Abstract
PurposeThe purpose of this study was to determine the effects of blood flow restriction (BFR) using a pneumatic tourniquet on CD34+ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose compared with standard exercise.MethodsFifteen healthy volunteers (8 males and 7 females, 28.6 ± 3.6 years old) who were able to perform the exercise sessions on a VersaClimber participated. Participants were randomized to undergo an experimental (EXP) occluded testing session using the pneumatic tourniquets on all 4 extremities and a control (CON) session. The exercise protocol concluded after 9 minutes or when participants reached a rating of perceived exertion of 20. Blood draws were performed before testing and immediately after the exercise session. Blood analysis consisted of complete blood counts as well as flow cytometry to measure peripheral CD34+ counts as a marker for hematopoietic progenitor cells (HPCs).ResultsA significant increase from before to after exercise values was observed in both the EXP and CON groups with CD34+, WBC counts, platelets, and lymphocytes; however, no differences existed between EXP and CON groups for any variable. CD34+ increased in the EXP (3.1 ± 1.6 vs. 4.3 ± 1.8 cells · L–1; P < .001) and CON (3.3 ± 1.9 vs. 4.4 ± 1.4 cells · L–1; P < .001) sessions. White blood cells also significantly increased in both the EXP (7.8 ± 1.4 vs. 11.8 ± 2.5 K · L–1 K · L–1; P < .001) and CON (7.5 ± 1.8 vs. 11.3 ± 3.0 K · L–1; P < .001) sessions. Platelets also increased in both the EXP (258.6 ± 52.5 vs. 309.9 ± 52.7 K · L–1; P < .001) and CON (263.1 ± 44.7 vs. 316.1 ± 43.9 K · L–1; P < .001) sessions, and conversely, a significant decrease in the average neutrophil counts in the EXP (mean difference = –13.7%; P < .001) and CON (mean difference = –13.2%; P < .001) sessions was observed. Lymphocyte counts in the EXP (mean difference = 22.8%; P < .001) and CON (mean difference = 19.3%; P < .001) sessions increased significantly.ConclusionsThere were no significant differences in systemic cellular responses when undergoing aerobic-based exercise with and without a pneumatic tourniquet system.Level of Evidence2, prospective comparative study.
Highlights
The purpose of this study was to determine the effects of blood flow restriction (BFR) using a pneumatic tourniquet on CD34þ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose compared with standard exercise
Systemic cellular responses such as increases in CD34þ and cellular expression of genes related to muscle upregulation occur during exercise with BFR, which may contribute to increases in muscular size and strength to proximal muscle groups that are not directly occluded.[7,8,9,10]
The increases in proximal muscle size and strength with the use of BFR is ideal for orthopedic rehabilitation in patient populations who are unable to perform high-intensity exercise and who have failed to improve with traditional therapy.[2,5,11,12]
Summary
The purpose of this study was to determine the effects of blood flow restriction (BFR) using a pneumatic tourniquet on CD34þ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose compared with standard exercise. Most of the scientific literature on the cellular responses to BFR has been performed using pneumatic BFR devices that adjust in real time to ensure consistent limb occlusion pressure throughout the full range of motion of an exercise. These types of devices are more cumbersome and restrictive in their use, and can be expensive. The portability of the tourniquet system used in the current study makes it advantageous to use in clinical settings; there is currently a gap in knowledge regarding its efficacy in creating beneficial systemic cellular responses
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