Project description:Resistance-based blood flow restriction training (BFRT) improves skeletal muscle strength and size. Unlike heavy-load resistance training (HLRT), there is debate as to whether strength adaptations following BFRT interventions can be primarily attributed to concurrent muscle hypertrophy, as the magnitude of hypertrophy is often minor. The present study aimed to investigate the effect of 7 weeks of BFRT and HLRT on muscle strength and hypertrophy. The expression of protein growth markers from muscle biopsy samples was also measured. Male participants were allocated to moderately heavy-load training (HL; n = 9), low-load BFRT (LL + BFR; n = 8), or a control (CON; n = 9) group to control for the effect of time. HL and LL + BFR completed 21 training sessions (3 d.week-1) comprising bilateral knee extension and knee flexion exercises (HL = 70% one-repetition maximum (1-RM), LL + BFR = 20% 1-RM + blood flow restriction). Bilateral knee extension and flexion 1-RM strength were assessed, and leg muscle CSA was measured via peripheral quantitative computed tomography. Protein growth markers were measured in vastus lateralis biopsy samples taken pre- and post the first and last training sessions. Biopsy samples were also taken from CON at the same time intervals as HL and LL + BFR. Knee extension 1-RM strength increased in HL (19%) and LL + BFR (19%) but not CON (2%; p < 0.05). Knee flexion 1-RM strength increased similarly between all groups, as did muscle CSA (50% femur length; HL = 2.2%, LL + BFR = 3.0%, CON = 2.1%; TIME main effects). 4E-BP1 (Thr37/46) phosphorylation was lower in HL and LL + BFR immediately post-exercise compared with CON in both sessions (p < 0.05). Expression of other growth markers was similar between groups (p > 0.05). Overall, BFRT and HLRT improved muscle strength and size similarly, with comparable changes in intramuscular protein growth marker expression, both acutely and chronically, suggesting the activation of similar anabolic pathways. However, the low magnitude of muscle hypertrophy was not significantly different to the non-training control suggesting that strength adaptation following 7 weeks of BFRT is not driven by hypertrophy, but rather neurological adaptation.

Project description:Strength training responses are influenced by sets, repetitions, and mechanical load, whereas Blood Flow Restriction (BFR) training adds the variable of temporarily restricting blood flow via a tourniquet. This has intensified scientific discussions regarding the vascular responses and thereby safety of the BFR method. To address these concerns, we investigated intravascular pressure changes during low-load (LL-RT), low-load with BFR (LL-BFR-RT), and high-load (HL-RT) exercise. Ten healthy men (26.8 ± 4.59 years) performed unilateral biceps curls to failure in a randomized cross-over design: (1) LL-RT (30% 1RM), (2) LL-BFR-RT (30% 1RM, 50% LOP), and (3) HL-RT (75% 1RM). Total workload was significantly higher in LL-RT (692 ± 251 kg) compared to LL-BFR-RT (378 ± 58.7 kg) and HL-RT (327 ± 65.1 kg, p < 0.001). In terms of mean values, LL-BFR-RT resulted in higher diastolic and mean arterial pressures during rest periods between sets compared to other conditions (p ≤ 0.02). Both LL-RT and LL-BFR-RT led to longer durations spent at increased diastolic (above 90 mmHg, LL-RT: ~419 s vs. LL-BFR-RT: ~356 s vs. Hl-RT: ~122 s), systolic (above 140 mmHg, LL-RT: ~437 s vs. LL-BFR-RT: ~336 s vs. HL-RT: ~199 s), and mean arterial pressures (above 107 mmHg, LL-RT: ~451 s vs. LL-BFR-RT: ~384 s vs. HL-RT: ~168 s) compared to HL-RT (p ≤ 0.028). Relative to total exercise time, LL-BFR-RT resulted in higher proportion of time spent at elevated diastolic (above 90 mmHg, LL-RT: ~56.5% vs. LL-BFR-RT: ~68.7% vs. Hl-RT: ~33.5%) and mean arterial pressures (above 107 mmHg, LL-RT: ~60.8% vs. LL-BFR-RT: ~74.0% vs. HL-RT: ~45.7%) compared to HL-RT (p ≤ 0.034). Peripheral venous pressure was significantly higher in LL-BFR-RT compared to other conditions (p < 0.001), with both absolute and relative time spent at higher pressures (above 75 mmHg, LL-RT: ~57.0 s and ~ 9.12% vs. LL-BFR-RT: ~424 s and ~ 81.7% vs. HL-RT: ~36.0 s and ~ 8.99%, p ≤ 0.002). Our results suggest that BFR training performed to failure imposes greater arterial and venous stress in the exercising limb compared to high-load training without BFR, particularly due to prolonged exposure to elevated pressures. Further research is needed to assess the potential risks of elevated local arterial and venous pressure responses by frequent BFR use, particularly in populations with pre-existing medical conditions.

Project description:ObjectiveThe objective of this study is to compare the effectiveness of lower limb low-load blood flow restriction training (LL-BFRT) with high-load strength training (HL-ST) as part of an outpatient pulmonary rehabilitation programme on leg strength in patients with chronic obstructive pulmonary disease (COPD).MethodsParticipants were randomised to LL-BFRT or HL-ST (24 sessions). LL-BFRT was done at 30% 1-repetition maximum (1-RM) with 70% arterial occlusion pressure. HL-ST was done at 70% 1-RM. Primary outcome was isometric strength of knee extensors and flexors. Secondary outcomes were 1-RM, functional exercise capacity, physical activity, symptom burden and health-related quality of life. Perceptions of dyspnoea and leg fatigue were recorded after every exercise. We compared groups with t-tests.ResultsWe included 30 participants (13 women, 17 men, 64 (9) years, forced expiratory volume in 1 s 47 (18)% pred.), 24 completed the study. Isometric knee extensor strength improved to a clinically relevant degree in both legs in both groups (LL-BFRT: right leg 9 (20) Nm, left leg 10 (18) Nm; HL-ST: right leg 15 (26) Nm, left leg 16 (30) Nm, data are mean (SD)), without statistically significant or clinically relevant between-group differences (right leg mean difference= -6.4, 95% CI= -13.20 to 25.92 Nm, left leg mean difference= -5.6, 95% CI= -15.44 to 26.55 Nm). 1 min sit-to-stand test performance improved to a clinically relevant degree only in the LL-BFRT group (4 (4) vs 1 (5) repetitions). Interestingly, physical activity improved to a clinically relevant degree only in the LL-BFRT group (1506 (2441) vs -182 (1971) steps/day). LL-BFRT lowered perceived in-exercise dyspnoea and increased leg fatigue compared with HL-ST in the initial 12 trainings.ConclusionIn patients with stable COPD undergoing outpatient pulmonary rehabilitation, LL-BFRT was not superior to HL-ST in improving leg strength. LL-BFRT led to similar strength gains as HL-ST while reducing perceptions of dyspnoea in the initial training phase.Trial registration numberNCT04151771.

Project description:Muscle overload injuries in strength training might be prevented by providing personalized feedback about muscle load during a workout. In the present study, a new muscle load feedback application, which monitors and visualizes the loading of specific muscle groups, was developed in collaboration with the fitness company Gymstory. The aim of the present study was to examine the effectiveness of this feedback application in managing muscle load balance, muscle load level, and muscle soreness, and to evaluate how its actual use was experienced. Thirty participants were randomly distributed into 'control', 'partial feedback', and 'complete feedback' groups and monitored for eight workouts using the automatic exercise tracking system of Gymstory. The control group received no feedback, while the partial feedback group received a visualization of their estimated cumulative muscle load after each exercise, and the participants in the complete feedback group received this visualization together with suggestions for the next exercise to target muscle groups that had not been loaded yet. Generalized estimation equations (GEEs) were used to compare muscle load balance and soreness, and a one-way ANOVA was used to compare user experience scores between groups. The complete feedback group showed a significantly better muscle load balance (β = -18.9; 95% CI [-29.3, -8.6]), adhered better to the load suggestion provided by the application (significant interactions), and had higher user experience scores for Attractiveness (p = 0.036), Stimulation (p = 0.031), and Novelty (p = 0.019) than the control group. No significant group differences were found for muscle soreness. Based on these results, it was concluded that personal feedback about muscle load in the form of a muscle body map in combination with exercise suggestions can effectively guide strength training practitioners towards certain load levels and more balanced cumulative muscle loads. This application has potential to be applied in strength training practice as a training tool and may help in preventing muscle overload.

Project description:BackgroundShoulder pain is the third most common musculoskeletal disorder, often affecting people's daily living and work capacity. The most common shoulder disorder is the subacromial impingement syndrome (SIS) which, among other pathophysiological changes, is often characterised by rotator cuff tendinopathy. Exercise is often considered the primary treatment option for rotator cuff tendinopathy, but there is no consensus on which exercise strategy is the most effective. As eccentric and high-load strength training have been shown to have a positive effect on patella and Achilles tendinopathy, the aim of this trial is to compare the efficacy of progressive high-load exercises with traditional low-load exercises in patients with rotator cuff tendinopathy.Methods/designThe current study is a randomised, participant- and assessor-blinded, controlled multicentre trial. A total of 260 patients with rotator cuff tendinopathy will be recruited from three outpatient shoulder departments in Denmark, and randomised to either 12 weeks of progressive high-load strength training or to general low-load exercises. Patients will receive six individually guided exercise sessions with a physiotherapist and perform home-based exercises three times a week. The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.DiscussionPrevious studies of exercise treatment for SIS have not differentiated between subgroups of SIS and have often had methodological flaws, making it difficult to specifically design target treatment for patients diagnosed with SIS. Therefore, it was considered important to focus on a subgroup such as tendinopathy, with a specific tailored intervention strategy based on evidence from other regions of the body, and to clearly describe the intervention in a methodologically strong study.Trial registrationThe trial was registered with Clinicaltrials.gov ( NCT01984203 ) on 31 October 2013.

Dataset Information

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

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