Body position influences arterial occlusion pressure: implications for the standardization of pressure during blood flow restricted exercise

Sieljacks, Peter; Knudsen, Louise; Wernbom, Mathias; Vissing, Kristian

doi:10.1007/s00421-017-3770-2

Cited by 57 publications

(56 citation statements)

References 29 publications

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“…Furthermore, no conclusions can be drawn about the level of AOP in a sitting or standing position. A study by Sieljacks et al 5 indicated that body position influences lower limb AOP, with significantly higher values in a sitting position. Therefore, future studies need to determine whether the PO may give more accurate readings when measuring the AOP in different body positions.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigations have demonstrated that low-load resistance training in combination with BFR promotes increases in muscle mass and strength to a similar extent as traditional high-load training. [1][2][3] Besides cuff width [4][5][6] and the duration of BFR, 7 cuff pressure intensity is considered to be one of the most important determinants for optimal training adaptations 8,9 with both acute and chronic studies demonstrating pressure-dependent physiological responses. [10][11][12] While some studies use the same absolute pressure across all individuals, 13,14 setting an arbitrary absolute pressure does not necessarily restrict the same amount of blood flow for each individual and does thus not allow adequate standardization across subjects.…”

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confidence: 99%

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Blood-Flow-Restriction Training: Validity of Pulse Oximetry to Assess Arterial Occlusion Pressure

Zeng¹,

Centner²,

Gollhofer³

et al. 2019

International Journal of Sports Physiology and Performance

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Purpose: Setting the optimal cuff pressure is a crucial part of prescribing blood-flow-restriction training. It is currently recommended to use percentages of each individual’s arterial occlusion pressure, which is most accurately determined by Doppler ultrasound (DU). However, the practicality of this gold-standard method in daily training routine is limited due to high costs. An alternative solution is pulse oximetry (PO). The main purpose of this study was to evaluate validity between PO and DU measurements and to investigate whether sex has a potential influence on these variables. Methods: A total of 94 subjects were enrolled in the study. Participants were positioned in a supine position, and a 12-cm-wide cuff was applied in a counterbalanced order at the most proximal portion of the right upper and lower limbs. The cuff pressure was successively increased until pulse was no longer detected by DU and PO. Results: There were no significant differences between the DU and PO methods when measuring arterial occlusion pressure at the upper limb (P = .308). However, both methods showed considerable disagreement for the lower limbs (P = .001), which was evident in both men (P = .028) and women (P = .008). No sex differences were detected. Conclusions: PO is reasonably accurate to determine arterial occlusion pressure of the upper limbs. For lower limbs, PO does not seem to be a valid instrument when assessing the optimal cuff pressure for blood-flow-restriction interventions compared with DU.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Blood-Flow-Restriction Training: Validity of Pulse Oximetry to Assess Arterial Occlusion Pressure

Zeng¹,

Centner²,

Gollhofer³

et al. 2019

International Journal of Sports Physiology and Performance

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“…3,17,27,37,46,48,79 Currently, it is recommended that individual occlusion pressures be calculated as a percentage of the total arterial occlusion pressure (AOP), with individual protocols ranging from 60% to 80%. 35,40,69,84 The gold standard method of measuring AOP and true occlusion is Doppler ultrasound, 6,9,29,56,66 although recent investigations have begun to assess the feasibility of pulse oximetry as a lower maintenance alternative. 77,84 A previous method in the literature attempted to predict the AOP as a percentage of the brachial systolic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review

Patel

Kym

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Low-load blood flow restriction (BFR) training has attracted attention as a potentially effective method of perioperative clinical rehabilitation for patients undergoing orthopaedic procedures. Purpose: To (1) compare the effectiveness of low-load BFR training in conjunction with a standard rehabilitation protocol, pre- and postoperatively, and non-BFR interventions in patients undergoing anterior cruciate ligament reconstruction (ACLR) and (2) evaluate protocols for implementing BFR perioperatively for patients undergoing ACLR. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic review of the 3 medical literature databases was conducted to identify all level 1 and 2 clinical trials published since 1990 on BFR in patients undergoing ACLR. Patient demographics from included studies were pooled. Outcome data were documented, including muscle strength and size, and perceived pain and exertion. A descriptive analysis of outcomes from BFR and non-BFR interventions was performed. Results: A total of 6 studies (154 patients; 66.2% male; mean ± SD age, 24.2 ± 3.68 years) were included. Of these, 2 studies examined low-load BFR as a preoperative intervention, 1 of which observed a significant increase in muscle isometric endurance ( P = .014), surface electromyography of the vastus medialis ( P < .001), and muscle blood flow to the vastus lateralis at final follow-up ( P < .001) as compared with patients undergoing sham BFR. Four studies investigated low-load BFR as a postoperative intervention, and they observed significant benefits in muscle hypertrophy, as measured by cross-sectional area; strength, as measured by extensor torque; and subjective outcomes, as measured by subjective knee pain during session, over traditional low-load resistance training (all P < .05). BFR occlusion periods ranged from 3 to 5 minutes, with rest periods ranging from 45 seconds to 3 minutes. Conclusion: This systematic review found evidence on the topic of BFR rehabilitation after ACLR to be sparse and heterogeneous likely because of the relatively recent onset of its popularity. While a few authors have demonstrated the potential strength and hypertrophy benefits of perioperative BFR, future investigations with standardized outcomes, long-term follow-up, and more robust sample sizes are required to draw more definitive conclusions.

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“…This approach may have affected the precision of our method to measure the BFR pressure to be used during each protocol. In this regard, Sieljacks et al (2018) reported that 40% of seated BFR pressure corresponds to about 50% of BFR measure with the participant lying down, specifically in the lower body. Nonetheless, even if the restrictive pressure utilized in the current investigation corresponded to approximately 40% of BFR, previous studies have shown similar chronic neuromuscular adaptations with 40 and 90% of occlusion during resistance training combined with BFR (Counts et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Acute Physiological Responses to Resistance Exercise With Continuous Versus Intermittent Blood Flow Restriction: A Randomized Controlled Trial

et al. 2020

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The primary goal of this investigation was to examine the physiological responses of blood flow restriction (BFR) resistance exercise (RE) performed with continuous or intermittent BFR and to compare these results to those from conventional high-and low-load RE without BFR. Fourteen men randomly completed the following experimental trials: (1) low-load RE with continuous BFR (cBFR), (2) low-load RE with intermittent BFR (iBFR), (3) low-load RE without BFR (LI), and (4) conventional high-load RE without BFR (HI). For the cBFR, iBFR, and LI exercise trials, participants performed four sets of 30-15-15-15 repetitions of the bilateral leg press (LP) and knee extension (KE) exercises, at an intensity of 20% of their one-repetition maximum (1-RM), at a 1.5s contraction speed, and with a 1-min rest period between sets. The only difference between the cBFR and iBFR protocols was that the pressure of the cuffs was released during the rest intervals between sets for the iBFR trial. For the HI trial, participants completed four sets of 10 repetitions of the same exercises, at 70% of 1-RM, with a 1-min rest period between sets, and at the same contraction speed. Muscle activity was assessed during each set using superficial electromyography, as well as changes in blood lactate concentration [La − ] from baseline at 5 min post exercise and in muscle swelling and plasma volume (% PV) at 5 and 15 min post exercise. There were no significant differences in muscle activity (p < 0.05) across the cBFR, iBFR, and LI protocols at any time point, whereas they were all significantly lower than HI. There were also no significant (p < 0.05) differences across the three low-load RE conditions for [La − ],% PV, or muscle swelling. HI elicited significantly (p < 0.05) greater responses than cBFR, iBFR, and LI for all the physiological markers measured. In conclusion, RE combined with cBFR or iBFR induce the same acute physiological responses. However, the largest physiological responses are observed with HI, probably because of the significantly greater exercise volumes. Therefore, releasing the pressure of the restrictive cuffs during the rest periods between sets will not hinder the acute physiological responses from BFR RE.

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Body position influences arterial occlusion pressure: implications for the standardization of pressure during blood flow restricted exercise

Cited by 57 publications

References 29 publications

Blood-Flow-Restriction Training: Validity of Pulse Oximetry to Assess Arterial Occlusion Pressure

Blood-Flow-Restriction Training: Validity of Pulse Oximetry to Assess Arterial Occlusion Pressure

Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review

Acute Physiological Responses to Resistance Exercise With Continuous Versus Intermittent Blood Flow Restriction: A Randomized Controlled Trial

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