Acute and Chronic Effects of Blood Flow Restricted High-Intensity Interval Training: A Systematic Review

Abstract

Background The implementation of blood flow restriction (BFR) during exercise is becoming an increasingly useful adjunct method in both athletic and rehabilitative settings. Advantages in pairing BFR with training can be observed in two scenarios: (1) training at lower absolute intensities (e.g. walking) elicits adaptations akin to high-intensity sessions (e.g. running intervals); (2) when performing exercise at moderate to high intensities, higher physiological stimulus may be attained, leading to larger improvements in aerobic, anaerobic, and muscular parameters. The former has been well documented in recent systematic reviews, but consensus on BFR (concomitant or post-exercise) combined with high-intensity interval training (HIIT) protocols is not well established. Therefore, this systematic review evaluates the acute and chronic effects of BFR + HIIT. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify relevant studies. A systematic search on 1 February 2022, was conducted on four key databases: ScienceDirect, PubMed, Scopus and SPORTDiscus. Quality of each individual study was assessed using the Physiotherapy Evidence Database (PEDro) scale. Extraction of data from included studies was conducted using an adapted version of the 'Population, Intervention, Comparison, Outcome' (PICO) framework. Results A total of 208 articles were identified, 18 of which met inclusion criteria. Of the 18 BFR + HIIT studies (244 subjects), 1 reported both acute and chronic effects, 5 examined acute responses and 12 investigated chronic effects. Acutely, BFR challenges the metabolic processes (vascular and oxygenation responses) during high-intensity repeated sprint exercise—which accelerates central and peripheral neuromuscular fatigue mechanisms resulting in performance impairments. Analysis of the literature exploring the chronic effects of BFR + HIIT suggests that BFR does provide an additive physiological training stimulus to HIIT protocols, especially for measured aerobic, muscular, and, to some extent, anaerobic parameters. Conclusion Presently, it appears that the addition of BFR into HIIT enhances physiological improvements in aerobic, muscular, and, to some extent, anaerobic performance. However due to large variability in permutations of BFR + HIIT methodologies, it is necessary for future research to explore and recommend standardised BFR guidelines for each HIIT exercise type.

Resistance Training Causes the Stretch-Induced Force Deficit—A Randomized Cross-Over Study

“…However, even though significant, Wohlann et al [ 32 ] critically discussed the magnitude of such CK increases as clinically irrelevant. Another possibility from a rat study suggests that prolonged static stretching can restrict muscle blood flow [ 33 ], which could adversely impact metabolic activity [ 34 ] and cause fatigue [ 35 ] and thus impair force [ 36 ]. However, as there are no studies investigating structural stretching effects, this explanation remains speculative.…”

Acute Hemodynamic, Metabolic, and Hormonal Responses to a Boxing Exergame with and without Blood Flow Restriction in Non-Athlete Young Individuals

“…Specifically, BFR induces a spectrum of physiological effects, including augmented muscle protein synthesis, facilitated by an elevated anabolic hormonal environment; enhanced muscle hypertrophy and strength gains through metabolic stress and muscle fiber recruitment patterns that mimic those observed in high-load resistance training; and improvements in vascular function due to increased shear stress [ 9 ]. Furthermore, BFR has been shown to elevate lactate concentration and promote systemic hypoxia, which are critical factors in stimulating aerobic and anaerobic metabolism, thereby improving endurance and muscular efficiency [ 10 ]. In essence, BFR offers a mechanism by which training intensity can be intensified without the corresponding increase in load, thereby holding significant promise for advancing sports performance by amplifying the physiological impacts of training sessions [ 8 , 10 ].…”

“…Furthermore, BFR has been shown to elevate lactate concentration and promote systemic hypoxia, which are critical factors in stimulating aerobic and anaerobic metabolism, thereby improving endurance and muscular efficiency [ 10 ]. In essence, BFR offers a mechanism by which training intensity can be intensified without the corresponding increase in load, thereby holding significant promise for advancing sports performance by amplifying the physiological impacts of training sessions [ 8 , 10 ]. Bridging the gap between these innovative training methods and their physiological impacts, the convergence of technology and physical exercise opens a new chapter in understanding and optimizing the human body’s response to exercise.…”