Cardiovascular responses during and after aerobic and strength exercises with blood flow restriction in older adults

Blood flow restriction training (BFRT) is an increasingly widespread method of exercise that involves imposed restriction of blood flow to the exercising muscle. Blood flow restriction is achieved by inflating a pneumatic pressure cuff (or a tourniquet) positioned proximal to the exercising muscle before, and during, the bout of exercise (i.e., ischemic exercise). Low-intensity BFRT with resistance training promotes comparable increases in muscle mass and strength observed during high-intensity exercise without blood flow restriction. BFRT has expanded into the clinical research setting as a potential therapeutic approach to treat functionally impaired individuals, such as the elderly, and patients with orthopedic and cardiovascular disease/conditions. However, questions regarding the safety of BFRT must be fully examined and addressed before the implementation of this exercise methodology in the clinical setting. In this respect, there is a general concern that BFRT may generate abnormal reflex-mediated cardiovascular responses. Indeed, the muscle metaboreflex is an ischemia-induced, sympathoexcitatory pressor reflex originating in skeletal muscle, and the present review synthesizes evidence that BFRT may elicit abnormal cardiovascular responses resulting from increased metaboreflex activation. Importantly, abnormal cardiovascular responses are more clearly evidenced in populations with increased cardiovascular risk (e.g., elderly and individuals with cardiovascular disease). The evidence provided in the present review draws into question the cardiovascular safety of BFRT, which clearly needs to be further investigated in future studies. This information will be paramount for the consideration of BFRT exercise implementation in clinical populations.

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Strength training with blood flow restriction – a novel therapeutic approach for older adults with sarcopenia? A case report

Clinical Interventions in Aging ◽

10.2147/cia.s206522 ◽

2019 ◽

Vol Volume 14 ◽

pp. 1461-1469 ◽

Cited By ~ 2

Author(s):

Karynne Grutter Lopes ◽

Daniel Alexandre Bottino ◽

Paulo Farinatti ◽

Maria das Graças Coelho de Souza ◽

Priscila Alves Maranhão ◽

...

Keyword(s):

Older Adults ◽

Blood Flow ◽

Case Report ◽

Strength Training ◽

Therapeutic Approach ◽

Blood Flow Restriction ◽

Flow Restriction ◽

Novel Therapeutic

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Effects of Low-Load, Elastic Band Resistance Training Combined With Blood Flow Restriction on Muscle Size and Arterial Stiffness in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glu084 ◽

2014 ◽

Vol 70 (8) ◽

pp. 950-958 ◽

Cited By ~ 47

Author(s):

Tomohiro Yasuda ◽

Kazuya Fukumura ◽

Yusuke Uchida ◽

Hitomi Koshi ◽

Haruko Iida ◽

...

Keyword(s):

Older Adults ◽

Blood Flow ◽

Resistance Training ◽

Arterial Stiffness ◽

Blood Flow Restriction ◽

Muscle Size ◽

Elastic Band ◽

Flow Restriction ◽

Low Load

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Resistance Training with Blood Flow Restriction Compared to Traditional Resistance Training on Strength and Muscle Mass in Non-Active Older Adults: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111441 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11441

Author(s):

Darío Rodrigo-Mallorca ◽

Andrés Felipe Loaiza-Betancur ◽

Pablo Monteagudo ◽

Cristina Blasco-Lafarga ◽

Iván Chulvi-Medrano

Keyword(s):

Systematic Review ◽

Older Adults ◽

Blood Flow ◽

Resistance Training ◽

Muscle Mass ◽

High Intensity ◽

Meta Analysis ◽

Small Sample ◽

Blood Flow Restriction ◽

Flow Restriction

Low-intensity training with blood flow restriction (LI-BFR) has been suggested as an alternative to high-intensity resistance training for the improvement of strength and muscle mass, becoming advisable for individuals who cannot assume such a load. The systematic review aimed to determine the effectiveness of the LI-BFR compared to dynamic high-intensity resistance training on strength and muscle mass in non-active older adults. A systematic review was conducted according to the Cochrane Handbook and reportedly followed the PRISMA statement. MEDLINE, EMBASE, Web of Science Core Collection, and Scopus databases were searched between September and October 2020. Two reviewers independently selected the studies, extracted data, assessed the risk of bias and the quality of evidence using the GRADE approach. Twelve studies were included in the qualitative synthesis. Meta-analysis pointed out significant differences in maximal voluntary contraction (MVC): SMD 0.61, 95% CI [0.10, 1.11], p = 0.02, I2 71% p < 0.0001; but not in the repetition maximum (RM): SMD 0.07, 95% CI [−0.25, 0.40], p = 0.66, I2 0% p < 0.53; neither in the muscle mass: SMD 0.62, 95% CI [−0.09, 1.34], p = 0.09, I2 59% p = 0.05. Despite important limitations such as scarce literature regarding LI-BFR in older adults, the small sample size in most studies, the still differences in methodology and poor quality in many of them, this systematic review and meta-analysis revealed a positive benefit in non-active older adults. LI- BFR may induce increased muscular strength and muscle mass, at least at a similar extent to that in the traditional high-intensity resistance training.

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Acute effects of strength exercise with blood flow restriction on the arterial resistance index

Journal of Physical Education ◽

10.4025/jphyseduc.v31i1.3127 ◽

2020 ◽

Vol 31 (1) ◽

Author(s):

Sabrina Lencina Bonorino ◽

Vanessa da Silva Corralo ◽

Sedinei Lopes Copatti ◽

Eduardo Simões Da Matta ◽

Alex Lazzari Dornelles ◽

...

Keyword(s):

Blood Flow ◽

Brachial Artery ◽

Resistance Index ◽

Blood Flow Restriction ◽

Post Exercise ◽

Flow Restriction ◽

Strength Exercises ◽

Muscle Groups ◽

Small Muscle ◽

Large Muscle

The present study aimed to evaluate the acute behavior of the brachial artery resistance index (BARI) and popliteal artery resistance index (PARI) in response to low intensity strength exercises involving small (SMG) and large muscle groups (LMG) performed with and without blood flow restriction. Eleven men (age 23 ± 3.29 years) underwent a four-arm, randomized, cross-over experiment: Small muscle group exercise (SMG), small muscle groups with blood flow restriction (SMG+BFR), large muscle groups (LMG) and large muscle groups with blood flow restriction (LMG+BFR). The behavior of BARI and PARI was evaluated at rest, immediately after exercise, and at 15 and 30 minutes during recovery. Data analysis showed a significant reduction of the BARI from rest to post-exercise only in the protocols involving SMG, regardless of the BFR (p <0.05). Protocols involving LMG, with or without BFR, did not affect PARI (p> 0.05), but were efficient to promote significant increases in BARI (p <0.05) immediately after exercise. Our findings indicate that the exercises involving SMG, regardless of BFR, are efficient to promote local vasodilatation (brachial artery), but without systemic effects. None of the analyzed protocols affected the PARI behavior.

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