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Investigating the autoregulation of applied blood flow restriction training pressures in healthy, physically active adults: an intervention study evaluating acute training responses and safety
  1. Ewoud Jacobs1,
  2. Nicholas Rolnick2,
  3. Evi Wezenbeek1,
  4. Lenka Stroobant3,
  5. Robbe Capelleman1,
  6. Nele Arnout3,
  7. Erik Witvrouw1,
  8. Joke Schuermans1
  1. 1Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
  2. 2The Human Performance Mechanic, Lehman College, New York City, New York, USA
  3. 3Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
  1. Correspondence to Ewoud Jacobs, Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Gent 9000, Belgium; ewoud.jacobs{at}ugent.be

Abstract

Objective To examine the effects of autoregulated (AUTO) and non-autoregulated (NAUTO) blood flow restriction (BFR) application on adverse effects, performance, cardiovascular and perceptual responses during resistance exercise.

Methods Fifty-six healthy participants underwent AUTO and NAUTO BFR resistance exercise in a randomised crossover design using a training session with fixed amount of repetitions and a training session until volitional failure. Cardiovascular parameters, rate of perceived effort (RPE), rate of perceived discomfort (RPD) and number of repetitions were investigated after training, while the presence of delayed onset muscle soreness (DOMS) was verified 24 hours post-session. Adverse events during or following training were also monitored.

Results AUTO outperformed NAUTO in the failure protocol (p<0.001), while AUTO scored significantly lower for DOMS 24 hours after exercise (p<0.001). Perceptions of effort and discomfort were significantly higher in NAUTO compared with AUTO in both fixed (RPE: p=0.014, RPD: p<0.001) and failure protocol (RPE: p=0.028, RPD: p<0.001). Sixteen adverse events (7.14%) were recorded, with a sevenfold incidence in the fixed protocol for NAUTO compared with AUTO (NAUTO: n=7 vs AUTO: n=1) and five (NAUTO) vs three (AUTO) adverse events in the failure protocol. No significant differences in cardiovascular parameters were found comparing both pressure applications.

Conclusion Autoregulation appears to enhance safety and performance in both fixed and failure BFR-training protocols. AUTO BFR training did not seem to affect cardiovascular stress differently, but was associated with lower DOMS, perceived effort and discomfort compared with NAUTO.

Trial registration number NCT04996680.

  • Athletic Performance
  • Exercise training
  • Physiology
  • Muscle, Skeletal
  • BFR-training
  • KAATSU
  • Safety

Data availability statement

Data are available on reasonable request. Data are available upon reasonable request. Requests for data sharing from appropriate researchers and entities will be considered on a case-by-case basis. Interested parties should contact EJ (ewoud.jacobs@ugent.be).

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Data availability statement

Data are available on reasonable request. Data are available upon reasonable request. Requests for data sharing from appropriate researchers and entities will be considered on a case-by-case basis. Interested parties should contact EJ (ewoud.jacobs@ugent.be).

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Footnotes

  • Twitter @Ewoud Jacobs, @thebfrpros, @WezenbeekEvi

  • Contributors First author EJ is responsible for the overal content as guarantor. NR conceived of the study. EJ and NR designed the exercise protocol. EJ performed all data collection, statistical analyses and designed the tables with the help of EW and JS. LS was the responsible physician during data collection. EJ and NR drafted the first version of the manuscript. EJ, NR, EW, RC, NA and JS critically revised the manuscript and approved its final form.

  • Funding This research was funded by the Fonds voor Wetenschappelijk Onderzoek Vlaanderen (FWO).

  • Competing interests NR is the founder of The BFR PROS and teaches BFR training workshops to fitness and rehabilitation practitioners using a variety of BFR training devices.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.