Local and Systemic Effects of Blood Flow Restriction Therapy in an Animal Model

2020 ◽  
Vol 48 (13) ◽  
pp. 3245-3254
Author(s):  
Austin J. Ramme ◽  
Rose Darcy ◽  
Brennan J. Rourke ◽  
Carol Davis ◽  
James F. Markworth ◽  
...  
Keyword(s):  
Blood Flow ◽  
Satellite Cell ◽  
Cell Density ◽  
Muscle Mass ◽  
Peroneal Nerve ◽  
Blood Flow Restriction ◽  
Cross Sectional ◽  
Flow Restriction ◽  
Peroneal Nerve Stimulation

Background: Blood flow restriction therapy (BFRT) has been increasingly applied to improve athletic performance and injury recovery. Validation of BFRT has lagged behind commercialization, and currently the mechanism by which this therapy acts is unknown. BFRT is one type of ischemic therapy, which involves exercising with blood flow restriction. Repetitive restriction of muscle blood flow (RRMBF) is another ischemic therapy type, which does not include exercise. Hypothesis/Purpose: The purpose was to develop a rat model of ischemic therapy, characterize changes to muscle contractility, and evaluate local and systemic biochemical and histologic responses of 2 ischemic therapy types. We hypothesized that ischemic therapy would improve muscle mass and strength as compared with the control group. Study Design: Controlled laboratory study. Methods: Four groups of 10 Sprague-Dawley rats were established: control, stimulation, RRMBF, and BFRT. One hindlimb of each subject underwent 8 treatment sessions over 4 weeks. To simulate exercise, the stimulation group underwent peroneal nerve stimulation for 2 minutes. The RRMBF group used a pneumatic cuff inflated to 100 mm Hg with a 48-minute protocol. The BFRT group involved 100–mm Hg pneumatic cuff inflation and peroneal nerve stimulation for a 5-minute protocol. Four methods of evaluation were performed: in vivo contractility testing, histology, immunohistochemistry, and ELISA. Analysis of variance with post hoc Tukey test and linear mixed effects modeling were used to compare the treatment groups. Results: There was no difference in muscle mass among groups ( P = .40) or between hindlimbs ( P = .73). In vivo contractility testing showed no difference in maximum contractile force among groups ( P = .64) or between hindlimbs ( P = .30). On histology, myocyte cross-sectional area was not different among groups ( P = .55) or between hindlimbs ( P = .44). Pax7 immunohistochemistry demonstrated no difference in muscle satellite cell density among groups ( P = .06) or between hindlimbs ( P = .046). ELISA demonstrated the RRMBF group as eliciting elevated GH levels as compared with the other groups ( P < .001). Conclusion: Ischemic therapy did not induce gains in muscle mass, contractility strength, fiber cross-sectional area, or satellite cell density locally or systemically in this model, although the RRMBF group did have elevated GH levels on ELISA. Clinical Relevance: This animal model does not support ischemic therapy as a method to improve muscle mass, function, or satellite cell density.

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.

scholarly journals 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

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.

scholarly journals The effects of resistance training with blood flow restriction on muscle strength, muscle hypertrophy and functionality in patients with osteoarthritis and rheumatoid arthritis: A systematic review with meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259574
Author(s):  
Leonardo Peterson dos Santos ◽  
Rafaela Cavalheiro do Espírito Santo ◽  
Thiago Rozales Ramis ◽  
Juliana Katarina Schoer Portes ◽  
Rafael Mendonça da Silva Chakr ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Meta Analysis ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Intensity

Introduction Rheumatoid arthritis(RA) and osteoarthritis(OA) patients showed systemic manifestations that may lead to a reduction in muscle strength, muscle mass and, consequently, to a reduction in functionality. On the other hand, moderate intensity resistance training(MIRT) and high intensity resistance training(HIRT) are able to improve muscle strength and muscle mass in RA and OA without affecting the disease course. However, due to the articular manifestations caused by these diseases, these patients may present intolerance to MIRT or HIRT. Thus, the low intensity resistance training combined with blood flow restriction(LIRTBFR) may be a new training strategy for these populations. Objective To perform a systematic review with meta-analysis to verify the effects of LIRTBFR on muscle strength, muscle mass and functionality in RA and OA patients. Materials and methods A systematic review with meta-analysis of randomized clinical trials(RCTs), published in English, between 1957–2021, was conducted using MEDLINE(PubMed), Embase and Cochrane Library. The methodological quality was assessed using Physiotherapy Evidence Database scale. The risk of bias was assessed using RoB2.0. Mean difference(MD) or standardized mean difference(SMD) and 95% confidence intervals(CI) were pooled using a random-effects model. A P<0.05 was considered statistically significant. Results Five RCTs were included. We found no significant differences in the effects between LIRTBFR, MIRT and HIRT on muscle strength, which was assessed by tests of quadriceps strength(SMD = -0.01[-0.57, 0.54], P = 0.96; I² = 58%) and functionality measured by tests with patterns similar to walking(SMD = -0.04[-0.39, 0.31], P = 0.82; I² = 0%). Compared to HIRT, muscle mass gain after LIRTBFR was reported to be similar. When comparing LIRTBFR with low intensity resistance training without blood flow restriction(LIRT), the effect LIRTBFR was reported to be higher on muscle strength, which was evaluated by the knee extension test. Conclusion LIRTBFR appears to be a promising strategy for gains in muscle strength, muscle mass and functionality in a predominant sample of RA and OA women.

Effects of Chronic Blood-Flow Restriction Exercise on Skeletal Muscle Size and Myogenic Satellite Cell Expression

2016 ◽  
Vol 48 ◽  
pp. 1032-1033
Author(s):  
Per Aagaard ◽  
Mikkel Jacobsen ◽  
Kasper Y. Jensen ◽  
Jakob L. Nielsen ◽  
Jens Bülow ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Satellite Cell ◽  
Blood Flow Restriction ◽  
Muscle Size ◽  
Flow Restriction ◽  
Cell Expression

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 Low-load resistance training and blood flow restriction improves strength, muscle mass and functional performance in postmenopausal women: a controlled randomized trial

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Piettra Moura Galvao Pereira ◽  
Amandio Aristides Rihan Geraldes ◽  
Maria da Gloria David Silva Costa ◽  
Joamira Pereira de Araujo ◽  
Rodrigo Ramalho Aniceto ◽  
...  
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Randomized Trial ◽  
Postmenopausal Women ◽  
Muscle Mass ◽  
Functional Performance ◽  
Load Resistance ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Low Load

scholarly journals Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report

2021 ◽  
Vol 3 ◽  
Author(s):  
Maíra Camargo Scarpelli ◽  
João Guilherme Almeida Bergamasco ◽  
Estevan A. de Barros Arruda ◽  
Summer B. Cook ◽  
Cleiton Augusto Libardi
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Resistance Training ◽  
Muscle Mass ◽  
Vastus Lateralis ◽  
Blood Flow Restriction ◽  
Vastus Lateralis Muscle ◽  
Timed Up And Go ◽  
Flow Restriction

In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.

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