BFR & Effects

BFR Compared To Conventional Exercise Modalities

<strong>Aerobic Capacity</strong>
Forest plot of the overall (Total) and subgroup effects of blood flow restricted exercise on aerobic capacity

Formiga et al. (2020) effect of aerobic exercise training with and without blood flow restriction on aerobic capacity in healthy young adults- a systematic review with meta-analysis

<strong>Muscle Strength (High-load vs BFR)</strong>
Forest Plot (Random effects) as the distribution of studies calculated from post intervention scores on gains in maximal muscle strength

Grønfeldt et al. 2020 – Effect of blood-flow restricted vs. heavy-load strength training on muscle strength- Systematic review and meta-analysis
Forest plot demonstrating the effects of LL-BFR versus HL
training on muscular strength. Random random effects model

Centner et al. (2018) Effects of Blood Flow Restriction Training on Muscular Strength and Hypertrophy in Older Individuals: A Systematic Review and Meta-Analysis
<strong>Muscle Strength (Low-load vs BFR)</strong>
Fig. 4 Forest plot demonstrating the effects of LL-BFR versus LL
training on muscular strength. Random random effects model

Centner et al. (2018) Effects of Blood Flow Restriction Training on Muscular Strength and Hypertrophy in Older Individuals: A Systematic Review and Meta-Analysis
<strong>Muscle Mass (High-load vs BFR)</strong>
Fig. 3 Forest plot demonstrating the effects of LL-BFR versus HL
training on muscle mass. Random random effects model
<strong>Muscle Strength & Mass (Walking vs BFR-Walking)</strong>
Fig. 5 Forest plot demonstrating the effects of walking + BFR versus normal walking on muscular strength. Random random effects model

Fig. 6 Forest plot demonstrating the effects of walking + BFR versus normal walking on muscle mass. Random random effects model

<strong>Effect Size – A Nuanced Perspective</strong>

Low-load BFR (20-50% of 1RM) vs High-load RT (60-90% of 1RM) – repetitions to failure

Short-term muscle mass: Probably BFR
Long-term muscle mass: Similar
Short-term muscle strength: Similar
Long-term muscle strength: Probably High-Load RT
Muscle endurance: BFR
Rate of Force Development (RFD) lower body power – e.g. fall prevention, vertical jump, etc: High-load RT

Low-load BFR (20-50% of 1RM) vs Low-load RT (20-50% of 1RM) – Volume matched (equal repetitions and load)

Short-term muscle mass: BFR
Long-term muscle mass: BFR
Short-term muscle strength: BFR
Long-term muscle strength: BFR
Muscle endurance: BFR
Rate of Force Development (RFD) lower body power – e.g. fall prevention, vertical jump, etc: Similar

Low-load BFR (20-50% of 1RM) vs Low-load RT (20-50% of 1RM) – load matched but repetitions to failure

Short-term muscle mass: Similar
Long-term muscle mass: Similar
Short-term muscle strength: Similar
Long-term muscle strength: Similar
Muscle endurance: Similar Rate of Force Development (RFD) lower body power – e.g. fall prevention, vertical jump, etc: Similar

<strong>Other Relevant Effects Associated With BFR Training</strong>
  • Treatment of sarcopenia by increasing muscle mass (protective for a wide range of age-related issues and chronic conditions (How When & Why BFR)
  • Greater muscle strength – directly transferable to everyday activities (ADL) Fall prevention
  • Improved circulatory system
  • Better self-reported health
  • Improved bone, cartilage & tendon properties
  • Increased aerobic & anaerobic fitness
  • Enhanced body composition
  • Shorter training time
  • Shorter restitution time
  • Alternative or supplement to heavy training during the season (due to less mechanical strain)
  • Use during periodization training with a focus on high rep / low-load Occlusion training
  • Ischemic pre-conditioning (IPC) Link – ischemic preconditioning – youtube.
  • Experimental – combined with moderate heavy training Link for scientific paper – ncbi.nlm.nih.gov

<strong>Nerd Alert – The Adaptive Muscle Response</strong>

The partial restriction of blood flow in combination with muscles contractions creates a short-term edema (cell swelling) around the muscle cells which limits the supply of oxygen and nutrients so that metabolites accumulates (Cayot et al., 2014). This initiates a cascade of physiologic process, like the increase of growth hormone secretion, as approximately 2-3 fold greater compared to conventional resistance training. But also the increased activation of muscle satellite cells, about two fold larger than than conventional resistance training. This upregulates the net protein synthesis.(Yasuda et al., 2014; Segal et al., 2010; Roos and Lohmander 2003). Check also the Blog post from September 17, 2020

↑ Muscle oxygenation – hypoxia leading to short term ischemia
↑ Metabolite accumulation – accumulation of waste products
↑ Recruiting fast twice muscle fibers
↑ Cell Swelling
↑ Growth hormone 200-300% compared to conventional resistance training – relevant for bone and tendon health
↑ Satellite cell proliferation

↓ Secretion of muscle growth inhibitors (myostatin) – especially important for building muscle tissue
↑ Netto protein synthesis = Hypertrophy (muscle growth)
↑ Muscle strength and endurance
↓ Metabolic resistance – relevant for metabolic syndrome and diabetes
↑ Anaerobic threshold
↑ Mitochondrial content

These processes are further described in the scientific literature, especially by the leading researcher in the field of Associate Professor Jeremy P. Loenneke as he is attributed to a large part of the accumulated knowledge. For the past 10 years, he has published scientific articles on the underlying mechanisms and effects of occlusion training or Blood Flow Restriction. Overall there are published more than 300 scientific studies across all continents, which demonstrates the effect of occlusion training.

Treatment of sarcopenia by increasing muscle mass (protective for a wide range of age-related issues and chronic conditions (How When & Why BFR) Greater muscle strength – directly transferable to everyday activities (ADL) Fall prevention Improved circulatory system Better self-reported health Improved bone, cartilage & tendon properties Increased aerobic & anaerobic fitness Enhanced body composition Shorter training time Shorter restitution time Alternative or supplement to heavy training during the season (due to less mechanical strain) Use during periodization training with a focus on high rep / low-load Occlusion training combined with moderate heavy training Link for scientific paper – ncbi.nlm.nih.gov Ischemic pre-conditioning (IPC) Link – ischemic preconditioning – youtube.

  • Treatment of sarcopenia by increasing muscle mass (protective for a wide range of age-related issues and chronic conditions (How When & Why BFR)
  • Greater muscle strength – directly transferable to everyday activities (ADL) Fall prevention
  • Improved circulatory system
  • Better self-reported health
  • Improved bone, cartilage & tendon properties
  • Increased aerobic & anaerobic fitness
  • These processes are further described in the scientific literature, especially by the leading researcher in the field of Associate Professor Jeremy P. Loenneke as he is attributed to a large part of the accumulated knowledge. For the past 10 years, he has published scientific articles on the underlying mechanisms and effects of occlusion training or Blood Flow Restriction. Overall there are published more than 300 scientific studies across all continents, which demonstrates the effect of occlusion training
The partial restriction of blood flow in combination with muscles contractions creates a short-term edema (cell swelling) around the muscle cells which limits the supply of oxygen and nutrients so that metabolites accumulates (Cayot et al., 2014). This initiates a cascade of physiologic process, like the increase of growth hormone secretion, as approximately 2-3 fold greater compared to conventional resistance training. But also the increased activation of muscle satellite cells, about two fold larger than than conventional resistance training. This upregulates the net protein synthesis.(Yasuda et al., 2014; Segal et al., 2010; Roos and Lohmander 2003). Check also the Blog post from September 17, 2020
  • Enhanced body composition
  • Shorter training time
  • Shorter restitution time
  • Alternative or supplement to heavy training during the season (due to less mechanical strain)
  • Use during periodization training with a focus on high rep / low-load Occlusion training combined with moderate heavy training Link for scientific paper – ncbi.nlm.nih.gov
  • Ischemic pre-conditioning (IPC) Link – ischemic preconditioning – youtube.

  • The partial restriction of blood flow in combination with muscles contractions creates a short-term edema (cell swelling) around the muscle cells which limits the supply of oxygen and nutrients so that metabolites accumulates (Cayot et al., 2014). This initiates a cascade of physiologic process, like the increase of growth hormone secretion, as approximately 2-3 fold greater compared to conventional resistance training. But also the increased activation of muscle satellite cells, about two fold larger than than conventional resistance training. This upregulates the net protein synthesis.(Yasuda et al., 2014; Segal et al., 2010; Roos and Lohmander 2003). Check also the Blog post from September 17, 2020

    .

    ↑ Muscle oxygenation – hypoxia leading to short term ischemia
    ↑ Metabolite accumulation – accumulation of waste products
    ↑ Recruiting fast twice muscle fibers
    ↑ Cell Swelling
    ↑ Growth hormone 200-300% compared to conventional resistance training – relevant for bone and tendon health
    ↑ Satellite cell proliferation

    ↓ Secretion of muscle growth inhibitors (myostatin) – especially important for building muscle tissue
    ↑ Netto protein synthesis = Hypertrophy (muscle growth)
    ↑ Muscle strength and endurance
    ↓ Metabolic resistance – relevant for metabolic syndrome and diabetes
    ↑ Anaerobic threshold
    ↑ Mitochondrial content

    These processes are further described in the scientific literature, especially by the leading researcher in the field of Associate Professor Jeremy P. Loenneke as he is attributed to a large part of the accumulated knowledge. For the past 10 years, he has published scientific articles on the underlying mechanisms and effects of occlusion training or Blood Flow Restriction. Overall there are published more than 300 scientific studies across all continents, which demonstrates the effect of occlusion training.

    @ChrisBeardsley


    Source:

    Slysz et al. (2016) – The efficacy of blood flow restricted exercise A systematic review & meta-analysis

    Hughes et al. (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation in systematic review and meta-analysis

    Grønfeldt et al. (2020) effect of blood-flow restricted vs. heavy-load strength training on muscle strength: systematic review and meta-analysis

    The Pressure-Load Continuum in Blood FLow Restriction Training

    When comparing (LL-BFR) vs (C-LL) load matched and taken to failure the number of repetitions needed to elicit muscular adaptions is significantly less. The most recent literature shows 10-60% fewer repetitions are needed to reach the same state of muscular fatigue.

    But the time-benefit of doing BFR is relative to the amount of relative pressure, being that higher pressure 70-90% of Limb Occlusion Pressure (LOP) seems to be favorable for most circumstances.
    This is particularly relevant when using very low-load (<25% 1RM), as it there seems to be a threshold of at least 60% LOP when using very low load.

    From the literature it seems that relative load and relative pressure exists on mutual effected continuum. When using moderate-loads (40-50% of 1RM) use less pressure (40-60% LOP). On the other hand, when utilizing very low-load (<25% of 1 RM) It is strongly recommended to use higher relative pressures (70-90% LOP).

    The load-pressure continuum appears to be a very important consideration especially post-operation or in other occasions with prescribed load restrictions. Conversely, for BFR application in a gym setting without any strict load restriction, it is probably favorable to utilize less pressure (40-60% LOP) but higher relative load (30-50% 1 RM).

    Source:

    Cerqueira et al. (2021) Repetition Failure Occurs Earlier During Low-Load Resistance Exercise With High But Not Low Blood Flow Restriction Pressures: A Systematic Review and Meta-analysis

    Pignanelli et al (2019) Low-load resistance training to task failure with and without blood flow restriction- Muscular functional and structural adaptations

    There are many ways to compare the effect of Low-load resistance occlusion training (BFR) (20-50% of 1RM) vs. conventional Resistance Training (RT) and this results in varying conclusions of wherever BFR is more or less effective.

    There are many ways to compare the effect of Low-load resistance occlusion training (BFR) (20-50% of 1RM) vs. conventional Resistance Training (RT) and this results in varying conclusions of wherever BFR is more or less effective.

    When comparing (LL-BFR) vs (C-LL) load matched and taken to failure the number of repetitions needed to elicit muscular adaptions is significantly less. The most recent literature shows 10-60% fewer repetitions are needed to reach the same state of muscular fatigue.

    But the time-benefit of doing BFR is relative to the amount of relative pressure, being that higher pressure 70-90% of Limb Occlusion Pressure (LOP) seems to be favorable for most circumstances. This is particularly relevant when using very low-load (<25% 1RM), as it there seems to be a threshold of at least 60% LOP when using very low load.

    From the literature it seems that relative load and relative pressure exists on mutual effected continuum. When using moderate-loads (40-50% of 1RM) use less pressure (40-60% LOP). On the other hand, when utilizing very low-load (<25% of 1 RM) It is strongly recommended to use higher relative pressures (70-90% LOP).

    The load-pressure continuum appears to be a very important consideration especially post-operation or in other occasions with prescribed load restrictions. Conversely, for BFR application in a gym setting without any strict load restriction, it is probably favorable to utilize less pressure (40-60% LOP) but higher relative load (30-50% 1 RM).

    Source:

    Cerqueira et al. (2021) Repetition Failure Occurs Earlier During Low-Load Resistance Exercise With High But Not Low Blood Flow Restriction Pressures: A Systematic Review and Meta-analysis

    Pignanelli et al (2019) Low-load resistance training to task failure with and without blood flow restriction- Muscular functional and structural adaptations

    There are simply many ways to compare the effect of Low-load resistance occlusion training (BFR) (20-50% of 1RM) vs. conventional Resistance Training (RT) and this results in varying conclusions of wherever BFR is more or less effective.

    Source:

    Slysz et al. (2016) – The efficacy of blood flow restricted exercise A systematic review & meta-analysis

    Hughes et al. (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation in systematic review and meta-analysis

    Grønfeldt et al. (2020) effect of blood-flow restricted vs. heavy-load strength training on muscle strength: systematic review and meta-analysis

    When comparing (LL-BFR) vs (C-LL) load matched and taken to failure the number of repetitions needed to elicit muscular adaptions is significantly less. The most recent literature shows 10-60% fewer repetitions are needed to reach the same state of muscular fatigue. But the time-benefit of doing BFR is relative to the amount of relative pressure, being that higher pressure 70-90% of Limb Occlusion Pressure (LOP) seems to be favorable for most circumstances. This is particularly relevant when using very low-load (<25% 1RM), as it there seems to be a threshold of at least 60% LOP when using very low load. From the literature it seems that relative load and relative pressure exists on mutual effected continuum. When using moderate-loads (40-50% of 1RM) use less pressure (40-60% LOP). On the other hand, when utilizing very low-load (<25% of 1 RM) It is strongly recommended to use higher relative pressures (70-90% LOP). The load-pressure continuum appears to be a very important consideration especially post-operation or in other occasions with prescribed load restrictions. Conversely, for BFR application in a gym setting without any strict load restriction, it is probably favorable to utilize less pressure (40-60% LOP) but higher relative load (30-50% 1 RM). Cerqueira et al. (2021) Repetition Failure Occurs Earlier During Low-Load Resistance Exercise With High But Not Low Blood Flow Restriction Pressures: A Systematic Review and Meta-analysis Pignanelli et al (2019) Low-load resistance training to task failure with and without blood flow restriction- Muscular functional and structural adaptations
    There are many ways to compare the effect of Low-load resistance occlusion training (BFR) (20-50% of 1RM) vs. conventional Resistance Training (RT) and this results in varying conclusions of wherever BFR is more or less effective. Slysz et al. (2016) – The efficacy of blood flow restricted exercise A systematic review & meta-analysis Hughes et al. (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation in systematic review and meta-analysis Grønfeldt et al. (2020) effect of blood-flow restricted vs. heavy-load strength training on muscle strength: systematic review and meta-analysis

    When comparing (LL-BFR) vs (C-LL) load matched and taken to failure the number of repetitions needed to elicit muscular adaptions is significantly less. The most recent literature shows 10-60% fewer repetitions are needed to reach the same state of muscular fatigue.

    But the time-benefit of doing BFR is relative to the amount of relative pressure, being that higher pressure 70-90% of Limb Occlusion Pressure (LOP) seems to be favorable for most circumstances.
    This is particularly relevant when using very low-load (<25% 1RM), as it there seems to be a threshold of at least 60% LOP when using very low load.

    From the literature it seems that relative load and relative pressure exists on mutual effected continuum. When using moderate-loads (40-50% of 1RM) use less pressure (40-60% LOP). On the other hand, when utilizing very low-load (<25% of 1 RM) It is strongly recommended to use higher relative pressures (70-90% LOP).

    The load-pressure continuum appears to be a very important consideration especially post-operation or in other occasions with prescribed load restrictions. Conversely, for BFR application in a gym setting without any strict load restriction, it is probably favorable to utilize less pressure (40-60% LOP) but higher relative load (30-50% 1 RM).

    Cerqueira et al. (2021) Repetition Failure Occurs Earlier During Low-Load Resistance Exercise With High But Not Low Blood Flow Restriction Pressures: A Systematic Review and Meta-analysis

    Pignanelli et al (2019) Low-load resistance training to task failure with and without blood flow restriction- Muscular functional and structural adaptations

    <strong>Effect Size – A Nuanced Perspective</strong>

    Slysz et al. (2016) – The efficacy of blood flow restricted exercise A systematic review & meta-analysis

    Hughes et al. (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation in systematic review and meta-analysis

    Grønfeldt et al. (2020) effect of blood-flow restricted vs. heavy-load strength training on muscle strength: systematic review and meta-analysis

    When comparing (LL-BFR) vs (C-LL) load matched and taken to failure the number of repetitions needed to elicit muscular adaptions is significantly less. The most recent literature shows 10-60% fewer repetitions are needed to reach the same state of muscular fatigue.

    But the time-benefit of doing BFR is relative to the amount of relative pressure, being that higher pressure 70-90% of Limb Occlusion Pressure (LOP) seems to be favorable for most circumstances.
    This is particularly relevant when using very low-load (<25% 1RM), as it there seems to be a threshold of at least 60% LOP when using very low load.

    From the literature it seems that relative load and relative pressure exists on mutual effected continuum. When using moderate-loads (40-50% of 1RM) use less pressure (40-60% LOP). On the other hand, when utilizing very low-load (<25% of 1 RM) It is strongly recommended to use higher relative pressures (70-90% LOP).

    The load-pressure continuum appears to be a very important consideration especially post-operation or in other occasions with prescribed load restrictions. Conversely, for BFR application in a gym setting without any strict load restriction, it is probably favorable to utilize less pressure (40-60% LOP) but higher relative load (30-50% 1 RM).

    Cerqueira et al. (2021) Repetition Failure Occurs Earlier During Low-Load Resistance Exercise With High But Not Low Blood Flow Restriction Pressures: A Systematic Review and Meta-analysis

    Pignanelli et al (2019) Low-load resistance training to task failure with and without blood flow restriction- Muscular functional and structural adaptations

    <strong>Effect Size – A Nuanced Perspective</strong>

    Slysz et al. (2016) – The efficacy of blood flow restricted exercise A systematic review & meta-analysis

    Hughes et al. (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation in systematic review and meta-analysis

    Grønfeldt et al. (2020) effect of blood-flow restricted vs. heavy-load strength training on muscle strength: systematic review and meta-analysis

    <strong>Effect Size – A Nuanced Perspective</strong>

    <strong>Effect Size – A Nuanced Perspective</strong>

    There are many ways to compare the effect of Low-load resistance occlusion training (BFR) (20-50% of 1RM) vs. conventional Resistance Training (RT) and this results in varying conclusions of wherever BFR is more or less effective.

    Source:

    Slysz et al. (2016) – The efficacy of blood flow restricted exercise A systematic review & meta-analysis

    Hughes et al. (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation in systematic review and meta-analysis

    Grønfeldt et al. (2020) effect of blood-flow restricted vs. heavy-load strength training on muscle strength: systematic review and meta-analysis

    The Pressure-Load Continuum in Blood Flow Restriction Training

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    When comparing (LL-BFR) vs (C-LL) load matched and taken to failure the number of repetitions needed to elicit muscular adaptions is significantly less. The most recent literature shows 10-60% fewer repetitions are needed to reach the same state of muscular fatigue.

    But the time-benefit of doing BFR is relative to the amount of relative pressure, being that higher pressure 70-90% of Limb Occlusion Pressure (LOP) seems to be favorable for most circumstances.
    This is particularly relevant when using very low-load (<25% 1RM), as it there seems to be a threshold of at least 60% LOP when using very low load.

    From the literature it seems that relative load and relative pressure exists on mutual effected continuum. When using moderate-loads (40-50% of 1RM) use less pressure (40-60% LOP). On the other hand, when utilizing very low-load (<25% of 1 RM) It is strongly recommended to use higher relative pressures (70-90% LOP).

    The load-pressure continuum appears to be a very important consideration especially post-operation or in other occasions with prescribed load restrictions. Conversely, for BFR application in a gym setting without any strict load restriction, it is probably favorable to utilize less pressure (40-60% LOP) but higher relative load (30-50% 1 RM).

    Source:

    Cerqueira et al. (2021) Repetition Failure Occurs Earlier During Low-Load Resistance Exercise With High But Not Low Blood Flow Restriction Pressures: A Systematic Review and Meta-analysis

    Pignanelli et al (2019) Low-load resistance training to task failure with and without blood flow restriction- Muscular functional and structural adaptations



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