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http://dx.doi.org/10.4196/kjpp.2015.19.3.191

Low Intensity Resistance Exercise Training with Blood Flow Restriction: Insight into Cardiovascular Function, and Skeletal Muscle Hypertrophy in Humans  

Park, Song-Young (Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center)
Kwak, Yi Sub (Department of Physical Education, Dong-Eui University)
Harveson, Andrew (Department of Exercise and Sport Science, University of Utah, Salt Lake City)
Weavil, Joshua C. (Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center)
Seo, Kook E. (Department of Sports Science, Pusan National University)
Publication Information
The Korean Journal of Physiology and Pharmacology / v.19, no.3, 2015 , pp. 191-196 More about this Journal
Abstract
Attenuated functional exercise capacity in elderly and diseased populations is a common problem, and stems primarily from physical inactivity. Decreased function and exercise capacity can be restored by maintaining muscular strength and mass, which are key factors in an independent and healthy life. Resistance exercise has been used to prevent muscle loss and improve muscular strength and mass. However, the intensities necessary for traditional resistance training to increase muscular strength and mass may be contraindicated for some at risk populations, such as diseased populations and the elderly. Therefore, an alternative exercise modality is required. Recently, blood flow restriction (BFR) with low intensity resistance exercise (LIRE) has been used for such special populations to improve their function and exercise capacity. Although BFR+LIRE has been intensively studied for a decade, a comprehensive review detailing the effects of BFR+LIRE on both skeletal muscle and vascular function is not available. Therefore, the purpose of this review is to discuss previous studies documenting the effects of BFR+LIRE on hormonal and transcriptional factors in muscle hypertrophy and vascular function, including changes in hemodynamics, and endothelial function.
Keywords
Blood flow restriction; Low intensity resistance exercise; Muscular hypertrophy; Vascular function;
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1 Karabulut M, Abe T, Sato Y, Bemben MG. The effects of low-intensity resistance training with vascular restriction on leg muscle strength in older men. Eur J Appl Physiol. 2010;108:147-155.   DOI
2 Jones DA, Rutherford OM. Human muscle strength training: the effects of three different regimens and the nature of the resultant changes. J Physiol. 1987;391:1-11.
3 Heffernan KS, Sosnoff JJ, Fahs CA, Shinsako KK, Jae SY, Fernhall B. Fractal scaling properties of heart rate dynamics following resistance exercise training. J Appl Physiol (1985). 2008;105:109-113.   DOI
4 Ozaki H, Miyachi M, Nakajima T, Abe T. Muscle volume and strength and arterial compliance after walk training with blood flow reduction in elderly women. J Am Geriatr Soc. 2010;58:1597-1598.   DOI
5 Manini TM, Clark BC. Blood flow restricted exercise and skeletal muscle health. Exerc Sport Sci Rev. 2009;37:78-85.   DOI
6 Credeur DP, Hollis BC, Welsch MA. Effects of handgrip training with venous restriction on brachial artery vasodilation. Med Sci Sports Exerc. 2010;42:1296-1302.   DOI
7 Heffernan KS, Edwards DG, Rossow L, Jae SY, Fernhall B. External mechanical compression reduces regional arterial stiffness. Eur J Appl Physiol. 2007;101:735-741.   DOI
8 Iida H, Kurano M, Takano H, Kubota N, Morita T, Meguro K, Sato Y, Abe T, Yamazaki Y, Uno K, Takenaka K, Hirose K, Nakajima T. Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects. Eur J Appl Physiol. 2007;100:275-285.   DOI
9 Godfrey RJ, Whyte GP, Buckley J, Quinlivan R. The role of lactate in the exercise-induced human growth hormone response: evidence from McArdle disease. Br J Sports Med. 2009;43:521-525.   DOI
10 Gerber HP, Vu TH, Ryan AM, Kowalski J, Werb Z, Ferrara N. VEGF couples hypertrophic cartilage remodeling, ossification and angiogenesis during endochondral bone formation. Nat Med. 1999;5:623-628.   DOI
11 Nakajima T, Iida H, Kurano M, Takano H, Morita T, Meguro K, Sato Y, Yamazaki Y, Kawashima S, Ohshima H, Tachibana S, Ishii N, Abe T. Hemodynamic responses to simulated weightlessness of 24-h head-down bed rest and KAATSU blood flow restriction. Eur J Appl Physiol. 2008;104:727-737.   DOI
12 Renzi CP, Tanaka H, Sugawara J. Effects of leg blood flow restriction during walking on cardiovascular function. Med Sci Sports Exerc. 2010;42:726-732.
13 DeVan AE, Anton MM, Cook JN, Neidre DB, Cortez-Cooper MY, Tanaka H. Acute effects of resistance exercise on arterial compliance. J Appl Physiol (1985). 2005;98:2287-2291.   DOI
14 Tanaka M, Sugawara M, Ogasawara Y, Izumi T, Niki K, Kajiya F. Intermittent, moderate-intensity aerobic exercise for only eight weeks reduces arterial stiffness: evaluation by measurement of stiffness parameter and pressure-strain elastic modulus by use of ultrasonic echo tracking. J Med Ultrason (2001). 2013;40:119-124.   DOI
15 Sharman JE, McEniery CM, Campbell RI, Coombes JS, Wilkinson IB, Cockcroft JR. The effect of exercise on large artery haemodynamics in healthy young men. Eur J Clin Invest. 2005;35:738-744.   DOI
16 Ives DT, Calcus A, Kalluri S, Strelcyk O, Sheft S, Lorenzi C. Effects of noise reduction on AM and FM perception. J Assoc Res Otolaryngol. 2013;14:149-157.   DOI
17 Park S, Kim JK, Choi HM, Kim HG, Beekley MD, Nho H. Increase in maximal oxygen uptake following 2-week walk training with blood flow occlusion in athletes. Eur J Appl Physiol. 2010;109:591-600.   DOI
18 Takano H, Morita T, Iida H, Asada K, Kato M, Uno K, Hirose K, Matsumoto A, Takenaka K, Hirata Y, Eto F, Nagai R, Sato Y, Nakajima T. Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow. Eur J Appl Physiol. 2005;95:65-73.   DOI
19 Alomari MA, Welsch MA. Regional changes in reactive hyperemic blood flow during exercise training: time-course adaptations. Dyn Med. 2007;6:1.   DOI
20 McGowan CL, Levy AS, McCartney N, MacDonald MJ. Isometric handgrip training does not improve flow-mediated dilation in subjects with normal blood pressure. Clin Sci (Lond). 2007;112:403-409.   DOI
21 Patterson SD, Ferguson RA. Increase in calf post-occlusive blood flow and strength following short-term resistance exercise training with blood flow restriction in young women. Eur J Appl Physiol. 2010;108:1025-1033.
22 Loenneke JP, Wilson JM, Wilson GJ, Pujol TJ, Bemben MG. Potential safety issues with blood flow restriction training. Scand J Med Sci Sports. 2011;21:510-518.   DOI
23 Malfatto G, Facchini M, Sala L, Branzi G, Bragato R, Leonetti G. Effects of cardiac rehabilitation and beta-blocker therapy on heart rate variability after first acute myocardial infarction. Am J Cardiol. 1998;81:834-840.   DOI
24 Coats AJ. Exercise rehabilitation in chronic heart failure. J Am Coll Cardiol. 1993;22(4 Suppl A):172A-177A.   DOI
25 Mayer F, Scharhag-Rosenberger F, Carlsohn A, Cassel M, Muller S, Scharhag J. The intensity and effects of strength training in the elderly. Dtsch Arztebl Int. 2011;108:359-364.
26 Heydari M, Boutcher YN, Boutcher SH. High-intensity intermittent exercise and cardiovascular and autonomic function. Clin Auton Res. 2013;23:57-65.   DOI
27 Kiyohara Y. Trends in the type-specific incidence of stroke in a general Japanese population: the Hisayama Study. Nihon Rinsho. 2006;64 Suppl 7:38-42.
28 Takamoto K, Sakai S, Hori E, Urakawa S, Umeno K, Ono T, Nishijo H. Compression on trigger points in the leg muscle increases parasympathetic nervous activity based on heart rate variability. J Physiol Sci. 2009;59:191-197.   DOI
29 Burgomaster KA, Moore DR, Schofield LM, Phillips SM, Sale DG, Gibala MJ. Resistance training with vascular occlusion: metabolic adaptations in human muscle. Med Sci Sports Exerc. 2003;35:1203-1208.   DOI
30 Figueroa A, Vicil F. Post-exercise aortic hemodynamic responses to low-intensity resistance exercise with and without vascular occlusion. Scand J Med Sci Sports. 2011;21:431-436.   DOI
31 Cook SB, Clark BC, Ploutz-Snyder LL. Effects of exercise load and blood-flow restriction on skeletal muscle function. Med Sci Sports Exerc. 2007;39:1708-1713.   DOI
32 Fales JT, Heisey SR, Zierler KL. Blood flow from and oxygen uptake by muscle, during and after partial venous occlusion. Am J Physiol. 1962;203:470-474.
33 Karabulut M, Leal JA Jr, Garcia SD, Cavazos C, Bemben M. Tissue oxygenation, strength and lactate response to different blood flow restrictive pressures. Clin Physiol Funct Imaging. 2014;34:263-269.   DOI
34 Rossow LM, Fahs CA, Loenneke JP, Thiebaud RS, Sherk VD, Abe T, Bemben MG. Cardiovascular and perceptual responses to blood-flow-restricted resistance exercise with differing restrictive cuffs. Clin Physiol Funct Imaging. 2012;32:331-337.   DOI
35 Hamilton CA, Brosnan MJ, McIntyre M, Graham D, Dominiczak AF. Superoxide excess in hypertension and aging: a common cause of endothelial dysfunction. Hypertension. 2001;37:529-534.   DOI
36 Daley MJ, Spinks WL. Exercise, mobility and aging. Sports Med. 2000;29:1-12.   DOI
37 Fabre JM, Wood RH, Cherry KE, Su LJ, Cress ME, King CM, deVeer MJ, Ellis R, Jazwinski SM; Louisiana Healthy Aging Study. Age-related deterioration in flexibility is associated with health-related quality of life in nonagenarians. J Geriatr Phys Ther. 2007;30:16-22.   DOI
38 Savinainen M, Nygard CH, Korhonen O, Ilmarinen J. Changes in physical capacity among middle-aged municipal employees over 16 years. Exp Aging Res. 2004;30:1-22.   DOI
39 Tanaka H, Munakata M, Kawano Y, Ohishi M, Shoji T, Sugawara J, Tomiyama H, Yamashina A, Yasuda H, Sawayama T, Ozawa T. Comparison between carotid-femoral and brachialankle pulse wave velocity as measures of arterial stiffness. J Hypertens. 2009;27:2022-2027.   DOI
40 Celermajer DS, Sorensen KE, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Deanfield JE. Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol. 1994;24:471-476.   DOI
41 Hamilton MT, Areiqat E, Hamilton DG, Bey L. Plasma triglyceride metabolism in humans and rats during aging and physical inactivity. Int J Sport Nutr Exerc Metab. 2001;11 Suppl:S97-104.   DOI
42 Otsuki T, Takanami Y, Aoi W, Kawai Y, Ichikawa H, Yoshikawa T. Arterial stiffness acutely decreases after whole-body vibration in humans. Acta Physiol (Oxf). 2008;194:189-194.   DOI
43 Monahan KD, Dinenno FA, Tanaka H, Clevenger CM, DeSouza CA, Seals DR. Regular aerobic exercise modulates age-associated declines in cardiovagal baroreflex sensitivity in healthy men. J Physiol. 2000;529 Pt 1:263-271.   DOI
44 Tanaka H, DeSouza CA, Seals DR. Absence of age-related increase in central arterial stiffness in physically active women. Arterioscler Thromb Vasc Biol. 1998;18:127-132.   DOI
45 Cortez-Cooper MY, DeVan AE, Anton MM, Farrar RP, Beckwith KA, Todd JS, Tanaka H. Effects of high intensity resistance training on arterial stiffness and wave reflection in women. Am J Hypertens. 2005;18:930-934.   DOI
46 Madden KM, Lockhart C, Cuff D, Potter TF, Meneilly GS. Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension, and hypercholesterolemia. Diabetes Care. 2009;32:1531-1535.   DOI
47 Jackson AS, Sui X, Hebert JR, Church TS, Blair SN. Role of lifestyle and aging on the longitudinal change in cardiorespiratory fitness. Arch Intern Med. 2009;169:1781-1787.
48 Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK; American College of Sports Medicine. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41:459-471.
49 Kawano H, Tanimoto M, Yamamoto K, Sanada K, Gando Y, Tabata I, Higuchi M, Miyachi M. Resistance training in men is associated with increased arterial stiffness and blood pressure but does not adversely affect endothelial function as measured by arterial reactivity to the cold pressor test. Exp Physiol. 2008;93:296-302.   DOI
50 Miyachi M, Kawano H, Sugawara J, Takahashi K, Hayashi K, Yamazaki K, Tabata I, Tanaka H. Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study. Circulation. 2004;110:2858-2863.   DOI
51 Abe T, Sakamaki M, Fujita S, Ozaki H, Sugaya M, Sato Y, Nakajima T. Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in older adults. J Geriatr Phys Ther. 2010;33:34-40.
52 Ozaki H, Miyachi M, Nakajima T, Abe T. Effects of 10 weeks walk training with leg blood flow reduction on carotid arterial compliance and muscle size in the elderly adults. Angiology. 2011;62:81-86.   DOI
53 Fry CS, Glynn EL, Drummond MJ, Timmerman KL, Fujita S, Abe T, Dhanani S, Volpi E, Rasmussen BB. Blood flow restriction exercise stimulates mTORC1 signaling and muscle protein synthesis in older men. J Appl Physiol (1985). 2010;108:1199-1209.   DOI
54 Yasuda T, Fukumura K, Uchida Y, Koshi H, Iida H, Masamune K, Yamasoba T, Sato Y, Nakajima T. Effects of low-load, elastic band resistance training combined with blood flow restriction on muscle size and arterial stiffness in older adults. J Gerontol A Biol Sci Med Sci. 2014. [Epub ahead of print]
55 Abe T, Kearns CF, Sato Y. Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol (1985). 2006;100:1460-1466.   DOI
56 Ryushi T, Kumagai K, Hayase H, Abe T, Shibuya K, Ono A. Effect of resistive knee extension training on postural control measures in middle aged and elderly persons. J Physiol Anthropol Appl Human Sci. 2000;19:143-149.   DOI
57 Thiebaud RS, Loenneke JP, Fahs CA, Rossow LM, Kim D, Abe T, Anderson MA, Young KC, Bemben DA, Bemben MG. The effects of elastic band resistance training combined with blood flow restriction on strength, total bone-free lean body mass and muscle thickness in postmenopausal women. Clin Physiol Funct Imaging. 2013;33:344-352.   DOI
58 Fahs CA, Rossow LM, Thiebaud RS, Loenneke JP, Kim D, Abe T, Beck TW, Feeback DL, Bemben DA, Bemben MG. Vascular adaptations to low-load resistance training with and without blood flow restriction. Eur J Appl Physiol. 2014;114:715-724.   DOI
59 Mackintosh SF, Goldie P, Hill K. Falls incidence and factors associated with falling in older, community-dwelling, chronic stroke survivors (>1 year after stroke) and matched controls. Aging Clin Exp Res. 2005;17:74-81.   DOI
60 Rees SS, Murphy AJ, Watsford ML. Effects of whole-body vibration exercise on lower-extremity muscle strength and power in an older population: a randomized clinical trial. Phys Ther. 2008;88:462-470.   DOI
61 Mackintosh SF, Hill K, Dodd KJ, Goldie P, Culham E. Falls and injury prevention should be part of every stroke rehabilitation plan. Clin Rehabil. 2005;19:441-451.   DOI
62 Hakkinen K. Neuromuscular fatigue and recovery in male and female athletes during heavy resistance exercise. Int J Sports Med. 1993;14:53-59.   DOI
63 Hakkinen K, Pakarinen A. Acute hormonal responses to two different fatiguing heavy-resistance protocols in male athletes. J Appl Physiol (1985). 1993;74:882-887.   DOI
64 Kraemer RR, Hollander DB, Reeves GV, Francois M, Ramadan ZG, Meeker B, Tryniecki JL, Hebert EP, Castracane VD. Similar hormonal responses to concentric and eccentric muscle actions using relative loading. Eur J Appl Physiol. 2006;96:551-557.   DOI
65 Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and training. Sports Med. 2005;35:339-361.   DOI
66 Takarada Y, Takazawa H, Sato Y, Takebayashi S, Tanaka Y, Ishii N. Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. J Appl Physiol (1985). 2000;88:2097-2106.   DOI
67 Takarada Y, Sato Y, Ishii N. Effects of resistance exercise combined with vascular occlusion on muscle function in athletes. Eur J Appl Physiol. 2002;86:308-314.   DOI
68 Takarada Y, Nakamura Y, Aruga S, Onda T, Miyazaki S, Ishii N. Rapid increase in plasma growth hormone after low-intensity resistance exercise with vascular occlusion. J Appl Physiol (1985). 2000;88:61-65.   DOI
69 Pierce JD, Goodyear-Bruch C, Hall S, Clancy RL. Effect of dopamine on rat diaphragm apoptosis and muscle performance. Exp Physiol. 2006;91:731-740.   DOI
70 Takarada Y, Takazawa H, Ishii N. Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc. 2000;32:2035-2039.   DOI
71 Ploutz LL, Tesch PA, Biro RL, Dudley GA. Effect of resistance training on muscle use during exercise. J Appl Physiol (1985). 1994;76:1675-1681.   DOI
72 Hawke TJ, Garry DJ. Myogenic satellite cells: physiology to molecular biology. J Appl Physiol (1985). 2001;91:534-551.   DOI
73 Barton ER. Viral expression of insulin-like growth factor-I isoforms promotes different responses in skeletal muscle. J Appl Physiol (1985). 2006;100:1778-1784.   DOI
74 Drummond MJ, Fujita S, Abe T, Dreyer HC, Volpi E, Rasmussen BB. Human muscle gene expression following resistance exercise and blood flow restriction. Med Sci Sports Exerc. 2008;40:691-698.   DOI
75 Bamman MM, Shipp JR, Jiang J, Gower BA, Hunter GR, Goodman A, McLafferty CL Jr, Urban RJ. Mechanical load increases muscle IGF-I and androgen receptor mRNA concentrations in humans. Am J Physiol Endocrinol Metab. 2001;280:E383-390.   DOI
76 Bickel CS, Slade J, Mahoney E, Haddad F, Dudley GA, Adams GR. Time course of molecular responses of human skeletal muscle to acute bouts of resistance exercise. J Appl Physiol (1985). 2005;98:482-488.   DOI
77 Semsarian C, Sutrave P, Richmond DR, Graham RM. Insulin-like growth factor (IGF-I) induces myotube hypertrophy associated with an increase in anaerobic glycolysis in a clonal skeletal-muscle cell model. Biochem J. 1999;339:443-451.   DOI
78 Kim H, Barton E, Muja N, Yakar S, Pennisi P, Leroith D. Intact insulin and insulin-like growth factor-I receptor signaling is required for growth hormone effects on skeletal muscle growth and function in vivo. Endocrinology. 2005;146:1772-1779.   DOI
79 Yasuda T, Brechue WF, Fujita T, Shirakawa J, Sato Y, Abe T. Muscle activation during low-intensity muscle contractions with restricted blood flow. J Sports Sci. 2009;27:479-489.   DOI
80 Gerber HP, Hillan KJ, Ryan AM, Kowalski J, Keller GA, Rangell L, Wright BD, Radtke F, Aguet M, Ferrara N. VEGF is required for growth and survival in neonatal mice. Development. 1999;126:1149-1159.
81 Hunt TK, Aslam R, Hussain Z, Beckert S. Lactate, with oxygen, incites angiogenesis. Adv Exp Med Biol. 2008;614:73-80.   DOI
82 MacDougall JD, Tuxen D, Sale DG, Moroz JR, Sutton JR. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol (1985). 1985;58:785-790.   DOI
83 Rowell L. Cardiovascular control. New York: Oxford University press; 1993.
84 Bogaard HJ, Woltjer HH, Dekker BM, van Keimpema AR, Postmus PE, de Vries PM. Haemodynamic response to exercise in healthy young and elderly subjects. Eur J Appl Physiol Occup Physiol. 1997;75:435-442.   DOI
85 Smolander J, Aminoff T, Korhonen I, Tervo M, Shen N, Korhonen O, Louhevaara V. Heart rate and blood pressure responses to isometric exercise in young and older men. Eur J Appl Physiol Occup Physiol. 1998;77:439-444.   DOI