Effects of blood flow restriction without additional exercise on strength reductions and muscular atrophy following immobilization: A systematic review

Cerqueira, Mikhail Santos; Nascimento, José Diego Sales do; Maciel, Daniel Germano; Barboza, Jean Artur Mendonça; Vieira, Wouber Hérickson de Brito

doi:10.1016/j.jshs.2019.07.001

Cited by 25 publications

(25 citation statements)

References 45 publications

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“…12,13 Systematics reviews reported that low intensity aerobic exercise combined with BFR can facilitate muscular size, strength and hypertrophy improvements on the elderly 14 and may be a strategy to mitigate strength and muscle mass loss during immobilization periods. 15 The BFR, also known as occlusion vascular training, consists of using a cuff that reduces the exercised limbs' blood flow, which in addition to the muscles' blood supply decrease also the difficulties of venous return. 12 During BFR strength training, a cuff is applied to the upper third of the inferior or superior limbs, then pressure is insufflated in the cuff, according to the tolerance of each individual.…”

Section: Introductionmentioning

confidence: 99%

“…lactate) increased concentration, inducing various cellular and hormonal changes which associated with muscle hypoxia, induce greater muscle fiber recruitment. 10,[12][13][14][15] Although individual clinical trials have identified BFR associated with exercise positive effects, such as muscle's strength gain and hypertrophy, function and performance, no systematic review has investigated the BFR effects in subjects with knee ostheoarthritis.…”

Section: Introductionmentioning

confidence: 99%

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The blood flow restriction training effect in knee osteoarthritis people: a systematic review and meta-analysis

Ferlito¹,

Pecce²,

Oselame³

et al. 2020

Clin Rehabil

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Objective: To synthesize evidence on the effects of blood flow restriction (BFR) comparing with high (HLT) and low load (LLT), and on the influence of different forms of application in individuals with knee osteoarthritis. Data sources: The CENTRAL, PEDro, PubMed and BVS, which include Lilacs, Medline and SciELO, until April 2020. Review methods: A systematic review and meta-analysis of randomized trials used the PRISMA guidelines, whose main keywords were: Therapeutic Occlusion, Resistance Training, and Knee Osteoarthritie, blood flow restriction and Kaatsu training. Method quality was evaluated with the PEDro scale. When studies demonstrated homogeneity on outcome measures, the mean differences or standardized mean differences with 95% confidence interval were calculated and pooled in a meta-analysis for pooled synthesis. Results: Five articles were eligible in this review with moderate to low risk bias. Our results, showed no difference between BFR and HLT in knee strength (SMD = 0.00, 95% CI, –0.54 to 0.54, P = 1.00), function (SMD = −0.20, 95% CI, –0.45 to 0.06, P = 0.13), pain and volume. But, when compared BFR and LLT, the descriptive analysis demonstrated significant results in favor BFR to muscle strength (71.4% of measurement) and volume (MD = 1.66, 95% CI, 0.93 to 2.38, P < 0.00001), but not in pain or function. Conclusion: BFR can be used as a strategy in the rehabilitation of osteoarthritis due to gains in strength and volume with low mechanical stress. However, its application must be safe and individualized, since they can attenuate the stimuli offered by BFR.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The blood flow restriction training effect in knee osteoarthritis people: a systematic review and meta-analysis

Ferlito¹,

Pecce²,

Oselame³

et al. 2020

Clin Rehabil

View full text Add to dashboard Cite

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“…Inclusion criteria were determined on the basis of the population, intervention, comparison, and outcome approach (PICO) (Cerqueira et al, 2020). The population included adult groups (i.e., without major neurological diseases).…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…We assessed the risk of bias using the Cochrane risk of bias assessment tool (Cerqueira et al, 2020). Study quality assessment included random sequence generation; allocation concealment; blinding of investigators, participants, assessors, and outcome assessors; description of losses and exclusions; selective report; and other biases.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Effects of Transcranial Direct Current Stimulation Combined With Physical Training on the Excitability of the Motor Cortex, Physical Performance, and Motor Learning: A Systematic Review

Wang

Xiao

et al. 2021

Front. Neurosci.

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Purpose: This systematic review aims to examine the efficacy of transcranial direct current stimulation (tDCS) combined with physical training on the excitability of the motor cortex, physical performance, and motor learning.Methods: A systematic search was performed on PubMed, Web of Science, and EBSCO databases for relevant research published from inception to August 2020. Eligible studies included those that used a randomized controlled design and reported the effects of tDCS combined with physical training to improve motor-evoked potential (MEP), dynamic posture stability index (DPSI), reaction time, and error rate on participants without nervous system diseases. The risk of bias was assessed by the Cochrane risk of bias assessment tool.Results: Twenty-four of an initial yield of 768 studies met the eligibility criteria. The risk of bias was considered low. Results showed that anodal tDCS combined with physical training can significantly increase MEP amplitude, decrease DPSI, increase muscle strength, and decrease reaction time and error rate in motor learning tasks. Moreover, the gain effect is significantly greater than sham tDCS combined with physical training.Conclusion: tDCS combined with physical training can effectively improve the excitability of the motor cortex, physical performance, and motor learning. The reported results encourage further research to understand further the synergistic effects of tDCS combined with physical training.

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“…Indications for using BFRT as an intervention in this population include the following: postsurgical and postimmobilization rehabilitation, patellofemoral pain syndrome, meniscal tears, ligament strains, low back pain, and skilled rehabilitation for musculoskeletal disorders. 10,18,32,57,74 The current understanding of the physiological mechanisms of BFRT and related performance appears to be well-documented. { The use of BFRT during aerobic training and RT elicits increases in muscle strength and size.…”

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confidence: 99%

The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review

et al. 2019

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Background: The effectiveness of blood flow restriction training (BFRT) as compared with other forms of training, such as resistance training, has been evaluated in the literature in clinical and nonclinical populations. However, the safety of this intervention has been summarized only in healthy populations and not in clinical populations with musculoskeletal disorders. Purpose: To evaluate the safety and adverse events associated with BFRT in patients with musculoskeletal disorders. Study Design: Systematic review. Methods: A literature search was conducted with 3 online databases (MEDLINE, CINAHL, and Embase). Eligibility criteria for selecting studies were as follows: (1) BFRT was used as a clinical intervention, (2) study participants had a disorder of the musculoskeletal system, (3) authors addressed adverse events, (4) studies were published in English, and (5) the intervention was performed with human participants. Results: Nineteen studies met eligibility criteria, with a pooled sample size of 322. Diagnoses included various knee-related disorders, inclusion body myositis, polymyositis or dermatomyositis, thoracic outlet syndrome, Achilles tendon rupture, and bony fractures. Nine studies reported no adverse events, while 3 reported rare adverse events, including an upper extremity deep vein thrombosis and rhabdomyolysis. Three case studies reported common adverse events, including acute muscle pain and acute muscle fatigue. In the randomized controlled trials, individuals exposed to BFRT were not more likely to have an adverse event than individuals exposed to exercise alone. Of the 19 studies, the adverse events were as follows: overall, 14 of 322; rare overall, 3 of 322; rare BFRT, 3 of 168; rare control, 0 of 154; any adverse BFRT, 10 of 168; any adverse control, 4 of 154. A majority of studies were excluded because they did not address safety. Conclusion: BFRT appears to be a safe strengthening approach for knee-related musculoskeletal disorders, but further research is needed to make definitive conclusions and to evaluate the safety in other musculoskeletal conditions. Improved definitions of adverse events related to BFRT are needed to include clear criteria for differentiating among common, uncommon, and rare adverse events. Finally, further research is needed to effectively screen who might be at risk for rare adverse events.

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Effects of blood flow restriction without additional exercise on strength reductions and muscular atrophy following immobilization: A systematic review

Cited by 25 publications

References 45 publications

The blood flow restriction training effect in knee osteoarthritis people: a systematic review and meta-analysis

The blood flow restriction training effect in knee osteoarthritis people: a systematic review and meta-analysis

Effects of Transcranial Direct Current Stimulation Combined With Physical Training on the Excitability of the Motor Cortex, Physical Performance, and Motor Learning: A Systematic Review

The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review

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