Restricted Flow Research Articles

Enhancing Economic, Social, and Ecological Resilience Through Sustainable Waterfront Development in Penang

The global economic disruption caused by the COVID-19 pandemic has significantly impacted development across various regions, including Penang, where supply chain disruptions, restricted cash flow, and delayed progress have led to reduced economic growth for stakeholders and communities alike. This study aims to explore the interconnected economic, social, and ecological (ESE) systems within the context of sustainable waterfront development in Penang, focusing on how these systems contribute to economic resilience and dynamism. The land and water resources of Penang, strategically situated along vital maritime routes, present substantial potential for economic revitalization. A quantitative research approach was employed, gathering data from questionnaire surveys, revealing a positive correlation between ESE variables. Key attributes such as local authority governance, development scale and impact, business operations, place identity, heritage preservation, and waste management were found to play crucial roles in shaping sustainable waterfront initiatives. The study highlights that Penang’s core economic sectors—agriculture, mining and quarrying, manufacturing, construction, and services—have historically driven the local economy, but the growing focus on waterfront development offers new avenues for economic recovery and growth. The results validate the chosen quantitative methodology and underscore the importance of adopting integrated strategies to address land and water management challenges. By aligning with sustainability goals and adopting a holistic approach, Penang's waterfront development can foster resilience, ensuring long-term socio-economic and ecological balance. The insights provided contribute to a broader understanding of sustainable urban development and offer actionable strategies for policymakers and stakeholders involved in Penang's waterfront projects.

Body position and cuff size influence lower limb arterial occlusion pressure and its predictors: implications for standardizing the pressure applied in training with blood flow restriction.

Background: Arterial occlusion pressure (AOP) is a relevant measurement for individualized prescription of exercise with blood flow restriction (BFRE). Therefore, it is important to consider factors that may influence this measure. Purpose: This study aimed to compare lower limb AOP (LL-AOP) measured with 11cm (medium) and 18cm (large) cuffs, in different body positions, and explore the predictors for each of the LL-AOP measurements performed. This information may be useful for future studies that seek to develop approaches to improve the standardization of pressure adopted in BFRE, including proposals for equations to estimate LL-AOP. Methods: This is a cross-sectional study. Fifty-one healthy volunteers (males, n = 25, females, n = 26; Age: 18-40years old) underwent measurement of thigh circumference (TC), brachial blood pressure, followed by assessments of LL-AOP with medium and large cuffs in positions supine, sitting and standing positions. Results: The large cuff required less external pressure (mmHg) to elicit arterial occlusion in all three-body positions when compared to the medium cuff (p < 0.001). The LL-AOP was significantly lower in the supine position, regardless of the cuff used (p < 0.001). Systolic blood pressure was the main predictor of LL-AOP in the large cuff, while TC was the main predictor of LL-AOP with the medium cuff. Body position influenced strength of the LL-AOP predictors. Conclusion: Our results indicate that LL-AOP and its predictors are substantially influenced by body position and cuff width. Therefore, these variables should be considered when standardizing the pressure prescribed in BFRE.

Blood flow restriction training (BFRT) in patients before and after total knee arthroplasty

In healthy individuals, blood flow restriction training (BFRT) has shown positive effects on muscle mass, strength, fatigue resistance, as well as tendon and bone metabolism. BFRT reduces blood flow in the extremities using inflatable cuffs, creating local muscular hypoxia, which produces an anabolic metabolic environment. This promotes significant muscular and cardiovascular adaptations even at low mechanical training loads. BFRT also shows promising initial results in pre- and postoperative applications for knee endoprostheses (KTEP). Both preoperative and postoperative BFRT can improve muscle strength and joint function, accelerate recovery, and alleviate pain. Although the method is generally safe, potential risks such as discomfort and rare side effects must be considered. Clear application protocols are still lacking, necessitating further research and individualized programs to achieve optimal training effects. BFRT thus offers an innovative way to effectively rehabilitate patients despite their low load tolerance.

Low-Load Resistance Exercise With Blood Flow Restriction Versus High-Load Resistance Exercise on Hamstring Muscle Adaptations in Recreationally Trained Men.

Kamiş, O, Gürses, VV, Şendur, HN, Altunsoy, M, Pekel, HA, Yıldırım, E, and Aydos, L. Low-load resistance exercise with blood flow restriction vs. high-load resistance exercise on hamstring muscle adaptations in recreationally trained men. J Strength Cond Res XX(X): 000-000, 2024-Low-load resistance exercise with blood flow restriction (BFR-RE) has been suggested as a viable alternative exercise for traditional high-load resistance exercise (HL-RE). However, very little is known about hamstring muscle thickness, stiffness, and strength after BFR-RE. This study aimed to compare the effects of 6 weeks of BFR-RE and HL-RE on hamstring muscle thickness, stiffness, and strength. Twenty-nine recreationally trained men were pair matched and randomly assigned to the BFR-RE (n = 15) and HL-RE (n = 14) groups. The BFR-RE groups performed bilateral lying leg curl exercise (30-15-15-15 reps, 30-second rest between the sets, 30% 1RM) with BFR cuffs (60% of limb occlusion pressure), whereas HL-RE performed the same exercise (3 × 12 reps, 90-second rest between the sets, 70% 1RM) without BFR cuffs. Hamstring muscle thickness, muscle stiffness, isokinetic muscle strength, and 1RM were assessed at baseline and follow-up after completing a 6-week resistance exercise program (3× a week). Hamstring muscle thickness was assessed by ultrasonography, whereas muscle stiffness was evaluated by shear wave elastography. Isokinetic dynamometry and a 1RM strength test were used to determine muscular strength before and after the exercise program. Statistical significance was set at p < 0.05. No significant effect was found for hamstring muscle strength, thickness, and stiffness for group and group × time interaction, and only a significant main effect of time (p < 0.001) was observed for all outcomes. Both groups experienced significant improvements for all outcomes from baseline to follow-up without any between-group differences. In conclusion, results revealed that BFR-RE can provide similar hamstring muscle strength, thickness, and stiffness compared with HL-RE.

A Review of the Efficacy and Mechanisms of Blood Flow Restriction Training in Enhancing Somatic Function and Preventing Falls in Older Adults.

Falls have become an important public health problem that seriously affects the quality of survival of older adultsand are a major cause of fractures, death, and reduced quality of life. With the advent of an aging society, the social, economic, and medical burdens of falls in older adults are increasing. Currently, there is a lack of effective means to prevent falls in older adults, and traditional health education and clinical interventions are not effective. It is urgent to find a safe and effective training method that can improve balance function and is suitable for the elderly. Low-intensity blood flow restriction training (BFRT) is an emerging training modality that, by restricting blood flow to the limbs and combining it with low-intensity exercise, can effectively improve muscle mass, aerobic capacity, and bone density, and has been shown to enhance somatic function in older adults. However, the effectiveness and specific mechanisms of BFRT in preventing falls in older adults are unclear. Based on recent research progress, this paper explores the possibility of BFRT in preventing falls in older adults by analyzing its positive effects on muscle mass, balance function, and cognitive function, the risk factors of falling in the elderly are summarized, as well as its potential role in reducing fall risk factors. It aims to provide new thinking for academia and clinical practice and to provide a scientific basis for reducing the risk of falls in the elderly.

Comparing adaptations from blood flow restriction exercise training using regulated or unregulated pressure systems: A systematic review and meta-analysis

Objective No study has examined outcomes derived from blood flow restriction exercise training interventions using regulated compared with unregulated blood flow restriction pressure systems. Therefore, we used a systematic review and meta-analyses to compare the chronic adaptations to blood flow restriction exercise training achieved with regulated and unregulated blood flow restriction pressure systems. Data sources The electronic database search included using the tool EBSCOhost and other online database search engines. The search included Medline, SPORTDiscus, CINAHL, Embase and SpringerLink. Methods Included studies utilised chronic blood flow restriction exercise training interventions greater than two weeks duration, where blood flow restriction was applied using a regulated or unregulated blood flow restriction pressure system, and where outcome measures such as muscle strength, muscle size or physical function were measured both pre- and post-training. Studies included in the meta-analyses used an equivalent non-blood flow restriction exercise comparison group. Results Eighty-one studies were included in the systematic review. Data showed that regulated (n = 47) and unregulated (n = 34) blood flow restriction pressure systems yield similar training adaptations for all outcome measures post-intervention. For muscle strength and muscle size, this was reaffirmed in the included meta-analyses. Conclusion This review indicates that practitioners may achieve comparable training adaptations with blood flow restriction exercise training using either regulated or unregulated blood flow restriction pressure systems. Therefore, additional factors such as device quality, participant comfort and safety, cost and convenience are important factors to consider when deciding on appropriate equipment to use when prescribing blood flow restriction exercise training.

Deciphering Blood Flow Restriction Training to Aid Lipid Lowering in Obese College Students through Untargeted Metabolomics.

(1) Objective: The aim of this study was to observe the lipid-lowering effects of blood flow restriction training (BFR) combined with moderate-intensity continuous training (MICT) in obese college students by observing lipid-lowering hormones and untargeted metabolomics. (2) Methods: In this study, 14 obese college students were convened into three groups-MICT, MICT+BFR, and high-intensity interval training (HIIT)-for a crossover experiment. Blood was drawn before and after exercise for the analysis of lipolytic agents and untargeted metabolomics. The study used a paired t-test and ANOVA for statistical analyses. (3) Results: The lipolytic agent results showed that MICT+BFR was superior to the other two groups in terms of two agents (p = 0.000 and p = 0.003), namely, GH and IL-6 (difference between before and after testing: 10,986.51 ± 5601.84 and 2.42 ± 2.49, respectively), and HIIT was superior to the other two groups in terms of one agent (p = 0.000), i.e., EPI (22.81 ± 16.12). No advantage was observed for MICT. The metabolomics results showed that, compared to MICT, MICT+BFR was associated with the upregulated expression of xanthine, succinate, lactate, N-lactoylphenylalanine, citrate, ureido acid, and myristic acid after exercise, with the possibility of the involvement of the citric acid cycle, alanine, aspartic acid, glutamate metabolism, butyric acid metabolism, and the histidylate metabolism pathway. (4) Conclusions: The superior lipid-lowering effect of MICT+BFR over MICT in a group of obese college students may be due to the stronger activation of GH and IL-6 agents, with the citric acid cycle and alanine, aspartate, and glutamate metabolic pathways being associated with this type of exercise.

Enhancing lower limb and core muscle activation with blood flow restriction training: a randomized crossover study on high-intensity squat exercises.

The primary objective of this study was to assess the impact of high-intensity deep squat training integrated with various blood flow restriction (BFR) modalities on the activation of lower limb and core muscles. A randomized, self-controlled crossover experimental design was employed with 12 participants. The exercise protocol consisted of squat training at 75% of one-repetition maximum (1RM), performed in 3 sets of 8 repetitions with a 2-min inter-set rest period. This was conducted under four distinct BFR conditions: continuous low BFR (T1), intermittent medium BFR (T2), intermittent high BFR (T3), and a non-restricted control (C). Surface electromyography (EMG) was utilized to collect EMG signals from the target muscles during the BFR and squat training sessions. The root mean square (RMS) amplitude standard values were calculated for each squat set to quantify muscle activation levels, with these values expressed as a percentage of the maximum voluntary contraction (%MVC). Rating of Perceived Exertion was evaluated after each squat set, and leg circumference measurements were taken. 1) During the first two sets of deep squats, the %MVC of the vastus lateralis and vastus medialis in all compression groups was significantly higher than that in the control group (p < 0.05). Furthermore, in the first set, the %MVC of the vastus lateralis in Group T3 was significantly higher than in Group T2 (p < 0.05). In the third set, the %MVC of the vastus medialis in Groups T1 and T3 was significantly lower than in the first two sets (p < 0.05). 2) Group T1 showed an increased activation of the biceps femoris and semitendinosus muscles in the second and third sets, with %MVC values significantly greater than in the first set (p < 0.05). Group T2 only showed an increase in biceps femoris activation in the third set (p < 0.05). Group T3 significantly increased the activation of the biceps femoris and semitendinosus muscles only in the first set (p < 0.05). 3) No significant differences were observed in the changes of rectus abdominis %MVC among the groups (p > 0.05). In the first set, Group T3's erector spinae %MVC was significantly higher than the control group's; in the second set, it was significantly higher than both Group T2 and the control group's (p < 0.05). 4) After training, a significant increase in thigh circumference was observed in all groups compared to before training (p < 0.05). 5) For RPE values, Group T2's post-squat values were significantly higher than the control group's after all three sets (p < 0.05). Group T1's RPE values were also significantly higher than the control group's after the third set (p < 0.05). Groups T1, T2, and C all had significantly higher RPE values in the second and third sets compared to the first set (p < 0.05). All BFR modalities significantly enhanced the activation level of the anterior thigh muscles, with the continuous low BFR mode demonstrating a more stable effect. No significant differences were found in the activation level of the rectus abdominis among the groups. However, the intermittent high BFR mode was the most effective in increasing the activation level of the erector spinae muscles. While BFR did not further augment leg circumference changes, it did elevate subjective fatigue levels. The RPE was lowest during squatting under the intermittent high BFR condition.

Acute neuromuscular and perceptual responses to blood flow restriction exercise in adults with severe haemophilia: A pilot study.

No previous studies have implemented a standard blood flow restriction (BFR) training session in people with severe haemophilia (PwH), where this type of training has been contraindicated. The purpose of this study was to evaluate the tolerability, adverse events, and neuromuscular and perceptual responses to an acute session of low load (LL) knee extensions with BFR in PwH under prophylaxis. Eight PwH performed one LL-BFR session with 40% arterial occlusion pressure (AOP). Perceptual responses and adverse effects were assessed, together with high-density surface electromyography of vastus medialis (VM) and lateralis (VL). Significant normalized root mean square differences were found within each set, but not between sets. Spatial distribution (centroid displacement (p>.05), modified entropy (VM, set two, cycles three and five, p=.032) and coefficient of variation (VM, set two, cycles four and five lower than cycle three (p=.049; p=.036)) showed changes within each set. Median frequency showed a slight increase during cycle four of set four (p=.030). Rate of perceived exertion slightly increased with each set while tolerability slightly decreased in the last set and fear of training with BFR generally decreased after the session. In PwH, a LL-BFR session at 40% AOP is safe and feasible. Our results suggest that potential muscle impairments may blunt neuromuscular adaptations induced by BFR.

Acute effects of blood flow restricted aerobic exercise in type 2 diabetes mellitus.

This study aimed to compare the acute effects of aerobic exercise performed with blood flow restriction (BFR), a novel method to increase exercise gains, with blood free flow (BFF) conditions in type 2 diabetes mellitus (T2DM). Fifteen individuals with T2DM performed BFF and BFR (40% of arterial occlusion pressure) cycling exercises 48 hours apart, at equal intensity (45% heart rate reserve) and duration (38 minutes). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), blood glucose, heart rate, and muscle oxygen saturation (SmO2) were assessed before-after and during exercise sessions. SBP, DBP, and MAP in the overload phase were higher in the BFR group than in the BFF group (P = .009, 0.031, and 0.013, respectively). Changes in blood pressure (∆SBP and ∆DBP) were similar between the BFF and BFR groups (P > .05), whereas ∆MAP differed (P = .016). Changes in blood glucose levels and heart rates were not significantly different between the groups. Although SmO2baseline was lower in the BFR group (P = .049), SmO2min and SmO2max did not differ significantly between the BFF and BFR groups. The similar decrease in blood glucose levels between the groups suggests that BFR exercise is favorable in terms of hypoglycemia. The higher blood pressure observed during the BFR exercise remained within safe limits. These results suggest that people with T2DM can safely perform BFR aerobic exercises; however, further studies are required.

Caffeine Abstinence in Habituated Users: Cardiovascular Responses to Exercise With Blood Flow Restriction.

Blood flow restriction resistance exercise studies often require caffeine abstinence to avoid cardiovascular effects that could change the blood flow restriction stimulus. However, effects may be attenuated for habituated users. To compare cardiovascular responses to blood flow restriction resistance exercise when habituated users consume or abstain from caffeine. Thirty participants completed a 3-visit within-subject study beginning with familiarization and caffeine intake questionnaire. Visits 2 and 3 consisted of blood flow restriction resistance exercise (3 sets bicep curls to failure, 30% 1-repetition max, 40% arterial occlusion pressure [AOP]), following participants' normal caffeine consumption (CAFF) or abstaining (ABS). AOP, systolic (SBP) and diastolic (DBP) blood pressure, and heart rate were measured preexercise and postexercise. Prevalues and preexercise to postexercise change scores for SBP, DBP, AOP (all millimeters of mercury), heart rate (in beats per minute), and repetitions were compared between conditions. Results are represented as mean (SD). Preexercise AOP was similar for CAFF (137.8 [14.4]) and ABS (137.1 [14.9], BF10 = 0.2), although pre-SBP was higher for CAFF (115.4 [9.8]) than ABS (112.3 [9.4], BF10 = 1.9). Pre-DBP was similar between conditions. The exercise-induced change in AOP was greater for CAFF (18.4 [11.2]) than ABS (13.2 [14.9]), though evidence was anecdotal (BF10 = 0.7). Exercise-induced changes in SBP, DBP, and heart rate were similar between conditions (all BF10 ≤ 0.40). More repetitions were completed for CAFF (63 [26]) than ABS (57 [17], BF10 = 2.1). The findings of this study suggest that for habituated users, maintaining daily caffeine habits will not have substantial effects on common cardiovascular variables relevant to blood flow restriction.

Acute neuromuscular, cardiovascular, and muscle oxygenation responses to low-intensity aerobic interval exercises with blood flow restriction.

We investigated the influence of short- and long-interval cycling exercise with blood flow restriction (BFR) on neuromuscular fatigue, shear stress and muscle oxygenation, potent stimuli to BFR-training adaptations. During separate sessions, eight individuals performed short- (24×60s/30s; SI) or long-interval (12×120s/60s; LI) trials on a cycle ergometer, matched for total work. One leg exercised with (BFR-leg) and the other without (CTRL-leg) BFR. Quadriceps fatigue was quantified using pre- to post-interval changes in maximal voluntary contraction (MVC), potentiated twitch force (QT) and voluntary activation (VA). Shear rate was measured by Doppler ultrasound at cuff release post-intervals. Vastus lateralis tissue oxygenation was measured by near-infrared spectroscopy during exercise. Following the initial interval, significant (P<0.05) declines in MVC and QT were found in both SI and LI, which were more pronounced in the BFR-leg, and accounted for approximately two-thirds of the total reduction at exercise termination. In the BFR-leg, reductions in MVC (-28±15%), QT (-42±17%), and VA (-15±17%) were maximal at exercise termination and persisted up to 8min post-exercise. Exercise-induced muscle deoxygenation was greater (P<0.001) in the BFR-leg than CTRL-leg and perceived pain was more in LI than SI (P<0.014). Cuff release triggered a significant (P<0.001) shear rate increase which was consistent across trials. Exercise-induced neuromuscular fatigue in the BFR-leg exceeded that in the CTRL-leg and was predominantly of peripheral origin. BFR also resulted in diminished muscle oxygenation and elevated shear stress. Finally, short-interval trials resulted in comparable neuromuscular and haemodynamic responses with reduced perceived pain compared to long-intervals.

The effect of low-intensity suspension training with blood flow restriction on GH, IGF-1, and their association with physical fitness in young women.

Blood flow restriction (BFR) has been incorporated in resistance training for over 20 years. We aimed to investigate the impact of low-intensity suspension training with BFR (LIST+BFR) on GH, IGF-1, and their association with physical fitness in young women. Thirty-six active women participated and were randomly assigned to either the high-intensity suspension training (HIST), LIST+BFR, or control (CON) groups. Training groups exercised three sessions weekly for 8 weeks. The CON only engaged in regular physical activity. Fasting serum hormones and physical fitness were assessed 48 h before and after the training intervention. GH and IGF-1 levels significantly higher in the LIST+BFR compared to the HIST and CON. These hormones were significantly higher by HIST, compared to CON. LIST+BFR led to significant enhancements in muscular strength and endurance compared to HIST and CON. Additionally, HIST significantly higher than compared to CON. Sprinting and agility time lower in both suspension training groups rather than the CON. No significant between-groups differences were found in weight. There was a large or moderate correlation between GH and IGF-1 and muscular strength, endurance, sprint, and agility performance. LIST+BFR could more enhanced GH, IGF-1, and muscular strength and endurance in females than HIST.

Individuals Can be Taught to Sense the Degree of Vascular Occlusion: Implications for Practical Blood Flow Restriction.

Song, JS, Hammert, WB, Kataoka, R, Yamada, Y, Kang, A, and Loenneke, JP. Individuals can be taught to sense the degree of vascular occlusion: Implications for practical blood flow restriction. J Strength Cond Res 38(8): 1413-1418, 2024-It is currently unknown if individuals can be conditioned to a relative arterial occlusion pressure (AOP) and replicate that pressure at a later time point. The purpose of this study was to determine whether individuals can be taught to sense a certain relative pressure (i.e., target pressure) by comparing a conditioning method with a time-matched non-conditioning control. Fifty-eight subjects completed 2 visits in a randomized order: (a) conditioning condition and (b) time-matched control condition. The conditioning involved 11 series of inflations to 40% AOP for 12 seconds followed by cuff deflation for 22 seconds. The pressure estimations were taken at 5 and 30 minutes after each condition. Data are presented as mean differences (95% credible interval). The absolute error at 5 minutes was greater for the control compared with conditioning condition (7.1 [2.0-12.1] mm Hg). However, this difference in absolute error between conditioning and control was reduced at 30 minutes (2.9 [-1.3 to 7.1] mm Hg). The mean difference and 95% limits of agreement for the control were 8.2 (-42.4 to 58.5) mm Hg at 5 minutes and 0.02 (-43.5 to 43.5) at 30 minutes. The agreements for the conditioning were -6.2 (-32.4 to 20.0) mm Hg at 5 minutes and -11.2 (-36.6 to 14.3) mm Hg at 30 minutes. The results suggest that the individuals can be taught to sense the target pressure, but this effect only lasts a short amount of time. Future work is necessary to refine the conditioning method to extend the duration of this conditioning effect.

The Effect of Blood Flow Restriction Training on Quadriceps Activity After Anterior Cruciate Ligament Reconstruction: A Preliminary Randomized Controlled Trial

The Effect of Blood Flow Restriction Training on Quadriceps Activity After Anterior Cruciate Ligament Reconstruction: A Preliminary Randomized Controlled Trial

Leveraging Pumped Storage Power Plants for Innovative Stability Enhancement of Weakly Interconnected Power Systems

The hybrid AC/DC grid, based on a significant share of renewable energy sources, is gradually becoming an essential aspect of the modern energy system. The integration of intermittent renewable generators into contemporary energy systems is accompanied by the decommissioning of power plants containing synchronous generators. Consequently, this leads to a reduction in system inertia and an increase in the risk of stability disruption. The abrupt disconnection of the primary generator or power line can result in an unanticipated mismatch between power generation and consumption. This discrepancy can trigger substantial and swiftly evolving alterations in power distribution, angular speed, load flow, and the frequency of generators. The risks of an energy system collapse can be mitigated through automation, enabling rapid adjustments to generation and load capacities, as well as power flows, in the electrical network. This article justifies the utilisation of a power control method for high-voltage power line interconnections. The technology of hydro storage power plants and measurements of voltage phasors are employed. The potential for easing power flow restrictions and realising substantial economic benefits is supported by the results obtained using simplified dynamic model of the Baltic power system and Nord Pool electricity market model.

Hypoalgesia and Conditioned Pain Modulation in Blood Flow Restriction Resistance Exercise.

We compared the magnitude of exercise-induced hypoalgesia and conditioned pain modulation between blood-flow restriction (BFR) resistance exercise (RE) and moderate-intensity RE. Twenty-five asymptomatic participants performed unilateral leg press in two visits. For moderate-intensity RE, subjects exercised at 50% 1RM without BFR, whereas BFR RE exercised at 30% 1RM with a cuff inflated to 60% limb occlusion pressure. Exercise-induced hypoalgesia was quantified by pressure pain threshold changes before and after RE. Conditioned pain modulation was tested using cold water as the conditioning stimulus and mechanical pressure as the test stimulus and quantified as pressure pain threshold change. Difference in conditioned pain modulation pre- to post-RE was then calculated. The differences of RE on pain modulations were compared using paired t-tests. Pearson's r was used to examine the correlation between exercise-induced hypoalgesia and changes in conditioned pain modulation. We found greater hypoalgesia with BFR RE compared to moderate-intensity RE (p=0.008). Significant moderate correlations were found between exercise-induced hypoalgesia and changes in conditioned pain modulation (BFR: r=0.63, moderate-intensity: r=0.72). BFR RE has favorable effects on pain modulation in healthy adults and the magnitude of exercise-induced hypoalgesia is positively correlated with conditioned pain modulation activation.

Are calves trainable? Low-intensity calf muscle training with or without blood flow restriction: a randomized controlled trial

Abstract Objectives Whether low-load resistance training (RT) without muscle failure, with or without blood flow restriction (BFR), is sufficient to increase strength and muscle growth of calf muscles in trained individuals is still unclear. This study aimed to compare the effects of low-intensity BFR RT vs. traditional low-intensity RT (noBFR) with moderate training volume on strength and circumference. Methods We designed a parallel, randomized controlled trial including 36 RT-trained participants (BFR: 7 females, 32.9 ± 8.8 years, 11 males, 28.4 ± 3.6 years; noBFR; 8 females, 29.6 ± 3.4 years; 10 males, 28.6 ± 4.9 years) who underwent eight weeks of twice-weekly low-load RT with 16 weekly RT sets (30 % of one-repetition maximum [1RM]). RT consisted of bilateral calf raises and seated unilateral calf raises, each conducted with 4 sets (30, 15, 15, 15 repetitions not to failure) of either BFR or noBFR. Outcome measures included calf circumference (CC), leg stiffness (LS), and various strength tests (seated and standing calf raise 1RM, isokinetic strength of plantar- and dorsiflexion). Results There were no significant interactions or group effects for most measures. Both groups showed significant improvements in seated calf raise strength (p=0.046, η 2 p=0.17). Pairwise comparisons indicated moderate to large effect sizes for strength improvements (standardized mean differences: 0.35–1.11), but no changes in calf circumference were observed in either group. Conclusions Low-load RT with and without BFR are useful to increase strength without necessarily affecting hypertrophy. Low-intensity BFR training did not confer additional benefits over traditional low-intensity RT for calf muscle strength or circumference, questioning its general advantage under such conditions.

Design, modelling and evaluation of a variable inertance bypass fluid inerter

The inerter emerged as a mechanical analogy to the electrical capacitor, completing the force-current analogy. It operates as a one-port, two terminal device, where the equal and opposite forces at its terminals correlate with the relative acceleration between them. This relationship is governed by ‘inertance’, a quantity that bears the unit of mass, allowing inerters to exert inertial forces. Inerters have gained considerable traction, particularly in vibration control applications. Derived from their passive counterparts, variable inertance inerters enable active control of their inertance through integrated control mechanisms. This work presents the design, modelling and evaluation of a variable inertance inerter prototype dubbed the ‘Variable Inertance Bypass Fluid Inerter’ (VIBFI). An experimental prototype of the concept was designed, constructed and tested. Simultaneously, an effort to develop and validate a mathematical model of the VIBFI is thoroughly documented. Experimental results demonstrate the controllability of performance parameters of the device, including inertance and damping coefficients, through modulating the flow restriction of the bypass channel. The mathematical models derived for the device can serve as an estimate for its performance parameters, though further refinement is required.

Atrial Septal Defect Stent Compression During Resuscitation of an Infant With Hypoplastic Left Heart Syndrome.

A newborn with hypoplastic left heart syndrome underwent a Norwood procedure with a Sano shunt. A month later, he had an atrial septal defect (ASD) stent placed due to ASD size and flow restriction. Three weeks later, he had sudden bradycardia and cardiac arrest in the intensive care unit. He was resuscitated and cannulated for extracorporeal membrane oxygenation (ECMO) through a right neck approach. An attempt to wean him from ECMO a week later failed due to hypoxia. Echocardiography showed ASD flow restriction and a chest x-ray showed flattening of the left atrial side of the ASD stent from chest compression resulting in a restrictive ASD. The patient underwent surgical removal of the ASD stent with ASD enlargement and was successfully weaned from ECMO after surgery.