Effects of blood flow restriction exercises on bone metabolism: a systematic review.

This study analysed the effect of low-intensity (LI) exercises with blood flow restriction (BFR) on bone metabolism compared with high-intensity (HI) exercises without BFR. The following databases were searched using the keywords therapeutic occlusion training OR BFR training OR vascular occlusion training OR KAATSU training OR ischaemia training AND osteogenesis OR bone biomarkers OR bone metabolic marker OR bone mass OR bone turnover OR osteoporosis OR osteopenia: PubMed, Web of Science, SPORTDiscus, CINAHL, Science Direct, Cochrane and Google Scholar. Two researchers, independently and blindly, selected the studies based on established inclusion and exclusion criteria. Electronic and manual searches located 170 articles published in English; after screening, only four studies showed that BFR training increases the expression of bone formation markers (e.g. bone-specific alkaline phosphatase) and decreases bone resorption markers (e.g. the amino-terminal telopeptides of type I collagen) after both aerobic and anaerobic exercise across several populations. The results of this study show that few studies have confirmed the positive effect of exercise with BFR on bone metabolism, formation and resorption. Furthermore, no methodological standardization of the samples, exercise type, intervention frequency or duration was observed.

A preliminary study of static and dynamic balance in sedentary obese young adults: the relationship between BMI, posture and postural balance.

The aim of this study was to evaluate the postural control of obese young adults with normal body mass index during different static (bipedic and unipedic support) and dynamic postural conditions (gait velocity and limits of stability) in order to compare the static and dynamic balance of these individuals. A cross-sectional quantitative study was carried out to evaluate static and dynamic balance in 25 sedentary individuals. The sample was divided into two groups, 10 in the normal-weight group (24.70 ± 3.89 years and 21.5 ± 1.66 kg m-2 ) and 15 in the obese group (26.80 ± 5.16 years and 35.66 ± 4.29 kg m-2 ). Postural evaluation was performed through visual inspection, and balance analyses were performed using the Timed Up & Go test (TUGT) and Balance System (Biodex). Descriptive analyses, Fisher's exact test and Mann Whitney U-tests were performed using the Statistical Package for Social Sciences (SPSS - 20.0, Armonk, NY) software. Most of the obese volunteers presented postural alterations, such as head protrusion (47.6%), hyperkyphosis (46.7%) and hyperlordosis (26.7%). Medial-lateral dynamic displacement, risk of falls and mean time to perform the limits of stability test and TUGT were higher for obese subjects (P < 0.05), while there were no significant differences between the groups (P > 0.05) for static balance tests for either bipedal or unipedal tasks. The disadvantage presented by the young obese subjects occurs in dynamic activities, representing worse balance and an increase in time needed to accomplish these activities.

Effects of strength training with blood flow restriction on torque, muscle activation and local muscular endurance in healthy subjects.

The present study aimed to analyse the effects of six weeks of strength training (ST), with and without blood flow restriction (BFR), on torque, muscle activation, and local muscular endurance (LME) of the knee extensors. Thirty-seven healthy young individuals were divided into four groups: high intensity (HI), low intensity with BFR (LI+BFR), high intensity and low intensity + BFR (COMB), and low intensity (LI). Torque, muscle activation and LME were evaluated before the test and at the 2nd, 4th and 6th weeks after exercise. All groups had increased torque, muscle activation and LME (p<0.05) after the intervention, but the effect size and magnitude were greater in the HI, LI+BFR and COMB groups. In conclusion, the groups with BFR (LI+BFR and COMB) produced magnitudes of muscle activation, torque and LME similar to those of the HI group.

Peak torque and knee kinematics during gait after eccentric isokinetic training of quadriceps in healthy subjects / O pico de torque e a cinemática do joelho durante a marcha após treino isocinético excêntrico do quadríceps em sujeitos saudáveis

OBJECTIVE: To evaluate the effects of eccentric isokinetic training on knee range of motion (ROM) of healthy subjects. METHODS: The knee extensor and flexor isokinetic peak torques and ROM of flexion/extension and varus/valgus knee movements during gait of 18 healthy men (21.7±2.2 years; 1.73±0.10m; 68.7±9.4kg; body mass index: 22.6±2kg/m²) were analyzed, before and after six weeks of bilateral eccentric isokinetic training of the knee extensors at 30º/s. RESULTS: The knee extensor torque increased in both limbs (right, from 229±54 to 304±53Nm; p<0.01; and left, from 228±59 to 311±63Nm; p<0.01), without any difference in torque gain between them. The knee flexor peak torque increased (from 114±30 to 123±22Nm; p<0.05), but the hamstrings/quadriceps (H/Q) ratio decreased (from 0.5±0.08 to 0.39±0.07; p<0.01) after the training. There were no differences in the flexion/extension and varus/valgus movements after the training, except for a small change (4°) in valgus for the left knee. CONCLUSIONS: The eccentric isokinetic training of the knee extensors increased the extensor torque and decreased the H/Q ratio, although the effect on the gait pattern seemed negligible in healthy subjects. Associated training for flexors, complementary to the extensor training, seems to be necessary for balance between knee agonists and antagonists.

OBJETIVO: Avaliar os efeitos do treino isocinético excêntrico sobre a amplitude de movimento (ADM) do joelho em sujeitos saudáveis. MÉTODOS: Foram analisados os picos de torque isocinético dos extensores e flexores do joelho e a ADM de flexo/extensão e valgo/varo, durante a marcha, de 18 homens saudáveis (21,7±2,2 anos; 1,73±0,10m; 68,7±9,4kg; índice de massa corpórea: 22,6±2kg/m²) antes e após seis semanas de treino isocinético excêntrico bilateral dos extensores do joelho a 30º/s. RESULTADOS: O torque extensor do joelho aumentou em ambos os membros, direito (de 229±54 para 304±53Nm; p<0,01) e esquerdo (de 228±59 para 311±63Nm; p<0,01) sem diferença de ganho de torque entre eles. O pico de torque flexor aumentou (de 114±30 para 123±22Nm; p<0,05), mas a razão isquiotibiais/quadríceps (I/Q) diminuiu (de 0,5±0,08 para 0,39±0,07; p<0,01) após o treino. Não houve diferença para os movimentos de flexo/extensão e valgo/varo após o treino, exceto uma pequena mudança (4°) no valgo para o joelho esquerdo. CONCLUSÕES: O treino isocinético excêntrico dos extensores do joelho aumentou o torque extensor e diminuiu a razão I/Q, entretanto o efeito sobre o padrão da marcha parece desprezível em sujeitos saudáveis. Um treino associado dos flexores, complementar ao treino dos extensores parece ser necessário para o equilíbrio entre agonistas e antagonistas do joelho.