The Efficacy And Validity Of Blood Flow Restriction Training In Clinical And Post-Surgical Populations

Background: We currently know BFR training is a viable modality for strength gains in the healthy population. However, it is unknown the effect of BFR training on post-surgical and clinical populations. Furthermore, the optimal use of the BFR modality regarding resistance vs. no-resistance (bodyweight) is also unknown. This literature review adds new information to the field of BFR training specifically in the post-surgical and clinical populations. The objective of the study is to explore the validity and efficacy of blood-restriction training (BFR) in conjunction with low-load resistance training (LL-BFR) versus low-load training without BFR and high-load resistance training without BFR to determine which is superior for strength gains. Methods: The authors used SPORTDiscus, EBSCO, PubMed, and Science Direct to search for peer-reviewed articles. The articles chosen had the keywords/phrases “BFR,” “vascular occlusion,” “strength training,” “resistance training.” The studied emphasized patients with either clinical conditions (osteoarthritis) or musculoskeletal injuries (ACL reconstruction, total knee arthroplasty, knee arthroscopy). One hundred seventy-one articles were screened, and 17 articles reviewed. Results: BFR, in conjunction with low-load resistance training yields superior strength gains when compared to lowload training alone (p<.05). The outcome measures show a higher 1-rep max (isotonic strength) and greater muscle size (cross-sectional area, muscle mass, muscle volume) (p<.05). However, BFR with low-load resistance training does not yield superior strength gains in comparison to high-load resistance training alone (p<.03). Conclusion: As healthcare providers treating patients with musculoskeletal conditions, we know the importance of resistance training as a tool for rehabilitation and activities of daily living. However, at times heavy resistance training is contraindicated either due to joint instability/degeneration, pain, surgical restrictions. BFR training can be implemented with a 10-30% 1-rep max for comparable strength gains. This can be a potential tool used to offset post-surgical atrophy and atrophy due to arthralgia seen in certain systemic conditions. This can translate to better functional outcomes in post-surgical patients and superior quality of life in the geriatric population.

Effect of walk training combined with blood flow restriction on resting heart rate variability and resting blood pressure in middle-aged men

Aim: To investigate the effects of low-intensity walk training with and without blood flow restriction (BRF) on resting heart rate variability (HRV) and blood pressure (BP) in middle-aged men. Methods: Twenty-one men were randomly assigned into the walk training group with (BRF-W; n = 11) and without (NOR-W; n = 10) BFR. The resting HRV and blood pressure were assessed pre- and post-6 weeks of the intervention [3 times/week, 5 sets of 3-min walking (6 km.h-1) with 1-min of rest, totalizing 18 sessions of training]. The BFR-W group received the occlusive stimulus before of training sessions though of a standard sphygmomanometer and performed the training sessions with the vascular occlusion (80-100 mmHg) in both the legs. Results: Only BRF-W group improved HRV on time domain indices (SDNN and RMSSD; p < 0.05) after training but it was not found differences on frequency domain indices. In addition, systolic blood pressure (SBP) improved after training (PRE: 128.5 ± 5.9 vs POST: 119.1 ± 8.6 mmHg; Cohen's d = -1.30; p < 0.01) only in BFR-W group. There was not a significant difference on diastolic blood pressure (DBP) after training, however, effect size was moderate for BFR-W (Cohen's d = -0.56; p > 0.05). Conclusion: Our results showed that walking training with blood flow restriction can improve health cardiovascular parameters in middle-aged men.(AU)

Effect of 16-week blood flow restriction exercise on functional fitness in sarcopenic women: a randomized controlled trial / Efecto del ejercicio de restricción del flujo sanguíneo de 16 semanas sobre la aptitud funcional en mujeres sarcopénicas: un ensayo controlado aleatorio

SUMMARY: We investigated the effect of the intervention using the BFR method on functional capacity after 16 weeks in elderly women. In a controlled clinical trial, 23 women were randomly allocated into two groups, low-intensity exercise with blood flow restriction (LI + BFR, N = 11, Age: 69.40 ± 5.73) and control group (CG, N = 12, Age: 69.00 ± 6.39). The LI + BFR group had a volume of 75 repetitions at 20-30 % of 1RM and 3-4 sets per exercise (30, 15, 15 and repetitions with 30" rest between sets). The CG did not undergo any type of exercise. Functional capacity, anthropometry and sarcopenia were verified through a battery of tests before and after 16 weeks. The LI + BFR group had significant improvement in performance in Handgrip strength, Chair Stand, Arm curl, 2.44 Up-and-Go and 6 min walk, Sit-andreach and Back Scratch (p<0.05) after the intervention. The elderly women were still classified as sarcopenic, despite the improvement in the Muscle Mass Index (p<0.01). CG did not present significant changes. The BFR method can be an effective in the intervention process using physical exercise as an auxiliary strategy in the control of sarcopenia, providing a physical profile during the aging process.

RESUMEN: Investigamos en mujeres ancianas el efecto de la intervención utilizando el método de restricción del flujo sanguíneo en la capacidad funcional, después de 16 semanas. En un ensayo clínico controlado, 23 mujeres fueron asignadas aleatoriamente en dos grupos; ejercicio de baja intensidad con restricción de flujo sanguíneo (BI + RFS, N = 11, edad: 69,40 ± 5,73) y grupo control (GC, N = 12, Edad: 69,00 ± 6,39). El grupo BI + RFS tuvo un volumen de 75 repeticiones al 20-30 % de 1RM y 3-4 series por ejercicio (30, 15, 15 y repeticiones con 30 " de descanso entre series). El GC no fue sometido a ningún tipo de ejercicio. La capacidad funcional, la antropometría y la sarcopenia se verificaron mediante una batería de pruebas antes y después de 16 semanas. El grupo BI + RFS tuvo una mejora significativa en el rendimiento de la fuerza de la empuñadura, soporte de la silla, curvatura del brazo, 2,44 up-and-go y 6 min, 'sit-and-reach' 'Back Scratch' (p<0,05) después de la intervención. Las mujeres de edad avanzada seguían clasificadas como sarcopénicas, a pesar de la mejora en el índice de masa muscular (p<0,01). El GC no presentó cambios significativos. El método de restricción del flujo sanguíneo puede ser efectivo en el proceso de intervención utilizando ejercicio físico como estrategia auxiliar en el control de la sarcopenia, proporcionando un perfil físico durante el proceso de envejecimiento.