When restricting blood flow for the purpose of increasing or maintaining muscle fitness, the aim is to reduce the amount of arterial flow into the limb and restrict the venous flow out of the limb. Doing so has been shown to elicit positive adaptations with regards to skeletal muscle size, and strength, while some evidence also eludes to beneficial effects on vascular and bone tissue. Regarding skeletal muscle, the main benefits of blood flow restriction are the ability to stimulate increases in size and strength while avoiding the greater mechanical stress associated with traditional high-load resistance training, and the greater volumes required when exercising with low loads to failure. While the most robust benefits are observed following blood flow restriction during low-load resistance training, evidence suggests positive adaptations occur while restricting blood flow during low-intensity aerobic exercise, and perhaps even during periods of disuse in the absence of exercise. Although the exact mechanisms are unclear, most of the evidence seems to allude to cell swelling and metabolite-induced fatigue during exercise stimulating synthetic pathways that can lead to muscle growth. While the blood flow restriction stimulus has been shown to be relatively safe for participants, the practitioner should be cognizant of the relative pressure being applied to the underlying tissue. This is important as cuff type, cuff width, and limb circumference can all influence the restrictive stimulus. Therefore, to ensure a similar, safe stimulus all variables should be accounted for.

Mechanisms of blood flow restriction: The new testament

Purpose No current guidelines or recommendations exist informing the selection of restriction pressure during blood flow restriction exercise (BFRE). Moreover, the effects of specific relative restriction pressures on the acute muscle, metabolic and cardiopulmonary responses to blood flow restriction (BFR) exercise are unclear. The purpose of this study was to characterize these acute responses at different levels of restriction pressure. Methods Participants (n=10) completed rhythmic isometric knee extension exercise across five experimental trials in a balanced randomised order. Three were BFRE trials [B-40 (restriction pressure set to 40% LOP (total limb occlusion pressure)); B-60 (60% LOP); and B-80 (80% LOP)] with a workload equivalent to 20% maximal voluntary force (MCV), one was non-BFRE at 20% MVC (LL) and one was non-BFRE at 80% MVC (HL). Measurements recorded were torque, muscle activity via electromyography (EMG), tissue oxygenation via near infrared spectroscopy, whole body oxygen consumption, blood lactate and heart rate. Results For the LL and B-40 trials, most measures remained constant. However, for the B-60 and B-80 trials, significant fatigue was demonstrated by a reduction in MVC torque across the trial (p 0.05). Conclusion We demonstrate graded/progressive acute responses with increasing applied pressure during BFRE, from which we speculate that an effective minimum ‘threshold’ around 60% LOP may be necessary for BFRE to be effective with training. While these data provide some insight on the possible mechanisms by which BFRE develops skeletal muscle size and strength when undertaken chronically across a training programme, the outcomes of chronic training programmes using different levels of applied restriction pressures remain to be tested. Overall, the present study recommends 60% - 80% LOP as a suitable ‘minimum’ BFRE pressure.

/pdf/the-effects-of-restriction-pressures-on-the-acute-responses-3ujl29yeji.pdf

The Effects of Restriction Pressures on the Acute Responses to Blood Flow Restriction Exercise.

The aim of this study was to investigate the effect of leg blood flow restriction (BFR) applied during a 3-a-side futsal game on strength-related parameters. Twelve male futsal players were randomly assigned into two groups (n = 6 for each group) during 10 training sessions either with or without leg BFR. Prior to and post-training sessions, participants completed a series of tests to assess anabolic hormones and leg strength. Pneumatic cuffs were initially inflated to 110% of leg systolic blood pressure and further increased by 10% after every two completed sessions. In comparison with baseline, the resting post-training levels of myostatin (p = 0.002) and IGF-1/MSTN ratio (p = 0.006) in the BFR group changed, whereas no change in the acute level of IGF-1 and myostatin after exercise was observed. Peak torque of knee extension and flexion increased in both groups (p < 0.05). A trend of increased neural activation of all heads of the quadriceps was observed in both groups, however, it was statistically significant only for rectus femoris in BFR (p = 0.02). These findings indicated that the addition of BFR to normal futsal training might induce greater neuromuscular benefits by increasing muscle activation and augmenting the hormonal response.

/pdf/blood-flow-restriction-during-futsal-training-increases-50r6wqsau5.pdf

Blood Flow Restriction During Futsal Training Increases Muscle Activation and Strength

Clinical Physiology started in 1942, when Torgny Sjöstrand became professor in the discipline at the Karolinska Hospital in Stockholm. For several decades it has been a firmly established clinical speciality in Denmark, Finland and Sweden. From its start, the speciality focused on diagnostic examination and functional evaluation of the cardiovascular, the respiratory and the renal systems. While many of the techniques used in the early days of the speciality have become obsolete, technical development has led to new techniques for functional investigations in vivo. This has widened the scope of the speciality. Clinical physiologists are now using several imaging techniques such as ultrasound, nuclear medicine and functional magnetic resonance. Nuclear medicine is often integrated with clinical. The rapid growth in application of imaging techniques in clinical medicine has also led to closer co-operation between clinical physiology and other medical specialities, e.g. diagnostic radiology and cardiology. The Scandinavian Society of Clinical Physiology and Nuclear Medicine was founded in 1979 with the purpose of stimulating research and education in the field of clinical physiology. The journal of the society, Clinical Physiology, started in 1981 and has over its 20 years of existence provided interesting reading for anyone interested in human physiology and pathophysiology. Although medical imaging has been represented in Clinical Physiology from its first volume, the increasing use of imaging techniques for studies of human physiology has prompted the Scandinavian Society of Clinical Physiology and Nuclear Medicine to change the name of its journal to Clinical Physiology and Functional Imaging. This entails not so much a change of scope of the journal as increased emphasis on studies using imaging techniques. Submission of manuscripts based upon the full range of traditional methods and newer imaging techniques is thereby encouraged. As from this issue, there is also a change of the editors of the journal. On behalf of the Scandinavian Society of Clinical Physiology and Nuclear Medicine, we would like to thank Professor Esko Länsimies for his outstanding work during the 4 years he has served as Editor of Clinical Physiology. Professor Länsimies has been working with great enthusiasm for the journal and has made a major contribution to its development. We would also like to thank Professor Anssi Sovijärvi for his excellent work as review articles editor during this period.

Clinical Physiology and Functional Imaging

Comparison of blood flow restriction devices and their effect on quadriceps muscle activation.

The purpose of this study was to determine whether the acute hormone response to exercise differed between low intensity blood flow restricted resistance exercise and traditional highintensity resistance exercise in college-aged women. A total of 13 healthy women (aged 18-25 yrs), who were taking oral contraceptives, volunteered for this randomized crossover study. Subjects performed a session of low intensity blood flow restricted resistance exercise (BFR) (20% of 1-RM, 1 set 30 reps, 2 sets 15 reps) and a session of traditional high intensity resistance exercise without blood flow restriction (HI) (3 sets of 10 repetitions at 80% of 1-RM) on separate days. Fasting serum cortisol and growth hormone (GH) and blood lactate responses were measured in the morning pre and post exercise sessions. GH (Change: HI: 6.34 ± 1.72; BFR: 4.22 ± 1.40 ng·mL -1 ) and cortisol (Change: HI: 4.46 ± 1.53; BFR: 8.10 ± 2.30 ug·dL -1 ) significantly (p < 0.05) increased immediately post exercise for both protocols compared to baseline and there were no significant differences between the protocols for these responses. In contrast, blood lactate levels (HI: 7.35 ± 0.45; BFR: 4.02 ± 0.33 mmol·L -1 ) and ratings of perceived exertion were significantly (p < 0.01) higher for the HI protocol. In conclusion, acute BFR restricted resistance exercise stimulated similar increases in anabolic and catabolic hormone responses in young women.

http://www.jssm.org/hfpdf.php?volume=13&issue=1&page=91

Hormone responses to an acute bout of low intensity blood flow restricted resistance exercise in college-aged females.

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Hormone responses to an acute bout of low intensity blood flow restricted resistance exercise in college-aged females.