Measuring arterial occlusion pressure for training with blood flow restriction: a scoping review and recommendations for measurement
Sport Sciences for Health - Trang 1-14 - 2023
Tóm tắt
It is recommended that the pressure applied in training with blood flow restriction (BFR) be relativized based on the arterial occlusion pressure (AOP). However, several factors can affect the measurement of AOP that may require consideration. The purpose of this review was to explore variables capable of impacting AOP and provide recommendations for measurement. On August 8, 2023, PubMed® and Scopus databases were consulted to identify studies that analyzed variables capable of affecting AOP. In addition, the list of references of eligible studies, as well as Google Scholar citations, were consulted to identify additional studies. Twenty-three studies (n = 1335 participants) were included in this review. Studies analyzed the effects of cuff characteristics (n = 9), cuff bladder position (n = 1), body position (n = 6), inflation protocol (n = 1), time (n = 1), sex (n = 5), and segment (n = 5) on AOP. Results demonstrated that wider cuffs promote arterial occlusion with lower external pressures. In addition to width, cuff placement also affects AOP; when the bladder is positioned above the artery, less external pressure is needed to promote arterial occlusion. Body position significantly affects AOP, with more pronounced effects in the lower limbs. The time of day AOP is measured, but not the inflation protocol, has a significant effect on AOP. For the effect of sex and segment, results were divergent. In conclusion, several factors may influence AOP. For standardizing the prescribed pressure in training with BFR, all these variables should be considered.
Tài liệu tham khảo
Abe T, Fujita S, Nakajima T, Sakamaki M, Ozaki H, Ogasawara R, Sugaya M, Kudo M, Kurano M, Yasuda T, Sato Y, Ohshima H, Mukai C, Ishii N (2010) Effects of low-intensity cycle training with restricted leg blood flow on thigh muscle volume and VO2MAX in young men. J Sports Sci Med 9:452–458
Abe T, Kearns CF, Sato Y (2006) Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol 100(5):1460–1466
Lixandrão ME, Ugrinowitsch C, Berton R, Vechin FC, Conceição MS, Damas F, Libardi CA, Roschel H (2018) Magnitude of muscle strength and mass adaptations between high-load resistance training versus low-load resistance training associated with blood-flow restriction: a systematic review and meta-Analysis. Sports Med 48(2):361–378. https://doi.org/10.1007/s40279-017-0795-y
Takarada Y, Takazawa H, Ishii N (2000) Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc 32(12):2035–2039. https://doi.org/10.1097/00005768-200012000-00011
Centner C, Wiegel P, Gollhofer A, König D (2019) Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals: a systematic review and meta-analysis. Sports Med 49(1):95–108. https://doi.org/10.1007/s40279-018-0994-1
Li S, Shaharudin S, Abdul Kadir MR (2021) Effects of blood flow restriction training on muscle strength and pain in patients with knee injuries: a meta-analysis. Am J Phys Med Rehabil 100(4):337–344. https://doi.org/10.1097/PHM.0000000000001567
Bjørnsen T, Wernbom M, Kirketeig A, Paulsen G, Samnøy L, Bækken L, Cameron-Smith D, Berntsen S, Raastad T (2019) Type 1 muscle fiber hypertrophy after blood flow-restricted training in powerlifters. Med Sci Sports Exerc 51(2):288–298. https://doi.org/10.1249/MSS.0000000000001775
Luebbers PE, Fry AC, Kriley LM, Butler MS (2014) The effects of a 7-week practical blood flow restriction program on well-trained collegiate athletes. J Strength Cond Res 28(8):2270–2280. https://doi.org/10.1519/JSC.0000000000000385
Jessee MB, Mattocks KT, Buckner SL, Dankel SJ, Mouser JG, Abe T, Loenneke JP (2018) Mechanisms of blood flow restriction: the new testament. Tech Orthop 33(2):72–79
Loenneke JP, Fahs CA, Rossow LM, Abe T, Bemben MG (2012) The anabolic benefits of venous blood flow restriction training may be induced by muscle cell swelling. Med Hypotheses 78(1):151–154
Takarada Y, Takazawa H, Sato Y, Takebayashi S, Tanaka Y, Ishii N (2000) Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. J Appl Physiol 88(6):2097–2106. https://doi.org/10.1152/jappl.2000.88.6.2097
Loenneke JP, Fahs CA, Rossow LM, Thiebaud RS, Mattocks KT, Abe T, Bemben MG (2013) Blood flow restriction pressure recommendations: a tale of two cuffs. Front Physiol 4:249. https://doi.org/10.3389/fphys.2013.00249
Loenneke JP, Fahs CA, Rossow LM, Sherk VD, Thiebaud RS, Abe T, Bemben DA, Bemben MG (2012) Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise. Eur J Appl Physiol 112(8):2903–2912. https://doi.org/10.1007/s00421-011-2266-8
de Queiros VS, de França IM, Trybulski R et al (2021) Myoelectric activity and fatigue in low-load resistance exercise with different pressure of blood flow restriction: a systematic review and meta-analysis. Front Physiol 12:786752. https://doi.org/10.3389/fphys.2021.786752
Soligon SD, Lixandrão ME, Biazon T, Angleri V, Roschel H, Libardi CA (2018) Lower occlusion pressure during resistance exercise with blood-flow restriction promotes lower pain and perception of exercise compared to higher occlusion pressure when the total training volume is equalized. Physiol Int 105(3):276–284. https://doi.org/10.1556/2060.105.2018.3.18
Patterson SD, Hughes L, Warmington S et al (2019) Blood flow restriction exercise: considerations of methodology, application, and safety. Front Physiol 10:533. https://doi.org/10.3389/fphys.2019.00533
Loenneke JP, Thiebaud RS, Fahs CA, Rossow LM, Abe T, Bemben MG (2013) Effect of cuff type on arterial occlusion. Clin Physiol Funct Imaging 33(4):325–327. https://doi.org/10.1111/cpf.12035
Zeng Z, Centner C, Gollhofer A, König D (2019) Blood-flow-restriction training: validity of pulse oximetry to assess arterial occlusion pressure. Int J Sports Physiol Perform 14(10):1408–1414. https://doi.org/10.1123/ijspp.2019-0043
Hughes L, Jeffries O, Waldron M, Rosenblatt B, Gissane C, Paton B, Patterson SD (2018) Influence and reliability of lower-limb arterial occlusion pressure at different body positions. PeerJ 6:e4697. https://doi.org/10.7717/peerj.4697
Sieljacks P, Knudsen L, Wernbom M, Vissing K (2018) Body position influences arterial occlusion pressure: implications for the standardization of pressure during blood flow restricted exercise. Eur J Appl Physiol 118(2):303–312. https://doi.org/10.1007/s00421-017-3770-2
Buckner SL, Dankel SJ, Counts BR et al (2017) Influence of cuff material on blood flow restriction stimulus in the upper body. J Physiol Sci 67(1):207–215. https://doi.org/10.1007/s12576-016-0457-0
Brown H, Binnie MJ, Dawson B, Bullock N, Scott BR, Peeling P (2018) Factors affecting occlusion pressure and ischemic preconditioning. Eur J Sport Sci 18(3):387–396. https://doi.org/10.1080/17461391.2017.1421712
Tricco AC, Lillie E, Zarin W et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169(7):467–473
Horsley T, Dingwall O, Sampson M (2011) Checking reference lists to find additional studies for systematic reviews. Cochrane Database Syst Rev 2011(8):MR000026. https://doi.org/10.1002/14651858.MR000026.pub2
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan—a web and mobile app for systematic reviews. Syst Rev 5(1):1–10. https://doi.org/10.1186/s13643-016-0384-4
Borges A, Teodósio C, Matos P, Mil-Homens P, Pezarat-Correia P, Fahs C, Mendonça GV (2018) Sexual dimorphism in the estimation of upper-limb blood flow restriction in the seated position. J Strength Cond Res 32(7):2096–2102. https://doi.org/10.1519/JSC.0000000000002582
Jessee MB, Buckner SL, Dankel SJ, Counts BR, Abe T, Loenneke JP (2016) The influence of cuff width, sex, and race on arterial occlusion: implications for blood flow restriction research. Sports Med 46(6):913–921. https://doi.org/10.1007/s40279-016-0473-5
Neto GR, Silva JC, Umbelino RK et al (2018) Are there differences in auscultatory pulse in total blood flow restriction between positions, limbs and body segments? Rev Bras Cineantropom Desempenho Hum 20(5):381–390. https://doi.org/10.5007/1980-0037.2018v20n5p381
Tafuna’i ND, Hunter I, Johnson AW, Fellingham GW, Vehrs PR (2021) Differences in femoral artery occlusion pressure between sexes and dominant and non-dominant legs. Medicina (Kaunas) 57(9):863. https://doi.org/10.3390/medicina57090863
Vehrs PR, Blazzard C, Hart HC, Kasper N, Lacey R, Lopez D, Richards S, Eggett DL (2023) Comparison of two cuff inflation protocols to measure arterial occlusion pressure in males and females. Appl Sci 13(3):1438. https://doi.org/10.3390/app13031438
Montoye AHK, Neph SE, Plouffe AA, Vondrasek JD, Nordbeck JT, Cox BA, Vranish JR (2023) Understanding lower limb blood flow occlusion parameters for use in field-based settings. J Sports Sci 26:1–9. https://doi.org/10.1080/02640414.2023.2240995
Weatherholt AM, Vanwye WR, Lohmann J, Owens JG (2019) The effect of cuff width for determining limb occlusion pressure: a comparison of blood flow restriction devices. Int J Exerc Sci 12(3):136–143
Mouser JG, Dankel SJ, Mattocks KT, Jessee MB, Buckner SL, Abe T, Loenneke JP (2018) Blood flow restriction and cuff width: effect on blood flow in the legs. Clin Physiol Funct Imaging 38:944–948
Mouser JG, Dankel SJ, Jessee MB, Mattocks KT, Buckner SL, Counts BR, Loenneke JP (2017) A tale of three cuffs: the hemodynamics of blood flow restriction. Eur J Appl Physiol 117(7):1493–1499. https://doi.org/10.1007/s00421-017-3644-7
Spitz RW, Bell ZW, Wong V, Viana RB, Chatakondi RN, Abe T, Loenneke JP (2020) The position of the cuff bladder has a large impact on the pressure needed for blood flow restriction. Physiol Meas 41(1):01NT01
Hannah SS, Miller SC (2018) The effect of postural position on lower limb arterial occlusion pressure: a methodological consideration for blood flow restriction. Age (Years) 23:3–1
Karanasios S, Koutri C, Moutzouri M, Xergia SA, Sakellari V, Gioftsos G (2022) The effect of body position and the reliability of upper limb arterial occlusion pressure using a handheld doppler ultrasound for blood flow restriction training. Sports Health 14(5):717–724. https://doi.org/10.1177/19417381211043877
Lima-Soares F, Pessoa KA, Torres Cabido CE, Lauver J, Cholewa J, Rossi F, Zanchi NE (2022) Determining the arterial occlusion pressure for blood flow restriction: pulse oximeter as a new method compared with a handheld Doppler. J Strength Cond Res 36(4):1120–1124
Ingram JW, Dankel SJ, Buckner SL et al (2017) The influence of time on determining blood flow restriction pressure. J Sci Med Sport 20(8):777–780. https://doi.org/10.1016/j.jsams.2016.11.013
Evin HA, Mahoney SJ, Wagner M, Bond CW, MacFadden LN, Noonan BC (2021) Limb occlusion pressure for blood flow restricted exercise: Variability and relations with participant characteristics. Phys Ther Sport 47:78–84. https://doi.org/10.1016/j.ptsp.2020.11.026
Loenneke JP, Allen KM, Mouser JG, Thiebaud RS, Kim D, Abe T, Bemben MG (2015) Blood flow restriction in the upper and lower limbs is predicted by limb circumference and systolic blood pressure. Eur J Appl Physiol 115(2):397–405. https://doi.org/10.1007/s00421-014-3030-7
Bezerra de Morais AT, Santos Cerqueira M, Moreira Sales R, Rocha T, Galvão de Moura Filho A (2017) Upper limbs total occlusion pressure assessment: Doppler ultrasound reproducibility and determination of predictive variables. Clin Physiol Funct Imaging 37(4):437–441. https://doi.org/10.1111/cpf.12330
Rolnick N, Kimbrell K, de Queiros V (2023) Beneath the cuff: often overlooked and under-reported blood flow restriction device features and their potential impact on practice—a review of the current state of the research. Front Physiol 14:1089065. https://doi.org/10.3389/fphys.2023.1089065
Graham B, Breault MJ, McEwen JA, McGraw RW (1993) Occlusion of arterial flow in the extremities at subsystolic pressures through the use of wide tourniquet cuffs. Clin Orthop Relat Res 286:257–261
Lixandrão ME, Ugrinowitsch C, Laurentino G, Libardi CA, Aihara AY, Cardoso FN, Tricoli V, Roschel H (2015) Effects of exercise intensity and occlusion pressure after 12 weeks of resistance training with blood-flow restriction. Eur J Appl Physiol 115(12):2471–2480. https://doi.org/10.1007/s00421-015-3253-2
Laurentino GC, Loenneke JP, Ugrinowitsch C, Aoki MS, Soares AG, Roschel H, Tricoli V (2022) Blood-flow-restriction-training-induced hormonal response is not associated with gains in muscle size and strength. J Hum Kinet 8(83):235–243. https://doi.org/10.2478/hukin-2014-0039
Biazon TMPC, Ugrinowitsch C, Soligon SD, Oliveira RM, Bergamasco JG, Borghi-Silva A, Libardi CA (2019) The association between muscle deoxygenation and muscle hypertrophy to blood flow restricted training performed at high and low loads. Front Physiol 10:446. https://doi.org/10.3389/fphys.2019.00446
Pereira PMG, Geraldes AAR, Costa MGDS et al (2019) Low-load resistance training and blood flow restriction improves strength, muscle mass and functional performance in postmenopausal women: a controlled randomized trial. Int Phys Med Rehab J 4(2):63–68
Hinghofer-Szalkay H (2011) Gravity, the hydrostatic indifference concept and the cardiovascular system. Eur J Appl Physiol 111(2):163–174. https://doi.org/10.1007/s00421-010-1646-9
Mattocks KT, Mouser JG, Jessee MB, Buckner SL, Dankel SJ, Bell ZW, Abe T, Bentley JP, Loenneke JP (2019) Perceptual changes to progressive resistance training with and without blood flow restriction. J Sports Sci 37(16):1857–1864. https://doi.org/10.1080/02640414.2019.1599315