Abstract
The purpose of this study was to determine the difference in cuff pressure which occludes arterial blood flow for two different types of cuffs which are commonly used in blood flow restriction (BFR) research. Another purpose of the study was to determine what factors (i.e., leg size, blood pressure, and limb composition) should be accounted for when prescribing the restriction cuff pressure for this technique. One hundred and sixteen (53 males, 63 females) subjects visited the laboratory for one session of testing. Mid-thigh muscle (mCSA) and fat (fCSA) cross-sectional area of the right thigh were assessed using peripheral quantitative computed tomography. Following the mid-thigh scan, measurements of leg circumference, ankle brachial index, and brachial blood pressure were obtained. Finally, in a randomized order, arterial occlusion pressure was determined using both narrow and wide restriction cuffs applied to the most proximal portion of each leg. Significant differences were observed between cuff type and arterial occlusion (narrow: 235 (42) mmHg vs. wide: 144 (17) mmHg; p = 0.001, Cohen’s D = 2.52). Thigh circumference or mCSA/fCSA with ankle blood pressure, and diastolic blood pressure, explained the most variance in the cuff pressure required to occlude arterial flow. Wide BFR cuffs restrict arterial blood flow at a lower pressure than narrow BFR cuffs, suggesting that future studies account for the width of the cuff used. In addition, we have outlined models which indicate that restrictive cuff pressures should be largely based on thigh circumference and not on pressures previously used in the literature.
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References
ACSM (2009) American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 41(3):687–708
Cook SB, Clark BC, Ploutz-Snyder LL (2007) Effects of exercise load and blood-flow restriction on skeletal muscle function. Med Sci Sports Exerc 39(10):1708–1713
Crenshaw AG, Hargens AR, Gershuni DH, Rydevik B (1988) Wide tourniquet cuffs more effective at lower inflation pressures. Acta Orthop Scand 59(4):447–451
Fahs CA, Rossow LM, Seo DI, Loenneke JP, Sherk VD, Kim E, Bemben DA, Bemben MG (2011) Effect of different types of resistance exercise on arterial compliance and calf blood flow. Eur J Appl Physiol. doi:10.1007/s00421-011-1927-y
Iida H, Kurano M, Takano H, Kubota N, Morita T, Meguro K, Sato Y, Abe T, Yamazaki Y, Uno K, Takenaka K, Hirose K, Nakajima T (2007) Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects. Eur J Appl Physiol 100(3):275–285
Inagaki Y, Madarame H, Neya M, Ishii N (2011) Increase in serum growth hormone induced by electrical stimulation of muscle combined with blood flow restriction. Eur J Appl Physiol. doi:10.1007/s00421-011-1899-y
Kacin A, Strazar K (2011) Frequent low-load ischemic resistance exercise to failure enhances muscle oxygen delivery and endurance capacity. Scand J Med Sci Sports. doi:10.1111/j.1600-0838.2010.01260.x
Karabulut M, Bemben DA, Sherk VD, Anderson MA, Abe T, Bemben MG (2011a) Effects of high-intensity resistance training and low-intensity resistance training with vascular restriction on bone markers in older men. Eur J Appl Physiol 111(8):1659–1667
Karabulut M, McCarron J, Abe T, Sato Y, Bemben M (2011b) The effects of different initial restrictive pressures used to reduce blood flow and thigh composition on tissue oxygenation of the quadriceps. J Sports Sci 29(9):951–958
Kubota A, Sakuraba K, Sawaki K, Sumide T, Tamura Y (2008) Prevention of disuse muscular weakness by restriction of blood flow. Med Sci Sports Exerc 40(3):529–534
Kubota A, Sakuraba K, Koh S, Ogura Y, Tamura Y (2011) Blood flow restriction by low compressive force prevents disuse muscular weakness. J Sci Med Sport 14(2):95–99
Laurentino G, Ugrinowitsch C, Aihara AY, Fernandes AR, Parcell AC, Ricard M, Tricoli V (2008) Effects of strength training and vascular occlusion. Int J Sports Med 29(8):664–667
Laurentino G, Ugrinowitsch C, Roschel H, Aoki MS, Soares AG, Neves M, Aihara AY, da Rocha Correa Fernandes A, Tricoli V (2011) Strength training with blood flow restriction diminishes myostatin gene expression. Med Sci Sports Exerc. doi: 10.1249/MSS.0b013e318233b4bc
Loenneke JP, Pujol TJ (2009) The use of occlusion training to produce muscle hypertrophy. Strength Cond J 31(3):77–84
Loenneke JP, Pujol TJ (2011) Sarcopenia: an emphasis on occlusion training and dietary protein. Hippokratia 15(2):132–137
Loenneke JP, Kearney ML, Thrower AD, Collins S, Pujol TJ (2010a) The acute response of practical occlusion in the knee extensors. J Strength Cond Res 24(10):2831–2834
Loenneke JP, Wilson GJ, Wilson JM (2010b) A mechanistic approach to blood flow occlusion. Int J Sports Med 31(1):1–4
Loenneke JP, Balapur A, Thrower AD, Barnes JT, Pujol TJ (2011a) Blood flow restriction reduces time to muscular failure. Eur J of Sport Sci. doi:10.1080/17461391.2010.551420
Loenneke JP, Balapur A, Thrower AD, Barnes JT, Pujol TJ (2011b) The perceptual responses to occluded exercise. Int J Sports Med 32(3):181–184
Loenneke JP, Fahs CA, Wilson JM, Bemben MG (2011c) Blood flow restriction: the metabolite/volume threshold theory. Med Hypotheses 77(5):748–752
Loenneke JP, Thrower AD, Balapur A, Barnes JT, Pujol TJ (2011d) The energy requirement of walking with restricted blood flow. Acta Kinesiologica (In press)
Loenneke JP, Wilson JM, Wilson GJ, Pujol TJ, Bemben MG (2011e) Potential safety issues with blood flow restriction training. Scand J Med Sci Sports 21(4):510–518
Loenneke JP, Thrower AD, Balapur A, Barnes JT, Pujol TJ (2011f) Blood flow–restricted walking does not result in an accumulation of metabolites. Clin Physiol Funct Imaging. doi:10.1111/j.1475-097X.2011.01059.x
Manini TM, Vincent KR, Leeuwenburgh CL, Lees HA, Kavazis AN, Borst SE, Clark BC (2011) Myogenic and proteolytic mRNA expression following blood flow restricted exercise. Acta Physiol (Oxf) 201(2):255–263
O’Brien RM (2007) A caution regarding rules of thumb for variance inflation factors. Qual Quant 41:673–690
Patterson SD, Ferguson RA (2011) Enhancing strength and postocclusive calf blood flow in older people with training with blood-flow restriction. J Aging Phys Act 19(3):201–213
Rossow L, Fahs CA, Sherk VD, Seo D, Bemben DA, Bemben MG (2011) The effect of acute blood-flow-restricted resistance exercise on postexercise blood pressure. Clin Physiol Funct Imaging 31(6):429–434
Sakamaki M, Bemben MG, Abe T (2011) Legs and trunk muscle hypertrophy following walk training with restricted leg muscle blood flow. J Sports Sci Med 10:338–340
Shaw JA, Murray DG (1982) The relationship between tourniquet pressure and underlying soft-tissue pressure in the thigh. J Bone Joint Surg Am 64(8):1148–1152
Sugaya M, Yasuda T, Suga T, Okita K, Abe T (2011) Change in intramuscular inorganic phosphate during multiple sets of blood flow-restricted low-intensity exercise. Clin Physiol Funct Imaging 31(5):411–413
Takada S, Okita K, Suga T, Omokawa M, Morita N, Horiuchi M, Kadoguchi T, Takahashi M, Hirabayashi K, Yokota T, Kinugawa S, Tsutsui H (2011) Blood Flow Restriction Exercise in Sprinters and Endurance Runners. Med Sci Sports Exerc. doi:10.1249/MSS.0b013e31822f39b3
Teramoto M, Golding LA (2006) Low-intensity exercise, vascular occlusion, and muscular adaptations. Res Sports Med 14(4):259–271
Wernbom M, Augustsson J, Thomee R (2006) Effects of vascular occlusion on muscular endurance in dynamic knee extension exercise at different submaximal loads. J Strength Cond Res 20(2):372–377
Wernbom M, Jarrebring R, Andreasson MA, Augustsson J (2009) Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load. J Strength Cond Res 23(8):2389–2395
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Communicated by Keith Phillip George.
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Loenneke, J.P., Fahs, C.A., Rossow, L.M. et al. Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise. Eur J Appl Physiol 112, 2903–2912 (2012). https://doi.org/10.1007/s00421-011-2266-8
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DOI: https://doi.org/10.1007/s00421-011-2266-8