THE EFFICACY AND VALIDITY OF BLOOD FLOW RESTRICTION TRAINING IN CLINICAL AND POST-SURGICAL POPULATIONS
DOI:
https://doi.org/10.15621/ijphy/2019/v6i5/186836Keywords:
Blood flow restriction training, occlusion training, BFR training, venous occlusion, low load resistance training, resistance training, rehabilitationAbstract
Background: We currently know BFR training is a viable modality for strength gains in the healthy population. However, it is unknown the effect of BFR training on post-surgical and clinical populations. Furthermore, the optimal use of the BFR modality regarding resistance vs. no-resistance (bodyweight) is also unknown. This literature review adds new information to the field of BFR training specifically in the post-surgical and clinical populations. The objective of the study is to explore the validity and efficacy of blood-restriction training (BFR) in conjunction with low-load resistance training (LL-BFR) versus low-load training without BFR and high-load resistance training without BFR to determine which is superior for strength gains.
Methods: The authors used SPORTDiscus, EBSCO, PubMed, and Science Direct to search for peer-reviewed articles. The articles chosen had the keywords/phrases “BFR,” “vascular occlusion,” “strength training,” “resistance training.” The studied emphasized patients with either clinical conditions (osteoarthritis) or musculoskeletal injuries (ACL reconstruction, total knee arthroplasty, knee arthroscopy). One hundred seventy-one articles were screened, and 17 articles reviewed.
Results: BFR, in conjunction with low-load resistance training yields superior strength gains when compared to lowload training alone (p<.05). The outcome measures show a higher 1-rep max (isotonic strength) and greater muscle size (cross-sectional area, muscle mass, muscle volume) (p<.05). However, BFR with low-load resistance training does not yield superior strength gains in comparison to high-load resistance training alone (p<.03).
Conclusion: As healthcare providers treating patients with musculoskeletal conditions, we know the importance of resistance training as a tool for rehabilitation and activities of daily living. However, at times heavy resistance training is contraindicated either due to joint instability/degeneration, pain, surgical restrictions. BFR training can be implemented with a 10-30% 1-rep max for comparable strength gains. This can be a potential tool used to offset post-surgical atrophy and atrophy due to arthralgia seen in certain systemic conditions. This can translate to better functional outcomes in post-surgical patients and superior quality of life in the geriatric population.
References
Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine. American college of sports medicine position stand. quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59.
Pearson SJ, Hussain SR. A review on the mechanisms of blood-flow restriction resistance training-induced muscle hypertrophy. Sports Med. 2015;45:187–200.
Loenneke JP, Kim D, Fahs CA, et al. Effects of exercise with and without different degrees of blood flow restriction on torque and muscle activation. Muscle Nerve. 2015;51:713–21.
Schoenfeld BJ, Peterson MD, Ogborn D, et al. Effects of low- vs. high-load resistance training on muscle strength and hypertrophy in well-trained men. J Strength Cond Res. 2015;29:2954–63.
AORN Recommended Practices Committee. Recommended practices for the use of the pneumatic tourniquet in the perioperative practice setting. AORN J. 2007;86:640–55.
Burgomaster KA, Moore DR, Schofield LM, et al. Resistance training with vascular occlusion: metabolic adaptations in human muscle. Med Sci Sports Exerc. 2003;35:1203–8.
Dinenno FA, Jones PP, Seals DR, et al. Limb blood flow and vascular conductance are reduced with age in healthy humans: relation to elevations in sympathetic nerve activity and declines in oxygen demand. Circulation. 1999;100:164–70.
Takarada Y, Sato Y, Ishii N. Effects of resistance exercise combined with vascular occlusion on muscle function in athletes. Eur J Appl Physiol. 2002;86:308–14.
Hughes, Luke, et al. "Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis." Br J Sports Med. 51.13 (2017): 1003-1011.
Thomas AC, Wojtys EM, Brandon C, et al. Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction. J Sci Med Sport. 2016;19:7–11
Iversen E, Røstad V, Larmo A. Intermittent blood flow restriction does not reduce atrophy following anterior cruciate ligament reconstruction. J Sport Health Sci. 2016;5:115–8.
Sackett, D. L., Rosenberg, W. M., Gray, J. M., Haynes, R. B., & Richardson, W. S. Evidence based medicine: what it is and what it isn't. BMJ. 1996 Jan 13;312(7023):71-2.
Yamato, T. P., Maher, C., Koes, B., & Moseley, A. The PEDro scale had acceptably high convergent validity, construct validity, and interrater reliability in evaluating methodological quality of pharmaceutical trials. Journal of clinical epidemiology. 2017; 86, 176-181.
Ohta H, Kurosawa H, Ikeda H, et al. Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction Acta Orthop Scand. 2003;74:62–8.
Reeves GV, Kraemer RR, Hollander DB, et al. Comparison of hormone responses following light resistance exercise with partial vascular occlusion and moderately difficult resistance exercise without occlusion. J Appl Physiol. 2006;101:1616–22.
Tennent, D. J., Hylden, C. M., Johnson, A. E., Burns, T. C., Wilken, J. G., & Owens, J. Blood Flow Restriction Training After Knee Arthroscopy: A Randomized Controlled Pilot Study. Clinical Journal of Sport Medicine. 2017; 27(3): 245-252.
Petterson SC, Barrance P, Buchanan T, et al. Mechanisms underlying quadriceps weakness in knee osteoarthritis. Med Sci Sports Exerc. 2008;40:422–7.
Palmieri-Smith RM, Thomas AC, Karvonen-Gutierrez C, et al. Isometric quadriceps strength in women with mild, moderate, and severe knee osteoarthritis. Am J Phys Med Rehabil. 2010;89:541–8.
Segal NA, Glass NA, Felson DT, et al. Effect of quadriceps strength and proprioception on risk for knee osteoarthritis. Med Sci Sports Exerc. 2010;42:2081–8.
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