Supervisors info:
Μιχαήλ Κουτσιλιέρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαρία Μαριδάκη, Αναπληρώτρια Καθηγήτρια, ΤΕΦΑΑ, ΕΚΠΑ
Αναστάσιος Φιλίππου, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Summary:
Introduction: Over the last decade the application of Blood Flow Restriction (BFR) exercise has attracted the interest of physiotherapists, athletes, and other health professionals. Applied research has shown that BFR in exercised limbs provides significant benefits to physiotherapeutic rehabilitation, strengthening and hypertrophy of the exercising muscles. Various blood flow restriction regimens have been applied as complementary to the treatment of cardiovascular diseases, orthopedic anomalies and recovery after athletic activity, and retarding the aging process. Also, blood flow restriction method is being applied to astronauts under conditions of reduced gravity.
Objective: The purpose of this review is to present the fundamental principles of the action of blood flow restriction and to examine its effectiveness as a method of rehabilitation in physiotherapy and muscle strengthening in sport, aging, wound repair and the effect on skeletal muscles in conditions of reduced gravity. Recent studies on the mechanisms of action, expected benefits and possible risks and side-effects of its implementation and perspectives for incorporation into physiotherapy regimens will be reported.
Methods: A review of English and non-English articles was conducted across PubMed, Science Direct, and Google Scholar databases, including reference lists of relevant papers. Search results were limited to exercise training studies investigating the effects of blood flow resistance exercise on muscle physiology and morphology. The results of the search were limited to exercises that investigated the effects of exercise with blood flow restriction in muscle rehabilitation and strengthening in exercising subjects, adults, the elderly and people with musculoskeletal disorders. The terms used in the search included "muscle strength”, “physiotherapy and resistance training”, blood restriction therapy”, “blood occlusion therapy” and “kaatsu”. Additional research was identified by searching directly on available online scientific journals using various keywords describing the subject under investigation. Restrictions such as articles in English and Greek, clinical studies and reviews up to 2019. Initially, all abstracts were reviewed and those who met the inclusion criteria were selected for further evaluation.
Results: Research to date suggests that low-intensity exercise with restricted venous blood flow modifies systemic and local muscle tissue response to an extent that promotes physiotherapeutic rehabilitation and strengthening. Also, results strongly suggest that low-intensity exercise with restricted venous blood flow attenuates the effects of aging and microgravity conditions. The method, when applied by specialized therapists, provides an individualized approach to the treatment of limb muscle disorders in target populations.
Conclusion: Several methods have been applied to determine both muscle size and strength- thereby making direct comparisons between studies difficult. Although the low intensity training with BFR is effective in muscle rehabilitation, strengthening and maintenance, results between studies are difficult to compare due to non-standard protocols that vary in intensity, volume, duration and exercise frequencies. More long-term research is needed to compare different variables such as exercise, load, exercise volume, inter-set intervals, and precise pressure of the cuff.
Keywords:
Blood flow restriction and resistance training, Muscle hemodynamics, Cuff, Appendicular muscle circulation, Kaatsu training
