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March 29, 2020
In this video we present 6 exercise variations for the rotator cuff muscles (RCs). . 0:05-Flexion. 0:12-Abduction. 0:20-External rotation (ER) at 0°. 0:30-Internal rotation (IR) at 0°. 0:39-IR at 90°. 0:46-ER at 90°. . We find this interesting as a relatively new paper (only preliminary results presented), discovered that BFR for low-load resistance exercise to be effective for proximal gains i.e. RCs (1). . PURPOSE: If BFR promote greater increases in strength, muscular endurance, and lean mass for the RCs compared to exercise alone (No-BFR). Secondly, if BFR during acute low-load resistance exercise increases activation of RCs. . METHODS: (RCT) Eighteen healthy adults randomized into 2 groups (BFR vs. No-BFR). . Each group: 8 weeks (2/wk) as 4 low-load RCs resistance exercises at 20% of 1RM: Cable - external rotation (ER) & internal rotation (IR). Dumbbell – scaption & side-lying ER. . 1 set/30reps followed by 3 sets/15reps (30s inter-set rest, 2min inter-exercise rest). . For progression, 1lb (0.45 kg)/week if all repetitions where achieved. . Only BFR: Intermittent BFR stimuli (only during exercises) at 50% LOP. . RESULTS: Lean Mass: Arms BFR vs No-BFR, 8.15% vs. -0.43%, respectively. Shoulders BFR vs No-BFR, 28.10% vs. 11.23%, respectively. . Strength: Assessed in 6 different positions comparing dominant and non-dominant arm separately: For the dominant arm, all positions showed a strong trend for BFR be superior. ≈ 5-20% greater relative improvements for BFR vs. No-BFR. . Exercise Volume: 7/7 follow-up tests in favor of BFR. . Mean EMG activations: Same relative activation pattern for Infraspinatus, but BFR seemed to be superior for Teres Minor. . CONCLUSIONS: BFR augmented RCs exercises seems favorable. Possible due to a greater activation of shoulder musculature (1). . Discussion: The exercise intervention was designed in favor of BFR. The load was only 20% 1RM with a standardized rep-scheme and only allowed for 1lb (0.45 kg) once/week for progression. – Any thoughts? . An interesting sub-finding was that only the dominant arm for the BFR-group experienced a greater relative improvement in strength. - Any thoughts? . Source in the comments.
March 24, 2020
Coupon code active at fitcuffs.com, use: homebfr at checkout for 10% discount. This is a follow-up for the latest post, on how to progress your training when objective load is not available, e.g. elastic bands. Obviously, progression in regards to reps, is the most convenient way to start off. . Set the pressure at about 40-50% Limb Occlusion Pressure (LOP). Next, adjust the initial tension in the band for 30 reps until failure. Aim for about 10-15 reps in the following 3 sets, with 45 s. inter-set rest. If this is your first BFR session, we recommend doing only 1 or 2 exercises with this protocol. . For the next session, find a resistance that equals 30 reps for the first set, but try to do >15 reps in the following 3 sets. Then progress in the following days until you can manage about 30x20x20x20 reps. . After this have been accomplished, do 30x10x10x10 with the same amount of resistance as before, but this time around only with 30 s. inter-set rest. And progress again to reach 30x20x20x20. . For the next step, try to progress the relative pressure up to 50-60% LOP with the short inter-set rest period and 30x10x10x10. Again, progress by doing more reps. . When goal reps has been achieved, progress the pressure for about 60-70% LOP and start over again. We recommend that you keep the inter-set rest period for at least 30 s. and the relative pressure below 80% LOP. . It seems valid to adjust the resistance in the band by the initial set, as this is less affected by relative pressures and obviously not inter-set rest (1). . As a site note, you can start of by deflating the cuffs between exercises aka. intermittent BFR, then progress for 3 exercises with continuous BFR application. . When this is mastered, we will have our finger crossed for your local gym or physio center. And please reminisce, that this is only one example of how to progress your BFR workout. . Source: Counts et al. (2016) Low-load resistance training to task failure with and without BFR: muscular functional and structural adaptations. . Pignanelli et al. (2019) Muscular Adaptations to Low-Load Resistance Training to Repetition Failure with and Without BFR.
Marts 23, 2020
When everything are closed, we advise you to find the opportunity to move your exercise routine to urban areas, nature or for some restricted regions as home training. But when your local gym is not an option, you have to consider several factors for you to maintain muscle mass or strength.
For most gym rats it should be achievable to maintain muscle mass, but it becomes inherently more difficult when your goal is hypertrophy. In regards to absolute strength, it becomes even more difficult to retain and especially increase strength.
The amount of load and volume is obviously highly dependent on your current training status. But for a vast generalization, maintenance of muscle bulk should be obtainable for most people, especially with BFR and in less time!
As a proxy for estimation of 20-40% of 1 RM, these basic simple principles apply:
As rule of thumb, aim for 20-35 reps to voluntary failure for the first set, followed by 3 sets of 10-20 reps with an interset rest period of 30-45 s.
When considering the minimum effective volume, it becomes more difficult to generalize, but in regards to hypertrophy, more IS better! On the other hand, if your goal is to maintain strength, less volume is needed. Aim for at least 30 % 1 RM with every set near failure. Some evidence suggests that BFR can be optimized by exercising the same muscle group 1 or even 2 times a day in periods of 3 weeks.
Considering these principles for BFR, bodyweight squats is insufficient for most people, but can easily be progressed by means of:
External resistance with an elastic band ➡️ Unilateral like Bulgarian split squat ➡️ Higher relative pressure (mmHg).
For regression of push-ups, just elevate the hands relative to the feet as displayed.
Please also remember, that all exercise is better than no exercise! And BFR is Better For Results – when load is low!
March 10, 2020
This post is about our concurrent research on the reliability and validity of our new Bluetooth Device for assessment of Limb Occlusion Pressure (LOP). This is particularly relevant for Blood Flow Restriction (BFR) training and exercise. . The utility of the present research is beyond Fit Cuffs product selection, as this will have universal implications for osciliatory/ oscillometric blood pressure measurements for assessment of LOP, a potential valid alternative to hand-held dopplers. . We find this method to determine LOP highly interesting, as this is more assessable compared to the doppler-method, which is relevant for about everyone into BFR. . We truly appreciate everyone’s efforts and commitments to test our new Bluetooth Device. Without your practical and academic expertise this was not possible. This is greatly appreciated and we look forward to continuing our collaboration. . Especially thanks to Okan KAMİŞ & Mahdy El-Zein for the dedication that goes into this study: . Okan KAMİŞ, MSc, Lecturer, PhD Student, Faculty of Sports Sciences, Gazi University/Ankara,Turkey. . & . Mahdy El-Zein, PT, MPT Student, Faculty of Public Health, Lebanese University, Lebanon. . Please stay tuned for upcoming posts on this research.
March 3, 2020
This post is about knee rehab with extensions to the progressive model for BFR proposed by Loenneke et al. (1). . It seems that passive BFR (BFR without exercise), has the potential to attenuate muscle loss during periods of immobilization (2). Though, for obvious reasons this application is inferior to active modalities. . For the initial stage post-surgery or in some chronic cases, joint swelling and symptoms can be triggered by even low load resistance training. This is especially in such cases that BFR cycling can be the key to regain muscle and mass strength (3). . In the BFR literature, it seems that both continues or interval training can be utilized for hypertrophy and muscle strength (4). But as the muscle specific adaptations seems superior for conventional high intensity training (HIIT) vs. continues, it seems coherent that this is also the case for BFR training. Thus, a single study actually discover the opposite trend (4). . The central paradigm of this ladder-principle, is the reverse nature of progression or regression for early stage rehab vs. prehab, respectively: . Conventional high-load resistance training → . ⬆️ Low-Load resistance BFR training, moderate pressure (mmHg) → . ⬆️ Very low-load resistance BFR training, high pressure (mmHg) → . ⬆️ High intensity interval BFR Cycling → . . ⬆️ Continuous cardiovascular BFR i.e. steady state walking or cycling → . . ⬆️ Passive BFR . As described above, we propose that this extended progressive model should be reversed for the general population. That is, if you are able to lift heavy without any pain, conventional exercise should be first line healthcare, but if this is not applicable regress one step, etc. . In the video, a woman with a total knee replacement is training with high intensity intervals for late stage rehab, as in her case, even very low-load training is associated with excessive joint swelling. . Soure in the comments:
February 23, 2020
This post is about relative loads (% of 1RM), relative blood flow restriction (% of LOP) and the potential of a minimum effective pressure for very low loads. . The default recommendation for upper body and lower body BFR exercise is to use at least 40% LOP and 50% LOP, respectively, for non-failure BFR protocols like the standard four sets of 30-15-15-15 reps. But because both BFR Stimuli and load contribute to the fatigue caused by BFR exercise, we must also consider relative load for a final recommendation (1,2): . Because higher blood flow restriction pressures are likely to be beneficial for muscle growth when very low loads are used (1), it turns out that simple bodyweight-based BFR exercises such as squats and lunges are sufficient to increase muscle mass and strength in active adults (3). . For practical applications, if the relative load is very low (10-15% 1RM), then it can be compensated by higher reps and using a higher pressure (1), as about >70% and >80% for upper and lower body, respectively. This is especially relevant for well-trained people who do not have the opportunity to hit the gym, because of travel, lack of time or simply just for convenience. . Reversely, the current data suggest little or no differences in muscle growth, muscle size or endurance in response to 40% vs. 90% LOP when using higher relative load (30% 1RM). But the 90% LOP condition produced higher ratings of perceived discomfort (2), which is counter productive for adherence to about any exercise program. . But as the data also suggests, that the combined effect of higher loads and higher pressures means less exercise volume, this might have some relevance. So, if you can withstand the high discomfort by combining higher pressure and load, aim for about four sets of about 30-10-10-10 reps (2). . As displayed in the video, a higher relative load (30-50% 1RM) is being used, but as a tradeoff, use less pressure (40% LOP) and maybe slightly longer inter-set rest (45s -1 min). . Source in the comments
February 19, 2020
This post is about the width and material properties of BFR cuffs and how this effect different physical parameters and perceived discomfort.
A newly published review on BFR and discomfort concludes that particularly for the upper body, narrower cuffs seems to be favorable as wider cuffs seems to increase discomfort during exercise (1). For the general public and healthcare this is of huge importance as the adherence to exercise or rehabilitation is imperative for effect regardless of goal setting.
Though, there is a range of tradeoffs or pros and cons to consider when choosing the right cuff width:
Narrow cuffs require higher absolute pressures to elicit the same relative pressure which can inhibit estimation of LOP and increase compression into the underlying tissue (2). The relative fluctuation of pressure and mechanical compression during muscle contractions is also larger.
On the other hand, narrow cuffs allow for more freedom of movement and even though the localized pressure is higher, a smaller area of the muscle is affected by this which seems of importance (1).
During the prolonged development of Fit Cuffs into it’s current form, the cuff material has also been discovered as extremely important especially for the upper body, Thus, the research has yet to confirm this point (3).
Since muscle contractions in the upper arm expands the girth relatively more compared to the upper leg, a stiff material is not alone discomfortable, but also hinders muscle contractions and in extreme cases can lead to tissue damage (1,2).
For a visualization of the inherent properties of different cuff material, see the figure from Mcewen & Casey (cuff type B vs C). This is also why Fit Cuffs is designed with differentiated properties with the upper body cuffs being more pliable.
(1) Spitz et al. (2020) Blood Flow Restricted Exercise and Discomfort A Review.
(2) Mcewen & Casey (2009) Measurement of hazardous pressure levels and gradients produced on human limbs by non-pneumatic tourniquets.
(3) Buckner et al. (2016) Influence of cuff material on blood flow restriction stimulus in the upper body.
February 4, 2020
This post is about the brand new Bluetooth Unit for measurement of Limb Occlusion Pressure (LOP) by means of Oscillatory Blood Pressure (BP) (1,2). . When assessing BP you should always use a calibrated cuff in terms of the width of the cuff relative to the circumference of the limb you are assessing. The recommended cuff width is 0.4 relative to the circumference of the limb (3). . That is why a standard BP cuff is about 14 cm wide, which is a calibrated cuff size relative to the upper arm for most adults. But if you are assessing BP on obese or bodybuilders, this would not be a valid measurement of BP, as in these cases you would need a wider cuff to avoid overestimating BP (4). The same principles apply for a very small upper arm, as you need to use a narrow cuff (4). . So even though measurement of BP is only valid when using a calibrated cuff, the amount of pressure to completely stop arterial blood flow is both valid and reliable (5). . Practical Application - how to find LOP via Bluetooth: . Connect the Unit with your phone via standard bluetooth tech. . Connect the Bluetooth Unit with the hose of the Fit Manometer, then connect the unit to the cuff. . Completely rest the corresponding limb and follow the displayed guide provided by the app. . After appropriate measurement you will find SYS (SBP) on the top left corner on the phone. This is the Limb Occlusion Pressure (LOP) for that limb in that particular position, just as the standard but prolonged method with a hand held doppler. . When preparing for exercise just detach the Bluetooth Unit and set the pressure relative to SYS (40-80%). . Research has shown that this method (oscillatory blood pressure measurement), is more precise compared to a hand held doppler ultrasound, relative to the golden standard i.e. invasive methods (5). . Our preliminary testing is showing a very good inter-rater reliability, by comparing this bluetooth device vs. LOP by hand held doppler, as a variance of only 3-6%. . Source in the comments. . Disclaimer: Please contact us for the current app availability in your country.
January 22, 2020
January 21, 2020
This post is about some relevant considerations for BFR in rehab. . First of all, there is no such thing as an optimal rehab regime, and secondly, optimal rehab must be individualized. No people are alike, the same goes for any injury, because of this an individual approach is always recommended. . Individual components such as daily activity, type of surgery, pain levels and not at least personal preference of exercises should be considered. But for most people or relevant stakeholders, the expected time to return to sport or daily activity is of high priority. . Especially in cases of load or weight bearing restrictions, the application of BFR is an effective way to attenuate muscle loss as a supplement to other rehab modalities, as this can accelerate muscle strength and function much earlier compared to a conventional rehab protocols. Though, as always consider the healing properties of subsequent tissues. . E.g. post ACL reconstruction, muscle strength and function can conceivably be reestablished at a higher rate than the remodelling properties of the transplanted tendon. But by following the guidelines and time for return to play, the inclusion of BFR can lead to greater functional symmetry (1) and probably higher estimated pre-injury capacity (2), which are both proven to lower the risk of reinjury. . In rare occasions there can be adverse side effects or other contra indications that inhibits the use of BFR, especially for early stage rehab (0-2 weeks post op.). That is why it is recommended to consult the surgeon before implementation of early stage BFR and always be aware of any additional swelling compared to other conventional exercises. . Conclusion: BFR should be used on the basis of an individual preference with consideration of physical components, such as healing properties of surrounding tissues and potential contra indications. . Video material from @cjmcfarland17 . Source: (1) Kilgas et al (2019) -Exercise with Blood Flow Restriction to Improve Quadriceps Function Long After ACL Reconstruction. . (2) Wellsandt et al. (2017) Limb Symmetry Indexes Can Overestimate Knee Function After ACL Injury.
January 11, 2020
The incidence of fractures in DK/year is approx. 80,000, of which 3,000-4,000 are ankle-related. . Most often, the fracture is plastered, which can include marrow sewing, osteosynthesis and rarely external fixation. For the first 3 weeks, load is inhibited, at approx. 3 weeks post op. gradually increased weight bearing is recommended. . Therefore, one should be careful about starting exercising, to avoid compromising the healing mechanisms of the bones. As adjacent to the fracture, muscles, arteries and nerves can be injured due to the sharp surfaces of the fracture or during the operation, which potentially complicates the rehab. . Because of the required immobilization following operation, severe muscle atrophy (muscle loss) will occur. As ankle fractures results in longer periods without weight bearing and local immobility, the rehabilitation options are very limited in the early phase. . Though, it has been proven that atrophy can be reduced by a swift implementation of BFR, in respect to fracture type and possible complications. By reducing the associated loss of muscle mass, one could expect a shorter rehab period and therefor a faster return-to-play. By combining BFR with conventional low-load resisted knee-extension and knee-flexion exercises you got an effective combo to counter act the atrophy of the thighs, hamstrings and the superficial calf muscles. . Considering the recommendation of high frequency training as 1-2 daily for an effective retention of muscle mass for, elastic bands are being used as a low practical setup for 3 consecutive weeks. . Adjacent to this, BFR may reduce the fracture associated pain (hypoanalgesic effect) and improve overall functioning which may translate to less long-term disability, which is especially relevant for the elderly. . Source: Cancio et al. (2019) Blood Flow Restriction Therapy after Closed Treatment of Distal Radius Fractures. . Loenneke et al. (2012) Rehabilitation of an osteochondral fracture using blood flow restricted exercise: A case review. . (3) Bittar et al. (2017) Effects of blood flow restriction exercises on bone metabolism: a systematic review.
December 28, 2019
This post is about the effect of BFR Resistance Training (BFR-RT) on strength and muscle mass in comparison to Conventional Resistance Training (C-RT) or High Load Resistance Training (HL-RT). . Because of the inherent difficulties of a fair comparison, results are varying of wherever BFR-RT is more or less effective. Though, at least 4 meta-analysis has explored the potential effect of BFR-RT vs (C-RT) / (HL-RT). . But even though this has been explored in several metal-analysis, methodological difficulties make the question hard to answer without further clarification. . If we take a look at short term follow-up it seems that BFR-RT can be more effective, but probably only in regards to hypertrophy. For longer follow-up periods (>10 weeks) it seems that C-RT is more effective on most parameters. . But the largest issue for measuring the effect of BFR-RT, is the different group designs, i.e. type of exercise intervention. Therefore, we have tried to pin-point some relevant comparisons and the results extracted from various meta-analysis: . BFR-RT vs C-RT (repetition matched): Strength, significant in favor of BFR-RT. Hypertrophy, significant in favor of BFR-RT. Though much higher Ratings of Perceived Exertion for BFR-RT . BFR-RT vs C-RT (voluntary/repetition failure): Similar effects, thus in favor of BFR-RT. Similar Ratings of Perceived Exertion. But anywhere from 30-50% more repetition needed without BFR. . BFR-RT vs HL-RT (relative RM matched or voluntary failure): Strength, in favor of HL-RT. Hypertrophy, similar effect. Though, longer exercise duration for HL-RT. Similar Ratings of Perceived Exertion. . Summarized: Short-term muscle mass: Probably BFR-RT. Long-term muscle mass: Approximately same. Short-term muscle strength: Approximately same. Long-term muscle strength: HL-RT. Side note: Muscle endurance and anaerobic performance: BFR-RT. Maximum power development and training to improve running velocity: HL-RT. . But these comparisons have only limited practical importance as BFR-RT is primarily targeted the impaired e.g. injured or just as an adjunct to HL-RT for the majority of athletes and average Joe´s. . Source in the comments.
December 17, 2019
This post is actually a translated repost on the potential benefit of BFR to treat Patella Femoral Pain (PFP), aka. anterior knee pain, which is common among athletes of various levels. . In the video, a sub-elite orientation runner suffering from fluctuating PFP is implementing Fit Cuffs (older version) to augment the back squat and lunges. In his case, BFR has proven to be a gamechanger in regard to less aggravation of pain. . Typically, high-load resistance training focusing on strengthening the quadriceps and hip abductors, subsequently to graduated exposure, has been recommended. . But the results from a RCT comparing BFR training and conventional resistance training, shows that BFR is just as effective to elicit strength, though, superior for people with concurrent knee pain. . Background: BFR may provide low-load quadriceps strengthening method to treat PFP as heavy resistance exercises may aggravate knee pain. . Method: BFR, n=35 vs. conventional resistance training n=34, as 8 weeks of leg press and leg extension, at 70% 1RM vs. BFR group at 30% 1RM. Interventions were compared by Kujala Patellofemoral Score, Visual Analogue Scale and pain with daily activity, isometric knee extensor torque (strength) and quadriceps muscle thickness. . Results: BFR group had a significant 93% greater reduction in pain with activities of daily living. Participants with painful resisted knee extension (n=39) had a significant greater increases in knee strength with BFR. Though, no significant difference was detected at 6 months. . Conclusion: BFR group experienced greater reduction in pain with daily living at 8 weeks. Improvements were similar between groups as worst pain and Kujala score. The subgroup analysis showed that those with pain during knee extension had greater strength gains with BFR. . Therefore, BFR can be recommended to treat PFP, especially for athletes with pain during conventional exercise or in periods of high training load, e.g. in-season. . Source: Giles et al. (2017) Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial.
December 10, 2019
This post is about BFR and some supplementary pathways to elicit strength. . In the video @noor.reno is applying Bulgarian split squat with an elevated front foot for increased range of motion. Though, the most import aspect of this relatively low-load setup, is the augmentation of BFR for contralateral leg gain. . Maintaining or improving muscle mass and strength is imperative for higher-level sports and athletic performance. . But for some individuals into training and rehab, BFR is primarily seen as a tool for the injured or otherwise impaired individuals. Thus, recently the body of research on BFR has expanded enormously and repeatedly shows to be a game changer for rapid improvement of performance. This is a soundly reason why, BFR is currently being programmed into the training routines of high-level athletes all around the world. . A relevant implication of BFR for the impaired or for the high performing athlete, is the use of single leg exercises to improve strength in both the proximal and contralateral limb relative to the cuff, as recently discovered by Bowman et al: . Methods: RCT, conducted on healthy participants by a standardized 6-week BFR protocol. BFR training on 1 extremity compared to a control group, specified as BFR-Limp vs No-BFR-Limp vs. control. . Results: A statistically 2-3 fold greater increase in strength was seen proximal and distal to the cuff (BFR-Limp vs control). . Additionally, a significant increase occurred in the thigh girth and knee extension strength for the No-BFR -Limp compared with the control group as (2.3% vs 0.8%) and (8% vs 3%) respectively. . Conclusion: BFR training led to a 2-3 fold greater increase in muscle strength. BFR training had similar strengthening effects on both proximal and distal muscle groups relative to the cuff. Gains in the contralateral limb may corroborate a systemic or crossover effect. . Source: Bowman et al. (2019) Proximal, Distal, and Contralateral Effects of Blood Flow Restriction Training on the Lower Extremities: A Randomized Controlled Trial.
December 3, 2019
This post is about arthritis in the hand and fingers and the use of BFR to improve grip strength. . The joints in the hands are some of the most delicate and just the slightest hand arthritis (HA) complicates various parts of daily living. . 1 in about 10 adults suffers from visible or invisible symptoms of HA as either spontaneous or chronic with varying symptoms such as pain, swelling, stiffness and in severe cases deformity and grinding in the joints. . Subsequently to chronic HA is the loss of grip strength which aggravates symptoms even further. . The primary grip muscles are extrinsic, i.e. muscles localized to the forearms, as the intrinsic muscles localized to the palm and fingers are primarily focused on more subtle occupations. That is why indirect training of the extrinsic muscles can improve grip strength, i.e. palmar flexion of the wrist. . That is why people that suffers from chronic types of HA often are recommended to strengthen their grip and the rational for doing low-load BFR seems apparent, especially if conventional grip training are exacerbating symptoms. The use of BFR to improve grip strength has actually been explored in at least two RCT’s: . Two groups (BFR vs. No-BFR) exercised 3d/week for 4 weeks as bilateral handgrip training in 20 min with an intensity of 60% of Maximum Voluntary Contraction (MVC),15 reps/min. (1) . The BFR-group experienced superior strength gains compared to No-BFR (16.17% vs. 8.32%). But please consider that both groups exercised at the same moderate load (60 % MVC), and these findings could not be replicated in a later study using only 30-40% MVC. (2) . Conclusion: While applying BFR to improve grip strength, consider using more than 40% MVC. . In the video an Arm Cuff and Fit Manometer is used in a practical setup to monitor the contractions ≈ 50% MVC. . (1) Source: Credeur et al. (2010) Effects of handgrip training with venous restriction on brachial artery vasodilation. . (2) Velic & Hornswill (2014) KAATSU Training and Handgrip Strength.
November 25, 2019
In this post we present the interesting results from a yet another BFR-running RCT. . The present study explored the effects of interval running performed with or without BFR on different parameters of muscle physiology and performance. . Method: Sixteen participants randomized as either BFR or No-BFR for 8 running training sessions. Before and after training, subjects completed an incremental test to determine peak running velocity/maximal running speed maximal oxygen uptake “(VO2max)” and running economy, followed by a time to exhaustion run performed at peak running velocity. . Running training for both groups consisted of progressively increasing volumes of 30 s. intervals completed at 80% of their peak running velocity. . Results: Running economy only improved in the BFR group. . Peak running velocity improved in both groups with small but significant effect size of 0.31 in favor of BFR. . Incremental test time also increased in both groups with small but significant effect size ~0.3 in the BFR group. . Time to exhaustion run was also observed in both groups (27 ± 9% vs. 17 ± 6%) as a small but significant effect size ~ 0.3 in favor of BFR. . "VO2max" improved in both improved in both groups (6.3 ± 3.5 vs 4.0 ± 3.3%) with a trend for higher gains in the BFR group vs. No-BFR. . Conclusion: Running augmented by BFR seems to improve several parameters of performance. The beneficial adaptations after BFR-running are speculated to be primarily muscular rather than cardiovascular. . In the video @frederiksass has elastic band attached to his thighs for additional activation of the hip muscles, performed at a constant pace i.e. 20-30% of his peak running velocity. . We propose, that elastic band resistance combined with BFR-running to be just as beneficial compared to high velocity running, but evading the rapid fluctuation of pressure under the cuff during forceful strides. . Source: Paton at al. (2017) The effects of muscle blood flow restriction during running training on measures of aerobic capacity and run time to exhaustion.
November 17, 2019
In this post we present the results from a BFR-futsal RCT conducted on 12 elite futsal players. . The study combined futsal training with BFR and showed that the addition of BFR was superior to normal futsal training. . Aim: The effect of 3 weeks of BFR-Futsal on performance, strength and hormone levels. . Method: 12 players, 6 BFR-players vs. 6 No-BFR. 10 sessions as small sided games 3 vs. 3, 3 min futsal followed by 2 min rest for 4-8 intervals. BFR group had cuffs inflated to 110% of leg systolic blood pressure and further increased by 10% after every two completed sessions. Intensity 80–100 % HRmax in both groups. . Results: BFR-group had significantly greater improvements in peak torque knee extension (30.9 ± 8.0% vs. 14.9 ± 7.5%), flexion (23.8 ± 8.4% vs. 8.1 ± 5.7%), favorable serum concentration of myostatin and a trend for a greater improvement in a Futsal Special Performance Test. Though, Ratings of Perceived Exertion were higher in the BFR-group: (13–14 Borg) vs. (15-17 Borg). . Conclusion: The addition of BFR to futsal practice can enhance muscle activation, strength and hormonal responses. But please consider several limitations, e.g. sample size was fairly small. . Our recommendation regarding augmentation of BFR to team sports like futsal: Be cautious if you apply BFR in situations with near maximal effort such as jumping, acceleration and change of directions, as these types of movements are associated with peak muscle forces comparable to heavy lifting. And not least, the risk of adverse events in relation to contusions on blood flow restricted limbs, which is obviously not appealing. . The inclusion of BFR in futsal or similar sports is twofold. As shown in the current study the potential performance enhancement is obvious and for rehab and return to play this seems relevant. Regarding the high exercise intensity, olieveira et al. showed that Low-intensity BFR-interval running had similar benefit compared to high-intensity BFR. . Source: Amani et al. (2019) BFR During Futsal Training Increases Muscle Activation and Strength. . Oliveira et al. (2016) Short-term BFR interval training improves both aerobic fitness and Strength.
November 11, 2019
In this post we present the outstanding results from a BFR-running RCT conducted on physically active women. . The study combined interval running with BFR and showed that training intensity and pressure are important for aerobic, anaerobic, and muscular performance! . Purpose: Comparison of different BFR stimuli and exercise intensities on aerobic, anaerobic, and muscle strength in 4 different groups, as a dose response study. . A 4-week intervention period consisted of 3d/week, 10 sets for each session as 2 min running on a treadmill with BFR interspersed by 1 min of recovery without BFR. The pressure was estimated from thigh circumference. . The four groups: (IP-CE): Increasing Pressure with Constant Exercise intensity. (CPP-IE): Constant Partial Pressure with increasing Exercise intensity. (IP-IE) Increasing pressure with increasing exercise intensity. (CCP-IE): Constant Complete occlusion with increasing exercise intensity. . The study demonstrated improvements in all aerobic and anaerobic variables in all 4 groups, with a trend for greater gains for all parameters in response to progressing intensity and high BFR stimuli. . The CCP-IE (complete occlusion) group had a trend for the greatest overall effect (Vo2max Ꙟ 14.8%). - Though, it might be contrary for safety and could hypnotically lead to adverse events. Nevertheless, this is not the first study that shows a higher BFR stimuli is superior and this was also conducted on a young population + a trend for higher Ratings of Perceived Exertion (RPE) in the CCP-IE group. . Conclusion of the study: Interval based BFR-running with higher BFR stimuli and progressive intensity is superior for overall effectiveness. . We do not recommend complete occlusion for the general public, but it is common practice that you either progress effective running time or pace. . Another discovery is that circumference seems to be a legit way to set the pressure, while using Fit Cuffs, we recommend that you use the "App". . 1st. pic- copyright @elitestlab. . Source: Amani et al. (2019) Effects of Blood Flow Restriction and Exercise Intensity on Aerobic, Anaerobic, and Muscle Strength Adaptations in Physically..
October 31, 2019
This post is about a pragmatic research project at Odder Fitness Center. . A group of Physical Therapy Students from Copenhagen University of Applied Sciences are currently exploring the potential benefit of Low Load - Blood Flow Restriction Training (BFR) for people suffering from varying degrees of knee osteoarthritis (OA). (1,2) . Freely translated as: The effect of BFR for pain, quality of life (QOL) and functioning in knee OA - a case series . Background for their study: OA is the most common joint disease in Denmark (5%), most of those people have symptoms that negatively impact QOL. Currently, the treatment for these patients is exercise based, particularly popular is the initiative “Good Life with osteoArthritis in Denmark (GLA:D®)” . Purpose of the study: To explore the importance of BFR for patients with knee OA in terms of pain level, functioning and QOL in clinical practice. . Study design: A series of patients undergo PT supervised BFR twice weekly for one month. . As this is only a pragmatic trial designed to assess the outcome of BFR for knee OA in a clinical real-life practice, the sample size is too small for the results to be generalized and applied directly. But this is interesting from other perspectives, as it evaluates the potential effectiveness of BFR for this population in a direct setting. The next step for researchers would be a larger feasibility study on BFR for OA in direct clinical practice, which involves more factors to also measure cost-effectiveness. . If you have any questions related to this pragmatic study or how to utilize BFR for all types of arthritis (3), please comment below. Stay tuned for the upcoming results from this project. . Please mind that the video footage is not from this trial. . SOURCE: (1) Vanwye et al. (2017) – Blood Flow Restriction Training: Implementation into Clinical Practice. . (2) Segal et al. 2015 – Efficacy of Blood Flow Restricted Low-Load Resistance Training in Women with Risk Factors for Symptomatic Knee OA. . (3) Rodrigues et al. (2019) - Low-load resistance training with blood flow restriction increases muscle function, mass and function in RA.
October 29, 2019
This is second post in a miniseries about the less known effects of BFR training. . Conventional high intensity exercise as both aerobic and resistance training have proven to reduce pain, known as exercise-induced hypoalgesia. . In the recent years, BFR research has also shown to reduce pain both acutely and long lasting, with huge implications for both accelerated rehab and performance. For the modulation of acute pain, at least 3 interacting pathways have been proposed (1): . (A) Changing the feedback of the central nervous system via the working muscle and hypoxia which produces pain inhibiting hormones. (B) The short increases of blood pressure simply leads to hypoalgesia. (C) The training induced discomfort creates a reduction in perception of other painful stimuli. . Regarding the potential chronic pain relief from BFR, research shows that in people with pain underneath the kneecap (PFP) and osteoarthritis this effect long lasting effect seems legit. As BFR has been compared to conventional resistance training to treat PFP and osteoarthritis in at least two separate RCT's. It seems that BFR is superior in regards to both pain relief and improvement of strength of whom with symptoms reproduces during conventional resistance exercise (2,3). . A potential explanation of the augmented hypoalgesic effect of BFR vs conventional resistance exercise, is probably an interaction of acute pain modulation and less stress on the joints during exercise. . We recommend that future BFR research explores the potential comparable benefit for shoulder and elbow pain. But if you already know of any relevant research for the upper body, please let us know in a comment. . Thanks to @Sinisa_Entrenador for the videos. . SOURCE: (1) Hughes & Patterson (2019) Low intensity blood flow restriction exercise: Rationale for a hypoalgesia effect. . (2) Giles et al. (2017) Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind RCT. . (3) Ferraz et al. (2018) Benefits of Resistance Training with Blood Flow Restriction in Knee Osteoarthritis.
October 23, 2019
This post is a case story on how BFR can make a huge difference for post-surgery knee-rehab.
@SorenRotne 51, has always been active as a committed runner, swimmer and cyclist, but for years he had suffered from severe pain in his left knee because of damage to his meniscus and cartilage, as early signs of osteoarthritis.
After several doctor visits and numerous attempts with different terapedic modalities, such as acupuncture, massage etc., he was eventually referred for surgery. Subsequently he got the judgment from the surgeon: I advise you not attempt to run again.
Søren inaugurated her wife Runa, in this sad message. She immediately contacted her personal trainer at Odder Fitness Center, @AlexOdfit and asked if he could help Søren.
Alex was of a completely different view of the prognosis of Søren knee and the potential for a succesfull return to run. So Alex went to see Søren the day after the operation, explaining about BFR training with the use of a Leg Cuff for an immediate start of rehab.
Søren started by unweighted BFR exercises for the first 10 days, before he was joined by Lars Pårup (PT & MSc) who progressed the BFR training for an intense rehab at Odder Fitness Center. The progressive rehab continued for the next 10 weeks, after which Søren moved on to conventional resistance training.
Just 3 months after the operation, he performed a 1/4 ironman in just under 3 hours.
“A great commitment and a big thanks you to Lars and Alex at Odder Fitness Center, for a targeted and effective rehabilitation that was tough, but well worth it. Today, I can run and exercise 4-5 times a week without any pain.”
If this case has any interest or if you would like to know the exact protocol used in Sørens rehab, just ask!
October 16, 2019
This is the first post in a miniseries about the less known effects of BFR training.
It has been proven that complete occlusion over long periods, e.g. hours can be detrimental. Some even fear that blood clots or even venous thromboembolism (VTE) could be formed during BFR, which is known as a hypercoagulable effect. But please remember that BFR is a brief stimuly with a sub-occlusion pressure, that can be calculated by Web App or Android App (40-80 % LOP). The actual effect of BFR on the vascular system are probably the opposite i.e. hypocoagulational!
It has been proven that both BFR and regular resistance training results in optimized working conditions for the enzymes that degrade microscopic blood clots i.e. a fibrinolytic effect. It seems plausible that BFR promotes fibrinolysis and that blood thickening will be dissolved in connection with BFR as a long-term effect.(1)
Thus, for some patients there is additional considerations prior initiating BFR, as relevant contraindications should be screened for in the acute postsurgical patient by a general VTE risk questionnaire.(2) There is also need for additional research to completely understand the risks of BFR on the acutely post orthopaedic surgery patients, as the potential benefit for this population is enormous!
Conclusion: For the general population, BFR is likely beneficial in terms of the effects on vascular health , similarly to conventional resistance training. When the amount of research in BFR on vascular health increases, BFR might become a standard therapedic modality for various circulatory disorders and acutely after orthopaedic surgery.(3)
Disclaimer: The Content is not intended to be a substitute for professional medical advice.
SOURCES: (1) Nascimento et al. (2019) Effects of blood flow restriction exercise on hemostasis: a systematic review of randomized and non-randomized trials.
(2) Bond et al. (2019) Blood Flow Restriction Resistance Exercise as a Rehabilitation Modality Following Orthopaedic Surgery: A Review of Venous Thromboembolism Risk.
(3) Yasuda et al. (2016) Use and safety of KAATSU training: Results of a national survey.
October 6, 2019
Exercise bands are the perfect supplementation to BFR-walking, as presented in this video with the collab of @Kipeconcept (KE:PE) and @Fitcuffs.
So far all of the walking-BFR studies have yet to explore the potential of elastic band resistance. Thus, at this point of time several studies have demonstrated impressive results of BFR-Walking!
It might not seem of much and for this particular athlete i.e. @frederiksass, this is probably not a sufficient stimuly. But we find the potential synergistic benefit of combining walking-BFR with elastic bands to be obvious, especially for the load compromised individuals. As the compression of relevant joints is kept to a minimum, the injured and the elderly can improve on numerous parameters of performance:
Park et al. explored the potential benefit of only 2-weeks BFR-Walking in an semi-athletic population, they found significant increases in VO2max, thigh muscles and improvements in 1.5-mile runs!
Regarding the elderly, Letieri et al. found that BFR-Walking improves functional tests, as the 30 s sit to stand, 6‐minute walk, timed up‐and‐go, and stept-test, by 10-20 min walking at 4 km/t for 5d/week. Also, Ozaki et al 2011 found improved arterial compliance after 10 weeks of BFR-walking in a similar population.
In another study on younger individuals, Sakamaki et al. found hypertrophy of the thigh (3.8%) and lower leg (3.2%) after only 3 weeks of BFR-walk as 6 d/week, 2 times/day. Thus, hypertrophy only occurred in muscles downstream relative to the cuff, as the non-restricted muscles did not.
We propose that proximal gains can be achieved by adding elastic bands to BFR-walks, as they predominantly increase the demand of the hip flexors, extensors and abductors.
(SOURCE) Park et al. (2010) Increase in VO2max following 2-week walk training with BFR.
Letieri et al. (2019) Effect of 16-Week Blood Flow Restriction Exercise on Functional Fitness in Sarcopenic Women.
Ozaki et al (2011) Increases in thigh muscle volume and strength by BFR-walk .
Sakamaki et al. (2011) Legs and Trunk Muscle Hypertrophy Following BFR-Walk with Restricted Leg muscle.