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Textbook Of Work Physiology Physiological Bases Of Exercise

Background and objective Low-load exercise training with blood flow restriction (BFR) can increase muscle strength and may offer an effective clinical musculoskeletal (MSK) rehabilitation tool. The aim of this review was to systematically analyse the evidence regarding the effectiveness of this novel training modality in clinical MSK rehabilitation. Design This is a systematic review and meta-analysis of peer-reviewed literature examining BFR training in clinical MSK rehabilitation (Research Registry; researchregistry91). Data sources A literature search was conducted across SPORTDiscus (EBSCO), PubMed and Science Direct databases, including the reference lists of relevant papers. Two independent reviewers extracted study characteristics and MSK and functional outcome measures. Study quality and reporting was assessed using the Tool for the assEssment of Study qualiTy and reporting in EXercise. Eligibility Search results were limited to exercise training studies investigating BFR training in clinical MSK rehabilitation, published in a scientific peer-reviewed journal in English. Results Twenty studies were eligible, including ACL reconstruction (n=3), knee osteoarthritis (n=3), older adults at risk of sarcopenia (n=13) and patients with sporadic inclusion body myositis (n=1). Analysis of pooled data indicated low-load BFR training had a moderate effect on increasing strength (Hedges’ g=0.523, 95% CI 0.263 to 0.784, p Conclusion Compared with low-load training, low-load BFR training is more effective, tolerable and therefore a potential clinical rehabilitation tool. There is a need for the development of an individualised approach to training prescription to minimise patient risk and increase effectiveness.

https://bjsm.bmj.com/content/bjsports/51/13/1003.full.pdf

Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis

The primary objective of this investigation was to quantitatively identify which training variables result in the greatest strength and hypertrophy outcomes with lower body low intensity training with blood flow restriction (LI-BFR). Searches were performed for published studies with certain criteria. First, the primary focus of the study must have compared the effects of low intensity endurance or resistance training alone to low intensity exercise with some form of blood flow restriction. Second, subject populations had to have similar baseline characteristics so that valid outcome measures could be made. Finally, outcome measures had to include at least one measure of muscle hypertrophy. All studies included in the analysis utilized MRI except for two which reported changes via ultrasound. The mean overall effect size (ES) for muscle strength for LI-BFR was 0.58 [95% CI: 0.40, 0.76], and 0.00 [95% CI: −0.18, 0.17] for low intensity training. The mean overall ES for muscle hypertrophy for LI-BFR training was 0.39 [95% CI: 0.35, 0.43], and −0.01 [95% CI: −0.05, 0.03] for low intensity training. Blood flow restriction resulted in significantly greater gains in strength and hypertrophy when performed with resistance training than with walking. In addition, performing LI-BFR 2–3 days per week resulted in the greatest ES compared to 4–5 days per week. Significant correlations were found between ES for strength development and weeks of duration, but not for muscle hypertrophy. This meta-analysis provides insight into the impact of different variables on muscular strength and hypertrophy to LI-BFR training.

Low intensity blood flow restriction training: a meta-analysis

Many physiological changes occur with aging. These changes often, directly or indirectly, result in a deterioration of the quality of life and even in a shortening of life expectancy. Besides increased levels of reactive oxygen species, DNA damage and cell apoptosis, another important factor affecting the aging process involves a systemic chronic low-grade inflammation. This condition has already been shown to be interrelated with several (sub)clinical conditions, such as insulin resistance, atherosclerosis and Alzheimer's disease. Recent evidence, however, shows that chronic low-grade inflammation also contributes to the loss of muscle mass, strength and functionality, referred to as sarcopenia, as it affects both muscle protein breakdown and synthesis through several signaling pathways. Classic interventions to counteract age-related muscle wasting mainly focus on resistance training and/or protein supplementation to overcome the anabolic inflexibility from which elderly suffer. Although the elderly benefit from these classic interventions, the therapeutic potential of anti-inflammatory strategies is of great interest, as these might add up to/support the anabolic effect of resistance exercise and/or protein supplementation. In this review, the molecular interaction between inflammation, anabolic sensitivity and muscle protein metabolism in sarcopenic elderly will be addressed.

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The Role of Inflammation in Age-Related Sarcopenia

The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.

/pdf/blood-flow-restriction-exercise-considerations-of-2xfnfl6h42.pdf

Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety

PURPOSE Slow-walk training combined with restricted leg muscular blood flow (KAATSU) produces muscle hypertrophy and strength gains in young men, which may lead to increased aerobic capacity and functional fitness The purpose of this study was to investigate the effects of walk training combined with KAATSU on muscle size, strength, and functional ability, as well as aerobic capacity, in older participants METHODS A total of 19 active men and women, aged 60 to 78 years, were randomized into either a KAATSU-walk training group (n = 11, K-walk) or a nonexercising control group (n = 8, control) The K-walk group performed 20-minute treadmill walking (67 m/min), 5 days/wk for 6 weeks RESULTS Isometric (11%) and isokinetic (7%-16%) knee extension and flexion torques, muscle-bone cross-sectional area (58% and 51% for thigh and lower leg, respectively), as well as ultrasound-estimated skeletal muscle mass (60% and 107% for total and thigh, respectively) increased (P< 05) in the K-walk group but not in the control group Functional ability also increased significantly only in the K-walk group (P < 05); however, there was no change in the estimated peak oxygen uptake(absolute and relative to body mass) for either group CONCLUSION The results of the current study indicate that 6 weeks of KAATSU-walk training did not simultaneously improve cardiovascular and muscular fitness of older participants However, it significantly increased muscular size and strength as well as functional ability of active older men and women

Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in older adults.

Concurrent improvements in aerobic capacity and muscle hypertrophy in response to a single mode of training have not been reported. We examined the effects of low-intensity cycle exercise training with and without blood flow restriction (BFR) on muscle size and maximum oxygen uptake (VO2max). A group of 19 young men (mean age ± SD: 23.0 ± 1.7 years) were allocated randomly into either a BFR-training group (n=9, BFR-training) or a non-BFR control training group (n=10, CON-training), both of which trained 3 days/wk for 8 wk. Training intensity and duration were 40% of VO2max and 15 min for the BFR-training group and 40% of VO2max and 45 min for the CON-training group. MRI-measured thigh and quadriceps muscle cross-sectional area and muscle volume increased by 3.4-5.1% (P < 0.01) and isometric knee extension strength tended to increase by 7.7% (p < 0.10) in the BFR-training group. There was no change in muscle size (~0.6%) and strength (~1.4%) in the CON-training group. Significant improvements in VO2max (6.4%) and exercise time until exhaustion (15.4%) were observed in the BFR-training group (p < 0.05) but not in the CON-training group (-0.1 and 3. 9%, respectively). The results suggest that low-intensity, short-duration cycling exercise combined with BFR improves both muscle hypertrophy and aerobic capacity concurrently in young men.


Key points


Concurrent improvements in aerobic capacity and muscle hypertrophy in response to a single mode of training have not been reported.


In the present study, low-intensity (40% of VO2max) cycle training with BFR can elicit concurrent improvement in muscle hypertrophy and aerobic capacity.

https://www.jssm.org/hfpdf.php?volume=09&issue=3&page=452

Effects of Low-Intensity Cycle Training with Restricted Leg Blood Flow on Thigh Muscle Volume and VO2MAX in Young Men

We investigated the combined effect of low-intensity blood flow restriction and high-intensity resistance training on muscle adaptation. Forty young men (aged 22–32 years) were randomly divided into four groups of ten subjects each: high-intensity resistance training (HI-RT, 75% of one repetition maximum [1-RM]), low-intensity resistance training with blood flow restriction (LI-BFR, 30% 1-RM), combined HI-RT and LI-BFR (CB-RT, twice-weekly LI-BFR and once-weekly HI-RT), and nontraining control (CON). Three training groups performed bench press exercises 3 days/week for 6 weeks. During LI-BFR training sessions, subjects wore pressure cuffs on both arms that were inflated to 100–160 mmHg. Increases in 1-RM were similar in the HI-RT (19.9%) and CB-RT (15.3%) groups and lower in the LI-BFR group (8.7%, p < 0.05). Maximal isometric elbow extension (MVC) increased in the HI-RT (11.3%) and CB-RT (6.6%) groups; there was no change in the LI-BFR group (−0.2%). The cross-sectional area (CSA) of the triceps brachii (TB) increased (p < 0.05) in the HI-RT (8.6%), CB-RT (7.2%), and LI-BFR (4.4%) groups. The change in relative isometric strength (MVC divided by TB CSA) was greater (p < 0.05) in the HI-RT group (3.3%) than in the LI-BFR (−3.5%) and CON (−0.1%) groups. Following training, relative dynamic strength (1-RM divided by TB CSA) was increased (p < 0.05) by 10.5% in the HI-RT group and 6.7% in the CB-RT group. None of the variables in the CON group changed. Our results show that low-intensity resistance training with BFR-induced functional muscle adaptations is improved by combining it with HI-RT.

Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size.

We examined the effects of walk training combined with leg blood flow reduction (BFR) on muscle hypertrophy as well as on peak oxygen uptake (VO₂ peak) in older individuals. Both the BFR walk training (BFR-Walk, n = 10, age; 64 ± 1 years, body mass index [BMI]; 22.5 ± 0.9 kg/m²) and control walk training (CON-Walk, n = 8, age; 68 ± 1 years, BMI; 23.2 ± 1.0 kg/m²) groups performed 20 minutes of treadmill walking at an exercise intensity of 45% of heart rate reserve, 4 days per week, for 10 weeks. The BFR-Walk group wore pressure belts (160-200 mm Hg) on both legs during training. After the training, magnetic resonance imaging-measured thigh muscle cross-sectional area (3.1%, p < .01) and muscle volume (3.7%, p < .01) as well as maximal isometric (5.9%, p < .05) and isokinetic (up to 22%, p < .01) strength increased in the BFR-Walk group, but not in the CON-Walk group. Estimated VO₂ peak during a bicycle graded exercise test increased (p < .05) and correlated with oxygen pulse in both groups. In conclusion, BFR walk training improves both muscle volume and strength in older women.

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Increases in Thigh Muscle Volume and Strength by Walk Training with Leg Blood Flow Reduction in Older Participants

High-intensity resistance training increases muscle size, but reduces arterial compliance. Muscular blood flow reduction (BFR) during low-intensity training has been shown to elicit muscle hypertrophy. However, the effect on arterial compliance is unknown. We examined the effects of walk training with BFR on carotid arterial compliance and muscle size in the elderly adults. Both BFR-walk training (BFR-W, n = 13, 66 ± 1 year) and control-walk training (CON-W, n = 10, 68 ± 1 year) groups performed 20 minutes treadmill walking at an exercise intensity of 45% of heart rate reserve, 4 days/week for 10 weeks. The BFR-W group wore pressure cuffs on both legs during training. Maximum knee joint strength (∼15%) and MRI-measured thigh muscle cross-sectional area (3%) increased in the BFR-W, but not in the CON-W. Carotid arterial compliance improved in both BFR-W (50%) and CON-W (59%) groups. Walk training with blood flow reduction can improve thigh muscle size/strength as well as carotid arterial compliance, unlike high-intensity training, in the elderly.

Hayao Ozaki

Papers

Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in older adults.

Effects of Low-Intensity Cycle Training with Restricted Leg Blood Flow on Thigh Muscle Volume and VO2MAX in Young Men

Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size.

Increases in Thigh Muscle Volume and Strength by Walk Training with Leg Blood Flow Reduction in Older Participants

Effects of 10 weeks walk training with leg blood flow reduction on carotid arterial compliance and muscle size in the elderly adults