Abstract
What is the topic of this review? Blood-flow-restricted (BFR) exercise represents a potential approach to augment the adaptive response to training and improve performance in endurance-trained individuals. What advances does it highlight? When combined with low-load resistance exercise, low- and moderate-intensity endurance exercise and sprint interval exercise, BFR can provide an augmented acute stimulus for angiogenesis and mitochondrial biogenesis. These augmented acute responses can translate into enhanced capillary supply and mitochondrial function, and subsequent endurance-type performance, although this might depend on the nature of the exercise stimulus. There is a requirement to clarify whether BFR training interventions can be used by high-performance endurance athletes within their structured training programme. A key objective of the training programme for an endurance athlete is to optimize the underlying physiological determinants of performance. Training-induced adaptations are governed by physiological and metabolic stressors, which initiate transcriptional and translational signalling cascades to increase the abundance and/or function of proteins to improve physiological function. One important consideration is that training adaptations are reduced as training status increases, which is reflected at the molecular level as a blunting of the acute signalling response to exercise. This review examines blood-flow-restricted (BFR) exercise as a strategy for augmenting exercise-induced stressors and subsequent molecular signalling responses to enhance the physiological characteristics of the endurance athlete. Focus is placed on the processes of capillary growth and mitochondrial biogenesis. Recent evidence supports that BFR exercise presents an intensified training stimulus beyond that of performing the same exercise alone. We suggest that this has the potential to induce enhanced physiological adaptations, including increases in capillary supply and mitochondrial function, which can contribute to an improvement in performance of endurance exercise. There is, however, a lack of consensus regarding the potency of BFR training, which is invariably attributable to the different modes, intensities and durations of exercise and BFR methods. Further studies are needed to confirm its potential in the endurance-trained athlete.
Highlights
A key objective of the training programme for an endurance athlete is to optimize the underlying physiological determinants of performance (Figure 1)
The focus of the present review is on adaptations associated with capillary growth and mitochondrial biogenesis, because much of the published research on BFR training in relationship to endurance performance has been concentrated on these factors
Exercise with BFR presents an intensified training stimulus that promotes homeostatic perturbations and associated molecular signalling for endurance adaptation
Summary
A key objective of the training programme for an endurance athlete is to optimize the underlying physiological determinants of performance (Figure 1). When combined with low-load resistance exercise, low- and moderate-intensity endurance exercise and sprint interval exercise, BFR can provide an augmented acute stimulus for angiogenesis and mitochondrial biogenesis These augmented acute responses can translate into enhanced capillary supply and mitochondrial function, and subsequent endurance-type performance, this might depend on the nature of the exercise stimulus. An important consideration is that training adaptations are reduced as training status increases (e.g., Laursen & Jenkins, 2002) This is reflected at a molecular level as a blunting of the signalling response to a single session of exercise (Flück, 2010; Granata et al, 2020; Perry et al, 2010). The question is, what interventions can be used to augment the stress and subsequent signalling response to exercise which, if repeated over time, will lead to enhanced physiological adaptation and endurance performance, in trained populations? We examine the evidence for exercise performed with blood flow restriction (BFR) as an effective strategy to augment the exercise-induced stress and subsequent signalling
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