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Abstract
Purpose: Medically recommended training often faces the dilemma that necessary mechanical intensities for muscle adaptations exceed patients' physical capacity. In this regard, blood flow restriction (BFR) training is becoming increasingly popular because it enables gains in muscle mass and strength despite using low-mechanical loads combined with external venous occlusion. Since the underlying mechanisms are still unknown, we applied invasive measurements during exercise with and without BFR to promote physiological understanding and safety of this popular training technique.Methods: In a randomized cross-over design, ten healthy men (28.1 ± 6.5 years) underwent two trials of unilateral biceps curls either with (BFR) and without BFR (CON). For analysis of changes in intravascular pressures, blood gases, oximetry and electrolytes, an arterial and a venous catheter were placed at the exercising arm before exercise. Arterial and venous blood gases and intravascular pressures were analyzed before, during and 5 min after exercise.Results: Intravascular pressures in the arterial and venous system were more increased during exercise with BFR compared to CON (p < 0.001). Furthermore, arterial and venous blood gas analyses revealed a BFR-induced metabolic acidosis (p < 0.05) with increased lactate production (p < 0.05) and associated elevations in [K+], [Ca2+] and [Na+] (p < 0.001).Conclusion: The present study describes for the first time the local physiological changes during BFR training. While BFR causes greater hypertension in the arterial and venous system of the exercising extremity, observed electrolyte shifts corroborate a local metabolic acidosis with concurrent rises in [K+] and [Na+]. Although BFR could be a promising new training concept for medical application, its execution is associated with comprehensive physiological challenges.
Highlights
Training patients to maintain or improve muscle mass often faces a dilemma as the lower limit of recommended loads for resistance training (>50% one repetition maximum, 1RM) often exceeds the patients’ physical capacity
In the BFR trial, participants were not able to perform the same amount of repetitions beginning in the second set leading to a shorter time under tension in the last three sets (p < 0.001)
At Pre, before exercise, no significant differences between conditions were detected in any outcome parameter
Summary
Training patients to maintain or improve muscle mass often faces a dilemma as the lower limit of recommended loads for resistance training (>50% one repetition maximum, 1RM) often exceeds the patients’ physical capacity. Over the last two decades, there has been growing evidence that the original recommendations for exercise intensity are no longer tenable According to these data, 20–30% of the individual 1RM is sufficient to achieve muscle mass and strength gains when the blood supply to the working muscles is restricted and venous return is blocked (Patterson et al, 2019). 20–30% of the individual 1RM is sufficient to achieve muscle mass and strength gains when the blood supply to the working muscles is restricted and venous return is blocked (Patterson et al, 2019) This type of training is known as blood flow restriction training (BFR-training) and is becoming increasingly popular in recreational and competitive sports. To assess the physiological consequences of BFR-training on a local and systemic level, we performed an invasive catheter approach to measure changes in hemodynamic, metabolic and ionic balance during low-load BFR-training in both the arterial and venous system
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