Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

O’Brien, Liam; Jacobs, Ira

doi:10.3389/fphys.2022.1051529

Cited by 5 publications

(9 citation statements)

References 144 publications

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“…The threshold to pain perception likely reflects the responsiveness of nociceptors to noxious stimuli (Smith & Lewin, 2009), with an increased pain threshold mediated by a desensitisation of the nociceptors. Based on the current evidence, it is unlikely that IPC desensitises the group III/IV afferent nociceptors as previously postulated (De Oliveira Cruz et al, 2017; O’Brien & Jacobs, 2022). However, if a conditioned pain modulation effect was present (as suggested by a reduction in pain during the IPC) then it would be expected that there would also be an increase in pain threshold as is observed with typical conditioned pain modulation paradigms (Kennedy et al, 2016).…”

Section: Discussionsupporting

confidence: 72%

“…However, in the last decade, IPC has been found to enhance exercise performance (Crisafulli et al, 2011;De Groot et al, 2010;Santos de Oliveira Cruz et al, 2015), exercise recovery (Franz et al, 2018;Page et al, 2017;Patterson et al, 2021) and post-operative outcomes (Memtsoudis et al, 2010(Memtsoudis et al, , 2014Pereira et al, 2016). Pain, which is defined as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage" (Raja et al, 2020) is a common sensation that is experienced across these different physiological perturbations, and a reduction in pain perception may be one of the mechanisms which underpins the ergogenic effect of IPC (Astokorki & Mauger, 2017;Behrens et al, 2020;O'Brien & Jacobs, 2022;Pereira et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…It is also currently unclear as to whether remote IPC can induce a robust hypoalgesic response. This is important to establish as the physiological responses which cause IPC to improve exercise performance are not well understood (O’Brien & Jacobs, 2022).…”

Section: Introductionmentioning

confidence: 99%

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Remote ischaemic preconditioning increase tolerance to experimentally induced cold pain

Norbury,

Dickens,

Grant

et al. 2023

European Journal of Sport Science

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Ischaemic preconditioning (IPC) applied locally and remotely has been shown to reduce pain which may underpin its ergogenic effect on exercise performance, however, it is unclear how many IPC cycles are needed to induce hypoalgesia. Therefore the purpose of this study was to examine the number of cycles of IPC on experimental pain perception. Sixteen healthy participants underwent four, randomised, experimental sessions where they either underwent a sham protocol (1 × 5 min at 20 mmHg), and 1, 2 or 3 cycles × 5 min of remote IPC at 105% of limb occlusion pressure. Ten minutes post-intervention, participants underwent a cold-pressor test where pain threshold, pain tolerance and pain intensity were examined and compared between conditions with a one-way repeated measure analysis of variance. Pain threshold was not different between conditions (P = 0.065); but pain tolerance was increased by ∼30% in the 1 × 5 condition, 2 × 5 condition, and 3 × 5 condition compared to the sham condition. No differences in pain tolerance were seen between the different numbers of cycles (all P > 0.05). There was also no difference in the perception of pain 30 s into the cold pressor test (P = 0.279). Remote IPC appears to significantly improve tolerance to pain which may have significant implications for endurance performance and exercise rehabilitation, but this warrants further investigation. KEYWORDSIschaemic preconditioning; passive blood flow restriction; pain; hypoalgesia; cold pressor test Highlights. We found that one, two or three cycles of ischaemic preconditioning improved cold pain tolerance by 30% compared to a sham protocol, but there was no clear effect of IPC on pain threshold or pain intensity. . The pain reported during IPC decreased from cycle one to cycle three in the three cycle condition, suggesting a potential conditioned pain modulation effect. . An increase in pain tolerance may explain why IPC can improve exercise performance and IPC itself could be used as a tool to improve tolerance to pain.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Remote ischaemic preconditioning increase tolerance to experimentally induced cold pain

Norbury,

Dickens,

Grant

et al. 2023

European Journal of Sport Science

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“…There was more variation in the sham or control groups included in these studies. A sham procedure typically involves applying the cuff for the same duration of the IPC protocol but with a lower pressure applied, designed to mimic the IPC procedure and make the participants believe it is effective in a placebo effect ( O’Brien and Jacobs, 2022 ). Ten studies as shown in Table 2 included a sham (i.e., 20 mmHg) or control intervention group or crossover trial, resulting in a limited impact on blood flow.…”

Section: Resultsmentioning

confidence: 99%

The effects of lower limb ischaemic preconditioning: a systematic review

French,

Robbins,

Gernigon

et al. 2024

Front. Physiol.

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Ischaemic preconditioning (IPC) involves the use of repeated occlusions and reperfusions of the peripheral muscle blood supply at a limb. This systematic literature review examines the typical responses in response to the method of application during an IPC applied at the lower limb. This review focuses on the physiological responses for VO2max, haemoglobin, metabolic and genetic responses to various IPC interventions. The literature search was performed using four databases and assessed using the PRISMA search strategy and COSMIN to assess the quality of the articles. Seventeen articles were included in the review, with a total of 237 participants. While there is variation in the method of application, the average occlusion pressure was 222 ± 34 mmHg, ranging from 170 to 300 mmHg typically for 3 or 4 occlusion cycles. The distribution of this pressure is influenced by cuff width, although 8 studies failed to report cuff width. The majority of studies applies IPC at the proximal thigh with 16/17 studies applying an occlusion below this location. The results highlighted the disparities and conflicting findings in response to various IPC methods. While there is some agreement in certain aspects of the IPC manoeuvre such as the location of the occlusion during lower limb IPC, there is a lack of consensus in the optimal protocol to elicit the desired responses. This offers the opportunity for future research to refine the protocols, associated responses, and mechanisms responsible for these changes during the application of IPC.

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“…Specifically, the plasma concentration of an opioid neuropeptide such as beta-endorphin is thought to be released in response to stimulation of group III and group IV afferent fibers, activating the pain inhibitory pathways (13). Therefore, if ischemic preconditioning were to reduce the perception of fatigue and pain sensitivity, exercise performance might be augmented through attenuating fatigue development (25). In this study, there was evidence suggesting that pressure pain threshold increased after both ischemic preconditioning protocols relative to sham and control conditions, which has been used as an indirect marker of change in sensitivity of group III and group IV afferent fibers (1).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Different Ischemic Preconditioning Pressures on Pain Sensitivity and Resistance Exercise Performance

Kataoka,

Song,

Yamada

et al. 2024

Journal of Strength &Amp; Conditioning Research

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Kataoka, R, Song, JS, Yamada, Y, Hammert, WB, Seffrin, A, Spitz, RW, Wong, V, Kang, A, and Loenneke, JP. The impact of different ischemic preconditioning pressures on pain sensitivity and resistance exercise performance. J Strength Cond Res XX(X): 000–000, 2023—To determine (a) the impact of ischemic preconditioning pressures (applied as a % of arterial occlusion pressure [AOP]) on pressure pain threshold (PPT) and resistance exercise performance and (b) whether changes in performance could be explained by changes in PPT. Subjects (n = 39) completed 4 protocols in a randomized order: (a) ischemic preconditioning (IPC) at 110% AOP (IPC 110%), (b) IPC at 150% AOP (IPC 150%), (c) IPC at 10% AOP (Sham), and (d) time-matched control (CON). Each protocol included 4 cycles of 5 minutes of occlusion followed by 5 minutes of reperfusion. Pressure pain threshold was taken before and after. Discomfort ratings were given at the end of each cycle. Every visit finished with 2 sets of 75-second maximal isokinetic unilateral elbow flexion or extension. Overall, IPC 110% and IPC 150% resulted in similar increases in PPT relative to CON [110%: difference of 0.36 (0.18, 0.54) kg·m−2; 150%: difference of 0.377 (0.15, 0.59) kg·m−2] and Sham. Both resulted in greater discomfort than Sham and CON, with IPC 150% inducing greater discomfort than IPC 110% (BF10: 14.74). There were no differences between the conditions for total work (BF10: 0.23), peak torque (BF10: 0.035), or average power (BF10: 0.159). We did not find evidence that PPT mediated performance. We did not detect changes in performance with 2 different relative pressures greater than AOP. Our mean applied pressures were lower than those used previously. There might be a minimal level of pressure (e.g., >150% of AOP) that is required to induce ergogenic effects of ischemic preconditioning.

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Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

Cited by 5 publications

References 144 publications

Remote ischaemic preconditioning increase tolerance to experimentally induced cold pain

Remote ischaemic preconditioning increase tolerance to experimentally induced cold pain

The effects of lower limb ischaemic preconditioning: a systematic review

The Impact of Different Ischemic Preconditioning Pressures on Pain Sensitivity and Resistance Exercise Performance

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