Acute Responses in Blood Flow Restriction Low-intensity Aerobic
                    Training: A Meta-analysis

Victor Sabino de Queiros; Nicholas Rolnick; Angelo Sabag; Ingrid Martins de França; Phelipe Wilde; João Guilherme Vieira; Victor Machado Reis; Magno F. Formiga; Breno Guilherme de Araújo Tinôco Cabral; Paulo Moreira Silva Dantas

doi:10.1055/a-2038-3635

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2023; 44(08): 545-557
DOI: 10.1055/a-2038-3635

Review

Acute Responses in Blood Flow Restriction Low-intensity Aerobic Training: A Meta-analysis

Authors

Victor Sabino de Queiros

¹Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
Nicholas Rolnick

²The Human Performance Mechanic, CUNY Lehman College, New York, USA
Angelo Sabag

³NICM Health Research Institute, Western Sydney University, Westmead, Australia
Ingrid Martins de França

⁴Graduate Program in Physiotherapy, Federal University of Rio Grande do Rio Grande Norte (UFRN), Natal-RN, Brazil
Phelipe Wilde

¹Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
João Guilherme Vieira

⁵Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora-MG, Brazil
Victor Machado Reis

⁶Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
Magno F. Formiga

⁷Graduate Program in Physiotherapy and Functionality, Faculty of Medicine, Federal University of Ceará, Fortaleza - CE, Brazil
Breno Guilherme de Araújo Tinôco Cabral

¹Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil

⁸Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil
Paulo Moreira Silva Dantas

¹Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil

⁸Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil

Abstract

The purpose was to determine the effect low-intensity training with blood flow restriction (LI-BFR) versus high-intensity aerobic training (HIT) on acute physiological and perceptual responses. The Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, Scopus, SPORTDiscus and Web of Science databases and the reference list of eligible studies were consulted to identify randomized experimental studies, published until July 4, 2022, that analyzed physiological or perceptual responses between LI-BFR versus HIT in healthy young individuals. Mean difference (MD) and standardized mean difference (SMD) were used as effect estimates and random effects models were applied in all analyses. Twelve studies were included in this review. During exercise sessions, HIT promoted higher values of heart rate (MD=28.9 bpm; p<0.00001; I ²=79%), oxygen consumption (SMD=4.01; p<0.00001; I ²=83%), ventilation (MD=48.03 l/min; p=0.0001; I ²=97%), effort (SMD=1.54; p=0.003; I ²=90%) and blood lactate (MD=3.85 mmol/L; p=0.002; I ²=97%). Perception of pain/discomfort was lower in HIT (SMD=−1.71; p=0.04; I ²=77.5%). In conclusion, LI-BFR promotes less pronounced physiological responses than HIT but with greater perception of pain.

Key words

vascular occlusion - endurance training - high-intensity interval training - rating of perceived exertion - lactates

Full Text

References

References
1 Sato Y.. The history and future of KAATSU training. Int J KAATSU Train Res 2005; 1: 1-5
2 Patterson SD, Hughes L, Warmington S. et al. Blood flow restriction exercise: considerations of methodology, application, and safety. Front Physiol 15 10 533
3 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
4 Abe T, Fujita S, Nakajima T. et al. Effects of low-intensity cycle training with restricted leg blood flow on thigh muscle volume and VO2MAX in young men. J Sports Sci Med 2010; 9: 452-458
5 Silva JCG, Pereira Neto EA, Pfeiffer PAS. et al. Acute and chronic responses of aerobic exercise with blood flow restriction: A systematic review. Front Physiol 2019; 10: 1239
6 Loenneke JP, Fahs CA, Rossow LM. et al. The anabolic benefits of venous blood flow restriction training may be induced by muscle cell swelling. Med Hypotheses 2012; 78: 151-154
7 Formiga MF, Fay R, Hutchinson S. et al. Effect of aerobic exercise training with and without blood flow restriction on aerobic capacity in healthy young adults: A systematic review with meta-analysis. Int J Sports Phys Ther 2020; 15: 175-187
8 Moholdt T, Madssen E, Rognmo Ø, Aamot IL.. The higher the better? Interval training intensity in coronary heart disease. J Sci Med Sport 2014; 17: 506-510
9 Corvino RB, Rossiter HB, Loch T. et al. Physiological responses to interval endurance exercise at different levels of blood flow restriction. Eur J Appl Physiol 2017; 117: 39-52
10 Thomas HJ, Scott BR, Peiffer JJ.. Acute physiological responses to low-intensity blood flow restriction cycling. J Sci Med Sport 2018; 21: 969-974
11 Fiorenza M, Gunnarsson TP, Hostrup M. et al. Metabolic stress-dependent regulation of the mitochondrial biogenic molecular response to high-intensity exercise in human skeletal muscle. J Physiol 2018; 596: 2823-2840
12 Rolnick N, Kimbrell K, Cerqueira MS. et al. Perceived barriers to blood flow restriction training. Front Rehabil Sci 2021; 2: 697082
13 Kilgas MA, Yoon T, McDaniel J. et al. Physiological responses to acute cycling with blood flow restriction. Front Physiol 2022; 13: 800155
14 Corvino RB, Scheffer DDL, Penteado Dos Santos R. et al. Muscle fatigue is attenuated when applying intermittent compared with continuous blood flow restriction during endurance cycling. Int J Sports Physiol Perform 2022; 17: 1126-1131
15 Kim D, Loenneke JP, Thiebaud RS. et al. The acute muscular effects of cycling with and without different degrees of blood flow restriction. Acta Physiol Hung 2015; 102: 428-441
16 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71
17 Horsley T, Dingwall O, Sampson M.. Checking reference lists to find additional studies for systematic reviews. Cochrane Database Syst Rev 2011; 2011: MR000026
18 Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A.. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016; 5: 210
19 Van Belle G.. Statistical Rules of Thumb, 2^nd Edition. Hoboken: John Wiley & Sons; 2011
20 Centner C, Lauber B.. A systematic review and meta-analysis on neural adaptations following blood flow restriction training: what we know and what we don't know. Front Physiol 2020; 11: 887
21 Cerqueira MS, Maciel DG, Barboza JAM. et al. Low-load blood-flow restriction exercise to failure and nonfailure and myoelectric activity: A meta-analysis. J Athl Train 2022; 57: 402-417
22 Sterne JAC, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898
23 Borenstein M, Hedges LV, Higgins JPT, Rothstein HR.. Introduction to Meta-Analysis. Hoboken: John Wiley & Sons; 2009
24 Sullivan GM, Feinn R.. Using effect size-or why the P value is not enough. J Grad Med Educ 2012; 4: 279-282
25 Higgins JP, Thompson SG.. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539-1558
26 Sterne JA, Sutton AJ, Ioannidis JP. et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011; 343: d4002
27 Goldet G, Howick J.. Understanding GRADE: an introduction. J Evid Based Med 2013; 6: 50-54
28 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097
29 Lauver JD, Moran A, Guilkey JP. et al. Acute responses to cycling exercise with blood flow restriction during various intensities. J Strength Cond Res 2022; 36: 3366-3373
30 Ferreira MLV, Sardeli AV, De Souza GV. et al. Cardiac autonomic responses during and after a single session of aerobic exercise with and without blood flow restriction. J Sports Sci 2017; 35: 2412-2420
31 Wei J, Nassis GP, Gu Z. et al. Acute physiological and perceptual responses to moderate intensity cycling with different levels of blood flow restriction. Biol Sport 2021; 38: 437-443
32 Silva JCG, Domingos-Gomes JR, Freitas EDS. et al. Physiological and perceptual responses to aerobic exercise with and without blood flow restriction. J Strength Cond Res 2021; 35: 2479-2485
33 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
34 Spranger MD, Krishnan AC, Levy PD. et al. Blood flow restriction training and the exercise pressor reflex: a call for concern. Am J Physiol Heart Circ Physiol 2015; 309: H1440-H1452
35 Pope ZK, Willardson JM, Schoenfeld BJ.. Exercise and blood flow restriction. J Strength Cond Res 2013; 27: 2914-2926
36 Neto GR, Novaes JS, Salerno VP. et al. Acute effects of resistance exercise with continuous and intermittent blood flow restriction on hemodynamic measurements and perceived exertion. Percept Mot Skills 2017; 124: 277-292
37 Marcora SM.. Perception of effort. In: Goldstein EB, ed. Encyclopedia of Perception. Thousand Oaks: Sage; 2010: 380-383
38 de Morree HM, Klein C, Marcora SM.. Perception of effort reflects central motor command during movement execution. Psychophysiology 2012; 49: 1242-1253
39 de Morree HM, Marcora SM.. Psychobiology of perceived effort during physical tasks. In: Gendolla GHE, Tops M, Koole SL, eds. Handbook of Biobehavioral Approaches To Self-Regulation. New York: Springer; 2015: 255-270
40 Robertson RJ, Noble BJ.. Perception of physical exertion: methods, mediators, and applications. Exerc Sport Sci Rev 1997; 25: 407-452
41 Pageaux B.. Perception of effort in exercise science: Definition, measurement and perspectives. Eur J Sport Sci 2016; 16: 885-894

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