Optimal parameters of blood flow restriction and resistance training on quadriceps strength and cross-sectional area and pain in knee osteoarthritis

2021 ◽  
pp. 1-10
Author(s):  
Waleed S. Mahmoud ◽  
Ahmed Osailan ◽  
Ahmed S. Ahmed ◽  
Ragab K. Elnaggar ◽  
Nadia L. Radwan
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Knee Osteoarthritis ◽  
Quadriceps Strength ◽  
Sectional Area ◽  
Occlusion Pressure ◽  
Total Occlusion ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Low Intensity

BACKGROUND: Knee osteoarthritis (KOA) is one of the most common chronic diseases impacting millions of elderly people. OBJECTIVES: The study compared the effects of two intensities of partial blood flow restriction (BFR) with low-intensity resistance training on quadriceps strength and cross-sectional area (CSA), and pain in people with knee osteoarthritis (PwKOA). METHODS: Thirty-five PwKOA, aged 50–65, participated. Quadriceps CSA was measured by ultrasonography, quadriceps strength – by isokinetic dynamometry and pain by VAS. These outcome variables were obtained at the beginning of the study and re-evaluated eight weeks after the intervention. RESULTS: An interaction effect was present for quadriceps CSA (P= 0.042) and quadriceps strength (P= 0.006), showing that using 70% of total occlusion pressure with 30% 1RM had a more significant effect. Knee pain improved significantly through the main effect of BFR (P< 0.001), and low-intensity resistance training (P= 0.011). Pain improved more at 70% of total occlusion pressure, with 30% of 1RM (2.5 ± 1.06) than 50% total occlusion pressure with 10% of 1RM (5.77 ± 1.46). CONCLUSION: A combination of 70% of total occlusion pressure with 30% 1RM could be beneficial in PwKOA in improving pain, and increasing the quadriceps strength. The changes in the quadriceps strength could be a predictor for knee pain.

Blood Flow Restriction Therapy Impact on Musculoskeletal Strength and Mass

2021 ◽  
Vol 1 (5) ◽  
pp. 263502542110326
Author(s):  
Steven R. Dayton ◽  
Simon J. Padanilam ◽  
Tyler C. Sylvester ◽  
Michael J. Boctor ◽  
Vehniah K. Tjong
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Load Resistance ◽  
High Load ◽  
Blood Flow Restriction ◽  
Occlusion Pressure ◽  
Total Occlusion ◽  
Flow Restriction ◽  
Low Load

Background: Blood flow restriction (BFR) training restricts arterial inflow and venous outflow from the extremity and can produce gains in muscle strength at low loads. Low-load training reduces joint stress and decreases cardiovascular risk when compared with high-load training, thus making BFR an excellent option for many patients requiring rehabilitation. Indications: Blood flow restriction has shown clinical benefit in a variety of patient populations including healthy patients as well as those with osteoarthritis, anterior cruciate ligament reconstruction, polymyositis/dermatomyositis, and Achilles tendon rupture. Technique Description: This video demonstrates BFR training in 3 clinical areas: upper extremity resistance training, lower extremity resistance training, and low-intensity cycling. All applications of BFR first require determination of total occlusion pressure. Upper extremity training requires inflating the tourniquet to 50% of total occlusion pressure, while lower extremity exercises use 80% of total occlusion pressure. Low-load resistance training exercises follow a specific repetition scheme: 30 reps followed by a 30-second rest and then 3 sets of 15 reps with 30-seconds rest between each. During cycle training, 80% total occlusion pressure is used as the patient cycles for 15 minutes without rest. Results: Augmenting low-load resistance training with BFR increases muscle strength when compared with low-load resistance alone. In addition, low-load BFR has demonstrated an increase in muscle mass greater than low-load training alone and equivalent to high-load training absent BFR. A systematic review determined the safety of low-load training with BFR is comparable to traditional high-intensity resistance training. The most common adverse effects include exercise intolerance, discomfort, and dull pain which are also frequent in patients undergoing traditional resistance training. Severe adverse effects including deep vein thrombosis, pulmonary embolism, and rhabdomyolysis are exceedingly rare, less than 0.006% according to a national survey. Patients undergoing BFR rehabilitation experience less perceived exertion and demonstrate decreased pain scores compared with high-load resistance training. Conclusion: Blood flow restriction training is an effective alternative to high-load resistance training for patients requiring musculoskeletal rehabilitation for multiple disease processes as well as in the perioperative setting. Blood flow restriction has been shown to be a safe training modality when managed by properly trained physical therapists and athletic trainers.

Effects of Blood Flow Restriction Combined With Resistance Training or Neuromuscular Electrostimulation on Muscle Cross-Sectional Area

2021 ◽  
pp. 1-6
Author(s):  
João Guilherme Almeida Bergamasco ◽  
Ieda Fernanda Alvarez ◽  
Thais Marina Pires de Campos Biazon ◽  
Carlos Ugrinowitsch ◽  
Cleiton Augusto Libardi
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Hypertrophy ◽  
Vastus Lateralis ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Neuromuscular Electrostimulation ◽  
Muscle Cross Sectional Area

Context: Low-load resistance training (LL) and neuromuscular electrostimulation (NES), both combined with blood flow restriction (BFR), emerge as effective strategies to maintain or increase muscle mass. It is well established that LL-BFR promotes similar increases in muscle cross-sectional area (CSA) and lower rating of perceived exertion (RPE) and pain compared with traditional resistance training protocols. On the other hand, only 2 studies with conflicting results have investigated the effects of NES-BFR on CSA, RPE, and pain. In addition, no study directly compared LL-BFR and NES-BFR. Objective: The aim of the study was to compare the effects of LL-BFR and NES-BFR on vastus lateralis CSA, RPE, and pain. Individual response for muscle hypertrophy was also compared between protocols. Design: Intrasubject longitudinal study. Setting: University research laboratory. Intervention: Fifteen healthy young males (age = 23 [5] y; weight = 77.6 [11.3] kg; height = 1.76 [0.08] m). Main Outcome Measures: Vastus lateralis CSA was measured through ultrasound at baseline (pre) and after 20 training sessions (post). The RPE and pain responses were obtained through modified 10-point scales, handled during all training sessions. Results: Both protocols demonstrated significant increases in muscle CSA (P < .0001). However, the LL-BFR demonstrated significantly greater CSA changes compared with NES-BFR (LL-BFR = 11.2%, NES-BFR = 4.6%; P < .0001). Comparing individual increases in CSA, 12 subjects (85.7% of the sample) presented greater muscle hypertrophy for LL-BFR than for the NES-BFR protocol. In addition, LL-BFR produced significantly lower RPE and pain responses (P < .0001). Conclusions: The LL-BFR produced significantly greater increases in CSA with significant less RPE and pain than NES-BFR. In addition, LL-BFR resulted in greater individual muscle hypertrophy responses for most subjects compared with NES-BFR.

Effects of exercise intensity and occlusion pressure after 12 weeks of resistance training with blood-flow restriction

2015 ◽  
Vol 115 (12) ◽  
pp. 2471-2480 ◽  
Author(s):  
Manoel E. Lixandrão ◽  
Carlos Ugrinowitsch ◽  
Gilberto Laurentino ◽  
Cleiton A. Libardi ◽  
André Y. Aihara ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Exercise Intensity ◽  
Blood Flow Restriction ◽  
Occlusion Pressure ◽  
Flow Restriction

Training response to 8 weeks of blood flow restricted training is not improved by preferentially altering tissue hypoxia or lactate accumulation when training to repetition failure

2021 ◽  
Author(s):  
William Neil Morley ◽  
Shane Ferth ◽  
Mathew Ian Bergens Debenham ◽  
Matthew Boston ◽  
Geoffrey Alonzo Power ◽  
...  
Keyword(s):  
High Pressure ◽  
Blood Flow ◽  
Resistance Training ◽  
Blood Lactate ◽  
Blood Flow Restriction ◽  
Moderate Pressure ◽  
Muscular Endurance ◽  
Occlusion Pressure ◽  
Flow Restriction ◽  
Traditional Resistance Training

Despite compelling muscular structure and function changes resulting from blood flow restricted (BFR) resistance training, mechanisms of action remain poorly characterized. Alterations in tissue O2 saturation (TSI%) and metabolites are potential drivers of observed changes, but their relationships with degree of occlusion pressure are unclear. We examined local TSI% and blood lactate (BL) concentration during BFR training to failure using different occlusion pressures on strength, hypertrophy, and muscular endurance over an 8-week training period. Twenty participants (11M:9F) trained 3/wk for 8wk using high pressure (100% resting limb occlusion pressure, LOP, 20%1RM), moderate pressure (50% LOP, 20%1RM), or traditional resistance training (70%1RM). Strength, size, and muscular endurance were measured pre/post training. TSI% and BL were quantified during a training session. Despite overall increases, no group preferentially increased strength, hypertrophy, or muscular endurance (p>0.05). Neither TSI% nor BL concentration differed between groups (p>0.05). Moderate pressure resulted in greater accumulated deoxygenation stress (TSI%*time) (-6352±3081, -3939±1835, -2532±1349 au for moderate pressure, high pressure, and TRT, p=0.018). We demonstrate that BFR training to task-failure elicits similar strength, hypertrophy, and muscular endurance changes to traditional resistance training. Further, varied occlusion pressure does not impact these outcomes, nor elicit changes in TSI% or BL concentrations. Novelty Bullets • Training to task failure with low-load blood flow restriction elicits similar improvements to traditional resistance training, regardless of occlusion pressure. • During blood flow restriction, altering occlusion pressure does not proportionally impact tissue O2 saturation nor blood lactate concentrations

scholarly journals Effects of combined treatment with blood flow restriction and low-current electrical stimulation on muscle hypertrophy in rats

2019 ◽  
Vol 127 (5) ◽  
pp. 1288-1296
Author(s):  
Madoka Yoshikawa ◽  
Takeshi Morifuji ◽  
Tomohiro Matsumoto ◽  
Noriaki Maeshige ◽  
Minoru Tanaka ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Electrical Stimulation ◽  
Muscle Hypertrophy ◽  
Combined Treatment ◽  
Blood Flow Restriction ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Skeletal Muscle Hypertrophy

This study aimed to clarify the effects of a combined treatment comprising blood flow restriction and low-current electrical stimulation on skeletal muscle hypertrophy in rats. Male Wistar rats were divided into control (Cont), blood flow restriction (Bfr), electrical stimulation (Es), or Bfr with Es (Bfr + Es) groups. Pressure cuffs (80 mmHg) were placed around the thighs of Bfr and Bfr + Es rats. Low-current Es was applied to calf muscles in the Es and Bfr + Es rats. In experiment 1, a 1-day treatment regimen (5-min stimulation, followed by 5-min rest) was delivered four times to study the acute effects. In experiment 2, the same treatment regimen was delivered three times/wk for 8 wk. Body weight, muscle mass, changes in maximal isometric contraction, fiber cross-sectional area of the soleus muscle, expression of phosphorylated and total-ERK1/2, phosphorylated-rpS6 Ser235/236, phosphorylated and total Akt, and phosphorylated-rpS6 Ser240/244 were measured. Bfr and Es treatment alone failed to induce muscle hypertrophy and increase the expression of phosphorylated rpS6 Ser240/244. Combined Bfr + Es upregulated muscle mass, increased the fiber cross-sectional area, and increased phosphorylated rpS6 Ser240/244 expression and phosphorylated rpS6 Ser235/236 expression compared with controls. Combined treatment with Bfr and low-current Es can induce muscle hypertrophy via activation of two protein synthesis signaling pathways. This treatment should be introduced for older patients with sarcopenia and others with muscle weakness. NEW & NOTEWORTHY We investigated the acute and chronic effect of low-current electrical stimulation with blood flow restriction on skeletal muscle hypertrophy and the mechanisms controlling the hypertrophic response. Low-current electrical stimulation could not induce skeletal muscle hypertrophy, but a combination treatment did. Blood lactate and growth hormone levels were increased in the early response. Moreover, activation of ERK1/2 and mTOR pathways were observed in both the acute and chronic response, which contribute to muscle hypertrophy.

Early phase adaptations in muscle strength and hypertrophy as a result of low-intensity blood flow restriction resistance training

2018 ◽  
Vol 118 (9) ◽  
pp. 1831-1843 ◽  
Author(s):  
Ethan C. Hill ◽  
Terry J. Housh ◽  
Joshua L. Keller ◽  
Cory M. Smith ◽  
Richard J. Schmidt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Early Phase ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity

scholarly journals The effects of resistance training with blood flow restriction on muscle strength, muscle hypertrophy and functionality in patients with osteoarthritis and rheumatoid arthritis: A systematic review with meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259574
Author(s):  
Leonardo Peterson dos Santos ◽  
Rafaela Cavalheiro do Espírito Santo ◽  
Thiago Rozales Ramis ◽  
Juliana Katarina Schoer Portes ◽  
Rafael Mendonça da Silva Chakr ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Meta Analysis ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity

Introduction Rheumatoid arthritis(RA) and osteoarthritis(OA) patients showed systemic manifestations that may lead to a reduction in muscle strength, muscle mass and, consequently, to a reduction in functionality. On the other hand, moderate intensity resistance training(MIRT) and high intensity resistance training(HIRT) are able to improve muscle strength and muscle mass in RA and OA without affecting the disease course. However, due to the articular manifestations caused by these diseases, these patients may present intolerance to MIRT or HIRT. Thus, the low intensity resistance training combined with blood flow restriction(LIRTBFR) may be a new training strategy for these populations. Objective To perform a systematic review with meta-analysis to verify the effects of LIRTBFR on muscle strength, muscle mass and functionality in RA and OA patients. Materials and methods A systematic review with meta-analysis of randomized clinical trials(RCTs), published in English, between 1957–2021, was conducted using MEDLINE(PubMed), Embase and Cochrane Library. The methodological quality was assessed using Physiotherapy Evidence Database scale. The risk of bias was assessed using RoB2.0. Mean difference(MD) or standardized mean difference(SMD) and 95% confidence intervals(CI) were pooled using a random-effects model. A P<0.05 was considered statistically significant. Results Five RCTs were included. We found no significant differences in the effects between LIRTBFR, MIRT and HIRT on muscle strength, which was assessed by tests of quadriceps strength(SMD = -0.01[-0.57, 0.54], P = 0.96; I² = 58%) and functionality measured by tests with patterns similar to walking(SMD = -0.04[-0.39, 0.31], P = 0.82; I² = 0%). Compared to HIRT, muscle mass gain after LIRTBFR was reported to be similar. When comparing LIRTBFR with low intensity resistance training without blood flow restriction(LIRT), the effect LIRTBFR was reported to be higher on muscle strength, which was evaluated by the knee extension test. Conclusion LIRTBFR appears to be a promising strategy for gains in muscle strength, muscle mass and functionality in a predominant sample of RA and OA women.

Muscle Hypertrophy following Multi-joint Low Intensity Resistance Training with Single-joint Blood Flow Restriction

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S257
Author(s):  
Takashi Abe ◽  
William F. Brechue ◽  
Satoshi Fujita ◽  
Riki Ogasawara ◽  
Tomohiro Yasuda ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Hypertrophy ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity

scholarly journals Safety and possible effects of low-intensity resistance training associated with partial blood flow restriction in polymyositis and dermatomyositis

2014 ◽  
Vol 16 (5) ◽  
Author(s):  
Melina Andrade Mattar ◽  
Bruno Gualano ◽  
Luiz Augusto Perandini ◽  
Samuel Katsuyuki Shinjo ◽  
Fernanda Rodrigues Lima ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity
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