Blood Flow Restriction Does Not Attenuate Short-Term Detraining-Induced Muscle Size and Strength Losses After Resistance Training With Blood Flow Restriction
Emerson Luiz TeixeiraVítor de Salles PainelliCarla Silva‐BatistaTalita de Souza BarrosAriel Roberth LongoThiago LaseviciusBrad J. SchöenfeldAndré Yui AiharaBergson de Almeida Peres
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Abstract Teixeira, EL, de Salles Painelli, V, Silva-Batista, C, de Souza Barros, T, Longo, AR, Lasevicius, T, Schoenfeld, BJ, Aihara, AY, and de Almeida Peres, B. Blood flow restriction does not attenuate short-term detraining-induced muscle size and strength losses after resistance training with blood flow restriction. J Strength Cond Res 35(8): 2082–2088, 2021—After a short-term resistance training with blood flow restriction (BFR), we investigated the effects of 12 days of detraining (DET), without an exercise stimulus, on quadriceps cross-sectional area (QCSA) and muscle strength (1 repetition maximum [1RM]), with 1 leg receiving daily intermittent BFR during DET vs. the same nonexercise condition without BFR (CON) in the contralateral leg. Both subjects' legs were evaluated for QCSA and 1RM before (PRE) and after (POST) both legs being unilaterally submitted to 3 weeks (4 days per week) of low-load (3 sets of 15 repetitions, 30% 1RM) resistance training with BFR. The DET period started immediately after POST, where each leg was randomly submitted to a daily intermittent BFR protocol or CON, without any associated exercise stimulus. Quadriceps cross-sectional area and 1RM were reassessed after DET. Both legs at CON and BFR conditions increased QCSA (6.3 and 6.8%, respectively; both p < 0.0001) and 1RM (9.5 and 10.1%, respectively; both p < 0.05) from PRE to POST. Both legs at CON and BFR conditions reduced QCSA (−4.6 and 4.9%, respectively; both p < 0.0001) and 1RM (−9.0 and −8.2%, respectively; both p < 0.05) from POST to DET, with no significant differences between conditions ( p > 0.05). We conclude that muscle strength and hypertrophy gains obtained in 3 weeks of resistance training with BFR are not maintained after 12 days of DET. Moreover, the application of BFR, without an associated exercise stimulus, does not attenuate such losses.Keywords:
Blood Flow Restriction
One-repetition maximum
Leg press
Strength Training
The aim of this study is to evaluate the effectiveness of low-load blood flow restriction strength resistance training (LL-BFR) compared to high load strength resistance training (HL) on performance of professional soccer players.Eighteen male players from National Soccer Professional League were randomly allocated into two groups: LL-BFR, who performed a 6-weeks strength training program with low load (20-35% of one-repetition maximum-[1RM]), or HL, who performed a 6-week resistance training program with high load (70-85% 1RM). Before and after, thigh girth, vertical jump, lower limb strength, vertical force-velocity profile (F-v), and 30-m sprint were evaluated.After the training program, both LL-BFR and HL induced significant increases compared to baseline in thigh girth (+3.3% for LL-BFR and +3.1% for HL) and maximal velocity during sprinting (+6.0 and +6.2%, respectively), without between-group differences. In reference to FV, only HL players improved imbalance (-54.4%), maximal theoretical force production (+10.4%) and decreased extension velocity (-20.5%) compared to baseline, without between-group differences. Only LL-BFR induced increases in maximum voluntary contraction of left hamstring compared to baseline (+13.8%), without between-group differences. No differences were shown for the rest of variables (P>0.05).Although LL-BFR may increase muscle circumference and sprint ability, these results are similar to those induced with HL in male professional soccer. In terms of F-v, only HL induced improvements, but these changes were not greater than those observed after LL-BFR.
Blood Flow Restriction
Sprint
One-repetition maximum
Strength Training
Leg press
Running economy
Squat
Football players
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Abstract Teixeira, EL, Ugrinowitsch, C, de Salles Painelli, V, Silva-Batista, C, Aihara, AY, Cardoso, FN, Roschel, H, and Tricoli, V. Blood flow restriction does not promote additional effects on muscle adaptations when combined with high-load resistance training regardless of blood flow restriction protocol. J Strength Cond Res 35(5): 1194–1200, 2021—The aim of this study was to investigate, during high-load resistance training (HL-RT), the effect of blood flow restriction (BFR) applied during rest intervals (BFR-I) and muscle contractions (BFR-C) compared with HL-RT alone (no BFR), on maximum voluntary isometric contraction (MVIC), maximum dynamic strength (one repetition maximum [1RM]), quadriceps cross-sectional area (QCSA), blood lactate concentration ([La]), and root mean square of the surface electromyography (RMS-EMG) responses. Forty-nine healthy and untrained men (25 ± 6.2 years, 178.1 ± 5.3 cm and 78.8 ± 11.6 kg) trained twice per week, for 8 weeks. One leg of each subject performed HL-RT without BFR (HL-RT), whereas the contralateral leg was randomly allocated to 1 of 2 unilateral knee extension protocols: BFR-I or BFR-C (for all protocols, 3 × 8 repetitions, 70% 1RM). Maximum voluntary isometric contraction, 1RM, QCSA, and acute changes in [La] and RMS-EMG were assessed before and after training. The measurement of [La] and RMS-EMG was performed during the control sessions with the same relative load obtained after the 1RM test, before and after training. Similar increases in MVIC, 1RM, and QCSA were demonstrated among all conditions, with no significant difference between them. [La] increased for all protocols in pre-training and post-training, but it was higher for BFR-I compared with the remaining protocols. Increases in RMS-EMG occurred for all protocols in pre-training and post-training, with no significant difference between them. In conclusion, despite of a greater metabolic stress, BFR inclusion to HL-RT during rest intervals or muscle contraction did not promote any additive effect on muscle strength and hypertrophy.
Blood Flow Restriction
One-repetition maximum
Leg press
Bench press
Strength Training
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Reduced muscular strength and low muscle quality due to a lack of physical activity leading to poor physical function are modifiable risk factors common in persons with type 2 diabetes. Resistance training has been shown to increase muscular strength, however, it is unclear if combining strength and endurance training may impede strength development in type 2 diabetes compared to performing resistance training only. PURPOSE: To compare the progression of strength development in previously inactive individuals with type 2 diabetes from the Diabetes Aerobic and Resistance clinical trial (DARE). METHODS: Following a 4-week run-in phase, participants were randomized to 22-weeks of aerobic training only (A), resistance training only (R), combined training (A+R) or a control group (C). Muscular strength was measured as the 8 repetition maximum (8RM) on the seated row, bench press and leg press at 0, 3 and 6 months. Training volume (weight lifted x number of repetitions x number of sets performed) was averaged monthly on 11 strength exercises. RESULTS: 8RM load increased between 0-3 months on the leg press (A: 28.9kg, R: 43kg, A+R: 27.4kg, C: 15.2kg), bench press (A: 7.5kg, R: 14.7kg, A+R: 8.9kg, C: 5.6kg) and seated row (A: 11.1kg, R: 11.7kg, A+R: 11.9kg, C: 6.6kg). Smaller increments also occurred between 3-6 months on the leg press (A: 15.1kg, R: 21.7kg, A+R: 14.2kg, C: 6.2kg), on the bench press (A: 10.7kg, R: 4.6 kg, A+R: 4.1kg, C: 0.4kg) and on the seated row (A: 2kg, R: 2kg, A+R: 2.9kg). Increments in training volume were significantly greater in R compared A+R on the seated row (962.5 vs. 718.1 kg, p=0.002), bench press (540.9 vs. 471.2 kg, p<0.001), biceps curl (451.6 vs. 286.2 kg, p=0.003), shoulder press (470.1 vs. 365.4 kg, p=0.016) and lateral pulldown (691.1 vs. 610.4 kg, p=0.044). CONCLUSION: Both R and A+R improved strength with a 6-month training program although upper body strength development appeared to progress at a higher rate with resistance training only.
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The Impact Of Blood Flow Restriction Resistance Training On Pain Modulation In Pain Free Individuals
Blood flow restriction (BFR) resistance training (RT) is beneficial for enhancing muscle size and strength at low intensity and is effective and feasible in musculoskeletal rehabilitation. However, the effects of BFR RT on pain modulation remain unclear. PURPOSE: To evaluate the effects of low-intensity BFR and conventional moderate intensity (MI) RT on pain modulation in pain-free adults METHODS: Nineteen adults without current pain (10 M, mean age = 27 yrs., mean BMI = 23 kg/m2) participated in this study. Participants were screened for contraindications of BFR training (e.g., immobilization) and conditions that may influence pain modulation (e.g., neuropathy).A repeated measures design with counterbalanced order of RT conditions were applied. All participants completed two RT visits (MI or BFR) approximately 9 days apart. At each visit, dominant leg one-repetition maximum (1RM) was determined on a leg press machine after standardized warm-up. For both RT conditions, participants performed a unilateral leg press with the dominant leg. For MI, participants performed the unilateral leg press at 50% 1RM. For BFR RT, a 20-cm width cuff was placed at the proximal thigh during exercise. Participants performed the leg press at 30% 1RM with the cuff inflated to 60% limb occlusion pressure. Participants performed four sets of RT in each visit with a protocol of 30-15-15 repetitions at the first three sets and exercise to failure at the fourth set. Failure was defined as failing to maintain the form. A rate of two seconds per repetition was applied with a 30-second rest between sets. Pressure pain threshold (PPT) was measured over the rectus femoris immediately after exercise using a hand-held algometer. Exercise-induced hypoalgesia (EIH) was calculated as the change in PPT. Statistical Analysis: Paired t-tests (α = 0.05) and Cohen's d for effect size were used to assess statistical significance. RESULTS: Mean (SD) baseline PPT was 46.6 N (15.2) and 45.2 N (10.4) at Visit 1 and Visit 2, respectively. Greater EIH was found with BFR compared to MI RT (31.23% vs. 14.21%, p = 0.039, d = 0.62) CONCLUSIONS: Low-intensity BFR RT elicited a greater EIH effect compared to MI RT in pain-free adults. Future studies are needed to evaluate mechanisms underlying EIH with RT and to extend this work to clinical populations
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Leg press
Intensity
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The purpose of this study was to investigate the effects of a manual resistance training (MRT) program on muscular strength and endurance and to compare these effects with those of an identically structured weight resistance training (WRT) program. To do this, 84 healthy college students were randomly assigned to either an MRT (n = 53, mean +/- SD: age 25.6 +/- 6.0 years, height 170.1 +/- 8.1 cm, body mass 73.9 +/- 16.0 kg, and body fat 24.6 +/- 8.7%) or WRT (n = 31, mean +/- SD: age 25.5 +/- 5.2 years; height 169.6 +/- 10.1 cm, body mass 75.0 +/- 17.4 kg, and body fat 24.7 +/- 8.5%) group and engaged in a 14-week training program. Each participant's performance was assessed before and immediately after the 14-week training period. Muscular strength was assessed by the one-repetition maximum (1RM) bench press test and the 1RM squat test. Muscular endurance was recorded as the maximum number of repetitions performed with 70% of pretraining 1RM for the bench press and squat exercises. There were no significant differences between the MRT and WRT groups at baseline for muscular strength (p > 0.36) or muscular endurance (p > 0.46). Compared with baseline values, the 14-week training programs produced significant (p < 0.001) improvements in muscular strength and muscular endurance of the MRT and WRT groups. However, no significant difference was observed between the MRT and WRT groups for muscular strength (p > 0.22) or for muscular endurance (p > 0.09) after training. The improvements in muscular strength and muscular endurance after a 14-week MRT program in the present study were similar to those produced by a WRT program, and well-designed MRT exercises seem to be effective for improving muscular fitness.
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Squat
Leg press
One-repetition maximum
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Muscular fatigue
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Abstract Teixeira, EL, de Salles Painelli, V, Silva-Batista, C, de Souza Barros, T, Longo, AR, Lasevicius, T, Schoenfeld, BJ, Aihara, AY, and de Almeida Peres, B. Blood flow restriction does not attenuate short-term detraining-induced muscle size and strength losses after resistance training with blood flow restriction. J Strength Cond Res 35(8): 2082–2088, 2021—After a short-term resistance training with blood flow restriction (BFR), we investigated the effects of 12 days of detraining (DET), without an exercise stimulus, on quadriceps cross-sectional area (QCSA) and muscle strength (1 repetition maximum [1RM]), with 1 leg receiving daily intermittent BFR during DET vs. the same nonexercise condition without BFR (CON) in the contralateral leg. Both subjects' legs were evaluated for QCSA and 1RM before (PRE) and after (POST) both legs being unilaterally submitted to 3 weeks (4 days per week) of low-load (3 sets of 15 repetitions, 30% 1RM) resistance training with BFR. The DET period started immediately after POST, where each leg was randomly submitted to a daily intermittent BFR protocol or CON, without any associated exercise stimulus. Quadriceps cross-sectional area and 1RM were reassessed after DET. Both legs at CON and BFR conditions increased QCSA (6.3 and 6.8%, respectively; both p < 0.0001) and 1RM (9.5 and 10.1%, respectively; both p < 0.05) from PRE to POST. Both legs at CON and BFR conditions reduced QCSA (−4.6 and 4.9%, respectively; both p < 0.0001) and 1RM (−9.0 and −8.2%, respectively; both p < 0.05) from POST to DET, with no significant differences between conditions ( p > 0.05). We conclude that muscle strength and hypertrophy gains obtained in 3 weeks of resistance training with BFR are not maintained after 12 days of DET. Moreover, the application of BFR, without an associated exercise stimulus, does not attenuate such losses.
Blood Flow Restriction
One-repetition maximum
Leg press
Strength Training
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Low load [30% of one repetition maximum (1RM)] exercise performed to volitional failure appears to result in similar skeletal muscle adaptations as low load exercise with the addition of blood flow restriction (BFR). However, there may be a point where the training load becomes too low (<20% 1RM) to stimulate an anabolic response without the addition of BFR. PURPOSE: To examine the skeletal muscle adaptations to very low load exercise with and without BFR in the upper body. METHODS: Changes in muscle thickness (MT), one repetition maximum strength (1RM), isometric strength, isokinetic strength and endurance were examined following 8-weeks of training with a traditional high load [70% 1RM,(70/0)], low load (15% 1RM), low load with moderate BFR (15%1RM+40%BFR), or low load with greater BFR (15% 1RM+80%BFR). Results are displayed as mean (95% CI). RESULTS: 40 untrained men and women completed the study. For 1RM strength, there was a condition x time interaction (p = 0.003). 1RM strength changes were greater in the 70/0 condition [2.09 (95% CI=1.35-2.83) kg] compared to all low load conditions. For isometric and isokinetic strength, there were no changes. For endurance, there was a main effect for time [mean pre to post change = 7.9 (4.3, 11.6) repetitions, p <0.001]. At the 50% MT site there was a condition x time interaction (p = 0.004). The mean change in MT in the 70/0 condition [0.16 (0.10-0.22) cm] was greater than all low load conditions. For the 60% MT site there was a condition x time interaction (p = 0.014). The mean change in MT for the 70/0 condition [0.15 (0.08-0.22) cm] was greater than all low load conditions. For the 70% MT site there was a main effect of time (p=0.001). Muscle thickness increased from pre-testing to the midpoint [mean change = 0.06 (0.01- 0.10) cm] and remained elevated above baseline at post-testing [mean change = 0.09 (0.5 - 0.14) cm]. CONCLUSIONS: All groups increased muscle size; however, this response was lower in all very low training conditions compared to high load training. 1RM strength increased in the 70/0 condition only, with no other changes in strength observed. These results suggest that loads as low as 15% 1RM do not provide adaptations comparable to high load resistance training. Further, BFR cannot be used to compensate for an insufficient external load regarding muscle size and strength adaptations.
Blood Flow Restriction
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Leg press
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Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovia involvement and gradual degradation of peripheral joints. Strengthening exercises are widely recommended for improving muscle function and mass in RA. High-intensity resistance training (~75% 1RM) has been shown effective for both muscle mass and strength gains; however, patients with RA are often unable to exercise at such intensities. Alternatively, low-intensity resistance training (~30% 1RM) combined with partial blood flow restriction (LIO) has been alleged to induce similar gains in muscle function which could be beneficial for RA, as lower loads represent less stress to the affected joints. PURPOSE: To investigate the effects of a LIO training program on muscle strength, mass and functionality in patients with RA. METHODS: Twenty-three female patients with RA were divided into three groups: LIO (30% 1RM associated with partial blood-flow restriction), high-intensity training (HI: 80% 1RM), and control. LIO and HI underwent a 12-week, twice-a-week supervised training program and all patients were assessed for lower-limb 1RM (leg press and knee extension), functionality (timed-stands [TST] and timed-up-and-go test [TUG]), and quadriceps cross sectional area (CSA) at baseline and after the intervention. Absolute changes were tested by ANOVA. RESULTS: HI and LIO resulted in similar increases in leg-press (39.9 and 32.1%, respectively) and knee-extension 1RM (26.8 and 19.8%, respectively), which were significantly greater than control (all p<0.05). Functionality was significantly (all p<0.05) improved in both HI (TST: 10.7%; TUG: -12.3%) and LIO (TST: 9.6%; TUG: -7.3%) when compared with control (TST: -0.9%; TUG: 0.8%). In addition, quadriceps CSA was also significantly (all p<0.05) improved in both trained groups (HI: 12.8%; LIO: 7.7%) when compared with control (-2.0%). CONCLUSIONS: LIO was as effective as conventional HI in improving lower-body strength and muscle mass as well as functionality in RA patients. Importantly, LIO may be more advantageous than HI as lower training loads may be both safer and more enjoyable to these patients while maintaining training effectiveness. We conclude that LIO constitute a promising alternative adjunctive therapy for RA management.
Blood Flow Restriction
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Leg press
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Practical blood flow restriction (PBFR) training has been used as a training technique to induce muscular strength and hypertrophy gains while utilizing lighter loads [≤ 40% one repetition maximum (1RM)]. It is unclear if PBFR can be incorporated into traditional training programs to alleviate some exposure to heavy loads. Objective: Compare the impact of a traditional resistance training with the addition of PBFR (TRAD + PBFR) to traditional resistance training without PBFR (TRAD) on maximal bench press and leg press strength. Design and Methods: Participants performed full body training for 4 weeks (2-3x/week). PBFR group performed 62% of sets blood flow restricted at 30% 1RM while the TRAD group performed all sets at an intensity of >70% 1RM. Results: Twenty-one resistance trained individuals (≥ 1 year resistance training) completed the study. For bench press strength, there was no group (TRAD + PBFR vs. TRAD) by time (pre vs. post) interaction (BF10 = 0.32). However, there was a main effect for time (BF10 = 24.04). The TRAD + PBFR group increased strength from 99 ± 29 to 106 ± 23 kg and the traditional training condition increased from 111 ± 27 to 117 ± 24kg. For leg press strength, there was no interaction (BF10 = 0.83). However, there was a main effect for time, with both conditions increasing strength. For the PBFR group strength increased from 372 ± 61 to 423 ± 76 kg and the TRAD group increased strength from 354 ± 87 to 434 ± 96kg. Conclusion: TRAD + PBFR elicited similar strength adaptations compared to TRAD. PBFR may provide a means to exposing the muscle and connective tissue to less overall mechanical stress when incorporated into a traditional heavy resistance training program.
Blood Flow Restriction
Bench press
One-repetition maximum
Strength Training
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PURPOSE: The purpose of this study was to compare the effects of 8 weeks of blood flow restriction (BFR) training and traditional endurance resistance training on isotonic, isokinetic, isometric strength in older males. METHODS: A total of 17 males (57.0 yr ± 4.6 yr) completed the study. Subjects were randomly assigned to two training groups: blood flow restriction (BFR; n= 9) or endurance resistance training (END; n = 8). Prior to exercise training, baselines measurements were recorded, including height, weight, one repetition maximum (1RM), and unilateral knee extension testing to determine maximal voluntary contraction (MVC) and isokinetic torque at 60°/sec and 180°/sec. Training was held three times a week in a training room under laboratory settings and under the supervision of an experienced and certified strength and conditioning specialist, who ensured that subjects used proper exercise form and provided verbal encouragement. The following machine-based exercises were performed: Leg press, leg extension, leg curl, chest press, and shoulder press. Following a warm-up consisting of a 5-minute walk or jog, the BFR group performed 4 sets of 20 repetitions of the 5 exercises at 20-30% 1RM, while the END group performed 4 sets of 15 repetitions of the 5 exercises at 40-65% 1RM, with 30-60 seconds of rest between exercises. Cuffs were placed at the upper most portion of the limbs. Initial cuff tightness was kept between 30 and 40 mmHg for upper and lower limbs, and final pressure of the cuffs was between 140 to 160 mmHg for upper body 160 to 200 mmHg for lower body. BFR group rested 3-5 minutes between upper and lower body exercises. Following completion of the 8-week training, the measurements at baseline were re-recorded. RESULTS: One-way ANOVA resulted in no difference between groups at baseline. Time main effects were seen in 1RM (p ≤0.05), isokinetic torque at 60°/sec (p ≤0.05) and 80°/sec (p ≤0.05), and MVC (p ≤0.05) tests. CONCLUSION: The BFR and END training protocols resulted in similar results on improving strength after 8 weeks of resistance training. It could be speculated that even though half the weight was lifted during the BFR sessions compared to the END sessions, the BFR-related local and systemic changes elicited similar improvements in isotonic, isokinetic, and isometric strength in older males.
Blood Flow Restriction
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One-repetition maximum
Bench press
Strength Training
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