Perceptual responses: Clinical versus practical blood flow restriction resistance exercise

Miller, Ryan M.; Galletti, Bianca A.R.; Kozioł, Karolina; Freitas, Eduardo; Heishman, Aaron D.; Black, Christopher D.; Larson, Daniel J.; Bemben, Debra A.; Bemben, Michael G.

doi:10.1016/j.physbeh.2020.113137

Cited by 13 publications

(40 citation statements)

References 37 publications

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“…LLRE-BFR methodology is critical to the experience of the technique. Restrictive cuff pressures [ 48 , 64 ], cuff width [ 65 , 66 ], type of cuff [ 67 ] and exercise load [ 21 ] have been shown to substantially effect the perceptual and cardiovascular response. An interesting finding in the present study was an increase in perceptual and cardiovascular response during knee extension compared to leg press for all conditions, which may be worsened with BFR.…”

Section: Discussionmentioning

confidence: 99%

Comparative Perceptual, Affective, and Cardiovascular Responses between Resistance Exercise with and without Blood Flow Restriction in Older Adults

Parkington

Maden‐Wilkinson

Klonizakis

et al. 2022

IJERPH

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Older adults and patients with chronic disease presenting with muscle weakness or musculoskeletal disorders may benefit from low-load resistance exercise (LLRE) with blood flow restriction (BFR). LLRE-BFR has been shown to increase muscle size, strength, and endurance comparable to traditional resistance exercise but without the use of heavy loads. However, potential negative effects from LLRE-BFR present as a barrier to participation and limit its wider use. This study examined the perceptual, affective, and cardiovascular responses to a bout of LLRE-BFR and compared the responses to LLRE and moderate-load resistance exercise (MLRE). Twenty older adults (64.3 ± 4.2 years) performed LLRE-BFR, LLRE and MLRE consisting of 4 sets of leg press and knee extension, in a randomised crossover design. LLRE-BFR was more demanding than LLRE and MLRE through increased pain (p ≤ 0.024, d = 0.8–1.4) and reduced affect (p ≤ 0.048, d = −0.5–−0.9). Despite this, LLRE-BFR was enjoyed and promoted a positive affective response (p ≤ 0.035, d = 0.5–0.9) following exercise comparable to MLRE. This study supports the use of LLRE-BFR for older adults and encourages future research to examine the safety, acceptability, and efficacy of LLRE-BFR in patients with chronic disease.

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Section: Discussionmentioning

confidence: 99%

Comparative Perceptual, Affective, and Cardiovascular Responses between Resistance Exercise with and without Blood Flow Restriction in Older Adults

Parkington

Maden‐Wilkinson

Klonizakis

et al. 2022

IJERPH

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“…The authors observed that the elastic consistently resulted in complete vein occlusion when it was tightened on the thigh based on the perceptual response of 7 (moderate pressure without pain) on the tightness scale with 11 descriptors (0-10), but not in the arteries. This way of applying elastic wraps according to the response of a 7 out of 10 on the perceived tightness scale has subsequently been used in several studies [20][21][22][23][24][25][26][27][28]. However, applying the elastic wrap just for the perception of tightness, seems to be a limited prescription for pBFR, since there is no guarantee that the researcher or trainer will equally restrict the elastic segment in all training sessions.…”

Section: Prescription Of Pbfr Training: Focusing On Methodological As...mentioning

confidence: 99%

“…In analyzing muscle damage, Wilson et al [ 19 ] demonstrated that soreness, power and muscle swelling were similar between low-load resistance exercise with and without pBFR; in addition, Behringer et al [ 38 ] demonstrated that after 6 weeks of sprint training, the heart-type fatty acid-binding protein (h-FABP) was significantly lower in the group that trained with pBFR than in the control group, with similar responses between groups regarding cortisol. Additionally, studies have found similar acute pain responses between low-load resistance exercise with and without pBFR [ 26 , 40 ]; furthermore, the high-load resistance exercise induces greater pain scores than low-load resistance exercise with pBFR [ 26 ]. Considering cardiovascular events, studies have compared high-load resistance exercise with low-load resistance exercise with pBFR, noting that post-exercise acute responses are similar between the exercise protocols, in relation to autonomic modulation [ 25 ], as well as on arterial stiffness and brachial systolic or diastolic blood pressure [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Practical Blood Flow Restriction Training: New Methodological Directions for Practice and Research

Aniceto¹,

Leandro²

2022

Sports Med - Open

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Most studies with blood flow restriction (BFR) training have been conducted using devices capable of regulating the restriction pressure, such as pneumatic cuffs. However, this may not be a viable option for the general population who exercise in gyms, squares and sports centers. Thinking about this logic, practical blood flow restriction (pBFR) training was created in 2009, suggesting the use of elastic knee wraps as an alternative to the traditional BFR, as it is low cost, affordable and practical. However, unlike traditional BFR training which seems to present a consensus regarding the prescription of BFR pressure based on arterial occlusion pressure (AOP), studies on pBFR training have used different techniques to apply the pressure/tension exerted by the elastic wrap. Therefore, this Current Opinion article aims to critically and chronologically examine the techniques used to prescribe the pressure exerted by the elastic wrap during pBFR training. In summary, several techniques were found to apply the elastic wrap during pBFR training, using the following as criteria: application by a single researcher; stretching of the elastic (absolute and relative overlap of the elastic); the perceived tightness scale; and relative overlap of the elastic based on the circumference of the limbs. Several studies have shown that limb circumference seems to be the greatest predictor of AOP. Therefore, we reinforce that applying the pressure exerted by the elastic for pBFR training based on the circumference of the limbs is an excellent, valid and safe technique.

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“…Direct comparisons on neuromuscular, hemodynamics and perceptual responses between different restrictive approaches (i.e., pneumatic vs. practical BFR) are limited to acute studies ( 43 – 49 ). Interpretation of this small body of literature is challenging given that one ( 49 ) compared the resting blood flow responses between specialized elastic wraps to an automatic tourniquet of various pressures while the others investigated neuromuscular ( 45 , 46 ), perceptual ( 44 ) and physiological (i.e., lactate and muscle swelling) ( 46 ) responses. It appears that practical BFR may generate similar acute changes in variables thought to induce positive musculoskeletal adaptations (i.e., muscle activation) ( 46 , 48 ) while producing levels of perceptual demand that may be less than BFR training using pneumatic devices ( 44 ).…”

Section: Determining Barriers To Successful Bfr Trainingmentioning

confidence: 99%

“…Interpretation of this small body of literature is challenging given that one ( 49 ) compared the resting blood flow responses between specialized elastic wraps to an automatic tourniquet of various pressures while the others investigated neuromuscular ( 45 , 46 ), perceptual ( 44 ) and physiological (i.e., lactate and muscle swelling) ( 46 ) responses. It appears that practical BFR may generate similar acute changes in variables thought to induce positive musculoskeletal adaptations (i.e., muscle activation) ( 46 , 48 ) while producing levels of perceptual demand that may be less than BFR training using pneumatic devices ( 44 ). However, practical BFR may not be suitable for clinical populations given it has the capacity to under- or overestimate applied pressures in the limbs by as much as 25% on a day-to-day basis ( 50 ).…”

Section: Determining Barriers To Successful Bfr Trainingmentioning

confidence: 99%

Perceived Barriers to Blood Flow Restriction Training

Rolnick

Kimbrell²,

Cerqueira

et al. 2021

Front. Rehabilit. Sci.

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Blood flow restriction (BFR) training is increasing in popularity in the fitness and rehabilitation settings due to its role in optimizing muscle mass and strength as well as cardiovascular capacity, function, and a host of other benefits. However, despite the interest in this area of research, there are likely some perceived barriers that practitioners must overcome to effectively implement this modality into practice. These barriers include determining BFR training pressures, access to appropriate BFR training technologies for relevant demographics based on the current evidence, a comprehensive and systematic approach to medical screening for safe practice and strategies to mitigate excessive perceptual demands of BFR training to foster long-term compliance. This manuscript attempts to discuss each of these barriers and provides evidence-based strategies and direction to guide clinical practice and future research.

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Perceptual responses: Clinical versus practical blood flow restriction resistance exercise

Cited by 13 publications

References 37 publications

Comparative Perceptual, Affective, and Cardiovascular Responses between Resistance Exercise with and without Blood Flow Restriction in Older Adults

Comparative Perceptual, Affective, and Cardiovascular Responses between Resistance Exercise with and without Blood Flow Restriction in Older Adults

Practical Blood Flow Restriction Training: New Methodological Directions for Practice and Research

Perceived Barriers to Blood Flow Restriction Training

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