neuromuscular Adaptations To Resistance Training, Department of Physical Education, Federal University of Sao Carlos, Sao Carlos, Brazil.
| | - Miguel S Conceição
- School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65, Cidade Universitária, Sao Paulo, SP, 05508-030, Brazil
| | - Guilherme D Telles
- School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65, Cidade Universitária, Sao Paulo, SP, 05508-030, Brazil
| | - Cleiton A Libardi
- MUSCULAB, Laboratory of Neuromuscular Adaptations To Resistance Training, Department of Physical Education, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65, Cidade Universitária, Sao Paulo, SP, 05508-030, Brazil
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Spitz RW, Bell ZW, Wong V, Yamada Y, Song JS, Buckner SL, Abe T, Loenneke JP. Strength testing or strength training: considerations for future research. Physiol Meas 2020; 41:09TR01. [PMID: 33017302 DOI: 10.1088/1361-6579/abb1fa] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Maximal strength testing is often performed to assess the efficacy of training programs or as a way to prescribe exercise load. Generally, it is believed that high load exercise is superior to low load exercise at increasing absolute strength, however this is not always the case (i.e. strength increases similarly between groups). We hypothesized that some of the discrepancy in the literature may be related to performing the strength test itself. To investigate this further we reviewed the literature looking for studies comparing high load and low load exercise. The included studies were separated into 'no extra practice' and 'practice'. No extra practice means the strength test was only performed at pre and post whereas practice refers to additional strength tests performed throughout the training intervention. Our results indicated that the differences between high load and low load exercise can be reduced when the group training with a low load is allowed additional exposure to the maximal strength test. This suggests that repeated exposure to strength tests may augment low load training adaptations and influence the outcomes. We discuss potential moderators of this relationship (e.g. how low is the low load, complexity of the skill) and offer considerations for future research. Based on this it would be recommended that when investigating the effects of low load training strength tests should be limited to pre and post intervention or if a control group is utilized then the control group should receive the same number of exposures to the strength test.
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Affiliation(s)
- Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, United States of America
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Kelly MR, Cipriano KJ, Bane EM, Murtaugh BT. Blood Flow Restriction Training in Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-020-00291-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Centner C, Ritzmann R, Gollhofer A, König D. Effects of Whole-Body Vibration Training and Blood Flow Restriction on Muscle Adaptations in Women: A Randomized Controlled Trial. J Strength Cond Res 2020; 34:603-608. [PMID: 31842133 DOI: 10.1519/jsc.0000000000003401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Centner, C, Ritzmann, R, Gollhofer, A, and König, D. Effects of whole-body vibration training and blood flow restriction on muscle adaptations in women: a randomized controlled trial. J Strength Cond Res 34(3): 603-608, 2020-The purpose of the present randomized controlled trial was to investigate potential synergistic effects of whole-body vibration (WBV) training combined with blood flow restriction (BFR) on muscle mass and strength, and jump performance. Fifty healthy women (26.1 ± 4.6 years) were randomly allocated to one of the following experimental groups: WBV training combined with BFR (WBV + BFR) or WBV only. Before and after the 10-week training intervention, muscle cross-sectional area (CSA) of the vastus lateralis (VL) and gastrocnemius medialis (GM) was evaluated. Additionally, changes in muscle strength and jump performance were assessed before and after the intervention. The level of significance was set to p < 0.05. Vastus lateralis muscle CSA increased in both groups (p < 0.05). The increase in CSA was less pronounced after WBV than WBV + BFR, although the difference was not significant (p = 0.30). Likewise, GM CSA demonstrated comparable increases in both groups with a significant main effect of time (p < 0.05) but no interaction effect (p = 0.89). Assessment of muscular strength (p = 0.70) and jump performance (p = 0.40) did not reveal significant differences between the groups. The results of the present study indicate that the combination of WBV training with BFR shows a noticeable trend toward higher increases in muscle CSA compared with WBV alone. Despite the lack of significance, the results imply clinical relevance particularly in populations showing contraindications toward high training loads. This, however, needs to be confirmed in future research.
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Affiliation(s)
- Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany; and
| | - Ramona Ritzmann
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany; and.,Praxisklinik Rennbahn, Muttenz, Switzerland
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany; and
| | - Daniel König
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany; and
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Blood Flow Restriction as an Exercise Alternative to Ameliorate the Effects of Aging. CURRENT GERIATRICS REPORTS 2020. [DOI: 10.1007/s13670-020-00323-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Machek SB, Cardaci TD, Willoughby DS. Blood Flow Restriction Training and Betaine Supplementation as a Novel Combined Modality to Augment Skeletal Muscle Adaptation: A Short Review. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Low-intensity blood flow restriction calf muscle training leads to similar functional and structural adaptations than conventional low-load strength training: A randomized controlled trial. PLoS One 2020; 15:e0235377. [PMID: 32603351 PMCID: PMC7326162 DOI: 10.1371/journal.pone.0235377] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/12/2020] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to investigate whether a six-week, twice weekly resistance training (4 sets at 30% 1-RM until failure) with practical blood flow restriction (BFR) using 7cm wide cuffs with a twist lock placed below the patella is superior to training without BFR (NoBFR) concerning muscle mass and strength gains in calf muscles. A two-group (BFR n = 12, mean age 27.33 (7.0) years, training experience 7.3 (7.0) years; NoBFR n = 9, mean age 28.9 (7.4) years, training experience 7.1 (6.6) years) randomized matched pair design based on initial 1-RM was used to assess the effects on structural and functional adaptations in healthy males (Perometer calf volume [CV], gastrocnemius muscle thickness using ultrasound [MT], 7-maximal hopping test for leg stiffness [LS], 1-RM smith machine calf raise [1-RM], and visual analogue scale as a measure of pain intensity [VAS]). The mean number of repetitions completed per training session across the intervention period was higher in the NoBFR group compared to the BFR group (70 (16) vs. 52 (9), p = 0.002). VAS measured during the first session increased similarly in both groups from first to fourth set (p<0.001). No group effects or time×group interactions were found for CV, MT, LS, and 1-RM. However, there were significant time effects for MT (BFR +0.07 cm; NoBFR +0.04; p = 0.008), and 1-RM (BFR +40 kg; NoBFR +34 kg; p<0.001). LS and CV remained unchanged through training. VAS in both groups were similar, and BFR and NoBFR were equally effective for increasing 1-RM and MT in trained males. However, BFR was more time efficient, due to lesser repetition per training session.
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Minniti MC, Statkevich AP, Kelly RL, Rigsby VP, Exline MM, Rhon DI, Clewley D. The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review. Am J Sports Med 2020; 48:1773-1785. [PMID: 31710505 DOI: 10.1177/0363546519882652] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The effectiveness of blood flow restriction training (BFRT) as compared with other forms of training, such as resistance training, has been evaluated in the literature in clinical and nonclinical populations. However, the safety of this intervention has been summarized only in healthy populations and not in clinical populations with musculoskeletal disorders. PURPOSE To evaluate the safety and adverse events associated with BFRT in patients with musculoskeletal disorders. STUDY DESIGN Systematic review. METHODS A literature search was conducted with 3 online databases (MEDLINE, CINAHL, and Embase). Eligibility criteria for selecting studies were as follows: (1) BFRT was used as a clinical intervention, (2) study participants had a disorder of the musculoskeletal system, (3) authors addressed adverse events, (4) studies were published in English, and (5) the intervention was performed with human participants. RESULTS Nineteen studies met eligibility criteria, with a pooled sample size of 322. Diagnoses included various knee-related disorders, inclusion body myositis, polymyositis or dermatomyositis, thoracic outlet syndrome, Achilles tendon rupture, and bony fractures. Nine studies reported no adverse events, while 3 reported rare adverse events, including an upper extremity deep vein thrombosis and rhabdomyolysis. Three case studies reported common adverse events, including acute muscle pain and acute muscle fatigue. In the randomized controlled trials, individuals exposed to BFRT were not more likely to have an adverse event than individuals exposed to exercise alone. Of the 19 studies, the adverse events were as follows: overall, 14 of 322; rare overall, 3 of 322; rare BFRT, 3 of 168; rare control, 0 of 154; any adverse BFRT, 10 of 168; any adverse control, 4 of 154. A majority of studies were excluded because they did not address safety. CONCLUSION BFRT appears to be a safe strengthening approach for knee-related musculoskeletal disorders, but further research is needed to make definitive conclusions and to evaluate the safety in other musculoskeletal conditions. Improved definitions of adverse events related to BFRT are needed to include clear criteria for differentiating among common, uncommon, and rare adverse events. Finally, further research is needed to effectively screen who might be at risk for rare adverse events.
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Affiliation(s)
- Melissa C Minniti
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Andrew P Statkevich
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Ryan L Kelly
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Victoria P Rigsby
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Meghan M Exline
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
| | - Daniel I Rhon
- Physical Performance Service Line, Office of the Army Surgeon General, Falls Church, Virginia, USA.,Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Derek Clewley
- Division of Physical Therapy, Department of Orthopedics, Duke University, Durham, North Carolina, USA
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Nóbrega SR, Chachá SGF, Libardi CA. Resistance training combined with blood flow restriction in cirrhosis: study protocol for a randomized controlled trial. Trials 2020; 21:446. [PMID: 32471480 PMCID: PMC7257225 DOI: 10.1186/s13063-020-04410-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 05/14/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patients affected by hepatic cirrhosis show reductions in muscle mass and function, with poor quality of life and functional performance. As such, resistance training with blood flow restriction (BFR-RT) could be a useful therapeutic tool for health promotion. Thus, we aim to verify the effects of this intervention on muscle strength, muscle mass, fiber Pennation angle, fascicle length, functional performance, quality of life, and fall risk scores in this population. METHODS Thirty participants will be randomly distributed between 1) BFR-RT and 2) control (CTRL). Assessments will occur at three time points: before the training intervention (0 W), after 12 weeks (12 W), and at follow-up (24 W). The following variables will be assessed: Child-Pugh classification; MELD score; SF-36 questionnaire; fatigue severity index; 6-min walk test; timed-up and go; 30-s sitting and rising test; dietary record; one-repetition maximum (1-RM) strength test (knee extension exercise); and vastus lateralis' cross-sectional area, Pennation angle, and fascicle length. The BFR-RT group will undergo 12 weeks of knee extension exercise (1 × 30 repetitions and 3 × 15 repetitions at 20% 1-RM and 50% of total blood flow occlusion pressure), with two sessions per week. Data normality will be assessed using the Shapiro-Wilk test. In case of normal distribution, a one-way repeated measures analysis of variance will be implemented to test for differences in baseline values. A mixed model then will be applied for each dependent variable. In case of non-normal data distribution, a Kruskal-Wallis test will be implemented to test for differences in baseline values. Next, the Friedman test will be used to analyze repeated measures. Within- and between-group effect sizes will be calculated using Cohen's d for each outcome. Finally, the minimal clinically important difference will be analyzed with distribution-based methods. DISCUSSION To our knowledge, this will be the first trial to investigate BFR-RT in patients with cirrhosis and evaluate the effects on neuromuscular parameters, functional performance, disease severity, and quality of life outcomes. TRIAL REGISTRATION Brazilian Clinical Trials Registry (ReBec): RBR-395mfw. Registered on 25 August 2018.
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Affiliation(s)
- Sanmy Rocha Nóbrega
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos - UFSCar, Rod. Washington Luiz, km 235 - SP 310, São Carlos, SP, CEP 13565-905, Brazil
| | - Silvana Gama Florencio Chachá
- Department of Medicine, Federal University of São Carlos - UFSCar, Rod. Washington Luiz, km 235 - SP 310, São Carlos, SP, CEP 13565-905, Brazil
| | - Cleiton Augusto Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos - UFSCar, Rod. Washington Luiz, km 235 - SP 310, São Carlos, SP, CEP 13565-905, Brazil.
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