Application and side effects of blood flow restriction technique

Abstract

The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings. To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique. This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique. Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60–80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively). Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.

Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice—A review of the current state of the research

“…The interest and adoption of blood flow restriction (BFR) training in the rehabilitation and fitness settings has increased substantially in recent years ( de Queiros et al, 2021 ; Mills et al, 2021 ; Cuffe et al, 2022 ). Fueled at least in part by its ability to generate musculoskeletal and cardiovascular performance benefits with reduced mechanical loads ( Lixandrão et al, 2018 ; Formiga et al, 2020 ), this interest has also fueled an in-kind response from the device manufacturing market.…”

Blood Flow Restriction Training

“…Professionals reporting cases of subcutaneous hemorrhaging with BFRT stated that the subcutaneous hemorrhaging was transient and resolved quickly even if individuals continued their training session. 47 An effect that wasn't reported by Anderson and his colleagues but was reported to be seen by the cross-sectional study conducted by De Queiros and his associates was fainting. 47 Regarding witnessing individuals faint from BFRT, healthcare found fainting to be linked to the decrease in venous return induced by BFRT, which can cause a reduction in cardiac preload, which can lead to decreased blood flow to the brain.…”

“…44 From the studies analyzed, 1,672 people were reported to have an adverse event after undergoing BFRT out of 25,813 people. The most commonly reported adverse events that occurred in people that underwent BFRT were extremity tingling, delayed onset muscle soreness (DOMS), subcutaneous hemorrhaging, and rhabdomyolysis 44,47 In a cross-sectional study consisting of 113 professionals in the fields of physical rehabilitation and exercise science, the health professionals reported using BFRT on multiple age groups ranging from youth (≤18 years), young adults (20 to 29 years old), and older adults (60-80 years old). 47 The Health professionals within this study reported that only 3.5% of youth, 74.6% of young adults, and 30.7% of older adults they saw in their respective fields were subjected to BFRT.…”

“…Despite reporting numbness and tingling occurring in subjects that underwent BFRT, professionals in this study stated that numbness and tingling disappeared once pressure was released from the blood pressure cuffs. 47 A possible explanation for numbness and tingling disappearing once pressure is released from blood pressure cuffs can be seen in a study conducted by Clarke and colleagues. 48 A study conducted by Clarke and colleagues consisted of 16 young healthy adults (ages 18-30) performing 4 weeks of bilateral knee extension exercise for 3 days a week.…”

“…48 Concerning DOMS experienced with BFRT, this particular report or symptom should not be a major concern for health professionals since BFRT induces muscle damage, and most participants that underwent BFRT were not used to exercise. 47 DOMS was found to usually disappear within a few days, as the individuals subjected to BFRT became accustomed to the physiological and biological demands of BFRT. Professionals reporting cases of subcutaneous hemorrhaging with BFRT stated that the subcutaneous hemorrhaging was transient and resolved quickly even if individuals continued their training session.…”