Walking With Leg Blood Flow Restriction: Wide-Rigid Cuffs vs. Narrow-Elastic Bands

Abstract

Background: Blood flow restriction (BFR) training is becoming a popular form of exercise. Walking exercise in combination with pressurized wide-rigid (WR) cuffs elicits higher cardiac workload and a vascular dysfunction due presumably to reperfusion injury to the endothelium. In contrast, narrow-elastic (NE) BFR bands may elicit different hemodynamic effects. Therefore, we compared the acute cardiovascular responses to two distinct forms of BFR training during light-intensity exercise. Methods and Results: 15 young healthy participants (M = 9, F = 6) performed five bouts of 2-min walking intervals at 0.9 m/s with a 1-min rest and deflation period with either WR, NE, or no bands placed on upper thighs. Cuff pressure was inflated to 160 mmHg in WR cuffs and 300 mmHg in NE bands while no cuffs were used for the control. Increases in heart rate and arterial blood pressure were greater (p < 0.05) in the WR than the NE and control conditions. Double product increased to a greater extent in the WR than in the NE and control conditions. Increases in perceived exertion and blood lactate concentration were greater (p < 0.05) in the WR compared with the NE and control conditions (p < 0.05), while no differences emerged between the NE and control conditions. There were no changes in arterial stiffness or brachial artery flow-mediated dilation (FMD) after all three trials. Conclusion: Use of WR BFR cuffs resulted in a marked increase in blood pressure and myocardial oxygen demand compared with NE BFR bands, suggesting that NE bands present a safer alternative for at-risk populations to perform BFR exercise. Clinical Trial Registration: This study was registered in the Clinicaltrials.gov (NCT03540147).

The impact of cuff width on perceptual responses during and following blood flow restricted walking exercise

“…Whilst participants reported differences in discomfort in the present study, no differences in RPE were reported. This differs from a previous study indicating that wider cuffs resulted in greater RPE values when compared to narrower cuffs (Stray‐Gundersen, et al, 2020). An important distinction, however, is that the previous study used arbitrary pressures which may have resulted in a different restrictive stimulus between cuffs as indicated by differing heart rates and blood pressure values between cuffs (Stray‐Gundersen, et al, 2020).…”

“…This differs from a previous study indicating that wider cuffs resulted in greater RPE values when compared to narrower cuffs (Stray‐Gundersen, et al, 2020). An important distinction, however, is that the previous study used arbitrary pressures which may have resulted in a different restrictive stimulus between cuffs as indicated by differing heart rates and blood pressure values between cuffs (Stray‐Gundersen, et al, 2020). Indeed, others have shown that different absolute pressures result in altered perceptual responses (Spitz, et al, 2019, 2021), further detailing that the magnitude of applied pressure may alter perceptual responses.…”

“…We are aware of only one study assessing perceptual responses across different cuff widths in conjunction with walking exercise (Stray‐Gundersen, et al, 2020). Whilst the authors noted greater ratings of perceived exertion in response to wider cuffs, the comparison was made between 18‐cm cuffs inflated to 160 mm Hg and 5‐cm cuffs inflated to 300 mm Hg.…”

The Evolution of Blood Flow Restricted Exercise

“…As with most research designs, there are an infinite number of combinations of potentially confounding issues related to participant selection for the protocol, like age, sex, training status, health status, nutritional status, hormonal status, etc., but with blood flow restriction protocols, many other factors must also be considered. These additional factors could include the type of cuff used to induce the restriction pressure (width of the cuff, type of material, pneumatically controlled cuffs or tension wraps or bandages applied based on perceived discomfort; Loenneke et al, 2014c ; Buckner et al, 2017 ; Stray-Gundersen et al, 2020 ), initial pressure/tightness of the cuffs before inflation ( Karabulut et al, 2011a , 2014 ), the restrictive pressure used (absolute, relative, percent of total restrictive pressure, intermittent pressure, continuous pressure; Murray et al, 2020 ), the composition (fat and muscle mass; Karabulut et al, 2014 ) and size (circumference or girth) of the limb being restricted ( Loenneke et al, 2014a ), the mode of exercise (walking, cycling, resistance training, absolute loads, relative loads, contraction types – isometric, isotonic, isokinetic), the protocols used if exercise is required (number of repetitions, number of sets, muscle groups, cadence of the concentric and eccentric portions of the movement, time under tension), and if the responses are acute or due to prolonged training (how many sessions, days, weeks, etc.).…”

High-Intensity Interval Exercise with Blood Flow Restriction Improves Vascular Function in Obese Male Adolescents

“…Previous studies have found that exercise with BFR causes physiological adaptation (increased heart rate), similar to high-intensity exercise in obese adults (Karabulut et al, 2017), athletes (Willis et al, 2016), and hypertensive elderly people (Barili et al, 2018). Regarding vascular function, BFR does not cause damage to the blood vessels during either walking or resistance exercises (Stray-Gundersen et al, 2020;da Cunha et al, 2020). Aerobic exercise with BFR could significantly increase the heart rate when compared to aerobic exercise alone (Barili et al, 2018;Thomas et al, 2018).…”