Project description:The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
Project description:Background: The aim of the present study was to evaluate the effects of post-activation performance enhancement (PAPE) during successive sets of the bench press (BP) exercise under blood flow restriction (BFR). Methods: The study included 10 strength-trained males (age = 29.8 ± 4.6 years; body mass = 94.3 ± 3.6 kg; BP 1-repetition maximum (1RM) = 168.5 ± 26.4 kg). The experiment was performed following a randomized crossover design, where each participant performed two different exercise protocols: under blood flow restriction (BFR) and control test protocol (CONT) without blood flow restriction. During the experimental sessions, the study participants performed 3 sets of 3 repetitions of the BP exercise at 70%1RM with a 5 min rest interval between sets. The differences in peak power output (PP), mean power output (MP), peak bar velocity (PV), and mean bar velocity (MV) between the CONT and BFR conditions were examined using 2-way (condition × set) repeated measures ANOVA. Furthermore, t-test comparisons between conditions were made for the set 2-set 1, set 3-set 1, and set 3-set 2 delta values for all variables. Results: The post hoc results for condition × set interaction in PP showed a significant increase in set 2 compared to set 1 for BFR (p < 0.01) and CONT (p = 0.01) conditions, a significant increase in set 3 compared to set 1 for the CONT (p = 0.01) condition, as well as a significant decrease in set 3 compared to set 1 for BFR condition occurred (p < 0.01). The post hoc results for condition × set interaction in PV showed a significant increase in set 2 compared to set 1 for BFR (p < 0.01) and CONT (p = 0.01) conditions, a significant increase in set 3 compared to set 1 for CONT (p = 0.03) condition, as well as a significant decrease in set 3 compared to set 1 for BFR condition (p < 0.01). The t-test comparisons showed significant differences in PP (p < 0.01) and PV (p = 0.01) for set 3-set 2 delta values between BFR and CONT conditions. Conclusion: The PAPE effect was analyzed through changes in power output and bar velocity that occurred under both the CONT and BFR conditions. However, the effects of PAPE have different kinetics in successive sets for BFR and for CONT conditions.
Project description:The objective of this study is to evaluate the effects of blood flow restriction (BFR) on muscle oxygenation during low-intensity resistance exercise as well as postexercise expression of molecules related to physiological angiogenesis.Using a randomized cross-over design, six apparently healthy young adults (22 ± 1 yr) performed 120 unilateral knee extensions at 40% of 1 repetition maximum with and without BFR (CNTRL). Near-infrared spectroscopy was used to measure oxygenation of the vastus lateralis during exercise. Serum and muscle expression of Post-Resistance vascular endothelial growth factor (VEGF) were determined preexercise, 4 h postexercise, and 24 h postexercise. Transcript (mRNA) expression of VEGF and other angiogenic genes was also determined.BFR increased muscle hemoglobin (Hb) concentrations during exercise (14.4 ± 1.6 vs. 0.9 ± 1.6, P = 0.002), driven largely by an increase in deoxygenated Hb (11.0 ± 2.5 vs. 0.5 ± 1.1, P = 0.030). BFR also increased (P < 0.05) transcript expression of VEGF, VEGF-R2, hypoxia-inducible factor 1 alpha, inducible nitric oxide synthase (NOS), and neuronal NOS. The most dramatic change in response to BFR was an increase in VEGF mRNA at 4 h postexercise (4.1 ± 0.6 vs. 0.6 ± 0.2-fold change, P = 0.028). Compared with control, transcript expression of endothelial NOS, serum VEGF, or muscle protein expression of VEGF was not altered in response to BFR (P > 0.05).Acute BFR increases postexercise expression of mRNA related to skeletal muscle angiogenesis, plausibly in response to changes in muscle Hb concentrations.
Project description:PURPOSE:Combining blood flow restriction (BFR) with exercise can stimulate skeletal muscle hypertrophy. Recent observations in an animal model suggest that BFR performed without exercise can also induce anabolic effects. We assessed the effect of BFR performed both with and without low-load resistance-type exercise (LLRE) on in vivo myofibrillar protein synthesis rates in young men. METHODS:Twenty healthy young men (age = 24 ± 1 yr, body mass index = 22.9 ± 0.6 kg·m) were randomly assigned to remain in resting condition (REST ± BFR; n = 10) or to perform LLRE (LLRE ± BFR at 20% one-repetition maximum; n = 10), combined with two 5-min cycles of single leg BFR. Myofibrillar protein synthesis rates were assessed during a 5-h post-BFR period by combining a primed continuous L-[ring-C6]phenylalanine infusion with the collection of blood samples, and muscle biopsies from the BFR leg and the contralateral control leg. The phosphorylation status of anabolic signaling (mammalian target of rapamycin pathway) and metabolic stress (acetyl-CoA carboxylase)-related proteins, as well as the mRNA expression of genes associated with skeletal muscle mass regulation, was assessed in the collected muscle samples. RESULTS:Under resting conditions, no differences in anabolic signaling or myofibrillar protein synthesis rates were observed between REST + BFR and REST (0.044% ± 0.004% vs 0.043% ± 0.004% per hour, respectively; P = 0.683). By contrast, LLRE + BFR increased myofibrillar protein synthesis rates by 10% ± 5% compared with LLRE (0.048% ± 0.005% vs 0.043% ± 0.004% per hour, respectively; P = 0.042). Furthermore, compared with LLRE, LLRE + BFR showed higher phosphorylation status of acetyl-CoA carboxylase and 4E-BP1 as well as the elevated mRNA expression of MuRF1 (all P < 0.05). CONCLUSION:BFR does not increase myofibrillar protein synthesis rates in healthy young men under resting conditions. When combined with LLRE, BFR increases postexercise myofibrillar protein synthesis rates in vivo in humans.
Project description:Blood flow restriction training (BFRT) has been previously studied as an alternative form of resistance training to gain lean mass and improve performance outcomes. However, in all exercise studies of BFRT, the proportion of female participants represents only 17-29% of all research participants. This highlights a strong underrepresentation of females and the need for more knowledge on the impact of BFRT and sex differences. The primary objective was to compare the impact of 6-week BFRT on lean mass, strength, and performance outcomes between males and females. A total of 38 adults [age, 25.3 ± 3.1 years; female, n = 19 (50%)] performed whole-body resistance training program with blood flow restriction three times per week. Exercises were performed at 30% of 1-repetition maximum (1-RM) and blood flow restriction cuffs were set to 60% of each individual's limb occlusion pressure. Body composition was assessed via dual-energy x-ray absorptiometry and strength was measured using 1-RM. A significant increase in lean mass was observed in males (p = 0.009) and females (p = 0.023) with no difference in the change between groups (p = 0.279). Both males and females increased 1-RM for upper- and lower-body exercises, with significant interaction effects (time x sex) for chest press (p = 0.003), seated row (p = 0.038), knee flexion (p = 0.043), and knee extension (p = 0.035), suggesting males increased 1-RM more for these exercises. Furthermore, peak power was improved in males (p < 0.001) and females (p = 0.002) during a vertical squat jump, but a significant interaction (time x sex) effect was observed (p = 0.039), suggesting males increased to a greater extent. Males and females significantly increased lean body mass, to a similar degree, following six weeks of resistance training in combination with blood flow restriction. Likewise, both males and females improved muscle strength following 6-week BFRT, however males may improve strength to a greater extent than females.
Project description:New findingsWhat is the central question of this study? Does applying blood flow restriction during the rest periods of repeated sprint exercise in a hypoxic environment lead to greater local hypoxia within exercising muscles without compromising training workload? What is the main finding and its importance? Repeated sprint exercise with blood flow restriction administered during rest periods under systemic hypoxia led to severe local hypoxia within the exercised muscles without a reduction in power output. The maintained power output might be due to elevated neuromuscular activation. Accordingly, the proposed repeated sprint exercise in the current study may be an effective training modality.AbstractRepeated sprint exercise (RSE) is a popular training modality for a wide variety of athletic activities. The purpose of this study was to assess the combined effects of systemic hypoxia and blood flow restriction (BFR) on muscle deoxygenation and RSE performance. Twelve healthy young men performed a standard RSE training modality (five sets of 10 s maximal sprint with a 60 s rest) under four different conditions: (1) normoxic control (NC), normoxia (N, 20.9%) + control BFR (C, 0 mmHg); (2) normoxic BFR (NB), normoxia (N, 20.9%) + BFR (B, 140 mmHg); (3) hypoxic control (HC), hypoxia (H, 13.7%) + control BFR (C, 0 mmHg); and (4) hypoxic BFR (HB): hypoxia (H, 13.7%) + BFR (B, 140 mmHg). BFR was only administered during the rest period of the respective RSE trials. In the local exercising muscles, muscle oxygen saturation ( SmO2$\textit{Sm}{O}_{2}$ ) and neuromuscular activity were measured using near-infrared spectroscopy and surface electromyography, respectively. SmO2 was lower in systemic hypoxia conditions relative to normoxia conditions (P < 0.05). A rther decrease in SmO2 was observed in HB relative to HC (Set 1: HC 70.0 ± 17.5 vs. HB 57.4 ± 11.3%, P = 0.001; Set 4: HC 67.5 ± 14.6 vs. HB 57.0 ± 12.0%, P = 0.013; Set 5: HC 61.0 ± 15.3 vs. HB 47.7 ± 11.9%, P < 0.001). No differences in RSE performance were observed between any of the conditions (P > 0.05). Interestingly, an elevated neuromuscular activity was seen in response to the BFR, particularly during conditions of systemic hypoxia (P < 0.05). Thus, RSE with BFR administered during rest periods under systemic hypoxia led to severe local hypoxia without compromising training workload.
Project description:Blood flow restriction in combination with low-intensity resistance exercise (REFR) increases skeletal muscle size to a similar extent as compared with traditional high-intensity resistance exercise training. However, there are limited data describing the molecular adaptations that occur after REFR.To determine whether hypoxia inducible factor-1 alpha (HIF-1alpha) and REDD1 mRNA are expressed differently in REFR compared with low-intensity resistance exercise with no blood flow restriction (CONTROL). Secondly, to determine whether low-intensity resistance exercise is able to induce changes in mRNA expression of several anabolic and catabolic genes as typically seen with high-intensity resistance exercise.Six subjects were studied at baseline and 3 h after a bout of leg resistance exercise (20% 1RM) in REFR and CONTROL subjects. Each subject participated in both groups, with 3 wk separating each visit. Muscle biopsy samples were analyzed for mRNA expression, using qRT-PCR.Our primary finding was that there were no differences between CONTROL and REFR for any of the selected genes at 3 h after exercise (P > 0.05). However, low-intensity resistance exercise increased HIF-1alpha, p21, MyoD, and muscle RING finger 1 (MuRF1) mRNA expression and decreased REDD1 and myostatin mRNA expression in both groups (P < 0.05).Low-intensity resistance exercise can alter skeletal muscle mRNA expression of several genes associated with muscle growth and remodeling, such as REDD1, HIF-1alpha, MyoD, MuRF1, and myostatin. Further, the results from REFR and CONTROL were similar, indicating that the changes in early postexercise gene expression were attributable to the low-intensity resistance exercise bout, and not blood flow restriction.
Project description:PurposeThis study investigated the acute effects of a static balance exercise combined with different blood flow restriction (BFR) pressures on motor performance fatigue development and recovery as well as physiological and perceptual responses during exercise in males and females.MethodsTwenty-four recreational active males (n = 13) and females (n = 11) performed static balance exercise on a BOSU ball (3 sets of 60 s with 30 s rest in-between) on three separate (> 3 days) laboratory visits with three different BFR pressures (80% arterial occlusion pressure [AOP], 40%AOP, 30 mmHg [SHAM]) in random order. During exercise, activity of various leg muscles, vastus lateralis muscle oxygenation, and ratings of effort and pain perception were recorded. Maximal squat jump height was measured before, immediately after, 1, 2, 4, and 8 min after exercise to quantify motor performance fatigue development and recovery.ResultsQuadriceps muscle activity as well as ratings of effort and pain were highest, while muscle oxygenation was lowest in the 80%AOP compared to the 40%AOP and SHAM condition, with no differences in postural sway between conditions. Squat jump height declined after exercise with the highest reduction in the 80%AOP (- 16.4 ± 5.2%) followed by the 40%AOP (- 9.1 ± 3.2%), and SHAM condition (- 5.4 ± 3.3%). Motor performance fatigue was not different after 1 min and 2 min of recovery in 40% AOP and 80% AOP compared to SHAM, respectively.ConclusionStatic balance exercise combined with a high BFR pressure induced the largest changes in physiological and perceptual responses, without affecting balance performance. Although motor performance fatigue was increased by BFR, it may not lead to long-term impairments in maximal performance.
Project description:Background: Blood flow restriction or KAATSU exercise training is associated with greater muscle mass and strength increases than non-blood flow restriction equivalent exercise. Blood flow restriction exercise has been proposed as a possible alternative to more physically demanding exercise prescriptions (such as high-load/high-intensity resistance training) in a range of clinical and chronic disease populations. While the maintenance of muscle mass and size with reduced musculoskeletal tissue loading appeals in many of these physically impaired populations, there remains a disconnect between some of the desired clinical measures for chronic disease populations and those commonly measured in the literature examining blood flow restriction exercise. While strength does play a vital role in physical function, task-specific objective measures of physical function indicative of activities of daily living are often more clinically relevant and applicable for evaluating the success of medical and surgical interventions or monitoring age- and disease-related physical decline. Objective: To determine whether exercise interventions utilizing blood flow restriction are able to improve objective measures of physical function indicative of activities of daily living. Methods: A systematic search of Medline, Embase, CINAHL, SPORTDiscus, and Springer identified 13 randomized control trials utilizing an exercise intervention combined with blood flow restriction, while measuring at least one objective measure of physical function. Participants were ≥18 years of age. Systematic review of the literature and quality assessment of the included studies used the Cochrane Collaboration's tool for assessing risk bias. Results: Data from 13 studies with a total of 332 participants showed blood flow restriction exercise, regardless of modality, most notably increased performance on the 30 s sit-to-stand and timed up and go tests, and generally improved physical function on other tests including walking tests, variations of sit-to-stand tests, and balance, jumping, and stepping tests. Conclusions: From the evidence available, blood flow restriction exercise of multiple modalities improved objective measures of physical function indicative of activities of daily living.
Project description:This study systematically reviewed the available scientific evidence pertaining to the acute and chronic changes promoted by aerobic exercise (AE) combined with blood flow restriction (BFR) on neuromuscular, metabolic and hemodynamic variables. PubMed, Web of ScienceTM and Scopus databases were searched for the period from January 2000 to June 2019 and the analysis involved a critical content review. A total of 313 articles were identified, of which 271 were excluded and 35 satisfied the inclusion criteria. Twelve studies evaluated the acute effects and eight studies evaluated the chronic metabolic effects of AE + BFR. For the neuromuscular variables, three studies analyzed the acute effects of AE + BFR and nine studies analyzed the chronic effects. Only 15 studies were identified that evaluated the hemodynamic acute effects of AE + BFR. The analysis provided evidence that AE combined with BFR promotes positive acute and chronic changes in neuromuscular and metabolic variables, a greater elevation in hemodynamic variables than exercise alone, and a higher energy demand during and after exercise. Since these alterations were all well-tolerated, this method can be considered to be safe and feasible for populations of athletes, healthy young, obese, and elderly individuals.