Explore the vast range of titles available.

Blood flow restriction (BFR) training has been shown to induce exercise-induced muscle damage (EIMD) in some cases, although findings are inconsistent and the influence of the applied arterial occlusion pressure (AOP) remains unclear. This single-blind, randomized controlled trial investigated the effects of different percentages of AOP on EIMD and acute physiological responses in 40 participants allocated to four groups: no pressure (NP), low pressure (LP; 50% AOP), medium pressure (MP; 75% AOP), and high pressure (HP; 100% AOP). Participants performed unilateral knee extensions at 30% of their one-repetition maximum up to four sets of 20 repetitions or until failure. EIMD was primarily assessed by the changes in isokinetic peak torque 24 h, 48 h and 72 h post-exercise (Δ to baseline). Secondary markers included perceived pain, blood biomarkers (creatine kinase, myoglobin) and muscle swelling. Additionally, acute physiological responses were assessed, including continuous measurement of muscle oxygen saturation (SmO 2 ) during exercise, perceived exertion (RPE) immediately after the exercise bout, and blood lactate concentration measured at 1, 3, 7, and 10 min post-exercise. NP showed greater strength loss at 24 h post-exercise compared to MP (MD = − 9.95, p  = .042, 95% CI [− 19.7, − 0.19]) and HP (MD = − 10.51, p  = .034, 95% CI [− 20.52, − 0.49]). Pain ratings were higher in NP compared to MP ( p  = .001) and HP ( p  = .003) at 24 h post, and remained elevated at 48 h compared to MP ( p  = .003) and HP ( p  = .047). NP and LP completed more repetitions than MP and HP. HP exhibited a greater reduction in SmO 2 compared to NP. Perceived exertion was higher in MP and HP. LP showed higher average lactate concentrations than NP ( p  = .020). CK and MB responses showed no time-specific group differences. These findings suggest that BFR training, even at higher pressures, does not increase EIMD compared to free-flow exercise, and that MP and HP may even attenuate strength loss and pain following exercise.

Purpose Resistance exercise can attenuate muscular impairments associated with multiple sclerosis (MS), and blood flow restriction (BFR) may provide a viable alternative to prescribing heavy training loads. The purpose of this investigation was to examine the progression of upper and lower body low-load (30% of one-repetition maximum [1RM]) resistance training (RT) with BFR applied intermittently during the exercise intervals (RT + BFR) versus volume-matched heavy-load (65% of 1RM) RT. Methods Men and women with MS ( n  = 16) were randomly assigned to low-load RT + BFR (applied intermittently) or heavy-load RT and completed 12 weeks (2 × /week) of RT that consisted of bilateral chest press, seated row, shoulder press, leg press, leg extension, and leg curl exercises. Exercise load, tonnage, and rating of perceived exertion were assessed at baseline and every 6 weeks. Results Training load increased to a greater extent and sometimes earlier for RT + BFR (57.7–106.3%) than heavy-load RT (42.3–54.3%) during chest press, seated row, and leg curl exercises, while there were similar increases (63.5–101.1%) for shoulder press, leg extension, and leg press exercises. Exercise tonnage was greater across all exercises for RT + BFR than heavy-load RT, although tonnage only increased during the chest press (70.7–80.0%) and leg extension (89.1%) exercises. Perceptions of exertion (4.8–7.2 au) and compliance (97.9–99.0%) were similar for both interventions. Conclusion The training-induced increases in load, high compliance, and moderate levels of exertion suggested that RT + BFR and heavy-load RT are viable interventions among people with MS. RT + BFR may be a preferred modality if heavy loads are not well tolerated and/or to promote early-phase training responses.

To compare the effects of low-load (LL) blood flow restriction (BFR) and high-load (HL) training on cortical activation and the specific contributions of individual brain regions to functional recovery in stroke patients. Sixty-six patients with ischemic stroke were divided into BFR (30% one-repetition maximum [1RM]), matched LL, or HL (80% 1RM) groups. Patients underwent a four-week supervised cycling program, and oxyhemoglobin (HbO) concentrations were assessed during the first session and after the program via functional near-infrared spectroscopy (fNIRS). Muscle performance was characterized by the rectus femoris muscle cross-sectional area (CSA), knee extensor peak torque (PT), and Fugl-Meyer lower extremity (FMLE) scores. Compared with the LL group, the BFR and HL groups presented significant brain activation (increased HbO concentration) during the first session (P < 0.05). Following the 4-week intervention, the BFR and HL groups presented greater changes in the HbO concentration (ΔHbO), PT and FMLE scores than did the LL group (P < 0.05). The ΔHbO values in the primary motor cortex (M1), premotor cortex and supplementary motor area (PMC-SMA) of the affected hemisphere (AH) were considerably greater than those in the unaffected hemisphere (P < 0.05), whereas there was no difference in the dorsolateral prefrontal cortex (DLPFC). Changes in PT (mean r = 0.51 [range = 0.46-0.55]; P < 0.05) and FMLE scores (mean r = 0.54 [range = 0.48-0.62]; P < 0.05) were positively correlated with the AH M1 and PMC-SMA ΔHbO across groups. By actively manipulating the M1 and PMC-SMA, LL-BFR and HL training yield comparable short-term improvements in central and peripheral performance after stroke. (Registry: Chinese Clinical Trial Registry; ChiCTR2400087378).

ObjectiveKnee osteoarthritis (KOA) is a leading cause of global disability and remains challenging to treat. Blood flow restriction (BFR) shows promising rehabilitation outcomes, but its lasting effects in KOA are lacking. This study aimed to determine the 1-year outcomes of a BFR-enhanced exercise therapy programme in patients with KOA.MethodsThis study included 120 patients (33 male, 87 female) from a previously published randomised controlled trial comparing 12 weeks of traditional exercise therapy with and without BFR, performed twice per week. For the current analysis, patients were reassessed at 1 year. The primary outcome was the Knee Osteoarthritis Outcome Score (KOOS) questionnaire, with secondary outcomes including muscle strength and a functional test battery. Data on knee joint injections and activity levels were also reviewed at 1-year follow-up. Analyses consisted of linear mixed models with Dunn-Sidak corrections for multiple comparisons, with an intention to treat approach (NCT04996680).ResultsClinically meaningful improvements at 1 year were found in favour of the BFR group for KOOS subscales ‘pain’ (mean difference (MD): 15.1 points ES=0.79, p=0.0039), ‘symptoms’ (MD: 10.5 points, ES=0.51, p=0.0074), ‘activities of daily living’ (ADL) (MD: 11.3 points, ES=0.54, p=0.0054) and ‘quality of life’ (QoL) (MD: 14.7 points, ES=0.61, p=0.0032) compared with exercise therapy without BFR. The BFR group outperformed the non-BFR group for the functional tests, and muscle strength remained significantly higher at 1 year in the BFR group (ES=0.48, p=0.0010) as opposed to no BFR. The BFR group was more active by 1.5 hours/week (p=0.036) and had 3.6 times lower odds of receiving knee injections compared with the non-BFR group.ConclusionA 12-week BFR-enhanced exercise therapy programme provides benefits for pain, symptoms, ADL, QoL, muscle strength and functional capacity at 1-year follow-up while reducing the need for knee injections by 63.4% compared with traditional exercise therapy alone.

The purpose of this study was to investigate the effects of combining blood flow restriction training (BFRT) with electrical muscle stimulation (EMS) on muscle functions and sports performance in football players with knee osteoarthritis (KOA). This parallel randomized controlled trial was conducted on 64 football players diagnosed with KOA at Chengdu Sport University. Participants were enrolled based on predefined eligibility criteria and randomly allocated to four groups: the control group (CTR, n  = 16), BFRT-alone group (BFRT, n  = 16), EMS-alone group (EMS, n  = 16), and BFRT combined with EMS group (CMB, n  = 16). Data were gathered via the 10-meter sprint, 20-meter sprint, countermovement jump (CMJ), and Illinois agility test (IAT) to assess sports performance. Additionally, peak torque (PT) was used to measure muscle strength, the root mean square (RMS) was used to assess muscle activation, and the cross-sectional area (CSA) was used to evaluate muscle volume. The data were statistically analyzed via SPSS software, and a p -value < 0.05 was considered significant. Following the 8-week intervention, the CMB group showed a more pronounced change in the 10-m sprint compared to the CTR group ( p  < 0.001) and exhibited significant differences in the 20-m sprint (CTR: p  < 0.001, BFRT: p  = 0.015, EMS: p  < 0.001), CMJ (CTR: p  < 0.001, BFRT: p  = 0.019, EMS: p  < 0.001), and IAT (CTR: p  < 0.001, BFRT: p  = 0.009, EMS: p  = 0.018), outperforming the other three groups. To PT, the CMB groups demonstrated significant superiority over the other three groups (CTR: p  < 0.001, BFRT: p  < 0.001, EMS: p  < 0.001), while the BFRT group exhibited a notable difference in PT than the EMS group ( p  = 0.032). Concerning RMS, the EMS and CMB groups showed significant differences from the CTR (EMS: p  < 0.001, CMB: p  < 0.001) and BFRT (EMS: p  = 0.019, CMB: p  < 0.001) groups, whereas the change in the BFRT group was more significant than that in the CTR group ( p  = 0.007). For CSA, the BFRT and CMB groups presented notable differences from the CTR (BFRT: p  = 0.008, CMB: p  = 0.002)and EMS (BFRT: p  = 0.014, CMB: p  = 0.004) groups. In summary, the results suggest that BFRT combined with EMS can increase muscle strength in male football players with KOA through improving muscle volume and neuromuscular recruitment under low-intensity resistance training, thereby increasing explosive power and agility.

Background Evidence on the effects of exercise training with blood flow restriction (BFR) on upper extremity proprioception and performance is limited. The purpose of this study was to investigate the effects of 6 weeks of low-load elbow flexion exercise training with BFR on upper extremity strength, joint position sense (JPS), and functional performance. Methods Sixty healthy individuals were randomized into the experimental group ( n  = 30) which received low-load training with BFR or the control group ( n  = 30) which received no training. Elbow muscle strength, shoulder and elbow JPS, and upper extremity functional motor performance [Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), Functional Throwing Performance Index (FTPI), Single Arm Shot Put Test (SASPT), and Modified Pull-Up Test (MPUT)] were assessed. For normally distributed data, Two-way ANOVA [2 × 2, group (between-participant) X time (within-participant), repeated measures] was used to determine the intervention effects on dependent variables. F value was used based on sphericity assumed. We considered the time-group interaction term in analyses. For non-normally distributed data, we used the Wilcoxon Signed-rank Test to examine the changes in individual groups for the relevant results and the Mann-Whitney U Test to compare changes between two-time intervals between the groups. Results Time by Group showed significant effects for the results of flexor strength, CKCUEST, FTPI, and MPUT in favor of the experimental group (all p  < 0.001). The extensor strength, JPS, and SASPT results also improved in the experimental group compared to the control group ( p  < 0.05). The only change in the control group was a decrease in the FTPI percentile ( p  = 0.017). Conclusions This study adds new information about the effects of BFR on proprioception and performance. Six-week low-load elbow flexion training with BFR improves elbow muscle strength, shoulder and elbow proprioception, and upper extremity functional motor performance. Clinical trial registration NCT03401567 (ClinicalTrials.gov identifier) (Registration Date:23/12/2017).

Background and Objectives: This study compared the effects of blood flow restriction resistance exercise (BFR-RE) and high-load resistance exercise (HL-RE) in voluntary exhaustion on quadriceps muscle adaptations in untrained young males. Materials and Methods: This study used a randomized controlled design that included 30 untrained young males (age = 21.42 ± 2.51). The BFR-RE group performed leg extension exercises with 60% occlusion pressure and 30% of one maximum repetition in volitional exhaustion. The same exercise was conducted at 70% 1RM in the HL-RE group. Fourteen variables were used to evaluate the intervention efficacy, including muscle thickness, stiffness, strength, cross-sectional area (CSA), and subcutaneous fat thickness. Analyses were reported using frequentist and Bayesian approaches. The Bayes factor (BF10 and BFincl) was interpreted based on negative and positive values. Results: The results revealed that the main effect of time was statistically significant for muscle strength, thickness, CSA, and stiffness (p < 0.05, BFincl > 1) and, in intragroup comparisons, both groups showed improvements in these parameters (p < 0.05, BF10 > 1). A statistically significant decrease in subcutaneous fat thickness was observed in the BFR-RE group (p < 0.05, BF10 > 1), while this change was not observed in the HL-RE group (p > 0.05, BF10 < 1). Similarly, a statistically significant increase in right rectus femoris muscle stiffness was detected in the BFR-RE group (p < 0.05, BF10 > 1) but not in the HL-RE group (p > 0.05, BF10 < 1). Furthermore, time’s main effect was statistically insignificant for thigh circumference (p > 0.05, BFincl < 1). The group × time interaction was statistically significant only for peak power leg flexion left (p < 0.05, BFincl > 1), and a statistically significant difference in favor of the BFR-RE group was observed in the intergroup comparisons (p < 0.05, BF10 > 1). Conclusions: In conclusion, BF-RE exercise with voluntary exhaustion may be as effective as HL-RE for hypertrophic adaptations in untrained young males.

Given limited available data and information gaps related to the effects of endurance exercise along with blood flow restriction (BFR) on the heart. This study examined the effects of low-intensity endurance exercise training (Ex) alone and BFR on blood pressure (BP), electrocardiogram (ECG), heart rate variability (HRV), and heart rate recovery time (HRRT) in participants with grade 1 hypertension. In this randomized double-blind clinical trial, 43 hypertensive participants, 50-65 years old, were randomly divided into three groups: Ex+BFR, Ex, and the control (Con) group. The training program was conducted three times weekly for 10 weeks in spring 2024 at Kerman University of Medical Sciences. Before and 24 hours after the intervention, HRV parameters, BP, ECG, and HRRT were assessed. The Ex and Ex+BFR groups showed a significant increase in Root Mean Square of Successive Differences between normal heartbeats (RMSSD) (P=0.008, P=0.002), Standard Deviation of Successive Differences (SDSD) (P=0.008, P=0.002), and the standard deviation of the Poincaré plot ratio (SD1/SD2) (P=0.0004, P=0.0002), and a reduced low frequency to high frequency ratio (LF/HF) (P=0.013 and P=0.007) compared to Con group, respectively. The Ex+BFR group demonstrated a greater positive effect on frequency-domain parameters of HRV. In addition, both the Ex and Ex+BFR groups showed a significant reduction in HRRT (P=0.0001 vs. relevant baseline), mean arterial blood pressure (MAP) (P=0.0001), and prolonged PR interval (P=0.038 and P=0.035, respectively) and shortened QRS complex compared to the Con group. This study demonstrates that combining low-intensity endurance exercise with BFR exerts a positive effect on cardiovascular parameters such as BP, ECG, HRRT, and demonstrates superior effects on HRV compared to exercise alone in individuals with mild hypertension. A preprint version of this manuscript is available at DOI: https://doi.org/10.21203/rs.3.rs-5347658/v1.

BackgroundMusculoskeletal injury (MSKI) is the leading cause of medical downgrading and discharge within the UK military, with lower limb MSKI having the greatest incidence, negatively impacting operational readiness. Pain is a primary limiting factor to rehabilitation progress following MSKI. Heavy-load resistance training (RT; ie, loads >70% 1-repetition maximum) is traditionally used but may be contraindicated due to pain, potentially prolonging recovery and leading to failure of essential physical employment standards for UK military personnel. Low-load RT with blood flow restriction (BFR) can promote favourable morphological and physiological adaption, as well as elicit hypoalgesia in healthy and clinical populations (eg, post-operative), and has proven a viable option in military rehabilitation settings. The acceptability and tolerance of higher relative BFR pressures in persistent pain populations are unknown due to the complexity of presentation and the perception of discomfort experienced during BFR exercise. Greater relative pressures (ie, 80% limb occlusion pressure (LOP)) elicit a greater hypoalgesic response in pain-free individuals, but greater perceived discomfort which may not be tolerated in persistent pain populations. However, lower relative pressure (ie, 40% LOP) has elicited hypoalgesia in pain-free individuals, which therefore may be more clinically acceptable and tolerated in persistent pain populations. The primary aim of both randomised controlled trials (RCT) is to investigate the efficacy and acceptability of using high-frequency, low-load BFR-RT in UK military personnel with lower limb MSKI where persistent pain is the primary limiting factor for progression.MethodologyThe presented protocol is a two-phase RCT based within a military rehabilitation setting. Phase One is a 1-week RCT to determine the most efficacious and acceptable BFR-RT protocol (7× BFR-RT sessions over 5 days at 40% or 80% LOP; n=28). Phase Two is a 3-week RCT comparing the most clinically acceptable BFR pressure, determined by Phase One (21× BFR-RT sessions over 15 days; n=26) to usual care within UK Defence Rehabilitation residential rehabilitation practices. Outcomes will be recorded at baseline, daily and following completion of the intervention. The primary outcome will be the brief pain inventory. Secondary outcomes include blood biomarkers for inflammation and pain (Phase Two only), injury-specific outcome measures, lower extremity function scale, objective measures of muscle strength and neuromuscular performance, and pressure pain threshold testing.Ethics and disseminationThe study is approved by the Ministry of Defence Research Ethics Committee (2318/MODREC/24) and Northumbria University. All study findings will be published in scientific peer-reviewed journals and presented at relevant scientific conferences.Trial registration numberRegistered with Clinical Trials. The registration numbers are as follows: NCT06621914 (Phase One) and NCT06621953 (Phase Two).

Objective: To examine how limitations in blood circulation impact the training of stroke individuals. Methods: Between March 2022 and March 2023, a total of 34 individuals receiving treatment at the Fourth Affiliated Hospital of the School of Medicine, Zhejiang University, specifically within the Department of Rehabilitation Medicine, were chosen as participants. They were then assigned to experimental groups using a random number approach, with 17 individuals in each group, while also including a control group. The test group received BFR combined with cycle ergometers, while the control group performed a cycle ergometers regularly. Ultrasonography was employed to assess the size and thickness (RFT) of the rectus femoris (RFSTA) in patients both prior to and following training, as well as to evaluate the angle of the gastrocnemius pinna. Additionally, each patient completed a 30‐s sit‐to‐stand test, received results from a stretch test, and underwent the Fugl‐Meyer assessment for the lower extremities. Results: The muscles of RFT, RFTSA, and gastrocnemius pinna angle did not change significantly before and after in the control group. However, these values increased markedly in the experimental group. In addition, the FMA value recorded in the test group notably surpassed that of the control group. After all, walking speed, frequency, length and overall mobility will increase after training, but you will find it more important. Conclusion: BFR can promote rehabilitation functional, relieve stress, ensure safety, improve training effects and have high value clinical uses. BFR can promote the functional Rehabilitation of stroke patients and strengthen their motor ability without high ‐intensity and ensure safety, which has high clinical application value.