The effect of blood flow restriction exercise on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid mechanisms of pain modulation

This study aimed to investigate and compare the magnitude of exercise-induced hypoalgesia (EIH) with low-intensity blood flow restriction (BFR) resistance exercise (RE) at varying pressures to other intensities of resistance exercise and examine endogenous mechanisms of pain reduction. Twelve individuals performed four experimental trials involving unilateral leg press exercise in a randomized crossover design: low-load RE at 30% of one repetition maximum (1RM), high-load RE (70% 1RM), and BFR-RE (30% 1RM) at a low and high pressure. BFR pressure was prescribed relative to limb occlusion pressure at 40% and 80% for the low- and high-pressure trials. Pressure pain thresholds (PPT) were assessed before and 5 min and 24 h following exercise in exercising and nonexercising muscles. Venous blood samples were collected at the same timepoints to determine plasma concentrations of beta-endorphin and 2-arachidonoylglycerol. High-pressure BFR-RE increased PPTs in the exercising limb to a greater extent than all other trials. Comparable systemic EIH effects were observed with HLRE and both BFR-RE trials. PPTs in the exercising limb remained elevated above baseline at 24 h postexercise following both BFR-RE trials. Postexercise plasma beta-endorphin concentration was elevated during the BFR-RE trials. No changes to 2-arachidonoylglycerol concentration were observed. High pressure BFR-RE causes a greater EIH response in the exercising limb that persists for up to 24 h following exercise. The reduction in pain sensitivity with BFR-RE is partly driven by endogenous opioid production of beta-endorphin. BFR-RE should be investigated as a possible pain-modulation tool in individuals with acute and chronic pain. NEW & NOTEWORTHY High-pressure blood flow restriction (BFR) causes a greater hypoalgesia response in the exercising limb (48%) compared with light and heavy load resistance exercise (10–34%). Performing light load resistance exercise with BFR causes systemic hypoalgesia comparable with heavy load resistance exercise (10–18%). BFR resistance exercise prolonged the exercise-induced hypoalgesia response for 24 h in the exercising limb (15% and 24%, respectively). Activation of endogenous opioid production and a conditioned pain modulation effect partly mediate the relationship between exercise and hypoalgesia.

Download Full-text

Aerobic exercise with blood flow restriction causes local and systemic hypoalgesia and increases circulating opioid and endocannabinoid levels

Journal of Applied Physiology ◽

10.1152/japplphysiol.00543.2021 ◽

2021 ◽

Author(s):

Luke Hughes ◽

Ian Grant ◽

Stephen David Patterson

Keyword(s):

High Pressure ◽

Blood Flow ◽

Aerobic Exercise ◽

The Body ◽

Blood Flow Restriction ◽

Endogenous Opioid ◽

Post Exercise ◽

Beta Endorphin ◽

Flow Restriction ◽

Pressure Pain Thresholds

Aim: This study examined the effect of aerobic exercise with and without blood flow restriction on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid systems. Methodology: In a randomised crossover design, pain-free individuals performed 20 min of cycling in four experimental trials: 1) Low intensity aerobic exercise (LI-AE) at 40% V̇O2max; 2) LI-AE with low pressure BFR (BFR40); 3) LI-AE with high pressure BFR (BFR80); and 4) High intensity aerobic exercise (HI-AE) 70% V̇O2max. Pressure pain thresholds (PPT) were assessed before and 5 min post-exercise. Circulating concentrations of beta-endorphin and 2-arachidonoylglycerol were assessed before and 10 min post-exercise. Results: In the exercising legs, post-exercise PPTs were increased following BFR40 and BFR80 compared to LI-AE (23-32% vs 1-2%, respectively). Post-exercise PPTs were comparable to HI-AE (17-20%) with BFR40 and greater with BFR80 (30-32%). Both BFR80 and HI-AE triggered comparable systemic hypoalgesia in remote areas of the body (26-28% vs 19-21%). Post-exercise circulating beta-endorphin concentration was increased following BFR40 (11%) and HI-AE (14%, with the greatest change observed following BFR80 (29%). Post-exercise circulating 2-arachidonoylglycerol concentration was increased following BFR40 (22%) and BFR80 (20%), with the greatest change observed following HI-AE (57%). Conclusion: Addition of BFR to LI-AE can trigger both local and systemic hypoalgesia that is not observed follow LI-AE alone and activate endogenous opioid and endocannabinoid systems of pain inhibition. Compared to HI-AE, local and systemic hypoalgesia following LI-AE with high pressure BFR is greater and comparable, respectively. LI-AE with BFR may help pain management in load compromised individuals.

Download Full-text

Integrating blood flow restriction with low-load resistance exercise in a UK specialist military primary care rehabilitation facility

BMJ Military Health ◽

10.1136/bmjmilitary-2021-001897 ◽

2021 ◽

pp. bmjmilitary-2021-001897

Author(s):

Debra Hayhurst ◽

R J Coppack ◽

C Ingram ◽

D Conway ◽

R P Cassidy ◽

...

Keyword(s):

Primary Care ◽

Blood Flow ◽

Resistance Exercise ◽

Load Resistance ◽

Blood Flow Restriction ◽

Flow Restriction ◽

Rehabilitation Facility ◽

Low Load

Download Full-text

Greater discomfort with blood flow restriction training compared to standard low‐load resistance exercise when both are performed to task failure

Translational Sports Medicine ◽

10.1002/tsm2.184 ◽

2020 ◽

Vol 3 (6) ◽

pp. 607-615

Author(s):

Christopher Pignanelli ◽

Jamie F. Burr

Keyword(s):

Blood Flow ◽

Resistance Exercise ◽

Load Resistance ◽

Blood Flow Restriction ◽

Task Failure ◽

Flow Restriction ◽

Low Load

Download Full-text

Time course of regional vascular adaptations to low load resistance training with blood flow restriction

Journal of Applied Physiology ◽

10.1152/japplphysiol.00040.2013 ◽

2013 ◽

Vol 115 (3) ◽

pp. 403-411 ◽

Cited By ~ 38

Author(s):

Julie E. A. Hunt ◽

Dermot Galea ◽

Graham Tufft ◽

Danny Bunce ◽

Richard A. Ferguson

Keyword(s):

Blood Flow ◽

Resistance Exercise ◽

Popliteal Artery ◽

Reactive Hyperemia ◽

Load Resistance ◽

T Test ◽

Blood Flow Restriction ◽

Flow Restriction ◽

Low Load ◽

Transient Improvement

Distortion to hemodynamic and ischemic stimuli during blood flow restriction (BFR) exercise may influence regional vascular adaptation. We examined changes at the conduit, resistance, and capillary level in response to low load resistance exercise with BFR. Eleven males (22 ± 3 yr, 178 ± 4 cm, 78 ± 9 kg) completed 6 wk (3 days/wk) unilateral plantar flexion training with BFR at 30% 1 repetition maximum (1-RM). The contralateral leg acted as a nonexercised control (CON). Popliteal artery function [flow-mediated dilation, FMD%] and structure [maximal diameter] and resistance vessel structure [peak reactive hyperemia] were assessed using Doppler ultrasound before and at 2-wk intervals. Calf filtration capacity was assessed using venous occlusion plethysmography before and after training. BFR training elicited an early increase in peak reactive hyperemia (1,400 ± 278 vs. 1,716 ± 362 ml/min at 0 vs. 2 wk; t-test: P = 0.047), a transient improvement in popliteal FMD% (5.0 ± 2.1, 7.6 ± 2.9, 6.6 ± 2.1, 5.7 ± 1.6% at 0, 2, 4 and 6 wk, respectively; ANOVA: P = 0.002), and an increase in maximum diameter (6.06 ± 0.44 vs. 6.26 ± 0.39 mm at 0 vs. 6 wk; Bonferroni t-test: P = 0.048). Capillary filtration increased after 6 wk BFR training ( P = 0.043). No changes in the CON leg were observed. Adaptation occurred at all levels of the vascular tree in response to low load resistance exercise with BFR. Enhanced peak reactive hyperemia and transient improvement in popliteal artery function occurred before changes in artery structural capacity.

Download Full-text

The Effects of Resistance Exercise With Blood Flow Restriction on Flow-Mediated Dilation and Arterial Stiffness in Elderly People With Low Gait Speed: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.14691 ◽

2019 ◽

Author(s):

Samuel Amorim ◽

Hans Degens ◽

Alexandra Passos Gaspar ◽

Luciana Diniz Nagem Janot De Matos

Keyword(s):

Blood Flow ◽

Resistance Training ◽

Resistance Exercise ◽

Elderly People ◽

Gait Speed ◽

Controlled Trial ◽

Load Resistance ◽

Blood Flow Restriction ◽

Flow Mediated Dilation ◽

Flow Restriction

BACKGROUND During aging, a significant loss of muscle mass, strength, and power is associated with a decline in daily functional capacities. Traditionally, resistance training is prescribed to prevent or reverse the skeletal muscle weakness, but the required training intensity may be too demanding for older people with poor physical performance. Resistance exercise with blood flow moderation (KAATSU training), originally developed in Japan, combines resistance exercise with blood flow restriction. It has been reported that KAATSU training enhances muscle hypertrophy in many populations. However, few studies have evaluated the effects of resistance exercises with blood flow restriction in elderly people and how this affects vascular structure and function. OBJECTIVE The aim of this study was to evaluate (1) the acute and chronic effects of resistance exercise with blood flow restriction on vascular health in elderly people with low gait speed and (2) whether low-load resistance training with blood flow restriction elicits similar strength and gait speed gains to those elicited by conventional resistance training without blood flow restriction. METHODS This is an ongoing randomized controlled trial in elderly people with low gait speed. Overall, two study arms of 13 participants each perform resistance exercise with and without blood flow restriction. The 2 groups are as follows: the control group will perform conventional resistance exercise (60% of 1 repetition maximum) and the KAATSU group will perform the low-load resistance exercise with blood flow restriction (20% of 1 repetition maximum) for 12 weeks. Pulse wave velocity, venous occlusion plethysmography, and flow-mediated dilation are used to assess arterial stiffness, muscle blood flow, and endothelial function, respectively. The secondary outcomes are gait speed, strength, and quality of life. All measures will be performed before and after the training program. RESULTS This research study is in progress. Recruitment has started, and data collection is expected to finish in August 2020. CONCLUSIONS The findings of this study will have important implications for the rehabilitation of elderly people. CLINICALTRIAL ClinicalTrials.gov NCT03272737; https://clinicaltrials.gov/ct2/show/NCT03272737

Download Full-text

Blood flow restriction - short insight of the method

Timisoara Physical Education and Rehabilitation Journal ◽

10.2478/tperj-2019-0008 ◽

2019 ◽

Vol 12 (23) ◽

pp. 11-15

Author(s):

Tiberiu Puta ◽

Alexandra Mihaela Stănilă ◽

Remus Datcu

Keyword(s):

Blood Flow ◽

Resistance Exercise ◽

High Intensity ◽

Recovery Process ◽

Load Resistance ◽

Blood Flow Restriction ◽

High Intensity Training ◽

Flow Restriction ◽

Low Intensity ◽

Intensity Training

AbstractIntroduction: The blood flow restriction method is a training method that is based on the partial occlusion of circulation during a workout. This technique combines low-intensity exercise with the occlusion of the bloodstream which produces results similar to high-intensity training.Aim: We aimed to identify the areas in which this method is applicable, its potential benefits and effects, recommendations regarding the rules of use for maximal effects (dosage, intensity, etc.), and also possible contraindications or warnings regarding the use of this method.Methods: We have analyzed a number of 20 articles on this topic from the field literature of the last 10 years, using ”google academic” as a search engine.Results: After this study we concluded that blood flow restriction is a method with wide applicability in the field of sports training, but also in the recovery process; however, it requires attention in choosing the necessary equipment. For healthy individuals, best training adaptations occur when combining low-load blood flow restriction resistance exercise with traditional high-load resistance exercise.Conclusion: Low-intensity resistance exercise with blood flow restriction is as effective as high-intensity training (for strength and muscle mass gains), but only the high-intensity protocol promotes significant hypotensive responses after exercise.

Download Full-text