scholarly journals 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

10.2196/14691 ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. e14691 ◽  
Author(s):  
Samuel Amorim ◽  
Hans Degens ◽  
Alexandra Passos Gaspar ◽  
Luciana Diniz Nagem Janot De Matos

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. Trial Registration ClinicalTrials.gov NCT03272737; https://clinicaltrials.gov/ct2/show/NCT03272737 International Registered Report Identifier (IRRID) DERR1-10.2196/14691

2019 ◽  
Author(s):  
Samuel Amorim ◽  
Hans Degens ◽  
Alexandra Passos Gaspar ◽  
Luciana Diniz Nagem Janot De Matos

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


2021 ◽  
Vol 1 (5) ◽  
pp. 263502542110326
Author(s):  
Steven R. Dayton ◽  
Simon J. Padanilam ◽  
Tyler C. Sylvester ◽  
Michael J. Boctor ◽  
Vehniah K. Tjong

Background: Blood flow restriction (BFR) training restricts arterial inflow and venous outflow from the extremity and can produce gains in muscle strength at low loads. Low-load training reduces joint stress and decreases cardiovascular risk when compared with high-load training, thus making BFR an excellent option for many patients requiring rehabilitation. Indications: Blood flow restriction has shown clinical benefit in a variety of patient populations including healthy patients as well as those with osteoarthritis, anterior cruciate ligament reconstruction, polymyositis/dermatomyositis, and Achilles tendon rupture. Technique Description: This video demonstrates BFR training in 3 clinical areas: upper extremity resistance training, lower extremity resistance training, and low-intensity cycling. All applications of BFR first require determination of total occlusion pressure. Upper extremity training requires inflating the tourniquet to 50% of total occlusion pressure, while lower extremity exercises use 80% of total occlusion pressure. Low-load resistance training exercises follow a specific repetition scheme: 30 reps followed by a 30-second rest and then 3 sets of 15 reps with 30-seconds rest between each. During cycle training, 80% total occlusion pressure is used as the patient cycles for 15 minutes without rest. Results: Augmenting low-load resistance training with BFR increases muscle strength when compared with low-load resistance alone. In addition, low-load BFR has demonstrated an increase in muscle mass greater than low-load training alone and equivalent to high-load training absent BFR. A systematic review determined the safety of low-load training with BFR is comparable to traditional high-intensity resistance training. The most common adverse effects include exercise intolerance, discomfort, and dull pain which are also frequent in patients undergoing traditional resistance training. Severe adverse effects including deep vein thrombosis, pulmonary embolism, and rhabdomyolysis are exceedingly rare, less than 0.006% according to a national survey. Patients undergoing BFR rehabilitation experience less perceived exertion and demonstrate decreased pain scores compared with high-load resistance training. Conclusion: Blood flow restriction training is an effective alternative to high-load resistance training for patients requiring musculoskeletal rehabilitation for multiple disease processes as well as in the perioperative setting. Blood flow restriction has been shown to be a safe training modality when managed by properly trained physical therapists and athletic trainers.


2020 ◽  
Vol 318 (2) ◽  
pp. R284-R295 ◽  
Author(s):  
Christopher Pignanelli ◽  
Heather L. Petrick ◽  
Fatemeh Keyvani ◽  
George J. F. Heigenhauser ◽  
Joe Quadrilatero ◽  
...  

The application of blood flow restriction (BFR) during resistance exercise is increasingly recognized for its ability to improve rehabilitation and for its effectiveness in increasing muscle hypertrophy and strength among healthy populations. However, direct comparison of the skeletal muscle adaptations to low-load resistance exercise (LL-RE) and low-load BFR resistance exercise (LL-BFR) performed to task failure is lacking. Using a within-subject design, we examined whole muscle group and skeletal muscle adaptations to 6 wk of LL-RE and LL-BFR training to repetition failure. Muscle strength and size outcomes were similar for both types of training, despite ~33% lower total exercise volume (load × repetition) with LL-BFR than LL-RE (28,544 ± 1,771 vs. 18,949 ± 1,541 kg, P = 0.004). After training, only LL-BFR improved the average power output throughout the midportion of a voluntary muscle endurance task. Specifically, LL-BFR training sustained an 18% greater power output from baseline and resulted in a greater change from baseline than LL-RE (19 ± 3 vs. 3 ± 4 W, P = 0.008). This improvement occurred despite histological analysis revealing similar increases in capillary content of type I muscle fibers following LL-RE and LL-BFR training, which was primarily driven by increased capillary contacts (4.53 ± 0.23 before training vs. 5.33 ± 0.27 and 5.17 ± 0.25 after LL-RE and LL-BFR, respectively, both P < 0.05). Moreover, maximally supported mitochondrial respiratory capacity increased only in the LL-RE leg by 30% from baseline ( P = 0.006). Overall, low-load resistance training increased indexes of muscle oxidative capacity and strength, which were not further augmented with the application of BFR. However, performance on a muscle endurance test was improved following BFR training.


2019 ◽  
Vol 127 (6) ◽  
pp. 1660-1667 ◽  
Author(s):  
Christoph Centner ◽  
Benedikt Lauber ◽  
Olivier R. Seynnes ◽  
Simon Jerger ◽  
Tim Sohnius ◽  
...  

Low-load blood flow restriction (LL-BFR) training has gained increasing interest in the scientific community by demonstrating that increases in muscle mass and strength are comparable to conventional high-load (HL) resistance training. Although adaptations on the muscular level are well documented, there is little evidence on how LL-BFR training affects human myotendinous properties. Therefore, the aim of the present study was to investigate morphological and mechanical Achilles tendon adaptations after 14 wk of strength training. Fifty-five male volunteers (27.9 ± 5.1 yr) were randomly allocated into the following three groups: LL-BFR [20–35% of one-repetition maximum (1RM)], HL (70–85% 1RM), or a nonexercising control (CON) group. The LL-BFR and HL groups completed a resistance training program for 14 wk, and tendon morphology, mechanical as well as material properties, and muscle cross-sectional area (CSA) and isometric strength were assessed before and after the intervention. Both HL (+40.7%) and LL-BFR (+36.1%) training induced significant increases in tendon stiffness ( P < 0.05) as well as tendon CSA (HL: +4.6%, LL-BFR: +7.8%, P < 0.001). These changes were comparable between groups without significant changes in Young’s modulus. Furthermore, gastrocnemius medialis muscle CSA and plantar flexor strength significantly increased in both training groups ( P < 0.05), whereas the CON group did not show significant changes in any of the evaluated parameters. In conclusion, the adaptive change in Achilles tendon properties following low-load resistance training with partial vascular occlusion appears comparable to that evoked by high-load resistance training. NEW & NOTEWORTHY Low-load blood flow restriction (LL-BFR) training has been shown to induce beneficial adaptations at the muscular level. However, studies examining the effects on human tendon properties are rare. The findings provide first evidence that LL-BFR can increase Achilles tendon mechanical and morphological properties to a similar extent as conventional high-load resistance training. This is of particular importance for individuals who may not tolerate heavy training loads but still aim for improvements in myotendinous function.


2013 ◽  
Vol 115 (3) ◽  
pp. 403-411 ◽  
Author(s):  
Julie E. A. Hunt ◽  
Dermot Galea ◽  
Graham Tufft ◽  
Danny Bunce ◽  
Richard A. Ferguson

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.


2019 ◽  
Vol 12 (23) ◽  
pp. 11-15
Author(s):  
Tiberiu Puta ◽  
Alexandra Mihaela Stănilă ◽  
Remus Datcu

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.


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