The Application of Blood Flow Restriction: Lessons From the Laboratory

Abstract

Blood flow restriction by itself or in combination with exercise has been shown to produce beneficial adaptations to skeletal muscle. These adaptations have been observed across a range of populations, and this technique has become an attractive possibility for use in rehabilitation. Although there are concerns that applying blood flow restriction during exercise makes exercise inherently more dangerous, these concerns appear largely unfounded. Nevertheless, we have advocated that practitioners could minimize many of the risks associated with blood flow-restricted exercise by accounting for methodological factors, such as cuff width, cuff type, and the individual to which blood flow restriction is being applied. The purpose of this article is to provide an overview of these methodological factors and provide evidence-based recommendations for how to apply blood flow restriction. We also provide some discussion on how blood flow restriction may serve as an effective treatment in a clinical setting.

Effects of Walking Training with Restricted Blood Flow on HR and HRV Kinetics and HRV Recovery

“…Training using lower exercise intensities ( < 40 % 1RM) combined with BFR appears to be sufficient to induce increases in muscle size and strength [29,30]. However, BFR protocols using higher exercise intensities (e. g., ≥ 40 % 1-RM) do not seem to have any additional benefit in muscle size and strength [29,30].…”

“…Training using lower exercise intensities ( < 40 % 1RM) combined with BFR appears to be sufficient to induce increases in muscle size and strength [29,30]. However, BFR protocols using higher exercise intensities (e. g., ≥ 40 % 1-RM) do not seem to have any additional benefit in muscle size and strength [29,30]. Moreover, low intensity training (LIT) combined with BFR shows similar muscle hypertrophy when compared with high intensity training (HIT) without BFR [31], but HIT without BFR seems to be more effective for increasing the maximum muscle strength [31].…”

Blood Flow Restriction Training nach Rekonstruktion des vorderen Kreuzbandes

“…Nebenprodukte, die möglicherweise eine direkte Vermehrung der Muskelmasse aufgrund der Stimulation anaboler Hormone veranlassen [9]. Des Weiteren werden Wachstumshormone (GH) ausgeschüttet, die ein direktes Muskelwachstum zur Folge haben [8]. Die systematische Hormonantwort, speziell der Wachstumshormone, ist bei einem Training mit BFR ähnlich der, wenn mit hohen Gewichten ohne BFR trainiert werden würde [10].…”

“…Mit zunehmender Dauer der Okklusion geht die Muskulatur eine Sauerstoffschuld ein, was wiederum zu einer Anhäufung von metabolischen Nebenprodukten führt und eine Ermüdung der aktiven Fasern der Muskulatur zur Folge hat. Daraufhin kommt es zur ver-mehrten Aktivierung noch nicht zugeschalteter motorischer Einheiten [8].…”

Greater discomfort with blood flow restriction training compared to standard low‐load resistance exercise when both are performed to task failure

“…Current research suggests that when unrestricted, low‐load resistance exercise (LL‐RE) exercise is work‐matched to LL‐BFR, superior muscular adaptations occur with LL‐BFR 5‐9 . LL‐BFR has consequently been popularized as a modality with potential utility for improving or maintaining muscular strength and size among those unable to perform high‐load or high‐volume resistance exercise, such as elderly or rehabilitative populations 10 . However, when sets of LL‐RE and LL‐BFR exercise are performed to volitional fatigue (also known as task failure) using within‐subject, unilateral models, comparable and appreciable changes in strength and size can occur with both modalities 11‐13 .…”