Purpose: The purpose of this study was two-fold: (1) determine if muscle activation was greater in a BFR exercise condition compared to non-BFR exercise condition using MRI T2 mapping, and (2) determine if the muscle activation for both BFR and non-BFR exercise conditions differs between postbariatric surgery individuals and individuals in 2 control groups. Methods: Three groups participated: (1) a normal-BMI group, (2) a postbariatric surgery group, and (3) a matched group for the surgery individuals. Ultrasound imaging was used to find the optimal BFR pressure for each participant. All participants participated in both BFR and non-BFR exercises. Using a 3-Telsa MRI, a T2 map was imaged prior to and immediately following exercise. Analyses included within-group-across-condition comparisons and within-condition-across-group comparisons. The outcome variable of interest was the change in muscle activation determined via T2 mapping. Results: There was no statistical difference in the increase in muscle activation between BFR and non-BFR exercise conditions (p-value range 0.1091 to 0.9166). When comparing groups across conditions, we found that the surgery group elicited a significantly greater increase in activation compared to the normal-BMI group in every condition (p-value range 0.0014 to 0.0217) and in several muscles when compared to the matched group (p-value range 0.0060 to 0.0311). Other muscles compared to the matched group were not significantly different (p-value range 0.0683 to 0.129). No difference was found between the control groups (p-value range 0.2041 to 0.9557) in muscle activation for either condition. Conclusion: These results did not suggest a difference between BFR exercise and non-BFR exercise for the calf-raise protocol. Postbariatric surgery patients elicited an equal muscle activation response in some conditions and a greater muscle activation response in others when compared to both control groups. Further research is needed to determine whether a greater intensity or duration of exercise is needed to elicit an acute response to BFR and what factors are contributing to the increased muscle activation seen in the postbariatric surgery group.

O objetivo do presente estudo foi verificar os efeitos do treinamento pliométrico com restrição do fluxo sanguíneo (TP-RFS) ou sem (TP) sobre a performance musculoesquelética, variáveis antropométricas e os indicadores indiretos de dano muscular. Objetivos secundários foram comparar os percentuais de mudanças de todas as variáveis entre os grupos e correlacionar os percentuais de mudanças da performance da velocidade cíclica com o da força. 20 homens jovens (18-30 anos) desempenharam exercícios de saltos (hurdle jumps e drop jumps) duas vezes por semana durante oito semanas usando esfignamômetros específicos para a restrição do fluxo sanguíneo (RFS) ou sem a sua utilização. Durante as sessões com RFS, os participantes ficaram inflados de modo total e intermitente na região proximal em ambas as pernas. A velocidade de deslocamento cíclico foi mensurada pelos testes de velocidade de 10m e de 30m e o teste T-40 para avaliar o desempenho da velocidade de deslocamento cíclico-acíclico. A performance de salto foi quantificada pelos saltos horizontais (SHs) unilaterais e bilaterais saindo da posição parada e os saltos verticais (SVs) [squat jump (SJ) e countermovement jump (CMJ)]. A força muscular dinâmica foi avaliada por meio de uma repetição máxima (1-RM) no agachamento com barra guiada. A antropometria foi mensurada pela porcentagem de gordura, massa magra e pelo volume muscular dos membros inferiores. Os marcadores indiretos de dano muscular foram recordados pela atividade plasmática das enzimas creatina quinase (CK) e lactato desidrogenase (LDH). Estas avaliações foram obtidas pré, durante e pós o programa de treinamento. Os resultados demonstraram que o grupo TP-RFS apresentou ganhos significativos nos testes de velocidade de 30m, teste T-40, SH direita, SH esquerda, SH bilateral, SJ e 1-RM. O grupo TP mostrou melhoras em relação aos testes de velocidade de 10m, SH direita, SH bilateral, SJ e CMJ, assim como, o grupo TP demonstrou incrementos superiores significativos quando comparado com o grupo TP-RFS sobre os percentuais de mudanças dos testes de velocidade de 10m, SJ e CMJ. Verificou-se correlação entre os percentuais de mudanças da velocidade de 30m e o teste de CMJ no grupo TP. Foi observada diminuição da porcentagem de gordura entre os diferentes momentos em ambos os grupos. Entretanto, não foram verificadas nenhuma mudança em relação a massa magra e as medidas de circunferência de coxa tanto no grupo TP-RFS quanto no grupo TP. Para análise da atividade plasmática das enzimas CK e LDH, não foram demonstradas nenhuma alteração quando comparados os diferentes momentos de coletas em ambos os grupos e o percentual de mudança entre os grupos. Conclui-se que a RFS em combinação com o TP não aumenta a performance musculoesquelética e as variáveis relacionadas com a antropometria quando comparado o TP aplicado de maneira independente. No que diz respeito a CK e LDH, ambas as condições com ou sem RFS não suportam a hipótese de haver dano muscular para o protocolo de treinamento realizado / The aim of this study was to investigate the effects of plyometric training with blood flow restriction (PT-BFS) or without (PT) on the musculoskeletal performance, anthropometric variables and indirect indicators of muscle damage. Secondary objectives were to compare the changes in percentage of all variables between the groups and to correlate the percentage changes of the cyclical speed performance with strength. 20 young men (18-30 years) played jumping exercises (jumps hurdle and drop jumps) twice a week for eight weeks using specific cuffs for blood flow restriction (BFR) or without their use. During the sessions with RFS, participants were inflated fully and intermittently in the proximal region in both legs. The cyclic shift speed was measured by the speed tests 10m and 30m and T-40 test to evaluate the performance of the cyclic-acyclic speed. The jump performance was measured by horizontal jumps (HJs) unilateral and bilateral leaving the stop position and the vertical jumps (VJs) [squat jump (SJ) and countermovement jump (CMJ)]. The dynamic muscle strength was evaluated by one repetition maximum (1-RM) squat with guided bar. Anthropometry was measured by the percentage of fat, lean mass and the muscular volume of the lower limbs. The indirect markers of muscle damage were recalled by plasma activity of the enzymes creatine kinase (CK) and lactate dehydrogenase (LDH). These datas were obtained before, during and after the training program. The results showed that PT-BFR group showed significant gains in speed tests 30m, T-40 test, right HJ, HJ left bilateral HJ, SJ and 1-RM. PT group showed improvements regarding speed testing 10m, right HJ, bilateral HJ, SJ and CMJ, as well as the PT group demonstrated significant higher increases compared with the PT-BFR group on percentage change of the test speed 10m, SJ and CMJ. There was correlation between the percentage changes of 30m speed and CMJ test the PT group. It was observed decrease in fat percentage between different moments in both groups. However, it was not observed any change in relation to lean body mass and thigh circumference measurements both in PT-BFR group as in the PT group. For analysis of plasma activity of CK and LDH were not substantiated any changes when comparing the different times of collections in both groups and the percentage of change between groups. It follows that RFS in combination with the PT does not increase the performance musculoskeletal and no change the variables anthropometry when compared PT applied independently. As regards CK and LDH, both with or without BFR conditions do not support the hypothesis of muscle damage done to the training protocol

O objetivo do presente estudo foi verificar os efeitos do treinamento pliométrico com restrição do fluxo sanguíneo (TP-RFS) ou sem (TP) sobre a performance musculoesquelética, variáveis antropométricas e os indicadores indiretos de dano muscular. Objetivos secundários foram comparar os percentuais de mudanças de todas as variáveis entre os grupos e correlacionar os percentuais de mudanças da performance da velocidade cíclica com o da força. 20 homens jovens (18-30 anos) desempenharam exercícios de saltos (hurdle jumps e drop jumps) duas vezes por semana durante oito semanas usando esfignamômetros específicos para a restrição do fluxo sanguíneo (RFS) ou sem a sua utilização. Durante as sessões com RFS, os participantes ficaram inflados de modo total e intermitente na região proximal em ambas as pernas. A velocidade de deslocamento cíclico foi mensurada pelos testes de velocidade de 10m e de 30m e o teste T-40 para avaliar o desempenho da velocidade de deslocamento cíclico-acíclico. A performance de salto foi quantificada pelos saltos horizontais (SHs) unilaterais e bilaterais saindo da posição parada e os saltos verticais (SVs) [squat jump (SJ) e countermovement jump (CMJ)]. A força muscular dinâmica foi avaliada por meio de uma repetição máxima (1-RM) no agachamento com barra guiada. A antropometria foi mensurada pela porcentagem de gordura, massa magra e pelo volume muscular dos membros inferiores. Os marcadores indiretos de dano muscular foram recordados pela atividade plasmática das enzimas creatina quinase (CK) e lactato desidrogenase (LDH). Estas avaliações foram obtidas pré, durante e pós o programa de treinamento. Os resultados demonstraram que o grupo TP-RFS apresentou ganhos significativos nos testes de velocidade de 30m, teste T-40, SH direita, SH esquerda, SH bilateral, SJ e 1-RM. O grupo TP mostrou melhoras em relação aos testes de velocidade de 10m, SH direita, SH bilateral, SJ e CMJ, assim como, o grupo TP demonstrou incrementos superiores significativos quando comparado com o grupo TP-RFS sobre os percentuais de mudanças dos testes de velocidade de 10m, SJ e CMJ. Verificou-se correlação entre os percentuais de mudanças da velocidade de 30m e o teste de CMJ no grupo TP. Foi observada diminuição da porcentagem de gordura entre os diferentes momentos em ambos os grupos. Entretanto, não foram verificadas nenhuma mudança em relação a massa magra e as medidas de circunferência de coxa tanto no grupo TP-RFS quanto no grupo TP. Para análise da atividade plasmática das enzimas CK e LDH, não foram demonstradas nenhuma alteração quando comparados os diferentes momentos de coletas em ambos os grupos e o percentual de mudança entre os grupos. Conclui-se que a RFS em combinação com o TP não aumenta a performance musculoesquelética e as variáveis relacionadas com a antropometria quando comparado o TP aplicado de maneira independente. No que diz respeito a CK e LDH, ambas as condições com ou sem RFS não suportam a hipótese de haver dano muscular para o protocolo de treinamento realizado / The aim of this study was to investigate the effects of plyometric training with blood flow restriction (PT-BFS) or without (PT) on the musculoskeletal performance, anthropometric variables and indirect indicators of muscle damage. Secondary objectives were to compare the changes in percentage of all variables between the groups and to correlate the percentage changes of the cyclical speed performance with strength. 20 young men (18-30 years) played jumping exercises (jumps hurdle and drop jumps) twice a week for eight weeks using specific cuffs for blood flow restriction (BFR) or without their use. During the sessions with RFS, participants were inflated fully and intermittently in the proximal region in both legs. The cyclic shift speed was measured by the speed tests 10m and 30m and T-40 test to evaluate the performance of the cyclic-acyclic speed. The jump performance was measured by horizontal jumps (HJs) unilateral and bilateral leaving the stop position and the vertical jumps (VJs) [squat jump (SJ) and countermovement jump (CMJ)]. The dynamic muscle strength was evaluated by one repetition maximum (1-RM) squat with guided bar. Anthropometry was measured by the percentage of fat, lean mass and the muscular volume of the lower limbs. The indirect markers of muscle damage were recalled by plasma activity of the enzymes creatine kinase (CK) and lactate dehydrogenase (LDH). These datas were obtained before, during and after the training program. The results showed that PT-BFR group showed significant gains in speed tests 30m, T-40 test, right HJ, HJ left bilateral HJ, SJ and 1-RM. PT group showed improvements regarding speed testing 10m, right HJ, bilateral HJ, SJ and CMJ, as well as the PT group demonstrated significant higher increases compared with the PT-BFR group on percentage change of the test speed 10m, SJ and CMJ. There was correlation between the percentage changes of 30m speed and CMJ test the PT group. It was observed decrease in fat percentage between different moments in both groups. However, it was not observed any change in relation to lean body mass and thigh circumference measurements both in PT-BFR group as in the PT group. For analysis of plasma activity of CK and LDH were not substantiated any changes when comparing the different times of collections in both groups and the percentage of change between groups. It follows that RFS in combination with the PT does not increase the performance musculoskeletal and no change the variables anthropometry when compared PT applied independently. As regards CK and LDH, both with or without BFR conditions do not support the hypothesis of muscle damage done to the training protocol

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Background: Blood flow restriction training (BFRT) is an effective way of training that enables training with low external load while receiving similar effects to high load training. The lack of knowledge of BFRT for people with chronic obstructive pulmonary disease (COPD) or heart failure (HF) led to the making of this scoping review.  Objective: This scoping review aims to map the existing knowledge, effects, safety, and feasibility of BFRT for people with COPD or heart failure HF. Method: The review followed PRISMAs structure for scoping review. Selection involved title and abstract screening, followed by full text analysis and peer-review by both authors.  Results: A wide variety of study designs was included in this scoping review. Of 11 included studies all were original intervention studies-, whereof 8/11 studies were focused on HF. A large majority of participants were male. Training methods used in intervention studies varied from exercises like leg extensions, leg press and cycling, all while using vascular blood flow restriction. All studies followed different training protocols. The reported outcomes indicated promising improvements like increased functional exercise capacity, muscle strength, reduced symptom burden, and several positive physiological changes for both people with COPD and HF. Some concerns remain regarding the safety of BFRT, but no serious adverse events were reported directly linked to BFRT.  Conclusion: With many reported improvements, BFRT could be a safe and feasible alternative rehabilitation method for people with COPD or HF. Furthermore, with minimal reported adverse events, the method appears safe for both groups. Despite this, the included studies all had small sample sizes, so more high-quality studies with larger sample sizes are needed to give a better understanding on BFRTs effects on both short- and long term. Better studies including females are also needed.