scholarly journals Does Blood Flow Restriction Training Improve Quadriceps Measures After Arthroscopic Knee Surgery? A Critically Appraised Topic

2020 ◽  
Vol 25 (5) ◽  
pp. 221-226
Author(s):  
Erik H. Arve ◽  
Emily Madrak ◽  
Aric J. Warren
Keyword(s):  
Blood Flow ◽  
Cross Sectional Area ◽  
Knee Surgery ◽  
Blood Flow Restriction ◽  
Sectional Area ◽  
Bottom Line ◽  
Cross Sectional ◽  
Arthroscopic Knee Surgery ◽  
Flow Restriction ◽  
Arthroscopic Knee

Focused Clinical Question: Is there evidence to suggest that blood flow restriction (BFR) training improves strength, cross-sectional area, and thigh girth of the quadriceps musculature in patients after arthroscopic surgical procedures of the knee? Clinical Bottom Line: There is moderate consistent, but low-level, evidence supporting the use of BFR training to improve knee extensor muscular outcomes (strength, cross-sectional area, and/or thigh girth) immediately after arthroscopic knee surgery.

scholarly journals Effects of combined treatment with blood flow restriction and low-current electrical stimulation on muscle hypertrophy in rats

2019 ◽  
Vol 127 (5) ◽  
pp. 1288-1296
Author(s):  
Madoka Yoshikawa ◽  
Takeshi Morifuji ◽  
Tomohiro Matsumoto ◽  
Noriaki Maeshige ◽  
Minoru Tanaka ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Electrical Stimulation ◽  
Muscle Hypertrophy ◽  
Combined Treatment ◽  
Blood Flow Restriction ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Skeletal Muscle Hypertrophy

This study aimed to clarify the effects of a combined treatment comprising blood flow restriction and low-current electrical stimulation on skeletal muscle hypertrophy in rats. Male Wistar rats were divided into control (Cont), blood flow restriction (Bfr), electrical stimulation (Es), or Bfr with Es (Bfr + Es) groups. Pressure cuffs (80 mmHg) were placed around the thighs of Bfr and Bfr + Es rats. Low-current Es was applied to calf muscles in the Es and Bfr + Es rats. In experiment 1, a 1-day treatment regimen (5-min stimulation, followed by 5-min rest) was delivered four times to study the acute effects. In experiment 2, the same treatment regimen was delivered three times/wk for 8 wk. Body weight, muscle mass, changes in maximal isometric contraction, fiber cross-sectional area of the soleus muscle, expression of phosphorylated and total-ERK1/2, phosphorylated-rpS6 Ser235/236, phosphorylated and total Akt, and phosphorylated-rpS6 Ser240/244 were measured. Bfr and Es treatment alone failed to induce muscle hypertrophy and increase the expression of phosphorylated rpS6 Ser240/244. Combined Bfr + Es upregulated muscle mass, increased the fiber cross-sectional area, and increased phosphorylated rpS6 Ser240/244 expression and phosphorylated rpS6 Ser235/236 expression compared with controls. Combined treatment with Bfr and low-current Es can induce muscle hypertrophy via activation of two protein synthesis signaling pathways. This treatment should be introduced for older patients with sarcopenia and others with muscle weakness. NEW & NOTEWORTHY We investigated the acute and chronic effect of low-current electrical stimulation with blood flow restriction on skeletal muscle hypertrophy and the mechanisms controlling the hypertrophic response. Low-current electrical stimulation could not induce skeletal muscle hypertrophy, but a combination treatment did. Blood lactate and growth hormone levels were increased in the early response. Moreover, activation of ERK1/2 and mTOR pathways were observed in both the acute and chronic response, which contribute to muscle hypertrophy.

Skeletal muscle adaptations following blood flow-restricted training during 30 days of muscular unloading

2010 ◽  
Vol 109 (2) ◽  
pp. 341-349 ◽  
Author(s):  
Summer B. Cook ◽  
Kimberly A. Brown ◽  
Keith DeRuisseau ◽  
Jill A. Kanaley ◽  
Lori L. Ploutz-Snyder
Keyword(s):  
Blood Flow ◽  
Muscle Strength ◽  
Knee Extensor ◽  
Exercise Group ◽  
Cross Sectional Area ◽  
Knee Extensors ◽  
Muscular Endurance ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Restriction

This study evaluated the effectiveness of low-load resistance training with a blood flow restriction (LLBFR) to attenuate muscle loss and weakness after 30 days of unilateral lower limb suspension (ULLS). Sixteen subjects (ages 18–50 yr) underwent 30 days of ULLS. Measurements of muscle strength, cross-sectional area, and endurance on the knee extensors and plantar flexors were collected before and after ULLS. Plasma concentrations of IGF-1 and IGFBP-3 were also assessed. During ULLS, eight subjects (5 males, 3 females) participated in LLBFR three times per week (ULLS + Exercise) while eight subjects (4 males, 4 females) did not exercise (ULLS). The blood flow-restricted exercise consisted of dynamic knee extension at 20% of the subject's isometric maximum voluntary contraction coupled with a suprasystolic blood flow restriction. After 30 days of limb suspension, the ULLS + Exercise group experienced minimal and insignificant losses in knee extensor cross-sectional area and strength (1.2% and 2.0%, respectively; P ≤ 0.05), while the ULLS group demonstrated significant reductions in cross-sectional area and strength (7.4% and 21%, respectively). Decrements in plantar flexor strength (23.7%) and cross-sectional area (7.4%) were observed after ULLS ( P < 0.05) and were of similar magnitude between the experimental groups ( P > 0.05). Muscular endurance in the knee extensors improved 31% in the ULLS + Exercise group, while it decreased 24% in the ULLS group ( P = 0.01). No changes were seen in hormone concentrations throughout the study. In conclusion, LLBFR of the knee extensors is effective in maintaining muscle strength and size during 30 days of ULLS and results in improved knee extensor muscular endurance.

Effects of Blood Flow Restriction Combined With Resistance Training or Neuromuscular Electrostimulation on Muscle Cross-Sectional Area

2021 ◽  
pp. 1-6
Author(s):  
João Guilherme Almeida Bergamasco ◽  
Ieda Fernanda Alvarez ◽  
Thais Marina Pires de Campos Biazon ◽  
Carlos Ugrinowitsch ◽  
Cleiton Augusto Libardi
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Muscle Hypertrophy ◽  
Vastus Lateralis ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Neuromuscular Electrostimulation ◽  
Muscle Cross Sectional Area

Context: Low-load resistance training (LL) and neuromuscular electrostimulation (NES), both combined with blood flow restriction (BFR), emerge as effective strategies to maintain or increase muscle mass. It is well established that LL-BFR promotes similar increases in muscle cross-sectional area (CSA) and lower rating of perceived exertion (RPE) and pain compared with traditional resistance training protocols. On the other hand, only 2 studies with conflicting results have investigated the effects of NES-BFR on CSA, RPE, and pain. In addition, no study directly compared LL-BFR and NES-BFR. Objective: The aim of the study was to compare the effects of LL-BFR and NES-BFR on vastus lateralis CSA, RPE, and pain. Individual response for muscle hypertrophy was also compared between protocols. Design: Intrasubject longitudinal study. Setting: University research laboratory. Intervention: Fifteen healthy young males (age = 23 [5] y; weight = 77.6 [11.3] kg; height = 1.76 [0.08] m). Main Outcome Measures: Vastus lateralis CSA was measured through ultrasound at baseline (pre) and after 20 training sessions (post). The RPE and pain responses were obtained through modified 10-point scales, handled during all training sessions. Results: Both protocols demonstrated significant increases in muscle CSA (P < .0001). However, the LL-BFR demonstrated significantly greater CSA changes compared with NES-BFR (LL-BFR = 11.2%, NES-BFR = 4.6%; P < .0001). Comparing individual increases in CSA, 12 subjects (85.7% of the sample) presented greater muscle hypertrophy for LL-BFR than for the NES-BFR protocol. In addition, LL-BFR produced significantly lower RPE and pain responses (P < .0001). Conclusions: The LL-BFR produced significantly greater increases in CSA with significant less RPE and pain than NES-BFR. In addition, LL-BFR resulted in greater individual muscle hypertrophy responses for most subjects compared with NES-BFR.

scholarly journals The Effects of Blood Flow Restriction in Patients Undergoing Knee Surgery: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652110272
Author(s):  
Lawrence Wengle ◽  
Filippo Migliorini ◽  
Timothy Leroux ◽  
Jaskarndip Chahal ◽  
John Theodoropoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Meta Analysis ◽  
Quadriceps Muscle ◽  
Patient Reported Outcome ◽  
Knee Surgery ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Patient Reported

Background: Blood flow restriction (BFR) training has been shown to have beneficial effects in reducing quadriceps muscle atrophy and improving strength in patients with various knee pathologies. Furthermore, the effectiveness of BFR training in patients undergoing knee surgery has been investigated to determine if its use can improve clinical outcomes. Purpose/Hypothesis: The purpose of this study was to conduct a systematic review and meta-analysis to examine the effectiveness of BFR training in patients undergoing knee surgery. We hypothesized that BFR, before or after surgery, would improve clinical outcomes as well as muscle strength and volume. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: This systematic review and meta-analysis of peer-reviewed literature was conducted using PubMed, Embase, and Cochrane databases from 1980 to present. Search results were limited to those assessing BFR training in patients undergoing knee surgery published in a scientific peer-reviewed journal in English. Selected studies subsequently underwent data extraction, methodological quality assessment, and data analysis. Results: Eleven studies were eligible, including anterior cruciate ligament reconstruction (n = 10) and knee arthroscopy (n = 1). Two studies specifically assessed BFR use in the preoperative time frame. For the meta-analysis, including 4 studies, the primary outcome variables included the cross-sectional area of the quadratus femoris muscle group assessed with magnetic resonance imaging or ultrasonography, and patient-reported outcome measure scores. The results demonstrated that BFR use in the postoperative time period can lead to a significant improvement in the cross-sectional area when quantifying muscle atrophy. However, there were no significant differences found for patient-reported outcome measures between the included studies. It should be noted that 4 of the included papers in this review reported increases in clinical strength when using BFR in the postoperative setting. Last, preoperative BFR training did not show any significant clinical benefit between the 2 studies. Conclusion: This is the first systematic review and meta-analysis to study the effects of BFR in patients undergoing knee surgery. The results of this analysis show that BFR in the postoperative period after knee surgery can improve quadriceps muscle bulk compared with a control group. However, future research should examine the effects of preconditioning with BFR before surgery. Lastly, BFR protocols need to be further investigated to determine which provide the best patient outcomes. This will help standardize this type of treatment modality for future studies.

Optimal parameters of blood flow restriction and resistance training on quadriceps strength and cross-sectional area and pain in knee osteoarthritis

2021 ◽  
pp. 1-10
Author(s):  
Waleed S. Mahmoud ◽  
Ahmed Osailan ◽  
Ahmed S. Ahmed ◽  
Ragab K. Elnaggar ◽  
Nadia L. Radwan
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Knee Osteoarthritis ◽  
Quadriceps Strength ◽  
Sectional Area ◽  
Occlusion Pressure ◽  
Total Occlusion ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Low Intensity

BACKGROUND: Knee osteoarthritis (KOA) is one of the most common chronic diseases impacting millions of elderly people. OBJECTIVES: The study compared the effects of two intensities of partial blood flow restriction (BFR) with low-intensity resistance training on quadriceps strength and cross-sectional area (CSA), and pain in people with knee osteoarthritis (PwKOA). METHODS: Thirty-five PwKOA, aged 50–65, participated. Quadriceps CSA was measured by ultrasonography, quadriceps strength – by isokinetic dynamometry and pain by VAS. These outcome variables were obtained at the beginning of the study and re-evaluated eight weeks after the intervention. RESULTS: An interaction effect was present for quadriceps CSA (P= 0.042) and quadriceps strength (P= 0.006), showing that using 70% of total occlusion pressure with 30% 1RM had a more significant effect. Knee pain improved significantly through the main effect of BFR (P< 0.001), and low-intensity resistance training (P= 0.011). Pain improved more at 70% of total occlusion pressure, with 30% of 1RM (2.5 ± 1.06) than 50% total occlusion pressure with 10% of 1RM (5.77 ± 1.46). CONCLUSION: A combination of 70% of total occlusion pressure with 30% 1RM could be beneficial in PwKOA in improving pain, and increasing the quadriceps strength. The changes in the quadriceps strength could be a predictor for knee pain.

scholarly journals Sequential alterations in the diameters of capillaries in rabbit skeletal muscle following deep transverse friction - a morphometric study

2005 ◽  
Vol 61 (2) ◽  
Author(s):  
M. A. Gregory ◽  
M. N. Deane ◽  
M. Marsh
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Muscle Blood Flow ◽  
Biceps Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Biceps Femoris Muscle ◽  
Beneficial Effects ◽  
The Cross

Objective: The precise mechanisms by which massage promotes repair in injured soft tissue are unknown. Various authorshave attributed the beneficial effects of massage to vasodilation and increased skin and muscle blood flow. The aim of this study was to determine whether deep transverse friction massage (DTF) causes capillary vasodilation in untraumatised skeletal muscle. Setting: Academic institution.Interventions: Twelve New Zealand white rabbits were anaesthetised and the left biceps femoris muscle received 10 minutes of DTF. Following treatment, wedge biopsies were taken from the musclewithin 10 minutes of treatment (R1 - 4), 24 hours (R5 - 8) and 6 days(R9 - 12) after treatment. To serve as controls, similar biopsies weretaken from the right biceps femoris of animals. The samples were fixed, dehydrated and embedded in epoxy resin.Transverse sections (1µm) of muscle were cut, stained with 1% aqueous alkaline toluidine blue and examined with a light microscope using a 40X objective. Images containing capillaries were captured using an image analyser with SIS software and the cross sectional diameters of at least 60 capillaries were measured from each specimen. Main Outcome Measures: Changes in capillary diameter. Results: The mean capillary diameters in control muscle averaged 4.76 µm. DTF caused a significant immediate increase of 17.3% in cross sectional area (p<0.001), which was not significantly increased by 10.0% after 24 hours (p>0.05). Six days after treatment the cross-sectional area of the treated muscle was 7.6% smaller than the controls. Conclusions: This confirms the contention that DTF stimulates muscle blood flow immediately after treatment and this may account for its beneficial effects in certain conditions. 

scholarly journals Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear

2017 ◽  
Vol 16 (3) ◽  
pp. 214-219 ◽  
Author(s):  
Marta Gimunová ◽  
Martin Zvonař ◽  
Kateřina Kolářová ◽  
Zdeněk Janík ◽  
Ondřej Mikeska ◽  
...  
Keyword(s):  
Blood Flow ◽  
Venous Blood ◽  
Cross Sectional Area ◽  
Popliteal Vein ◽  
Control Group ◽  
Venous Disease ◽  
Venous Blood Flow ◽  
Sectional Area ◽  
Cross Sectional ◽  
Experimental Group

Abstract Background During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen’s d test to calculate effect size. Results With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application.

scholarly journals Temporal trends and regional variation in the rate of arthroscopic knee surgery in England: analysis of over 1.7 million procedures between 1997 and 2017. Has practice changed in response to new evidence?

2018 ◽  
Vol 53 (24) ◽  
pp. 1533-1538 ◽  
Author(s):  
Simon G F Abram ◽  
Andrew Judge ◽  
David J Beard ◽  
Hannah A Wilson ◽  
Andrew J Price
Keyword(s):  
Regional Variation ◽  
Hospital Admissions ◽  
Average Rate ◽  
Temporal Trends ◽  
Knee Surgery ◽  
Cross Sectional ◽  
Arthroscopic Knee Surgery ◽  
Diagnostic Arthroscopy ◽  
Arthroscopic Knee ◽  
New Evidence

ObjectivesWe investigated trends and regional variation in the rate of arthroscopic knee surgery performed in England from 1997–1998 to 2016–2017.DesignCross-sectional study of the national hospital episode statistics (HES) for England.MethodsAll hospital episodes for patients undergoing a knee arthroscopy between 1 April 1997 and 31 March 2017 were extracted from HES by procedure code. Age and sex-standardised rates of surgery were calculated using Office for National Statistic population data as the denominator. Trends in the rate of surgery were analysed by procedure both nationally and by Clinical Commissioning Group (CCG).ResultsA total of 1 088 872 arthroscopic partial meniscectomies (APMs), 326 600 diagnostic arthroscopies, 308 618 knee washouts and 252 885 chondroplasties were identified (1 759 467 hospital admissions; 1 447 142 patients). The rate of APM increased from a low of 51/100 000 population (95% CI 51 to 52) in 1997–1998 to a peak at 149/100 000 (95% CI 148 to 150) in 2013–2014; then, after 2014–2015, rates declined to 120/100 000 (95% CI 119 to 121) in 2016–2017. Rates of arthroscopic knee washout and diagnostic arthroscopy declined steadily from 50/100 000 (95% CI 49 to 50) and 47/100 000 (95% CI 46 to 47) respectively in 1997–1998, to 4.8/100 000 (95% CI 4.6 to 5.0) and 8.1/100 000 (95% CI 7.9 to 8.3) in 2016–2017. Rates of chondroplasty have increased from a low of 3.2/100 000 (95% CI 3.0 to 3.3) in 1997–1998 to 51/100 000 (95% CI 50.6 to 51.7) in 2016–2017. Substantial regional and age–group variation in practice was detected. In 2016–2017, between 11% (22/207) and 16% (34/207) of CCGs performed at least double the national average rate of each procedure.ConclusionsOver the last 20 years, and likely in response to new evidence, rates of arthroscopic knee washout and diagnostic arthroscopy have declined by up to 90%. APM rates increased about 130% overall but have declined recently. Rates of chondroplasty increased about 15-fold. There is significant variation in practice, but the appropriate population intervention rate for these procedures remains unknown.

Alterations of mature arterioles associated with chronically reduced blood flow

1993 ◽  
Vol 264 (1) ◽  
pp. H40-H44 ◽  
Author(s):  
D. H. Wang ◽  
R. L. Prewitt
Keyword(s):  
Blood Flow ◽  
Vascular Wall ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Adaptive Responses ◽  
Total Blood ◽  
Cross Sectional ◽  
Old Rats ◽  
Total Blood Flow ◽  
Autoregulatory Mechanism

Adaptive responses of mature arterioles were examined after a 38% reduction in total blood flow to the cremaster muscle produced by unilateral orchidectomy in 12-wk-old rats. Four weeks later, the muscle was smaller than the contralateral cremaster, which did not increase in size during this period. Measured by closed-circuit television microscopy, the internal diameters of first- through fourth-order arterioles (1A-4A) were smaller, but wall cross-sectional area was reduced only in 3As. The smaller diameter of the 1A in the orchidectomy muscle resulted in unchanged wall shear rate. As determined from the perfusion-fixed, microfilled cremaster muscles, the total length of the arcading arterioles and the number of 3As were not statistically different, but the total number of 4As was significantly reduced on the orchidectomy side. Therefore, chronic load reduction in a mature muscle resulted in reduced blood flow, decreased number of 4As, and smaller arteriolar internal diameters in the absence of net changes in vascular wall cross-sectional area. A local autoregulatory mechanism related to flow-induced shear stress is suggested as the mechanism mediating the changes.

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