Blood restriction therapy12/3/2023 However, absolute pressure varies depending on cuff width ( 4, 5). Cuff pressures are typically prescribed at 40–90% of the individual’s arterial occlusion pressure (i.e., relative pressure). cuff width, cuff pressure, continuous versus intermittent pressure application). Although the magnitude of increases in muscular strength and hypertrophy is less than that of resistance training, this is a significant finding considering that conventional “aerobic exercise” typically does not improve muscular strength and hypertrophy.īeyond frequency, intensity, and duration there are other unique considerations that can impact BFR training effectiveness (e.g. One of the most interesting findings of BFR aerobic training is significant improvements in muscular strength and hypertrophy using the aforementioned exercise parameters. VEGF is a protein associated with the formation of new capillaries and improvements in oxygen delivery to exercising skeletal muscle ( 13). However, a potential reason could be enhanced levels of vascular endothelial growth factor (VEGF) concentrations. The physiological explanation of this enhanced cardiovascular function after aerobic training with BFR training is not well understood. These changes have been observed with walk and cycle training at intensities as low as 30% of heart rate reserve, durations of 10–15 minutes at a frequency of 2–3 times a week for 6 weeks ( 2). Low intensity (LI) BFR aerobic training results in significant improvements in cardiorespiratory endurance (i.e., VO 2 peak). This indicates that the traditional paradigm of early strength gains due to neural adaptations followed by muscular hypertrophy is potentially reversed with LL-BFR training ( 8). Interestingly, early hypertrophy (≤4 weeks) is a consistent finding, whereas significant increases in strength are typically not observed until ≥10 weeks of training. IGF-1 has powerful anabolic effects by enhancing satellite cell proliferation and therefore increased muscle mass ( 10). A surge in GH increases insulin-like growth factor-1 (IGF-1) production, a protein linked to muscle growth. The goal of this training volume scheme is metabolite accumulation (i.e., lactate), which stimulates an increase in serum growth hormone (GH) thus promoting collagen synthesis for tissue repair and recovery. High volume is ideal a standard structure for LL-BFR training is 75 repetitions over 4 sets (i.e., 30/15/15/15) with 30-second rest periods between sets. However, a frequency greater than this appears to be less effective, possibly due to overtraining ( 8). The largest effects have been observed training 2–3 days per week. LL-BFR resistance training at intensities as low as 20% of an individual’s 1-RM strength results in significant improvements in muscular strength and hypertrophy. One of the main tenets of resistance exercise prescription is intensity of exercise or load. Thus far, research results regarding the efficacy of LL-BFR have been consistent and promising ( 8). However, multiple units are now readily available worldwide, facilitating expansion of research in this area. Prior to 2008 LL-BFR training equipment was scarce outside of Japan. The cuff is manually tightened or pneumatically inflated to a pressure that occludes venous flow yet allows arterial inflow.īFR training was originally conceived and developed in Japan in the late 1960’s by Yoshiaki Sato and termed KAATSU training. LL-BFR training entails applying a tourniquet-style cuff on the proximal aspect of a limb just prior to exercise. However, muscular strength and hypertrophy can be improved with LL resistance training if combined with blood flow restriction (BFR). Therefore, clinicians often implement low load (LL) resistance training which, unless performed to muscular fatigue, is ineffective at eliciting increases in muscular strength and/or hypertrophy ( 8). Unfortunately, this intensity is often impossible or contraindicated in clinical populations (e.g., post-acute injury, post-operative, certain chronic diseases). Resistance training at an intensity of 60–80% of an individual’s 1-repetition maximum strength (1-RM) is recommended to achieve improvements in muscular strength and hypertrophy ( 4).
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