Blood flow restricted training: applications, mechanisms, and future directions

Abstract

There is a growing body of research suggesting that low intensity resistance training, completed under reduced blood flow by external compressive force on the vasculature, can elicit adaptations similar to traditional resistance training, but at a significantly reduced exercise intensity. Blood flow restriction (BFR) training was developed as a method of maintaining skeletal muscle mass in the ageing population, but advances in this area of research have broadened its application for use in both performance and rehabilitative populations. There are several proposed mechanistic theories; however, a definitive explanation is still unclear. The purpose of this article is to discuss the use of blood flow restriction in performance and rehabilitative applications, examine potential mechanisms of action, and review areas of limitation within research practices. This article also examines BFR training during transient involuntary muscle contractions evoked by transcutaneous electrical muscle stimulation as a novel training intervention for individuals with reduced motor capability. BFR is an attractive training method that could be considered as an effective modality for use by appropriately trained health and fitness practitioners, especially those working with individuals that require modified resistance training programming.