Blood Flow Restriction Therapy

And it’s effects on muscular strength

By Cody Small

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Overview

Make up of a muscle and steps for contractions

Muscle Hypertrophy and how it occursWhy muscle strength is importantWhat Is Blood Flow restriction therapy?Case StudyHow can it benefit our patients What are some complications with BFR

exercise

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Components of a Muscle

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Muscle Contractions

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Muscle Hypertrophy

Muscle grows along lines of stressExercise increases muscle size and cross

sectional area• Eccentric and Concentric contractions at about

80-90% 1 RM(2-6 reps) • Low intensity: 20-30% with 20-30 reps

Progressive overloadMyofibril hypertrophy increases

strength

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Why is muscle Strength important?

Provide Stability and support to our body

Allows patients to perform ADL

Overall increase in health

Injury Prevention/disease

Increased Endurance

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What is Blood Flow restriction?

Blood flow restriction uses a tourniquet/occlusion bands to restrict venous blood flow without restricting arterial blood flow.

Commonly used in Surgery and Strength training

So how does this work?

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Mechanism of BFR therapy

Occlusion of venous blood flow without affecting arterial blood flow

Decrease 02 recruits type 2 fibers• Leads to increase in production of muscle

metabolites; GH, IGF1, satelliteLow oxygen supply leads to anaerobic

energy production build up of lactic acid protein synthesis

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Case Study: Title

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Case Study: Objective

Achieve muscle hypertrophy with the use of elastic bands instead of high intensity exercise in conjunction with BFR

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Case Study: Methods

Subjects: 9 healthy men, 23-41 years of ageSubjects were required to perform bilateral triceps extension and bicep flexion with and without a BFR cuff separated 1 week apart randomly30 reps followed by 3 sets of 15 reps

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Case Study: Methods continued

Cuff restriction(170-260 mmhg) was determined by rate of perceived exertion during the exercises that were to be conducted in the study

EMG recording was done to look at muscle activity for each exercise treatment

Heart Rate measurements were taken baseline, Post and 15 minute post exercise

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Case Study: Methods continuedBlood lactate levels were measured prior to treatment, Post treatment, and 15 minutes post treatment

Exercise intensity was determined with EMG recordings with free weights for the same exercises(10%, 20%, 30%, 40% and 50%)

RPE was measured with the Borg scale at the end of each set

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Case Study: Results

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Case Study: Results

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Case Study: Results

At baseline Blood lactate levels were no different between the BFR and the control group(1.0 +/- . 01 vs 1.0 +/- .2 mmol/L). Blood lactate Post exercise was higher in the BFR group(3.6 vs 2.1 mmol/L) and remained elevated(1.8 vs 1.2mml)

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Case Study: Results

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Case Study: Results

No measurable difference at baseline for heart rate(67.4 +/-9.6 vs 66.0 +/- 9.2)

After exercises Heart rate was higher in the BFR group(109+/- 22 a min vs 90 +/- 15 a min

RPE was greater in the BFR group(17.4 +/- 1.7 vs 12.9 +/- 1.6)

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How it Relates to Physical Therapy

BFR allows you to reduce the load on a joint while still increasing strength gains

No longer have to do Max Reps to see strength gains!

Can be used for patient’s, like Total knee replacement patient’s

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Down sides to Blood flow restriction Therapy

Delayed onset muscle soreness

Can only be used for the extremities

Cuff can be applied to tightly

Increase in HR and BP at same intensity without BFR

Possibility of Thrombosis • Recent study found that there is an increase in tPA

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References Hackney, K., Everett, M., Scott, J., & Ploutz-Snyder, L. (2012). Blood flow-restricted exercise in space. Extreme Physiology & Medicine, 12-12. Retrieved December 15, 2014, from http://www.extremephysiolmed.com/content/1/1/12#refs

Yasuda, T., Fukuda, T., Fukumura, K., Lida, H., Imuta, H., Sato, Y., ... Nakajima, T. (2012). Effects of Low intensity, elastic band resistance exercise combined with blow flow restriction on muscle activation. Scandinavian Journal of Medicine and Science in Sports, 55-61.