The eternal question is whether BFR is safe. The simple answer is Yes, particularly with Fit Cuffs®.
We recommend using our algorithmic-based pressure assessible at Fit Cuffs Training App > “Calculate Pressure”. Or set the pressure relative (40-80%) to Limb Occlusion Pressure / Arterial Occlusion Pressure (LOP/AOP) which is a concept that quantifies the amount of blood flow that is restricted at rest. LOP can be assessed by the LOP Device, handheld dopplers, or by high-quality pulse oximeters.
It is commonly recommended to avoid severe and unintended muscle damage during your first session of BFR. As a rule of thumb, when unaccustomed to BFR in combination with low-load resistance training, avoid going to failure and use a preset protocol of about 30x15x15x15 reps, at about 20-30% 1RM, with 30-45 s. inter-set rest for one exercise at 50-60% LOP. However, gradual exposure to higher pressures (70-80% LOP) or load progression through the repeated bout effect is key for long-term adaptations to BFR Training.
Proper application of Fit Cuffs with precautions and relevant safety measures, is highly effective at augmenting the physiological adaptations to low-load resistance and aerobic training in all populations regardless of age or training status.
Absolute contraindications for BFR are rare, and circumstances where one should not use BFR before physician approval are listed in the guidelines you will find below.
In most clinical practices, the common contraindications are relative. That is why a thorough examination and anamneses to evaluate the accumulated frailty of a client is vital.
Blood Flow Restriction – Risk Stratification
Risk stratification is a tool that allows clinicians to use their knowledge, skills, and expertise to assess and manage any risks of BFR. The following questionnaires for risk stratification are adapted to guide clinicians for the referral and assessment, when necessary.
- Patterson et al. (2019) Blood Flow Restriction Exercise: Considerations of Methodology Application, and Safety.
- Wernbom et al. (2020) Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety.
- Burr et al. (2020) Response: Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety
- Marty D. Spranger (2020) Commentary: Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety
- Kambic et Jug et Lainscak (2021) Response: Commentary: Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety
- Patterson & Brandner (2018) The role of blood flow restriction training for applied practitioners: A questionnaire-based survey.
- Yasuda et al. (2016) Use and safety of KAATSU training- Results of a national survey in 2016.
- Nakajima et al. (2006) Use and safety of KAATSU training: Results of a national survey.
- Nascimento et al. (2019) – Potential Implications of Blood Flow Restriction Exercise on Vascular Health.
- Christina-Oliveira et al. (2019) Clinical safety of blood flow-restricted training. A comprehensive review of altered muscle metaboreflex in cardiovascular disease during ischemic exercise.
- Wernbom et al. (2019) Risk of Muscle Damage With Blood Flow–Restricted Exercise Should Not Be Overlooked.
- Cezar et al. (2016) Effects of exercise training with blood flow restriction on blood pressure in medicated hypertensive patients.
- Heitkamp (2015) Training with blood flow restriction. Mechanisms, gain in strength and safety.
- Loenneke (2011) Potential safety issues with blood flow restriction training.
- Nakajima et al. (2011) Key considerations when conducting KAATSU training.
- Wernbom et al. (2011) Contractile function and sarcolemmal permeability after acute low-load resistance exercise with blood flow restriction.
- Loenneke et al. (2014) Does blood flow restriction result in skeletal muscle damage? A critical review of available evidence.
- Kacin et al. (2015) Safety Considerations With Blood Flow Restricted Resistance Training.
- Bond et al. 2019 – Blood Flow Restriction Resistance Exercise as a Rehabilitation Modality Following Orthopaedic Surgery: A Review of Venous Thromboembolism Risk
- Kambic et al. (2022) Is blood flow restriction resistance training the missing piece in cardiac rehabilitation of frail patients?
- Nascimento et al. (2022) A Useful Blood Flow Restriction Training Risk Stratification for Exercise and Rehabilitation