Article

Acute Neuromuscular and Microvascular Responses to Concentric and Eccentric Exercises With Blood Flow Restriction

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Lauver, JD, Cayot, TE, Rotarius, TR, and Scheuermann, BW. Acute neuromuscular and microvascular responses to concentric and eccentric exercises with blood flow restriction. J Strength Cond Res XX(X): 000-000, 2019-The purpose of this study was to investigate the effects of the addition of blood flow restriction (BFR) during concentric and eccentric exercises on muscle excitation and microvascular oxygenation status. Subjects (N = 17) were randomly assigned to either a concentric (CON, CON + BFR) or eccentric (ECC, ECC + BFR) group, with one leg assigned to BFR and the other to non-BFR. Surface electromyography and near-infrared spectroscopy were used to measure muscle excitation and microvascular deoxygenation (deoxy-[Hb + Mb]) and [total hemoglobin concentration] during each condition, respectively. On separate days, subjects completed 4 sets (30, 15, 15, 15) of knee extension exercise at 30% maximal torque, and 1 minute of rest was provided between the sets. Greater excitation of the vastus medialis was observed during CON + BFR (54.4 ± 13.3% maximal voluntary isometric contraction [MVIC]) and ECC + BFR (53.0 ± 18.0% MVIC) compared with CON (42.0 ± 10.8% MVIC) and ECC (46.8 ± 9.6% MVIC). Change in deoxy-[Hb + Mb] was greater during CON + BFR (10.0 ± 10.4 μM) than during CON (4.1 ± 4.0 μM; p < 0.001). ECC + BFR (7.8 ± 6.7 μM) was significantly greater than ECC (3.5 ± 4.7 μM; p = 0.001). Total hemoglobin concentration was greater for ECC + BFR (7.9 ± 4.4 μM) compared with ECC (5.5 ± 3.5 μM). The addition of BFR to eccentric and concentric exercises resulted in a significant increase in metabolic stress and muscle excitation compared with non-BFR exercise. These findings suggest that although BFR may increase the hypertrophic stimulus during both modes of contraction, BFR during concentric contractions may result in a greater stimulus.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Notably, the sample sizes ranged anywhere from 6 16 to 60 individuals 27,34 . The majority of the included studies assessed either knee extension 15,16,[25][26][27][28]30,[32][33][34][35] or elbow flexion [17][18][19][20][21][22][23][24]31 exercises, with one study assessing plantar and dorsiflexion 29 . The speeds of isokinetic contractions included 30°/sec, 16,25,26 45°/sec, 15 60°/sec, 27,28,34 90°/sec, 32,33,35 120°/sec, [17][18][19][20][21][22][23][24]30,31 and 300°/sec 33 . ...
... The majority of the included studies assessed either knee extension 15,16,[25][26][27][28]30,[32][33][34][35] or elbow flexion [17][18][19][20][21][22][23][24]31 exercises, with one study assessing plantar and dorsiflexion 29 . The speeds of isokinetic contractions included 30°/sec, 16,25,26 45°/sec, 15 60°/sec, 27,28,34 90°/sec, 32,33,35 120°/sec, [17][18][19][20][21][22][23][24]30,31 and 300°/sec 33 . Studies incorporated either concentric, 16,18,19,21,22,24,[28][29][30][31]35 eccentric, 15,[25][26][27]34 or both concentric and eccentric 17,20,23 muscle actions. ...
... The speeds of isokinetic contractions included 30°/sec, 16,25,26 45°/sec, 15 60°/sec, 27,28,34 90°/sec, 32,33,35 120°/sec, [17][18][19][20][21][22][23][24]30,31 and 300°/sec 33 . Studies incorporated either concentric, 16,18,19,21,22,24,[28][29][30][31]35 eccentric, 15,[25][26][27]34 or both concentric and eccentric 17,20,23 muscle actions. Most of the studies incorporated submaximal contractions at 30% of peak eccentric, con- 29,33,35 Many different blood flow restriction pressures were used, with the most common incorporating relative pressures of 40% to 60% of arterial occlusion pressure. ...
Article
Full-text available
Objectives: Many studies have examined the efficacy of blood flow restriction (BFR) applied during isotonic muscle actions, but its application with isokinetic exercise has been less explored and was the purpose of this systematic review. Design: Systematic Review. Methods: The online databases of Pubmed, Scopus, and Web of Science were searched on May 16, 2023 using the following search: “blood flow restriction OR kaatsu OR occlusion AND isokinetic.” To be included in this review, the manuscripts had to incorporate human participants, involve the use of BFR during isokinetic exercise, and be written in English. Given limited studies comparing the same exercise completed with and without BFR, a quantitative meta-analysis was not completed. Results: Twenty-one studies met the inclusion criteria, most of which incorporated concentric isokinetic contractions at 30% of peak torque using 40-60% of arterial occlusion pressure. Acutely, the addition of BFR did not appear to increase heart rate, blood pressure, muscle swelling, blood flow, or delayed onset muscle soreness, but it did increase markers of muscle activation. Chronically, the addition of BFR did not appear to enhance muscle hypertrophy, but augmentations in muscle strength depended on the speed and type of contraction. Conclusion: The use of BFR during isokinetic exercise does not appear as effective when compared to isotonic exercise. Future studies may wish to examine different intensities and speeds of isokinetic exercises to determine its potential effi cacy.
... Microvascular hypoxia and localized accumulation of muscle metabolites may occur during both FF and BFR exercise but to greater extent during BFR [14,15]. The increased sensation of pain often reported with BFR exercise [6,16] is likely the result of both localized hypoxia and metabolite accumulation in the exercised musculature [17]. ...
... However, only a few studies have combined measurements of microvascular oxygenation and muscle excitability, and only one of these studies appears to have used failure-matched protocols [10,18]. Furthermore, previous findings have observed differences in intermuscular knee extensor microvascular hypoxia during submaximal cycling exercise [19], yet the effect of LL-BFR exercise performed to task failure on microvascular tissue oxygenation and/or blood-pooling has primarily been investigated in a single subdivision of the knee extensor muscle group, mostly vastus lateralis (VL) [8,10,14]. Investigating multiple subdivisions of the knee extensor muscle group simultaneously could provide valuable information on potential intermuscular differences in the physiological response with LL-BFR and LL-FF exercise. Potential exercise-induced intermuscular physiological differences may translate to differences in physiological adaptation (i.e., muscle strength) in response to longitudinal training. ...
... Previous studies support the present data of accelerated local microvascular deoxygenation with partial or full BFR exercise performed to task failure in VL and VM muscles when compared to LL-FF. Yet, at task failure, microvascular oxygenation with LL-BFR and LL-FF have both been reported as being similar and different [8,10], while work-matched protocols (e.g., the 1x30+3x15 repetition protocol) show consistently lower oxygenation during LL-BFR [8,14]. ...
Article
This paper aimed to examine the acute effect of low-load (LL) exercise with blood-flow restriction (LL-BFR) on microvascular oxygenation and muscle excitability of the vastus medialis (VM) and vastus lateralis (VL) muscles during a single bout of unilateral knee extension exercise performed to task failure. Seventeen healthy recreationally resistance-trained males were enrolled in a within-group randomized cross-over study design. Participants performed one set of unilateral knee extensions at 20% of one-repetition maximum (1RM) to task failure, using a LL-BFR or LL free-flow (LL-FF) protocol in a randomized order on separate days. Changes in microvascular oxygenation and muscle excitability in VL and VM were assessed using near-infrared spectroscopy (NIRS) and surface electromyography (sEMG), respectively. Pain measures were collected using the visual analog scale (VAS) before and following set completion. Within- and between- protocol comparisons were performed at multiple time points of set completion for each muscle. During LL-BFR, participants performed 43% fewer repetitions and reported feeling more pain compared to LL-FF (p<0.05). Normalized to time to task failure, LL-BFR and LL-FF generally demonstrated similar progression in microvascular oxygenation and muscle excitability during exercise to task failure. The present results demonstrate that LL-BFR accelerates time to task failure, compared with LL-FF, resulting in a lower dose of mechanical work to elicit similar levels of oxygenation, blood-pooling, and muscle excitability. LL-BFR may be preferable to LL-FF in clinical settings where high workloads are contraindicated, although increased pain experienced during BFR may limit its application. • Highlights • Compared to free flow (FF), neuromuscular fatigue mechanisms are accelerated during blood flow restricted (BFR) training. This can be observed as changes in microvascular oxygenation and muscle excitability occurring at a ∼43% faster mean rate during BFR compared to FF. • BFR exercise seems to elicit the same level of neuromuscular fatigue as FF training within a shorter timeframe. This reduces total joint load and may be especially helpful in cases where high training volumes may be contraindicated (e.g. recovering from a sports injury or orthopedic surgery).
... The results regarding the differences in muscle excitation between LL and LL-BFR training demonstrated a significant increase in surface muscle EMG in favor of LL-BFR. The longitudinal changes which are reviewed in this work, resemble findings from cross-sectional studies looking at the acute effects of training with partial vascular occlusion (Kinugasa et al., 2006;Lauver et al., 2017Lauver et al., , 2019Husmann et al., 2018;Ilett et al., 2019;Kjeldsen et al., 2019). In a frequently cited study by Moritani et al. (1992) participants were instructed to complete a 4-min bout of repeated intermittent isometric hand grip contractions (20% MVC) with one group having the blood flow restricted during the second minute (cuff pressure 200 mmHg). ...
... These differences were still apparent after the end of the 4-min period. Since then, similar observations were reported by several research groups (Kinugasa et al., 2006;Lauver et al., 2017Lauver et al., , 2019Husmann et al., 2018;Ilett et al., 2019;Kjeldsen et al., 2019). Even though the results of the latter studies indicated profound increases in muscle excitation with LL-BFR, there was also a small number of studies which could not find any between-group differences (Thiebaud et al., 2014;Oranchuk et al., 2019). ...
... For an adequate interpretation of the present findings, there are some critical aspects that need to be considered. Firstly, acute and cross-sectional studies examining the effects of LL-BFR training on neuromuscular parameters are currently becoming available in large quantities (Kinugasa et al., 2006;Lauver et al., 2017Lauver et al., , 2019Husmann et al., 2018;Ilett et al., 2019;Kjeldsen et al., 2019). However, trials investigating long-term peripheral and central neural adaptations are scarce. ...
Article
Full-text available
Objective: To summarize the existing evidence on the long-term effects of low-load (LL) blood flow restricted (BFR) exercise on neural markers including both central and peripheral adaptations. Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines. The literature search was performed independently by two reviewers in the following electronic databases: PubMed, Web of Science, Scopus and CENTRAL. The systematic review included long-term trials investigating the effects of LL-BFR training in healthy subjects and compared theses effects to either LL or high-load (HL) training without blood flow restriction. Results: From a total of N = 4499 studies, N = 10 studies were included in the qualitative synthesis and N = 4 studies in a meta-analysis. The findings indicated that LL-BFR resulted in enhanced levels of muscle excitation compared to LL training with pooled effect sizes of 0.87 (95% CI: 0.38–1.36). Compared to HL training, muscle excitation following LL-BFR was reported as either similar or slightly lower. Differences between central activation between LL-BFR and LL or HL are less clear. Conclusion: The summarized effects in this systematic review and meta-analysis highlight that BFR training facilitates neural adaptations following LL training, although differences to conventional HL training are less evident. Future research is urgently needed to identify neural alterations following long-term blood flow restricted exercise.
... BFR mechanistically operates via producing a localized, hypoxic, and subsequently acidotic cellular environment, concomitantly shifting towards anaerobic metabolism [3,5]. This acute metabolic alteration mediates the preferential activation of high-threshold motor units and associated fast-twitch muscle fibers that would otherwise remain largely underutilized in a low-intensity/load exercise scenario [5,7]. Furthermore, greater reliance on glycolysis-derived adenosine triphosphate (ATP) facilitates the lactate dehydrogenase A (LDHA)-dependent reduction of pyruvate to lactate. ...
... Both BFR exercise and betaine supplementation are touted for their ability to distinctly augment both intracellular and whole skeletal muscle level hypertrophic outcomes [2]. Moreover, a combined BFR-betaine supplementation synergy may uniquely support the metabolic environment and mechanical tension that are widely accepted to mediate BFR's skeletal muscle hypertrophy mechanisms [7,29]. The latter commonly employs low-loads and brief (30-60 s) rest periods, along with standardized set and repetition schemes in lieu of multiple sets to failure; this ultimately promotes an adequate mechanical stimulus for subsequent adaptation [30]. ...
Article
Full-text available
The purpose of this investigation was to compare the impacts of a potential blood flow restriction (BFR)-betaine synergy on one-leg press performance, lactate concentrations, and exercise- associated biomarkers. Eighteen recreationally trained males (25 ± 5 y) were randomized to supple- ment 6 g/day of either betaine anhydrous (BET) or cellulose placebo (PLA) for 14 days. Subsequently, subjects performed four standardized sets of one-leg press and two additional sets to muscular failure on both legs (BFR [LL-BFR; 20% 1RM at 80% arterial occlusion pressure] and high-load [HL; 70% 1RM]). Toe-tip lactate concentrations were sampled before (PRE), as well as immediately (POST0), 30 min (POST30M), and 3 h (POST3H) post-exercise. Serum homocysteine (HCY), growth hormone (GH) and insulin-like growth factor-1 concentrations were additionally assessed at PRE and POST30M. Analysis failed to detect any significant between-supplement differences for total repetitions completed. Baseline lactate changes (∆) were significantly elevated from POST0 to POST30 and from POST30 to POST3H (p < 0.05), whereby HL additionally demonstrated significantly higher ∆Lactate versus LL-BFR (p < 0.001) at POST3H. Although serum ∆GH was not significantly impacted by supplement or condition, serum ∆IGF-1 was significantly (p = 0.042) higher in BET versus PLA and serum ∆HCY was greater in HL relative to LL-BFR (p = 0.044). Although these data fail to support a BFR-betaine synergy, they otherwise support betaine’s anabolic potential.
... 6 5.80 ml·kg 21 ·min 21 (mean 6 SD); additional information about participants can be found in the results). Power calculations were performed using in the G*Power software using effect sizes from a previous study that examined muscle excitation and microvascular oxygenation responses during exercise with BFR (23). The most conservative effect size indicated that a sample size of 9 participants would be sufficient when a 5 0.05 and b 5 0.80. ...
... The NIRS signal was sampled at a frequency of 2 Hz, and StO 2 was averaged over the last 30 seconds of each work interval and the last 10 seconds of each recovery interval. To reduce the intersubject variability in the absolute baseline values, the NIRS data are expressed relative to the initial baseline (last 30 seconds of 20 W warm-up), and therefore, StO 2 responses are reported as the difference from baseline (ΔBSL) (23). Normalized StO 2 values were averaged throughout the protocol (beginning at the start of the first interval) to provide an average StO 2 value (StO 2 -Avg). ...
Article
Lauver, JD, Moran, A, Guilkey, JP, Johnson, KE, Zanchi, NE, and Rotarius, TR. Acute responses to cycling exercise with blood flow restriction during various intensities. J Strength Cond Res 36(12): 3366–3373, 2022—The purpose of this study was to investigate the acute physiological responses during cycling at various intensities with blood flow restriction (BFR). Subjects ( N = 9; V̇ o 2 peak = 36.09 ± 5.80 ml·kg ⁻¹ ·min ⁻¹ ) performed 5 protocols: high-intensity (HIGH), control (CON-90), 90% of ventilatory threshold (VT) work rate with BFR (90-BFR), 70% of VT with BFR (70-BFR), and 30% V̇ o 2 peak with BFR (30-BFR). Protocols consisted of five 2-minute work intervals interspersed with 1-minute recovery intervals. Blood flow restriction pressure was 80% of limb occlusion pressure. V̇ o 2 , muscle excitation, tissue oxygen saturation (StO 2 ), discomfort, and level of perceived exertion (RPE) were assessed. Muscle excitation was higher during HIGH (302.9 ± 159.9 %BSL [baseline]) compared with 70-BFR (99.7 ± 76.4 %BSL) and 30-BFR (98.2 ± 70.5 %BSL). StO 2 was greater during 90-BFR (40.7 ± 12.5 ∆BSL), 70-BFR (34.4 ± 15.2 ∆BSL), and 30-BFR (31.9 ± 18.7 ∆BSL) compared with CON-90 (4.4 ± 11.5 ∆BSL). 90-BFR (39.6 ± 12.0 ∆BSL) resulted in a greater StO 2 -Avg compared with HIGH (20.5 ± 13.8 ∆BSL). Also, HIGH (23.68 ± 5.31 ml·kg ⁻¹ ·min ⁻¹ ) resulted in a greater V̇ o 2 compared with 30-BFR (15.43 ± 3.19 ml·kg ⁻¹ ·min ⁻¹ ), 70-BFR (16.65 ± 3.26 ml·kg ⁻¹ ·min ⁻¹ ), and 90-BFR (18.28 ± 3.89 ml·kg ⁻¹ ·min ⁻¹ ); 90-BFR (intervals: 4 = 15.9 ± 2.3; intervals: 5 = 16.4 ± 2.5) resulted in a greater RPE compared with 30-BFR (intervals: 4 = 13.3 ± 1.4; intervals: 5 = 13.7 ± 1.7) during intervals 4 and 5. These results suggest that when adding BFR to various intensities of aerobic exercise, consideration should be given to peak work and VT to provide a balance between high local physiological stress and perceptual responses.
... An a priori power analysis using G*Power (Version 3.1) with estimates of effect sizes from previous studies examining acute physiological responses during exercise with BFR was conducted. The most conservative effect size indicated that a sample size of 10 subjects for each condition would be sufficient to detect clinically meaningful differences indicative of an effect size of 0.6 (moderate) for the number of repetitions completed, using a two-tailed test (alpha = 0.05) with 80% power based on previous findings [43][44][45]. Data are presented as mean ± standard deviation. The statistical significance was set at p < 0.05. ...
Article
Full-text available
Blood flow restriction (BFR) is a popular resistance exercise technique purported to increase metabolic stress and augment training adaptations over time. However, short-term use may lead to acute neuromuscular fatigue and higher exertion ratings. Objective: The purpose of the current study was to examine acute physiological responses to low-load resistance exercise utilizing BFR compared to higher-load, non-BFR resistance exercise. Methods: Recreationally trained males (n = 6) and females (n = 7) (mean ± standard deviation, age: 20 ± 1 yrs.; height: 172 ± 8 cm; weight: 73 ± 11 kg; BMI: 24.4 ± 2.2 kg·m−2; training experience: 4 ± 2 yrs.) had limb occlusion pressure determined (50%; right leg: 118 ± 11 mmHg; left leg: 121 ± 13 mmHg) using an automated, self-inflating cuff system during baseline testing. In subsequent sessions, using a randomized, cross-over design, participants completed one of two experimental conditions: (1) Low-load + BFR and (2) High load + non-BFR. In both conditions, participants completed one set of back squats at either 30% (BFR) or 60% (non-BFR) of an estimated 1RM for a max of 30 repetitions, followed by three additional sets with the same loads and a target of 15 repetitions per set. Blood lactate and countermovement jump (CMJ) height were measured pre- and post-back squat. Ratings of perceived exertion (RPE) were assessed following each set. Results: When collapsed across all sets, participants completed significantly more total repetitions in the BFR condition compared to non-BFR (75.0 ± 0.0 vs. 68.23 ± 9.27 reps; p = 0.015; ES: 1.03), but a lower training load volume (2380 ± 728 vs. 4756 ± 1538 kg; p < 0.001; ES: 1.97). There was a significant time-by-condition interaction (p < 0.001), with a greater increase in blood lactate occurring from baseline to post-back squat in the non-BFR condition (11.61 mmol/L, 95%CI: 9.93, 13.28 mmol/L) compared to BFR (5.98 mmol/L, 95%CI: 4.30, 7.65 mmol/L). There was another significant time-by-condition interaction (p = 0.043), with a greater reduction in CMJ occurring in the non-BFR condition (−6.01, 95%CI: −9.14, −2.88 cm; p < 0.001) compared to BFR (−1.50, 95%CI: −1.50, 4.51 cm; p = 0.312). Conclusions: Utilizing a low-load BFR protocol may allow for a higher training volume, yet lower metabolic stress and reduce neuromuscular fatigue compared to lifting at a higher load without the use of BFR.
... The blood flow restriction training method by low load has been generated 4 set, 15x15x15 high repetitions and 30 second short time recovery during upper body muscular contractions in eccentric 2 second and concentric 2 second implementation changes formed large muscle stimulation (Lauver et al, 2020). In the same time period, the training load for blood flow restriction was 30% of 1RM and physical men was 80% of 1RM. ...
Article
The blood flow restriction training was applied in low-load resistance training to ensure the continuity of oxygen transport in the blood flow and to the muscular strength and hypertrophy. The aim of the study is to determine the effect of blood flow restriction method on hypertrophy and muscle strength changes. Total 8 strength trained men participated low-load blood flow restriction 30% of 1RM training and 8 physical men participated 80% of 1RM traditional resistance training over 6 weeks 2 times per week. To upper body maximal strength characteristics provided arm circumference ES= 0.99, biceps brachi kg ES= 1.51 and triceps push down ES= 0.78 in this study. Cocluded that blood flow restriction training promote on arm hypertrophy and strength changes on biceps and triceps brachii muscules. Indeed, resistance load traditional loading only was support absolute strength efficiency, however, blood flow restriction training method provides upper body coordination, hypertrophy, strength development to strength trained men.
... The blood flow restriction training method by low load has been generated 4 set, 15x15x15 high repetitions and 30 second short time recovery during upper body muscular contractions in eccentric 2 second and concentric 2 second implementation changes formed large muscle stimulation (Lauver et al, 2020). In the same time period, the training load for blood flow restriction was 30% of 1RM and physical men was 80% of 1RM. ...
Article
The blood flow restriction training was applied in low-load resistance training to ensure the continuity of oxygen transport in the blood flow and to the muscular strength and hypertrophy. The aim of the study is to determine the effect of blood flow restriction method on hypertrophy and muscle strength changes. Total 8 strength trained men participated low-load blood flow restriction 30% of 1RM training and 8 physical men participated 80% of 1RM traditional resistance training over 6 weeks 2 times per week. To upper body maximal strength characteristics provided arm circumference ES= 0.99, biceps brachi kg ES= 1.51 and triceps push down ES= 0.78 in this study. Cocluded that blood flow restriction training promote on arm hypertrophy and strength changes on biceps and triceps brachii muscules. Indeed, resistance load traditional loading only was support absolute strength efficiency, however, blood flow restriction training method provides upper body coordination, hypertrophy, strength development to strength trained men.
... Additionally, unlike the present study, Hughes and Patterson (2020) reported an increase in PPT following BFR-75, which may reflect larger muscle mass involved during a leg press exercise (multi-joint exercise) compared to a knee extension exercise (single-joint exercise), which could have resulted in greater motor unit recruitment and motor cortex activity. For example, LL+BFR exercise has been associated with an increase in metabolite accumulation (Lauver, Cayot, Rotarius, & Scheuermann, 2017;Lauver, Cayot, Rotarius, & Scheuermann, 2020) and increased/early recruitment of type II muscle fibers compared to nonoccluded conditions (Fatela, Mendonca, Veloso, Avela, & Mil-Homens, 2019). Thus, our findings, in conjunction with previous investigations (Hughes & Patterson, 2020;Song, et al., 2021;Song, Yamada, et al., 2022b), suggest that one or more of the theoretical mechanisms mediate BFR-induced EIH. ...
Article
Exercise-induced hypoalgesia (EIH) is the acute pain reduction post-exercise. Typically, high-intensity and/or long-duration exercise is required to elicit EIH. Alternatively, low-load resistance exercise with blood flow restriction (LL+BFR) may elicit EIH. However, there is conflicting evidence regarding the necessary repetitions and volume load. This study evaluated EIH after 75-repetitions (1×30, 3×15) (BFR-75) and four sets to volitional failure (BFR-F) protocols. Twenty-six participants completed unilateral knee extensions at 30% of maximal strength using a BFR-75 and BFR-F protocol. Pain pressure threshold (PPT) of the rectus femoris was assessed before and after exercise. Repetitions completed, volume load, occlusion time, and PPT were analyzed. Participants completed more repetitions (91.4±30.5), volume load (5,204.9±2,367.0 Nm), and had a longer occlusion time (345.8±76.2 seconds) during BFR-F compared to BFR-75 (73.2±3.7 repetitions, 4,451.1±1,498.1 Nm, 300.5±52.2 seconds, respectively). Collapsed across sex, PPT increased from pre- (3.24±1.91 kgf) to post-exercise (3.76±2.27 kgf) for BFR-F but not BFR-75 (3.51±1.67 to 3.68±2.04 kgf). The results indicated that BFR-F, but not BFR-75, elicited EIH, as assessed by an increase in PPT. Lower loads used during LL+BFR may be a clinically relevant alternative to high-intensity and/or long-duration exercise in populations that may not tolerate high-intensity or prolonged exercise to induce EIH.
... 18 19 Its mechanism of action involves occluding venous blood flow while partially blocking arterial blood flow to create a state of limb ischaemia, thereby increasing local and systemic metabolic stress, activating the signalling pathways for muscle hypertrophy 20 and enhancing neuromuscular excitability. 21 The low training loads used in BFR training reduce joint loads during training, which is beneficial for increasing patient adherence. 22 Therefore, BFR training is expected to be a more efficient alternative to high-load resistance training in musculoskeletal rehabilitation. ...
Article
Full-text available
Background Patellofemoral pain (PFP) syndrome is a common knee joint functional disorder. Blood flow restriction (BFR) training has shown promise in improving PFP; however, the effectiveness of intermittent BFR (iBFR) training remains uncertain. This study aims to compare the rehabilitative effects of iBFR combined with low-load resistance training and high-load resistance training in PFP patients and to assess the effectiveness of iBFR combined with low-load resistance training for improving PFP. Methods and analysis This randomised, patient-assessor blinded, controlled trial will include 42 eligible PFP patients randomly allocated to an intervention group (iBFR combined with low-load resistance training) or a control group (high-load resistance training) in a 1:1 ratio. Participants will receive interventions three times per week for 8 weeks and will be followed up for 24 weeks. The primary outcome measure is pain, and the secondary outcomes include self-reported function, quality of life, muscle strength and muscle thickness. Assessments will be conducted at baseline, 8 weeks and 24 weeks during follow-up. Intention-to-treat analysis will be performed. Collectively, we expect that the findings of this randomised clinical trial will contribute to understanding the potential benefits of iBFR training and provide insightful guidance for developing more effective treatment strategies for patients with PFP. Ethics and dissemination This study was approved by the Sports Science Experiment Ethics Committee of Beijing Sport University (2022274H). Written informed consent will be obtained from all participants. Trial results will be disseminated through peer-reviewed publications. Trial registration number Chinese Clinical Trial Registry (ChiCTR2300068281).
... The same is true for the medium-term follow-up where the control group improved compared to the BFR intervention group by 11 points [39]. This may be due to the loss of BFR intervention properties such as metabolic stress when this adjuvant treatment is withdrawn, despite continued exercise [62]. ...
Article
Full-text available
Background: Blood flow restriction is characterized as a method used during exercise at low loads of around 20-40% of a repetition maximum, or at a low-moderate intensity of aerobic exercise, in which cuffs that occlude the proximal part of the extremities can partially reduce arterial flow and fully restrict the venous flow of the musculature in order to achieve the same benefits as high-load exercise. Objective: The main objective of this systematic literature review was to analyze the effects of BFR intervention on pain, functionality, and quality of life in subjects with neuromusculoskeletal pathologies. Methods: The search to carry out was performed in PubMed, Cochrane, EMBASE, PEDro, CINHAL, SPORTDiscus, Trip Medical Database, and Scopus: "kaatsu" OR "ischemic training" OR "blood flow restriction" OR "occlusion resistance training" OR "vascular occlusion" OR "vascular restriction". Results: After identifying 486 papers and eliminating 175 of them due to duplication and 261 after reading the title and abstract, 50 papers were selected. Of all the selected articles, 28 were excluded for not presenting a score equal to or higher than 6 points on the PEDro scale and 8 for not analyzing the target outcome variables. Finally, 14 papers were selected for this systematic review. Conclusions: The data collected indicate that the blood flow restriction tool is a therapeutic alternative due to its effectiveness under different exercise modalities. The benefits found include decreases in pain thresholds and improvement in the functionality and quality of life of the neuro-musculoskeletal patient during the first six weeks. However, the results provided by this tool are still not clear for medium- and long-term interventions.
... In order to determine the occlusion pressure for BFR exercise, the resting blood pressure of the lower extremity was measured with a sphygmomanometer for adults (Erka Perfect Aneroid, D-83646, Bad Tölz, Germany). The occlusion pressure was determined as 130% of the lower-extremity systolic blood pressure (22). During BFR exercise, blood flow was restricted with automated 10 cm wide cuffs (Smart Tool Cuff, Ohio, USA) in two different sizes (57 and 73 cm) depending on thigh circumference ( Figure 2). ...
Article
Full-text available
Purpose: The relationship between exercise and irisin and sex hormone release is unclear and is of interest to current research. This study aimed to investigate the acute effect of blood flow restricted (BFR) resistance exercise on irisin and sex hormones. Material and Methods: The study included healthy males over 18 years of age. Participants' physical activity levels were determined using International Physical Activity Questionnaire (IPAQ). Participants underwent body composition analysis and isotonic muscle strength measurement and were randomly divided into 3 groups: low-intensity (20% of 1-RM) resistance exercise with BFR, high-intensity (70% of 1-RM) resistance exercise without BFR, and a control group. Blood samples were obtained 15 minutes post-exercise to assess acute irisin, testosterone, and estrogen responses. Results: The study included 17 healthy males. The average age was 26.1±2.9 years, mean physical activity was 1259.2±1003.1 MET/week, and mean 1-RM max (as measured with isotonic muscle strength test) was 41.1±7.5 kg. The descriptive characteristics of the three groups were statistically similar (p>0.05). The acute post-intervention irisin and sex hormone levels were not statistically different between the groups (p>0.05). Conclusion: Acute changes in irisin and sex hormone levels were not statistically different for low-intensity BFR and high-intensity non-BFR exercise.
Article
Background Optimizing hamstring exercises is crucial for injury prevention and performance. This study explored the effects of blood flow restriction (BFR) during Nordic hamstring exercises (NHE) on hamstring muscle activation and vascular function. Methods A randomized, single-blind study included 14 healthy, physically active males (mean age: 27.5 years). Each participant's lower extremities were randomly assigned to BFR or control groups. In the BFR group, blood flow was restricted to 60% of arterial occlusion pressure. Participants performed three sets of five NHE repetitions. Endothelial function was assessed by flow-mediated dilation (FMD) via Doppler ultrasound before and after exercise. Surface electromyography (EMG) recorded neuromuscular activation of the semitendinosus (ST) and biceps femoris (BF) muscles during exercises. Results FMD values showed no significant differences between BFR and control groups (F(1,13) = 0.156, p = 0.7, partial η² = 0.012). Neuromuscular activations of ST and BF muscles decreased across sets in both groups but did not differ significantly between groups (ST: F(2,26) = 1.172, p = 0.448, partial η² = 0.09; BF: F(2,26) = 1.442, p = 0.527, partial η² = 0.1). Conclusions BFR did not produce acute additional effects on muscle activation or endothelial function compared to standard NHE. This suggests that incorporating BFR in NHE may not enhance immediate neuromuscular or vascular responses. Further research is needed to evaluate its long-term benefits.
Article
There is conflicting evidence regarding the prevalence and magnitude of exercise-induced muscle damage (EIMD) following low-load resistance exercise with blood flow restriction (LL+BFR) that may be related to exercise protocols. The purpose of this investigation was to examine the effects of 75-repetition (BFR-75) (1×30, 3×15) and 4 sets to failure (BFR-4x) protocols on indices of EIMD among untrained women. Thirteen women completed this investigation. One leg was randomly assigned to BFR-75 and the other to BFR-4x. Each leg performed isokinetic, unilateral, concentric-eccentric, leg extension muscle actions at 30% of maximal strength. Indices of EIMD (muscle soreness, range of motion [ROM], limb circumference, pain pressure threshold [PPT], and maximal voluntary isometric contraction [MVIC]) were recorded before exercise, 0-, 24-, 48-, 72-, and 96-hours post-exercise. There were no changes for ROM, circumference, or PPT. Muscle soreness increased similarly in both conditions 0-, 24-, and 48-hours post-exercise and MVIC increased 24-, 48-, 72-, and 96-hours post-exercise. These findings suggested BFR-75 and BFR-4x were not associated with EIMD and elicited similar physiological responses. The increases in muscle soreness may be due to metabolic stress associated with LL+BFR protocols apart from EIMD.
Article
Full-text available
The effects of low load resistance training with blood flow restriction (BFR) on hypertrophy of type I/II myofibers remains unclear, especially in females. The purpose of the present study is to examine changes in type I/II myofiber cross-sectional area (fCSA) and muscle CSA (mCSA) of the vastus lateralis (VL) pre- to post-6 weeks of high load resistance training (HL, n=15, 8 females) and low load resistance training with BFR (n=16, 8 females). Mixed-effects models were used to analyze fCSA with group (HL, BFR), sex (M, F), fiber type (I, II), and time (Pre-, Post-) included as factors. mCSA increased pre- to post-training (p<0.001, d=0.91) and was greater in males compared to females (p<0.001, d=2.26). Type II fCSA increased pre- to post-HL (p<0.05, d=0.46) and was greater in males compared to females (p<0.05, d=0.78). There were no significant increases in fCSA pre- to post-BFR for either fiber type or sex. Cohen's d, however, revealed moderate effect sizes in type I and II fCSA for males (d=0.59 & 0.67), although this did not hold true for females (d=0.29 & 0.34). Conversely, the increase in type II fCSA was greater for females than males following HL. In conclusion, low load resistance training with BFR may not promote myofiber hypertrophy to the level of HL resistance training, and similar responses were generally observed for males and females. In contrast, comparable effect sizes for mCSA and 1RM between groups suggest that BFR could play a role in a resistance training program.
Presentation
Full-text available
Abstract Purpose : To examine the effects of heavy loads strength training with and without blood flow restriction (BFR) on the maximal strength (1RM), power (W90%) and cross-sectionnal area (CSA). Methods : Fifteen students (11 mens, 4 womens) from the UFR STAPS of Montpellier with minimal background of 1 year squat practice were randomly divided in two groups (BFR and control). Squat training sessions were performed twice a week and lasted 4 weeks, with 3 sets of 3 repetitions at 90 % of the maximal repetition (1RM) and 4 min rest beetween sets. BFR group trained with an occlusion cuff inflated at 200 mmHg during rest and exercise. Results : No significant differences were observed on the 1RM (BFR +10,13% vs Control +11,98%) and W90 % (BFR +26,80% vs Control +19,34%), but differences in W90 % show a wide effect size (Cohen’s d=0,75). CSA significantly improve in control group (BFR -0,25% vs Control + 4,49%). Conclusion : Heavy loads strength training seems to generate similar effects on the maximal strength to be pratice with or without BFR. But data on CSA suggest that BFR group improve his strength without muscle gains while control group did improve his muscle mass. Power improvements seems to be influenced by BFR training, insomuch as initial level of BFR group was higher than control group. Keywords : BFR (blood flow restriction), maximal strength, CSA (cross-sectionnal area), power.
Article
Full-text available
Surface electromyography (sEMG) is a popular research tool in sport and rehabilitation sciences. Common study designs include the comparison of sEMG amplitudes collected from different muscles as participants perform various exercises and techniques under different loads. Based on such comparisons, researchers attempt to draw conclusions concerning the neuro- and electrophysiological underpinning of force production and hypothesize about possible longitudinal adaptations, such as strength and hypertrophy. However, such conclusions are frequently unsubstantiated and unwarranted. Hence, the goal of this review is to discuss what can and cannot be inferred from comparative research designs as it pertains to both the acute and longitudinal outcomes. General methodological recommendations are made, gaps in the literature are identified, and lines for future research to help improve the applicability of sEMG are suggested.
Article
Full-text available
We aimed to evaluate the effects of low-load resistance exercise with blood flow restriction (BFR) on high-energy phosphate metabolism, intracellular pH, and oxygenation level in the skeletal muscle. Seven males performed low-load ankle plantar flexion exercise (120 repetitions, 30% of one-repetition maximum) with and without BFR (130% of systolic blood pressure) inside a magnetic resonance device. Inorganic phosphate (Pi)-to-phosphocreatine (PCr) ratio, intracellular pH, and tissue oxygenation index (TOI) in the medial gastrocnemius were determined using ³¹P-magnetic resonance spectroscopy and near-infrared spectroscopy before and during exercise. The Pi-to-PCr ratio significantly increased during exercise in both conditions, with the BFR-condition values significantly exceeding the control-condition values. The BFR and control conditions showed significantly decreased intracellular pH during exercise, with the BFR-condition values being significantly lower than the control-condition values. The TOI significantly decreased during both exercises, but the decreases in the BFR condition were significantly greater than those observed in the control condition. Low-load BFR exercise places greater metabolic stress (greater PCr depletion, lower intracellular pH, and lower oxygenation level) on an exercising muscle than low-load non-restricted exercise.
Article
Full-text available
The purpose of this paper was to conduct a systematic review of the current body of literature and a meta-analysis to compare changes in strength and hypertrophy between low- versus high-load resistance training protocols. Searches of PubMed/MEDLINE, Cochrane Library and Scopus were conducted for studies that met the following criteria: 1) an experimental trial involving both low- (≤60% 1 RM) and high- (>60% 1 RM) load training; 2) with all sets in the training protocols being performed to momentary muscular failure; 3) at least one method of estimating changes in muscle mass and/or dynamic, isometric or isokinetic strength was used; 4) the training protocol lasted for a minimum of 6 weeks; 5) the study involved participants with no known medical conditions or injuries impairing training capacity. A total of 21 studies were ultimately included for analysis. Gains in 1RM strength were significantly greater in favor of high- versus low-load training, while no significant differences were found for isometric strength between conditions. Changes in measures of muscle hypertrophy were similar between conditions. The findings indicate that maximal strength benefits are obtained from the use of heavy loads while muscle hypertrophy can be equally achieved across a spectrum of loading ranges.
Article
Full-text available
We aimed to evaluate the effects of low-load resistance exercise with blood flow restriction (BFR) on high-energy phosphate metabolism, intracellular pH, and oxygenation level in the skeletal muscle. Seven males performed low-load ankle plantar flexion exercise (120 repetitions, 30% of one-repetition maximum) with and without BFR (130% of systolic blood pressure) inside a magnetic resonance device. Inorganic phosphate (Pi)-To-phosphocreatine (PCR) ratio, intracellular pH, and tissue oxygenation index (TOI) in the medial gastrocnemius were determined using 31P-magnetic resonance spectroscopy and near-infrared spectroscopy before and during exercise. The Pi-To-PCR ratio significantly increased during exercise in both conditions, with the BFR-condition values significantly exceeding the control-condition values. The BFR and control conditions showed significantly decreased intracellular pH during exercise, with the BFR-condition values being significantly lower than the control-condition values. The TOI significantly decreased during both exercises, but the decreases in the BFR condition were significantly greater than those observed in the control condition. Low-load BFR exercise places greater metabolic stress (greater PCR depletion, lower intracellular pH, and lower oxygenation level) on an exercising muscle than low-load non-restricted exercise.
Article
Full-text available
Controversy exists as to whether different dynamic muscle actions produce divergent hypertrophic responses. The purpose of this paper was to conduct a systematic review and meta-analysis of randomized controlled trials comparing the hypertrophic effects of concentric versus eccentric training in healthy adults following regimented resistance training (RT). Studies were deemed eligible for inclusion if they met the following criteria: 1) were an experimental trial published in an English-language refereed journal; 2) directly compared concentric and eccentric actions without the use of external implements (i.e. blood pressure cuffs) and all other RT variables equivalent; 3) measured morphologic changes via biopsy, imaging (magnetic resonance imaging, computerized tomography, or ultrasound), bioelectrical impedance, and/or densitometry; 4) had a minimum duration of 6 weeks; and, 5) used human participants without musculoskeletal injury or any health condition that could directly, or through the medications associated with the management of said condition, be expected to impact the hypertrophic response to resistance exercise. A systematic literature search determined that 15 studies met inclusion criteria. Results showed that eccentric muscle actions resulted in a greater effect size (ES) compared to concentric actions, but results did not reach statistical significance (ES difference = 0.25 ± 0.13; CI95: -0.03, 0.52; P = 0.076). The mean percent change in muscle growth across studies favored eccentric compared to concentric actions (10.0% vs 6.8, respectively). The findings indicate the importance of including eccentric and concentric actions in a hypertrophy-oriented RT program as both have shown to be effective in increasing muscle hypertrophy.
Article
Full-text available
PurposeTo examine the effect of low-intensity eccentric contractions with and without blood flow restriction (BFR) on microvascular oxygenation, neuromuscular activation, and the repeated bout effect (RBE). Methods Participants were randomly assigned to either low-intensity (LI), low-intensity with BFR (LI-BFR), or a control (CON) group. Participants in LI and LI-BFR performed a preconditioning bout of low-intensity eccentric exercise prior to about of maximal eccentric exercise. Participants reported 24, 48, 72, and 96 h later to assess muscle damage and function. Surface electromyography (sEMG) and near-infrared spectroscopy (NIRS) were used to measure neuromuscular activation and microvascular deoxygenation (deoxy-[Hb + Mb]) and [total hemoglobin] ([THC]) during the preconditioning bout, respectively. ResultsDuring set-2, LI-BFR resulted in greater activation of the VM-RMS (47.7 ± 11.5% MVIC) compared to LI (67.0 ± 20.0% MVIC), as well as during set-3 (p < 0.05). LI-BFR resulted in a greater change in deoxy-[Hb + Mb] compared to LI during set-2 (LI-BFR 13.1 ± 5.2 µM, LI 6.7 ± 7.9 µM), set-3 (LI-BFR 14.6 ± 6 µM, LI 6.9 ± 7.4 µM), and set-4 (p < 0.05). [THC] was higher during LI-BFR compared to LI (p < 0.05). All groups showed a decrease in MVIC torque immediately after maximal exercise (LI 74.2 ± 14.1%, LI-BFR 75 ± 5.1%, CON 53 ± 18.6%). At 24, 48, 72, and 96 h post maximal eccentric exercise, LI and LI-BFR force deficit was not different from baseline. Conclusion This study suggests that the neuromuscular and deoxygenation (i.e., metabolic stress) responses were considerably different between LI and LI-BFR groups; however, these differences did not lead to improvements in the RBE inferred by performing LI and LI-BFR.
Article
Full-text available
There is a growing body of evidence to suggest that resistance training exercise combined with blood flow restriction (BFR) increases muscle size and strength in humans. Eccentric contraction (ECC) frequently induces severe muscle damage. However, it is not known whether and to what extent muscle damage occurs following ECC + BFR due to the difficulty of conducting definitive invasive studies. The purpose of this study was to examine muscle fiber damage following ECC + BFR at the cellular level. High-intensity ECC was purposefully selected to maximize the opportunity for muscle damage and hypertrophic signaling in our novel in vivo animal model. Male Wistar rats were assigned randomly to the following groups: ECC and ECC + BFR at varying levels of occlusion pressure (140, 160, and 200 Torr). In all conditions, electrical stimulation was applied to the dorsiflexor muscles simultaneously with electromotor-induced plantar flexion. We observed severe histochemical muscle fiber damage (area of damaged fibers/total fiber area analyzed) following ECC (26.4 ± 4.0%). Surprisingly, however, muscle damage was negligible following ECC + BFR140 (2.6 ± 1.2%), ECC+BFR160 (3.0 ± 0.5%), and ECC + BFR200 (0.2 ± 0.1%). Ribosomal S6 kinase 1 (S6K1) phosphorylation, a downstream target of rapamycin (mTOR)-phosphorylation kinase, increased following ECC + BFR200 as well as ECC. In contrast, S6K1 phosphorylation was not altered by BFR alone. The present findings suggest that ECC combined with BFR, even at high exercise intensities, may enhance muscle protein synthesis without appreciable muscle fiber damage. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
Article
Full-text available
It has traditionally been believed that resistance training can only induce muscle growth when the exercise intensity is greater than 65 % of the 1-repetition maximum (RM). However, more recently, the use of low-intensity resistance exercise with blood-flow restriction (BFR) has challenged this theory and consistently shown that hypertrophic adaptations can be induced with much lower exercise intensities (<50 % 1-RM). Despite the potent hypertrophic effects of BFR resistance training being demonstrated by numerous studies, the underlying mechanisms responsible for such effects are not well defined. Metabolic stress has been suggested to be a primary factor responsible, and this is theorised to activate numerous other mechanisms, all of which are thought to induce muscle growth via autocrine and/or paracrine actions. However, it is noteworthy that some of these mechanisms do not appear to be mediated to any great extent by metabolic stress but rather by mechanical tension (another primary factor of muscle hypertrophy). Given that the level of mechanical tension is typically low with BFR resistance exercise (<50 % 1-RM), one may question the magnitude of involvement of these mechanisms aligned to the adaptations reported with BFR resistance training. However, despite the low level of mechanical tension, it is plausible that the effects induced by the primary factors (mechanical tension and metabolic stress) are, in fact, additive, which ultimately contributes to the adaptations seen with BFR resistance training. Exercise-induced mechanical tension and metabolic stress are theorised to signal a number of mechanisms for the induction of muscle growth, including increased fast-twitch fibre recruitment, mechanotransduction, muscle damage, systemic and localised hormone production, cell swelling, and the production of reactive oxygen species and its variants, including nitric oxide and heat shock proteins. However, the relative extent to which these specific mechanisms are induced by the primary factors with BFR resistance exercise, as well as their magnitude of involvement in BFR resistance training-induced muscle hypertrophy, requires further exploration.
Article
Full-text available
Low-intensity blood-flow restriction (BFR) resistance training significantly increases strength and muscle size, but some studies report it produces exercise-induced muscle damage (EIMD) in the lower body after exercise to failure. To investigate the effects of a pre-set number of repetitions of upper body concentric and eccentric exercise when combined with BFR on changes in EIMD. Ten young men had arms randomly assigned to either concentric BFR (CON-BFR) or eccentric BFR (ECC-BFR) dumbbell curl exercise (30% one-repetition maximum (1-RM), 1 set of 30 repetitions followed by 3 sets of 15 repetitions). Maximal isometric voluntary contraction force (MVC), muscle thickness (MTH), circumference, range of motion (ROM), ratings of perceived exertion (RPE), and muscle soreness were measured before, immediately after, and daily for 4 days post-exercise. MVC decreased by 36% for CON-BFR and 12% for ECC-BFR immediately after exercise but was not changed 1-4 days post-exercise (p > 0.05). Only CON-BFR had significant changes in MTH and circumference immediately after exercise (p < 0.05). Muscle soreness was observed in the ECC-BFR arm at 1 and 2 days after exercise. Low-intensity ECC-BFR produces significant muscle soreness at 24 h but neither ECC-BFR nor CON-BFR exercise produces significant changes in multiple indices of EIMD.
Article
Full-text available
It is well established that regimented resistance training can promote increases in muscle hypertrophy. The prevailing body of research indicates that mechanical stress is the primary impetus for this adaptive response and studies show that mechanical stress alone can initiate anabolic signalling. Given the dominant role of mechanical stress in muscle growth, the question arises as to whether other factors may enhance the post-exercise hypertrophic response. Several researchers have proposed that exercise-induced metabolic stress may in fact confer such an anabolic effect and some have even suggested that metabolite accumulation may be more important than high force development in optimizing muscle growth. Metabolic stress pursuant to traditional resistance training manifests as a result of exercise that relies on anaerobic glycolysis for adenosine triphosphate production. This, in turn, causes the subsequent accumulation of metabolites, particularly lactate and H(+). Acute muscle hypoxia associated with such training methods may further heighten metabolic buildup. Therefore, the purpose of this paper will be to review the emerging body of research suggesting a role for exercise-induced metabolic stress in maximizing muscle development and present insights as to the potential mechanisms by which these hypertrophic adaptations may occur. These mechanisms include increased fibre recruitment, elevated systemic hormonal production, alterations in local myokines, heightened production of reactive oxygen species and cell swelling. Recommendations are provided for potential areas of future research on the subject.
Article
Full-text available
We investigated the acute and chronic effects of low-intensity concentric or eccentric resistance training with blood flow restriction (BFR) on muscle size and strength. Ten young men performed 30% of concentric one repetition maximal dumbbell curl exercise (four sets, total 75 reps) 3 days/week for 6 weeks. One arm was randomly chosen for concentric BFR (CON-BFR) exercise only and the other arm performed eccentric BFR (ECC-BFR) exercise only at the same exercise load. During the exercise session, iEMG for biceps brachii muscles increased progressively during CON-BFR, which was greater (p<0.05) than that of the ECC-BFR. Immediately after the exercise, muscle thickness (MTH) of the elbow flexors acutely increased (p<0.01) with both CON-BFR and ECC-BFR, but was greater with CON-BFR (11.7%) (p<0.01) than ECC-BFR (3.9%) at 10-cm above the elbow joint. Following 6-weeks of training, MRI-measured muscle cross-sectional area (CSA) at 10-cm position and mid-upper arm (12.0% and 10.6%, respectively) as well as muscle volume (12.5%) of the elbow flexors were increased (p<0.01) with CON-BFR. Increases in muscle CSA and volume were lower in ECC-BFR (5.1%, 0.8% and 2.9%, respectively) than in the CON-BFR and only muscle CSA at 10-cm position increased significantly (p<0.05) after the training. Maximal voluntary isometric strength of elbow flexors was increased (p<0.05) in CON-BFR (8.6%), but not in ECC (3.8%). These results suggest that CON-BFR training leads to pronounced acute changes in muscle size, an index of muscle cell swelling, the response to which may be an important factor for promoting muscle hypertrophy with BFR resistance training.
Article
Full-text available
Six men were studied to determine the interrelationships among blood supply, motor unit (MU) activity and lactate concentrations during intermittent isometric contractions of the hand grip muscles. The subjects performed repeated contractions at 20% of maximal voluntary contraction (MVC) for 2 s followed by 2-s rest for 4 min with either unhindered blood circulation or arterial occlusion given between the 1st and 2nd min. The simultaneously recorded intramuscular MU spikes and surface electromyogram (EMG) data indicated that mean MU spike amplitude, firing frequency and the parameters of surface EMG power spectra (mean power frequency and root mean square amplitude) remained constant during the experiment with unhindered circulation, providing no electrophysiological signs of muscle fatigue. Significant increases in mean MU spike amplitude and frequency were, however, evident during the contractions with arterial occlusion. Similar patterns of significant changes in the surface EMG spectra parameters and venous lactate concentration were also observed, while the integrated force-time curves remained constant. These data would suggest that the metabolic state of the active muscles may have played an important role in the regulation of MU recruitment and rate coding patterns during exercise.
Article
Full-text available
Our previous study reported that intramuscular metabolic stress during low-intensity resistance exercise was significantly enhanced by combining blood flow restriction (BFR); however, they did not reach the levels achieved during high-intensity resistance exercise. That study was performed using a single set of exercise; however, usual resistance exercise consists of multiple sets with rest intervals. Therefore, we investigated the intramuscular metabolic stress during multiple-set BFR exercises, and compared the results with those during multiple-set high-intensity resistance exercise. Twelve healthy young subjects performed 3 sets of 1-min unilateral plantar flexion (30 repetitions) with 1-min intervals under 4 different conditions: low intensity (L, 20 % 1 RM) and high intensity (H, 65 % 1 RM) without BFR, and L with intermittent BFR (IBFR, only during exercise) and with continuous BFR (CBFR, during rest intervals as well as exercise). Intramuscular metabolic stress, defined as intramuscular metabolites and pH, and muscle fiber recruitment were evaluated by (31)P-magnetic resonance spectroscopy. The changes of intramuscular metabolites and pH during IBFR were significantly greater than those in L but significantly lower than those in H. By contrast, those changes in CBFR were similar to those in H. Moreover, the fast-twitch fiber recruitment, evaluating by a splitting Pi peak, showed a similar level to H. In conclusion, the multiple sets of low-intensity resistance exercise with continuous BFR could achieve with the same metabolic stress as multiple sets of high-intensity resistance exercise.
Article
Full-text available
Exercise-induced muscle damage (EIMD) occurs primarily from the performance of unaccustomed exercise, and its severity is modulated by the type, intensity, and duration of training. Although concentric and isometric actions contribute to EIMD, the greatest damage to muscle tissue is seen with eccentric exercise, where muscles are forcibly lengthened. Damage can be specific to just a few macromolecules of tissue or result in large tears in the sarcolemma, basal lamina, and supportive connective tissue, and inducing injury to contractile elements and the cytoskeleton. Although EIMD can have detrimental short-term effects on markers of performance and pain, it has been hypothesized that the associated skeletal muscle inflammation and increased protein turnover are necessary for long-term hypertrophic adaptations. A theoretical basis for this belief has been proposed, whereby the structural changes associated with EIMD influence gene expression, resulting in a strengthening of the tissue and thus protection of the muscle against further injury. Other researchers, however, have questioned this hypothesis, noting that hypertrophy can occur in the relative absence of muscle damage. Therefore, the purpose of this article will be twofold: (a) to extensively review the literature and attempt to determine what, if any, role EIMD plays in promoting skeletal muscle hypertrophy and (b) to make applicable recommendations for resistance training program design.
Article
Full-text available
Blood flow restriction training technique can be affected by several factors resulting in changes in responses to training; therefore it is necessary to investigate and reveal detailed information about this novel training technique. Participants had their thigh size, thickness of subcutaneous fat, and regional bone free muscle mass measured prior to testing. A Near-Infrared Spectrometer was used to measure tissue oxygenation and a cardiovascular profiling system was utilised to measure stroke volume and heart rate. Initial restrictive pressure of 30, 50, and 70 mmHg were set in random order on three separate days, and then six target pressures were sequentially applied. Tissue oxygenation decreased significantly as both initial restrictive pressure and target pressures increased, but the magnitude of decreases was stronger with higher initial restrictive pressure. There were significant negative correlations between tissue oxygenation and leg lean body mass, total lean body mass, and thigh circumference when initial restrictive pressure was set at 30 mmHg. The findings indicated that changes in initial restrictive pressure affected the amount of venous return verified by the decreases in tissue oxygenation and stroke volume. In addition, thigh composition and size had a significant impact on the effects of initial restrictive pressure.
Article
Full-text available
We investigated the combined effect of low-intensity blood flow restriction and high-intensity resistance training on muscle adaptation. Forty young men (aged 22-32 years) were randomly divided into four groups of ten subjects each: high-intensity resistance training (HI-RT, 75% of one repetition maximum [1-RM]), low-intensity resistance training with blood flow restriction (LI-BFR, 30% 1-RM), combined HI-RT and LI-BFR (CB-RT, twice-weekly LI-BFR and once-weekly HI-RT), and nontraining control (CON). Three training groups performed bench press exercises 3 days/week for 6 weeks. During LI-BFR training sessions, subjects wore pressure cuffs on both arms that were inflated to 100-160 mmHg. Increases in 1-RM were similar in the HI-RT (19.9%) and CB-RT (15.3%) groups and lower in the LI-BFR group (8.7%, p < 0.05). Maximal isometric elbow extension (MVC) increased in the HI-RT (11.3%) and CB-RT (6.6%) groups; there was no change in the LI-BFR group (-0.2%). The cross-sectional area (CSA) of the triceps brachii (TB) increased (p < 0.05) in the HI-RT (8.6%), CB-RT (7.2%), and LI-BFR (4.4%) groups. The change in relative isometric strength (MVC divided by TB CSA) was greater (p < 0.05) in the HI-RT group (3.3%) than in the LI-BFR (-3.5%) and CON (-0.1%) groups. Following training, relative dynamic strength (1-RM divided by TB CSA) was increased (p < 0.05) by 10.5% in the HI-RT group and 6.7% in the CB-RT group. None of the variables in the CON group changed. Our results show that low-intensity resistance training with BFR-induced functional muscle adaptations is improved by combining it with HI-RT.
Article
Full-text available
The quest to increase lean body mass is widely pursued by those who lift weights. Research is lacking, however, as to the best approach for maximizing exercise-induced muscle growth. Bodybuilders generally train with moderate loads and fairly short rest intervals that induce high amounts of metabolic stress. Powerlifters, on the other hand, routinely train with high-intensity loads and lengthy rest periods between sets. Although both groups are known to display impressive muscularity, it is not clear which method is superior for hypertrophic gains. It has been shown that many factors mediate the hypertrophic process and that mechanical tension, muscle damage, and metabolic stress all can play a role in exercise-induced muscle growth. Therefore, the purpose of this paper is twofold: (a) to extensively review the literature as to the mechanisms of muscle hypertrophy and their application to exercise training and (b) to draw conclusions from the research as to the optimal protocol for maximizing muscle growth.
Article
Full-text available
Our previous study reported that metabolic stress in skeletal muscle achieved by combining moderate blood flow restriction (BFR) with low-intensity resistance exercise at 20% of one repetition maximum (1 RM) could not reach the level achieved by high-intensity resistance exercise. Since the previous protocol is typical of current regimens of this type, we sought in this study to optimize the exercise protocol for low-intensity resistance exercise with BFR by examining the dose effects of exercise intensity and pressure. Twelve healthy subjects participated in this study. They were asked to perform unilateral plantar flexion for 2 min (30 repetitions/min) under six different conditions: two resistance exercises (20% 1 RM and 65% 1 RM) without BFR, and four BFR protocols. The four BFR protocols included three different exercise intensities (20, 30, and 40% 1 RM) with moderate pressure (MP) using 130% of systolic blood pressure (147+/-17 mmHg, mean+/-SD) and 20% 1 RM with high pressure at 200 mmHg. Intramuscular metabolites and pH were obtained by 31P-magnetic resonance spectroscopy. Significant dose effects on intramuscular metabolites and pH were observed for exercise intensity (P<0.001) but not for BFR pressure. The BFR protocol combining 30% 1 RM with MP had similar results as the high-intensity load at 65% 1 RM. Intramuscular metabolic stress during BFR exercise might be susceptible to increasing exercise intensity. To replace high-intensity resistance exercise, the BFR protocol might require an intensity of >or=30% 1 RM.
Article
Full-text available
The purpose of this study was to investigate muscle activity and endurance during fatiguing low-intensity dynamic knee extension exercise with and without blood flow restriction. Eleven healthy subjects with strength training experience performed 3 sets of unilateral knee extensions with no relaxation between repetitions to concentric torque failure at 30% of the 1 repetition maximum. One leg was randomized to exercise with cuff occlusion and the other leg to exercise without occlusion. The muscle activity in the quadriceps was recorded with electromyography (EMG). Ratings of perceived exertion (RPE) and acute pain were collected immediately, and delayed onset muscle soreness (DOMS) was rated before and at 24, 48, and 72 hours after exercise. The results demonstrated high EMG levels in both experimental conditions, but there were no significant differences regarding maximal muscle activity, except for a higher EMG in the eccentric phase in set 3 for the nonoccluded condition (p = 0.005). Significantly more repetitions were performed with the nonoccluded leg in every set (p < 0.05). The RPE and acute pain ratings were similar, but DOMS was higher in the nonoccluded leg (p < 0.05). We conclude that blood flow restriction during low-intensity dynamic knee extension decreases the endurance but does not increase the maximum muscle activity compared with training without restriction when both regimes are performed to failure. The high levels of muscle activity suggest that performing low-load dynamic knee extensions in a no-relaxation manner may be a useful method in knee rehabilitation settings when large forces are contraindicated. However, similarly to fatiguing blood flow restricted exercise, this method is associated with ischemic muscle pain, and thus its applications may be limited to highly motivated individuals.
Article
Full-text available
The aim of this systematic review was to determine if eccentric exercise is superior to concentric exercise in stimulating gains in muscle strength and mass. Meta-analyses were performed for comparisons between eccentric and concentric training as means to improve muscle strength and mass. In order to determine the importance of different parameters of training, subgroup analyses of intensity of exercise, velocity of movement and mode of contraction were also performed. Twenty randomised controlled trials studies met the inclusion criteria. Meta-analyses showed that when eccentric exercise was performed at higher intensities compared with concentric training, total strength and eccentric strength increased more significantly. However, compared with concentric training, strength gains after eccentric training appeared more specific in terms of velocity and mode of contraction. Eccentric training performed at high intensities was shown to be more effective in promoting increases in muscle mass measured as muscle girth. In addition, eccentric training also showed a trend towards increased muscle cross-sectional area measured with magnetic resonance imaging or computerised tomography. Subgroup analyses suggest that the superiority of eccentric training to increase muscle strength and mass appears to be related to the higher loads developed during eccentric contractions. The specialised neural pattern of eccentric actions possibly explains the high specificity of strength gains after eccentric training. Further research is required to investigate the underlying mechanisms of this specificity and its functional significance in terms of transferability of strength gains to more complex human movements.
Article
Full-text available
Eccentric contractions occur when activated muscles are forcibly lengthened. This mode of muscle function occurs frequently in the activities of daily living and in athletic competition. This review examines the experimental evidence that provides the foundation for our current understanding of the benefits, consequences, and control of eccentric contractions. Over the past several decades, numerous studies have established that eccentric contractions can maximize the force exerted and the work performed by muscle; that they are associated with a greater mechanical efficiency; that they can attenuate the mechanical effects of impact forces; and that they enhance the tissue damage associated with exercise. More recent evidence adds a new feature to this repertoire by suggesting a new hypothesis: that the neural commands controlling eccentric contractions are unique. Examination of this hypothesis is critical because the existence of such a control scheme would increase substantially the complexity of the strategies that the nervous system must use to control movement.
Article
Full-text available
Oxidative metabolism is the dominant source of energy for skeletal muscle. Near-infrared spectroscopy allows the non-invasive measurement of local oxygenation, blood flow and oxygen consumption. Although several muscle studies have been made using various near-infrared optical techniques, it is still difficult to interpret the local muscle metabolism properly. The main findings of near-infrared spectroscopy muscle studies in human physiology and clinical medicine are summarized. The advantages and problems of near-infrared spectroscopy measurements, in resting and exercising skeletal muscles studies, are discussed through some representative examples.
Article
Full-text available
Efforts to examine the relevant mechanisms involved in skeletal muscle fatigue are focusing on Ca(2+) handling within the active muscle cell. It has been demonstrated time and again that reductions in sarcoplasmic reticulum (SR) Ca(2+) release resulting from increased or intense muscle contraction will compromise tension development. This review seeks to accomplish two related goals: 1) to provide an up-to-date molecular understanding of the Ca(2+)-release process, with considerable attention devoted to the SR Ca(2+) channel, including its associated proteins and their regulation by endogenous compounds; and 2) to examine several putative mechanisms by which cellular alterations resulting from intense and/or prolonged contractile activity will modify SR Ca(2+) release. The mechanisms that are likely candidates to explain the reductions in SR Ca(2+) channel function following contractile activity include elevated Ca(2+) concentrations, alterations in metabolic homeostasis within the "microcompartmentalized" triadic space, and modification by reactive oxygen species.
Article
Full-text available
Acute and long-term effects of resistance exercise combined with vascular occlusion on muscular function were investigated. Changes in integrated electromyogram with respect to time (iEMG), vascular resistive index, and plasma lactate concentration were measured in five men either during or after elbow flexion exercises with the proximal end of the arm occluded at 0-100 mmHg. The mean iEMG, postexercise hyperemia, and plasma lactate concentration were all elevated with the increase in occlusion pressure at a low-intensity exercise, whereas they were unchanged with the increase in occlusion pressure at high-intensity exercise. To investigate the long-term effects of low-intensity exercise with occlusion, older women (n = 24) were subjected to a 16-wk exercise training for elbow flexor muscles, in which low-intensity [ approximately 50-30% one repetition maximum (1 RM)] exercise with occlusion at approximately 110 mmHg (LIO), low-intensity exercise without occlusion (LI), and high- to medium-intensity ( approximately 80-50% 1 RM) exercise without occlusion (HI) were performed. Percent increases in both cross-sectional area and isokinetic strength of elbow flexor muscles after LIO were larger than those after LI (P < 0.05) and similar to those after HI. The results suggest that resistance exercise at an intensity even lower than 50% 1 RM is effective in inducing muscular hypertrophy and concomitant increase in strength when combined with vascular occlusion.
Article
Full-text available
The mechanism(s) of load-induced muscle hypertrophy is as yet unclear, but increasing evidence suggests a role for locally expressed insulin-like growth factor I (IGF-I). We investigated the effects of concentric (CON) vs. eccentric (ECC) loading on muscle IGF-I mRNA concentration. We hypothesized a greater IGF-I response after ECC compared with CON. Ten healthy subjects (24.4 +/- 0.7 yr, 174.5 +/- 2.6 cm, 70.9 +/- 4.3 kg) completed eight sets of eight CON or ECC squats separated by 6-10 days. IGF-I, IGF binding protein-4 (IGFBP-4), and androgen receptor (AR) mRNA concentrations were determined in vastus lateralis muscle by RT-PCR before and 48 h after ECC and CON. Serum total testosterone (TT) and IGF-I were measured serially across 48 h, and serum creatine kinase activity (CK), isometric maximum voluntary contraction (MVC), and soreness were determined at 48 h. IGF-I mRNA concentration increased 62% and IGFBP-4 mRNA concentration decreased 57% after ECC (P < 0.05). Changes after CON were similar but not significant (P = 0.06-0.12). AR mRNA concentration increased (P < 0.05) after ECC (63%) and CON (102%). Serum TT and IGF-I showed little change. MVC fell 10% and CK rose 183% after ECC (P < 0.05). Perceived soreness was higher (P < 0.01) after ECC compared with CON. Results indicate that a single bout of mechanical loading in humans alters activity of the muscle IGF-I system, and the enhanced response to ECC suggests that IGF-I may somehow modulate tissue regeneration after mechanical damage.
Article
Full-text available
O2 uptake (VO2) kinetics and electromyographic (EMG) activity from the vastus medialis, rectus femoris, biceps femoris, and medial gastrocnemius muscles were studied during constant-load concentric and eccentric cycling. Six healthy men performed transitions from baseline to high-intensity eccentric (HE) exercise and to high-intensity (HC), moderate-intensity (MC), and low-intensity (LC) concentric exercise. For HE and HC exercise, absolute work rate was equivalent. For HE and LC exercise, VO2 was equivalent. VO2 data were fit by a two- or three-component exponential model. Surface EMG was recorded during the last 12 s of each minute of exercise to obtain integrated EMG and mean power frequency. Only in the HC exercise did VO2 increase progressively with evidence of a slow component (phase 3), and only in HC exercise was there evidence of a coincident increase with time in integrated EMG of the vastus medialis and rectus femoris muscles (P < 0.05) with no change in mean power frequency. The phase 2 time constant was slower in HC [24.0 +/- 1.7 (SE) s] than in HE (14.7 +/- 2.8 s) and LC (16.7 +/- 2.2 s) exercise, while it was not different from MC exercise (20.6 +/- 2.1 s). These results show that the rate of increase in VO2 at the onset of exercise was not different between HE and LC exercise, where the metabolic demand was similar, but both had significantly faster kinetics for VO2 than HC exercise. The VO2 slow component might be related to increased muscle activation, which is a function of metabolic demand and not absolute work rate.
Article
Full-text available
Near-infrared spectroscopy (NIRS) was utilized to gain insights into the kinetics of oxidative metabolism during exercise transitions. Ten untrained young men were tested on a cycle ergometer during transitions from unloaded pedaling to 5 min of constant-load exercise below (<VT) or above (>VT) the ventilatory threshold. Vastus lateralis oxygenation was determined by NIRS, and pulmonary O2 uptake (Vo --> Vo2) was determined breath-by-breath. Changes in deoxygenated hemoglobin + myoglobin concentration Delta[deoxy(Hb + Mb)] were taken as a muscle oxygenation index. At the transition, [Delta[deoxy(Hb + Mb)]] was unmodified [time delay (TD)] for 8.9 +/- 0.5 s at <VT or 6.4 +/- 0.9 s at >VT (both significantly different from 0) and then increased, following a monoexponential function [time constant (tau) = 8.5 +/- 0.9 s for <VT and 7.2 +/- 0.7 s for >VT]. For >VT a slow component of Delta[deoxy(Hb + Mb)] on-kinetics was observed in 9 of 10 subjects after 75.0 +/- 14.0 s of exercise. A significant correlation was described between the mean response time (MRT = TD + tau) of the primary component of Delta[deoxy(Hb + Mb)] on-kinetics and the tau of the primary component of the pulmonary Vo2 on-kinetics. The constant muscle oxygenation during the initial phase of the on-transition indicates a tight coupling between increases in O2 delivery and O2 utilization. The lack of a drop in muscle oxygenation at the transition suggests adequacy of O2 availability in relation to needs.
Article
We investigated if blood flow restriction (BFR, cuff pressure 20 mmHG below individual occlusion pressure) increases metabolic stress, hormonal response, release of muscle damage markers, and muscle swelling induced by moderate-intensity eccentric contractions. In a randomized, matched-pair design, 20 male subjects (25.3 ± 3.3 years) performed four sets of unilateral eccentric knee extensions (75% 1RM) to volitional failure with (IG) or without (CG) femoral BFR. Despite significant differences of performed repetitions between IG (85.6 ± 15.4 repetitions) and CG (142.3 ± 44.1 repetitions), peak values of lactate (IG 7.0 ± 1.4 mmol l(-1), CG 6.9 ± 2.7 mmol l(-1)), growth-hormone (IG 4.9 ± 4.8 ng ml(-1), CG 5.2 ± 3.5 ng ml(-1)), insulin-like growth factor 1 (IG 172.1 ± 41.9 ng ml(-1), CG 178.7 ± 82.1 ng ml(-1)), creatine-kinase (IG 625.5 ± 464.8 U l(-1), CG 510.7 ± 443.5 U l(-1)), the absolute neutrophil count (IG 7.9 ± 1.3 10(3) µl(-1), CG 8.7 ± 2.0 10(3) µl(-1)), induced muscle swelling of rectus femoris and vastus lateralis and perceived pain did not differ. The present data indicate that BFR is suitable to intensify eccentric exercises.
Article
Introduction: It has been suggested that disparities in effort and discomfort between high- and low-load resistance training might exist, which in turn have produced unequivocal adaptations between studies. Methods: Strength responses to heavier- (HL; 80% maximum voluntary isometric torque; MViT) and lighter- (LL; 50% MViT) load resistance training were examined in addition to acute perceptions of effort and discomfort. Seven men (20.6 ±0.5years; 178.9 ± 3.2cm; 77.1 ±2.7kg) performed unilateral resistance training of the knee extensors to momentary failure using HL and LL. Results: Analyses revealed significant pre- to post-intervention increases in strength for both HL and LL, with no significant between-group differences (P> 0.05). Mean repetitions per set, total training time, and discomfort were all significantly higher for LL compared to HL (P< 0.05). Discussion: This study indicates that resistance training with HL and LL produces similar strength adaptations, however, discomfort should be considered before selecting training load. This article is protected by copyright. All rights reserved
Article
Key points: Skeletal muscle hypertrophy is one of the main outcomes from resistance training (RT), but how it is modulated throughout training is still unknown. We show that changes in myofibrillar protein synthesis (MyoPS) after an initial resistance exercise (RE) bout in the first week of RT (T1) were greater than those seen post-RE at the third (T2) and tenth week (T3) of RT, with values being similar at T2 and T3. Muscle damage (Z-band streaming) was the highest during post-RE recovery at T1, lower at T2 and minimal at T3. When muscle damage was the highest, so was the integrated MyoPS (at T1), but neither were related to hypertrophy; however, integrated MyoPS at T2 and T3 were correlated with hypertrophy. We conclude that muscle hypertrophy is the result of accumulated intermittent increases in MyoPS mainly after a progressive attenuation of muscle damage. Abstract: Skeletal muscle hypertrophy is one of the main outcomes of resistance training (RT), but how hypertrophy is modulated and the mechanisms regulating it are still unknown. To investigate how muscle hypertrophy is modulated through RT, we measured day-to-day integrated myofibrillar protein synthesis (MyoPS) using deuterium oxide and assessed muscle damage at the beginning (T1), at 3 weeks (T2) and at 10 weeks of RT (T3). Ten young men (27 (1) years, mean (SEM)) had muscle biopsies (vastus lateralis) taken to measure integrated MyoPS and muscle damage (Z-band streaming and indirect parameters) before, and 24 h and 48 h post resistance exercise (post-RE) at T1, T2 and T3. Fibre cross-sectional area (fCSA) was evaluated using biopsies at T1, T2 and T3. Increases in fCSA were observed only at T3 (P = 0.017). Changes in MyoPS post-RE at T1, T2 and T3 were greater at T1 (P < 0.03) than at T2 and T3 (similar values between T2 and T3). Muscle damage was the highest during post-RE recovery at T1, attenuated at T2 and further attenuated at T3. The change in MyoPS post-RE at both T2 and T3, but not at T1, was strongly correlated (r ≈ 0.9, P < 0.04) with muscle hypertrophy. Initial MyoPS response post-RE in an RT programme is not directed to support muscle hypertrophy, coinciding with the greatest muscle damage. However, integrated MyoPS is quickly 'refined' by 3 weeks of RT, and is related to muscle hypertrophy. We conclude that muscle hypertrophy is the result of accumulated intermittent changes in MyoPS post-RE in RT, which coincides with progressive attenuation of muscle damage.
Article
Purpose: To determine what factors should be accounted for when setting the blood flow restriction (BFR) cuff pressure for the upper and lower body. Methods: One hundred and seventy one participants visited the laboratory for one testing session. Arm circumference, muscle (MTH) and fat (FTH) thickness were measured on the upper arm. Next, brachial systolic (SBP) and diastolic (DBP) blood pressure measurements were taken in the supine position. Upper body arterial occlusion was then determined using a Doppler probe. Following this, thigh circumference and lower body arterial occlusion were determined. Models of hierarchical linear regression were used to determine the greatest predictor of arterial occlusion in the upper and lower body. Two models were employed in the upper body, a Field (arm size) and a Laboratory model (arm composition). Results: The Laboratory model explained 58 % of the variance in arterial occlusion with SBP (β = 0.512, part = 0.255), MTH (β = 0.363, part = 0.233), and FTH (β = 0.248, part = 0.213) contributing similarly to explained variance. The Field model explained 60 % of the variance in arterial occlusion with arm circumference explaining the greatest amount (β = 0.419, part = 0.314) compared to SBP (β = 0.394, part = 0.266) and DBP (β = 0.147, part = 0.125). For the lower body model the third block explained 49 % of the variance in arterial occlusion with thigh circumference (β = 0.579, part = 0.570) and SBP (β = 0.281, part = 0.231) being significant predictors. Conclusions: Our findings indicate that arm circumference and SBP should be taken into account when determining BFR cuff pressures. In addition, we confirmed our previous study that thigh circumference is the greatest predictor of arterial occlusion in the lower body.
Article
IntroductionAn unresolved question in resistance training combined with blood flow restriction (BFR) is what percentage of estimated arterial occlusion pressure provides the most robust acute muscular response.Methods Forty participants were assigned to Experiments 1, 2, or 3. Each experiment completed exercise protocols differing by pressure, exercise load, and/or volume. Torque was measured pre- and postexercise, and muscle activation was measured pre- and during each set.ResultsPressure and load did not affect torque greatly. Muscle activation increased in all conditions (P < 0.05) and was higher with 30% 1RM compared with 20% 1RM. Pressure appeared to increase muscle activation from 40% to 50% arterial occlusion [66% vs. 87% maximal voluntary contraction (30% 1RM)] but was not further increased with higher pressure.Conclusion Different levels of BFR may alter the acute muscular response to a degree, although higher pressures do not appear to augment these changes. Muscle Nerve 51:713-721, 2015
Article
Previous studies have reported for the vastus lateralis (VL) that the extent of muscle hypertrophy in response to resistance training is greater in the distal than in the middle region, despite uniform muscle fibre composition within VL along its length. In the present study, to investigate mechanism(s) for such non-uniform muscle hypertrophy, we simultaneously measured neuromuscular activity and muscle oxygenation state at the middle and distal regions of VL during fatiguing heavy resistance exercise. Twelve males performed unilateral knee extension exercise which consisted of 4 sets of 8 repetitions at intensity of 80% of the individual one repetition maximum. During the resistance exercise, neuromuscular activities and muscle oxygenation status at the middle and distal regions (50% and 70% of the thigh length, respectively) of VL were measured by using electromyography and near-infrared spectroscopy, respectively. Neuromuscular activities were similar between the distal and middle regions of VL, whereas muscle tissue oxygenation saturation was significantly lower at the distal than at the middle region of VL. These results suggest a possibility that the regional difference in muscle oxygenation but not in neuromuscular activity during fatiguing heavy resistance exercise is responsible for the regional difference in hypertrophy within a muscle.
Article
Venous blood flow restriction (VBFR) combined with low intensity resistance exercise (20-30% concentric 1-RM) has been observed to result in skeletal muscle hypertrophy, increased strength, and increased endurance. Knowledge of the mechanisms behind the benefits seen with VBFR is incomplete, but the benefits have traditionally been thought to occur from the decreased oxygen and accumulation of metabolites. Although many of the proposed mechanisms appear valid and are likely true with VBFR combined with resistance exercise, there are certain situations in which benefits are observed without a large accumulation of metabolites and/or large increases in fast twitch fiber type recruitment. Cell swelling appears to be a likely mechanism that appears to be present throughout all studies. VBFR may be able to induce cell swelling through a combination of blood pooling, accumulation of metabolites, and reactive hyperemia following the removal of VBFR which may contribute to skeletal muscle adaptations that occur with VBFR. We hypothesize that cell swelling is important for muscle growth and strength adaptation but when coupled with higher metabolic accumulation, this adaptation is even greater.
Article
Traditionally it has been thought that muscle hypertrophy occurs primarily from an overload stimulus produced by progressively increasing an external load using at least 70% of one's concentric one repetition maximum (1RM). Blood flow restricted exercise has been demonstrated to result in numerous positive training adaptions, specifically muscle hypertrophy and strength at intensities much lower than this recommendation. The mechanisms behind these adaptions are currently unknown but a commonly cited concept is that acute elevations of systemic hormones, specifically growth hormone (GH), play a large role with resistance training induced muscle hypertrophy, possibly through stimulating muscle protein synthesis (MPS). We hypothesize that the alterations in the intramuscular environment which results in the rapid recruitment of FT fibers, is the large driving force behind the skeletal muscle hypertrophy seen with blood flow restriction, whereas the external load and systemic endogenous hormone elevations may not be as important as once thought. It is further hypothesized that although skeletal muscle hypertrophy can be achieved at low intensities without blood flow restriction when taken to muscular failure, the overall volume of work required is much greater than that needed with blood flow restriction.
Article
This study investigated the effects of frequent low-load ischemic resistance exercise performed to failure on quadriceps size and performance, muscle activation, oxygen kinetics and cardiovascular responses. Ten healthy males performed knee-extension exercise for 4 weeks (4 sessions/week) at 15% maximal voluntary muscle contraction (MVC). One leg was trained with free blood flow (C-leg) while in the other leg (I-leg) ischemia was induced by an inflatable cuff (≥230 mmHg). Quadriceps cross-sectional area (CSA) of the I-leg increased by 3.4% (P<0.05). A tendency for smaller increase in muscle CSAs at the cuff level was observed. MVC force did not change in either leg, whereas the number of repetitions during exercise test to failure increased (P<0.01) by 63% in I-leg and 36% in C-leg. The decrease in muscle oxygenated hemoglobin concentration acquired by NIRS was attenuated (P<0.01) by 56% in I-leg and 21% in C-leg. Electromyographic amplitude of rectus femoris in I-leg was ∼45% lower (P<0.025) during the ischemic test. Also, ∼9% increase (P<0.05) in pre-exercise diastolic pressure was observed. In conclusion, substantial gains in muscle endurance capacity were induced, which were associated with enhanced muscle oxygen delivery. The potential negative effects of ischemic exercise with high cuff pressure on muscle and nerve and on arterial pressure regulation need further investigation.
Article
The present study aimed to assess whether high intensity exhaustive eccentric (ECC) exercise was associated with a greater decrease in muscle oxygenation compared to high intensity exhaustive concentric (CON) exercise during maximal isokinetic knee extensions. On two separate days, ten recreationally active participants performed maximal isokinetic concentric (KE(CON)) and eccentric (KE(ECC)) knee extension exercises at 60°s(-1) until exhaustion. Muscle oxygenation profile and activity were acquired continuously from the vastus lateralis (VL) muscle using near-infrared spectroscopy, along with surface electromyography (sEMG). The torque output was significantly greater during KE(ECC) (P<0.01). Total time to exhaustion was longer in ECC condition (P<0.01). The decrease in tissue oxygenation index observed between the beginning and end-exercise values was significantly greater during KE(ECC) than during KE(CON) (P<0.05) while total haemoglobin volume did not differ significantly. KE(ECC) resulted in a significant increase in end-exercise integrated sEMG (P<0.05). We propose that the associated higher intramuscular pressure may have compressed blood vessels and led to a greater decrease in tissue oxygenation index. The observed end-exercise increase in neural drive during KE(ECC) may have occurred to prevent from muscle performance decrease. These results suggest that, over time, repeated maximal ECC actions induce a greater O(2) extraction compared to maximal CON actions.
Article
The effect of low-intensity resistance exercise with external limb compression (100 [EC100] and 160 [EC160] mm Hg) on limb blood flow and venous blood gas-metabolite response was investigated and compared with that of high-intensity resistance exercise (no external compression). Unilateral elbow flexion muscle contractions were performed at 20% (75 repetitions, 4 sets, 30-second rest intervals) and 70% of 1-repetition maximum (1-RM; 3 sets, each set was until failure, 3-minute rest intervals). Precontraction brachial arterial blood flow (Doppler ultrasound) was reduced with EC100 or EC160 (56% and 39% of baseline value, respectively) compared with no external compression (control). At 20% 1-RM, brachial arterial blood flow increased after contractions performed with EC160 (190%), but not with the others. Decreases in venous oxygen partial pressure (P(v)O(2)) and venous oxygen saturation (S(v)O(2)) were greater during EC100 and EC160 than control (mean [SE]: P(v)O(2), 28 [3] vs 26 [2] vs 33 [2] mm Hg; S(v)O(2), 41% [5%] vs 34% [4%] vs 52% [5%], respectively). Changes in venous pH (pH(v)), venous carbon dioxide partial pressure (P(v)CO(2)), and venous lactate concentration ([L(-)](v)) were greater with EC160 than EC100 and/or control (pH(v), 7.19 [0.01] vs 7.25 [0.01] vs 7.27 [0.02]; P(v)CO(2), 72 [3] vs 64 [2] vs 60 [3] mm Hg; [L(-)](v), 5.4 [0.6] vs 3.7 [0.4] vs 3.0 [0.4] mmol/L, respectively). Seventy percent 1-RM contractions resulted in greater changes in pH(v) (7.14 [0.02]), P(v)CO(2) (91 [5] mm Hg), and [L(-)](v) (7.0 [0.5] mmol/L) than EC100 and EC160, but P(v)O(2) (30 [4] mm Hg) and S(v)O(2) (40% [3%]) were similar. In conclusion, changes in pH(v), P(v)CO(2), and [L(-)](v), but not in P(v)O(2) and S(v)O(2), are sensitive to changes in relative, "internal" intensity of low-intensity muscle contractions caused by reduced blood flow (EC160) or high-intensity muscle contractions. Given the magnitude of the changes in pH(v), P(v)CO(2), and [L(-)](v), it appears plausible that they may be involved in stimulating the observed increase in muscle activation via group III and IV afferents.
Article
Skeletal muscle can undergo rapid growth in response to a sudden increase in work load. For example, the rat soleus muscle increases in weight by 40% within six days after the tendon of the synergistic gastrocnemius is sectioned. Such growth of the overworked muscle involves an enlargement of muscle fibers and occasional longitudinal splitting. Hypertrophy leads to greater maximal tension development, although decreased contraction time and reduced contractility have also been reported. Unlike normal developmental growth, work-induced hypertrophy can be induced in hypophysectomized or diabetic animals. This process thus appears independent of growth hormone and insulin as well as testosterone and thyroid hormones. Hypertrophy of the soleus can also be induced in fasting animals, in which there is a generalized muscle wasting. Thus muscular activity takes precedence over endocrine influences on muscle size. The increase in muscle weight reflects an increase in protein, especially sarcoplasmic protein, and results from greater protein synthesis and reduced protein breakdown. Within several hours after operation, the hypertrophying soleus shows more rapid uptake of certain amino acids and synthesis of phosphatidyl-inositol. By 8 hours, protein synthesis is enhanced. RNA synthesis also increases, and hypertrophy can be prevented with actinomycin D. Nuclear DNA synthesis also increases on the second day after operation and leads to a greater DNA content. The significance of the increased RNA and DNA synthesis is not clear, since most of it occurs in interstitial and satellite cells. The proliferation of the non-muscle cells seems linked to the growth of the muscle fibers; in addition, factors causing muscle atrophy (e.g. denervation) decrease DNA synthesis by such cells. In order to define more precisely the early events in hypertrophy, the effects of contractile activity were studied in rat muscles in vitro. Electrical stimulation enhanced active transport of certain amino acids within an hour, and the magnitude of this effect depended on the amount of contractile activity. Stimulation or passive stretch of the soleus or diaphragm also retarded protein degradation. Presumably these effects of mechanical activity contribute to the changes occuring during hypertrophy in vivo. However, under the same conditions, or even after more prolonged stimulation, no change in rates of protein synthesis was detected. These findings with passive tension in vitro are particularly interesting, since passive stretch has been reported to retard atrophy or to induce hypertrophy of denervated muscle in vivo. It is suggested that increased tension development (either passive or active) is the critical event in initiating compensatory growth.
Article
The purpose of this study was to investigate the difference in muscle oxygenation between the individual muscles involved in an exhaustive knee-extension exercise. Eight active women performed exercise by extending the knee joint from 90 degrees to 30 degrees (60 extensions min-1) at 20%, 30%, and 40% maximum voluntary contraction (MVC). Changes in oxy-(delta HbO2), deoxy-(delta Hb), and total (delta HbT) hemoglobin concentrations, and oxygen saturation (delta SO2NIRS = HbO2/HbT) in the vastus lateralis (VL) and rectus femoris (RF) muscles were measured with a spatially resolved near-infrared spectrometer (NIRS). The delta SO2NIRS in the VL and RF decreased rapidly from the pre-exercise control value (VL: 75.6 +/- 0.9%; RF: 81.6 +/- 1.6%) at the onset of exercise at three different intensities, although no significant difference in delta SO2NIRS was found between the two muscles at this time. However, the delta SO2NIRS decreased more rapidly thereafter and reached a lower value at exhaustion in the VL than in the RF. The difference in delta SO2NIRS between the VL (-10.3 +/- 1.7%) and RF (-4.0 +/- 1.0%) was significant (p < 0.05) when exercise intensity was 30% MVC. When the decreases in delta HbO2 and delta HbT (p < 0.05) were compared at different exercise intensities, the values at 30% and 40% MVC were significantly lower (delta HbO2: p < 0.01; delta HbT: p < 0.05) than those at 20% MVC in the VL, but there was no significant difference in any of the parameters in the RF, or in delta Hb in the VL. These results suggest that the muscle oxidative response to exhaustive knee-extension exercise differed between the VL and RF muscles. At exhaustion, oxygen saturation decreased to a lower level in the VL than in the RF, and an intensity-dependent difference in muscle oxygenation parameters was observed at 30% MVC in the VL but not in the RF muscles.
Article
The kinetics of the decrease in venous O(2) content in response to constant work rate exercise below the lactic acidosis threshold (LAT) is very rapid, reaching a constant value by approximately 1 min. However, for work rates above the LAT, a slow further decrease in venous O(2) content takes place that is attributable to the Bohr effect rather than further decrease in end capillary PO. We hypothesized that similar differences, with respect to the LAT, will be observed in muscle deoxygenation kinetics when studied with near-infrared spectroscopy (NIRS). Twelve normal subjects performed three constant work rate tests from unloaded cycling at 60% of LAT, 80% LAT, each with four repetitions, and above LAT (LAT + 35% between LAT and VO(2max) three times, on a cycle ergometer for 6 min. We measured tissue deoxygenation with NIRS, with the probe over the vastus lateralis muscle, time-averaging the repetitions. Gas exchange and heart rate (HR) were measured breath-by-breath and beat-by-beat. Tissue deoxygenation kinetics were significantly faster than VO(2) and HR at 60%- and 80%-LAT work rates. By 1 min of exercise, deoxygenation was constant for the work rate below the LAT. At 30 s, tissue deoxygenation was 70-95% complete, whereas VO(2) and HR were only 30-60% complete. For the work rate above the LAT, a steady state for muscle deoxygenation was not reached during the 6 min of exercise. After 1 min of above-LAT exercise, either one of two patterns of slow change in tissue oxygenation developed, deoxygenation or reoxygenation. It is postulated that these different responses might be due to effects of the exercise lactic acidosis. H accompanying lactate increase might cause further deoxygenation due to the Bohr effect, and acidosis-induced vasodilatation might cause reoxygenation after the initial deoxygenation. 1) The kinetics of tissue deoxygenation are significantly more rapid than VO(2) and HR kinetics at all work rates studied, and 2) steady-state in tissue deoxygenation is seen by 1 min of constant work rate exercise below the LAT, but this is much delayed for work rates above the LAT.
Article
The mechanisms that underlie the affect of acute program variables on muscle growth and strength development for strength/power athletes have been of great interest. This investigation examined the affects of two different resistance exercise protocols on muscle oxygenation, and the anabolic hormonal response to such exercise. Eleven experienced resistance-trained male athletes performed four sets of the squat exercise using either a low-intensity, high-volume (LI; 15 repetitions at 60% one-repetition maximum [1-RM]) or high-intensity, low-volume (HI; 4 repetitions at 90% 1-RM) load. Venous blood samples were obtained before (Pre), immediate (IP), 20- (20P), and 40-min (40P) postexercise. Continuous-wave near-infrared spectroscopy was used to measure oxygen desaturation during exercise. No differences in muscle deoxygenation were seen between LI and HI. However, time-dependent postexercise reoxygenation was significantly different between the two exercise sessions (35.3 +/- 17.4 s vs 24.5 +/- 14.3 s in LI and HI, respectively). Testosterone and growth hormone (GH) concentrations were significantly elevated from Pre at IP, 20P, and 40P in both LI and HI. GH concentrations were higher (P<0.05) for LI than at HI at 20P and 40P. Muscle oxygen recovery kinetics appeared to be influenced by differences in the intensity and volume of exercise, and delayed reoxygenation appears to affect the GH response to exercise.
Muscle deoxygenation as related to work rate
  • Chuang