25 Nov Blood Flow Restriction Training: New for Rehabilitation?
You may often see someone at a clinic facility or gym completing training or rehabilitation with a cuff on one of their limbs. This is an occlusion cuff and it is part of a relatively new training modality called Blood Flow Restriction. The cuff reduces arterial flow to the muscles and prevents the venous return to the heart. This tricks the body into thinking it is working harder than it is due to the increase in oxygen demands on the muscles and the work under resistance.
The ability for the body to achieve the same muscle strength and hypertrophy growths of high intensity (60% of 1RM) exercise but at a lower intensity (20-40% 1RM) allows a greater amount of people to achieve their performance or functional goals.
How is it Used?
Blood flow restriction has been used on both upper and lower limbs in resistance and aerobic exercise. It promotes increased hypertrophy, performance and VO2 max (as a result of increased cardiac output). Below are the recommendations:
- Aerobic Exercise: Cycling or treadmill- 2 minute sets with 1 minute rest at a total duration of 20mins.
- Resistance Exercise: 30 reps (to stimulate the mind muscle connection) + 3 sets of 15 reps with a 30 second break between each set.
The recommended intensities differ depending on the rehabilitation phase and the location of the cuff. Generally, the guidelines are 60-80% of Arterial occlusion pressure (AOP) for lower body and 40-50% of AOP for upper body.
AOP is lowest cuff pressure required to stop the arterial blood flow into the limb- when the pulse comes back in when listening on a stethoscope!
A New Tool for Rehabilitation?
The ability to stimulate significant muscle growth at a lower intensity is a vital tool for allied health professionals. In an acute phase of a musculoskeletal injury, load is often lowered to ensure soft tissue healing post-surgery. However, these exercises at a low load cannot induce enough hypertrophic growth to allow rehabilitation to progress. However, the addition of blood flow restriction could solve this barrier so there are strength gains within the acute phase of rehabilitation.
But Why Is It Important We Incorporate BFR Into Rehabilitation?
When we exercise, it creates a chemical signal which stimulates protein. The outcome of this is increased strength for our muscles to allow us to function. However, when there is a musculoskeletal injury, scar tissue builds up at the injury site. Within this scar tissue is a protein called myostatin which inhibits any muscle force production and protein synthesis.
However, when we complete rehabilitative strength training, there is a chemical signal called mTOR that is activated. This pathway allows for protein synthesis which breaks down the scar tissue. As a result, the muscle tissue can then be rebuilt and rehabilitation can continue.
This can create a rehabilitative setting where rehabilitation recovery time is reduced, and there are quicker, optimal strength outcomes in a safe, controlled modality for the soft tissues of the body.
Research and the incorporation of BFR into a rehabilitative setting is still new and more research needs to be conducted. However, as more research progresses, BFR is looking to become a new tool in musculoskeletal rehabilitation in all exercise physiologist clinics.
If you have any musculoskeletal injury and are looking for rehabilitation, book in with one of our specialist exercise physiologists via our website now!
*Disclaimer: Information contained within this blog post is provided as a guide only. For the safest rehabilitation and training we strongly advise that you follow the instructions and expertise of your allied health professional or medical specialist when looking to commence blood flow restriction.
Patterson, S. D., Hughes, L., Head, P., Warmington, S., & Brandner, C. (2017). Blood flow restriction training: a novel approach to augment clinical rehabilitation: how to do it. British journal of sports medicine, 51(23), 1648-1649.
Lu, Y., Patel, B. H., Kym, C., Nwachukwu, B. U., Beletksy, A., Forsythe, B., & Chahla, J. (2020). Perioperative blood flow restriction rehabilitation in patients undergoing ACL reconstruction: A systematic review. Orthopaedic journal of sports medicine, 8(3), 2325967120906822.
Hughes, L., Paton, B., Rosenblatt, B., Gissane, C., & Patterson, S. D. (2017). Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. British journal of sports medicine, 51(13), 1003-1011.