Effects of Electrostimulation with Blood Flow Restriction on Muscle Size and Strength

Natsume, Toshiharu; Ozaki, Hayao; Saito, Anneyuko I.; Abe, Takashi; Naito, Hisashi

doi:10.1249/mss.0000000000000722

Cited by 61 publications

(51 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More recently the combination of NMES with BFR has been investigated. The results of trials using NMES and BFR in humans are varied, with two studies reporting increased muscle strength and hypertrophy compared with NMES and BFR alone in healthy and spinal cord injured adults 11,12 one showing increased strength follloiwng NMES with BFR compared to a control group 13 and on demonstrating no added benefit 14 . Although mixed results have currently been observed, the clinical application for NMES and BFR increasing muscle strength and size post-surgery or during immobilisation when voluntary exercise is contraindicated, is promising.…”

Section: Introductionmentioning

confidence: 99%

“…Varied methodologies have led to conflicting findings in studies investigating NMES and BFR, thus limiting the understanding of underlying physiological mechanisms that induce changes in muscle strength and hypertrophy. The NMES protocols currently utilised have considerable variability, with frequencies ranging from 20-100 Hz and unclear reporting of other parameters including stimulation intensities [11][12][13][14] . To maximise quadriceps strength after NMES it is recommended to use a frequency of 50 Hz, maximal tolerable intensities and to place stimulating electrodes over muscle motor points 15 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Neuromuscular Electrical Stimulation (NMES) With Blood Flow Restriction: The Effect of Restriction Pressures

Head¹,

Waldron²,

Theis³

et al. 2021

Journal of Sport Rehabilitation

View full text Add to dashboard Cite

Context: Neuromuscular electrical stimulation (NMES) combined with blood flow restriction (BFR) has been shown to improve muscular strength and size better than NMES alone. However, previous studies used varied methodologies not recommended by previous NMES or BFR research. Objective: The present study investigated the acute effects of NMES combined with varying degrees of BFR using research-recommended procedures to enhance understanding and the clinical applicability of this combination. Design: Randomized crossover. Setting: Physiology laboratory. Participants: A total of 20 healthy adults (age 27 [4] y; height 177 [8] cm; body mass 77 [13] kg). Interventions: Six sessions separated by at least 7 days. The first 2 visits served as familiarization, with the experimental conditions performed in the final 4 sessions: NMES alone, NMES 40% BFR, NMES 60% BFR, and NMES 80% BFR. Main Outcome Measures: Maximal voluntary isometric contraction, muscle thickness, blood pressure, heart rate, rating of perceived exertion, and pain were all recorded before and after each condition. Results: The NMES 80% BFR caused greater maximal voluntary isometric contraction decline than any other condition (−38.9 [22.3] N·m, P < .01). Vastus medialis and vastus lateralis muscle thickness acutely increased after all experimental conditions (P < .05). Pain and ratings of perceived exertion were higher after NMES 80% BFR compared with all other experimental conditions (P < .05). No cardiovascular effects were observed between conditions. Conclusion: The NMES combined with 80% BFR caused greater acute force decrement than the other conditions. However, greater perceptual ratings of pain and ratings of perceived exertion were observed with NMES 80% BFR. These acute observations must be investigated during chronic interventions to corroborate any relationship to changes in muscle strength and size in clinical populations.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute Neuromuscular Electrical Stimulation (NMES) With Blood Flow Restriction: The Effect of Restriction Pressures

Head¹,

Waldron²,

Theis³

et al. 2021

Journal of Sport Rehabilitation

View full text Add to dashboard Cite

show abstract

“…The presence of additive or synergistic interaction(s) between the mechanical and ischemic stimuli in BFRRE has been hypothesized previously and might in part explain how loads as low as 20% of 1RM can result in marked muscle hypertrophy, despite seemingly producing only moderate mechanical stress even in the “functional ablation” scenario outlined above. Although still somewhat speculative, there are good reasons to postulate such interactions, given that heat stress alone and repeated brief ischemia‐reperfusion alone have been shown to induce muscle hypertrophy in some studies and that concomitant blood flow restriction can potentiate the muscle hypertrophy and strength gains resulting from electrically stimulated contractions. Furthermore, Goto et al reported that unilateral low‐intensity resistance exercise for the elbow flexors combined with heat stress in the same arm resulted in increased elbow flexor muscle CSA, whereas the same unilateral exercise protocol alone did not produce any hypertrophy in the contralateral arm.…”

Section: Discussionmentioning

confidence: 99%

Muscle fibre activation and fatigue with low‐load blood flow restricted resistance exercise—An integrative physiology review

Wernbom

Aagaard

2019

Acta Physiologica

View full text Add to dashboard Cite

Blood flow-restricted resistance exercise (BFRRE) has been shown to induce increases in muscle size and strength, and continues to generate interest from both clinical and basic research points of view. The low loads employed, typically 20%-50% of the one repetition maximum, make BFRRE an attractive training modality for individuals who may not tolerate high musculoskeletal forces (eg, selected clinical patient groups such as frail old adults and patients recovering from sports injury) and/or for highly trained athletes who have reached a plateau in muscle mass and strength. It has been proposed that achieving a high degree of muscle fibre recruitment is important for inducing muscle hypertrophy with BFRRE, and the available evidence suggest that fatiguing low-load exercise during ischemic conditions can recruit both slow (type I) and fast (type II) muscle fibres. Nevertheless, closer scrutiny reveals that type II fibre activation in BFRRE has to date largely been inferred using indirect methods such as electromyography and magnetic resonance spectroscopy, while only rarely addressed using more direct methods such as measurements of glycogen stores and phosphocreatine levels in muscle fibres. Hence, considerable uncertainity exists about the specific pattern of muscle fibre activation during BFRRE. Therefore, the purpose of this narrative review was (1) to summarize the evidence on muscle fibre recruitment during BFRRE as revealed by various methods employed for determining muscle fibre usage during exercise, and (2) to discuss reported findings in light of the specific advantages and limitations associated with these methods. K E Y W O R D Sfatigue, ischemia, motor units, muscle hypertrophy, occlusion 4 of 48 | WERNBOM aNd aaGaaRd 3.5.), which in turn can raise the recruitment threshold of the highest threshold units (discussed in Section 3.4.). As a result, the approximate upper limit for motor unit recruitment during more normal and physiologically relevant contraction durations (eg, 1-3 seconds) remains to be fully defined.

show abstract

“…Although this is a novel concept, studies combining low-intensity NMES with BFR have found increases in muscle size and strength. (98,99) NMES of the quadriceps does not involve transmission of large forces through the tibiofemoral joint, thus exhibiting a low risk of damaging the graft or exacerbating any cartilage, meniscal or bone injuries. Early increases in muscle strength and size are necessary to perform voluntary training later in the rehabilitation process, (100) and there is debate over whether passive BFR alone is truly effective.…”

Section: Bfr In Acl Rehabilitation: a Progressive Model Phase 1: Earlmentioning

confidence: 99%

Blood Flow Restriction Training in Rehabilitation Following Anterior Cruciate Ligament Reconstructive Surgery: A Review

Hughes¹,

Rosenblatt

Paton

et al. 2018

Techniques in Orthopaedics

View full text Add to dashboard Cite

Anterior cruciate ligament (ACL) rupture is a highly prevalent orthopaedic injury, resulting in substantial skeletal muscle atrophy due to changes in muscle protein balance and satellite cell abundance. Neural activation problems also contribute to strength loss, impacting upon a patients' physical function and rehabilitative capacity. Heavy loads typically required for muscle hypertrophy and strength adaptations are contraindicated due to graft strain and concomitant cartilage, meniscal and bone pathologies associated with ACL reconstruction. Strength of the quadriceps is a fundamental component for the ability to reduce shearing and torsional strains on the ACL with ground contact, and forms a critical component of ACL rehabilitation. Given the dangers of early post-operative heavy-loading, low-load blood flow restriction (BFR) training may provide an alternative rehabilitation tool for practitioners. Passive BFR can attenuate early muscle atrophy and strength loss, and may be more effective with the addition of novel, complementary therapies such as neuromuscular electrical stimulation. Upon ambulation, aerobic and resistance exercise with BFR can stimulate muscle hypertrophy and strength adaptations and resolve activation problems. This may occur through increasing muscle protein synthesis and satellite cell proliferation, decreasing muscle protein breakdown and improving muscle activation via altered recruitment patterns. Thus, BFR training may provide an effective rehabilitation tool that does not place heavy loads and force through the tibiofemoral joint. This may reduce the risk of damaging the graft, cartilage, meniscus or other intra-articular structures, providing thorough screening prior to use is followed by correct, evidenceinformed application.

show abstract

Effects of Electrostimulation with Blood Flow Restriction on Muscle Size and Strength

Abstract: Low-intensity NMES-BFR induces muscle hypertrophy and strength gain in untrained young male participants.

Cited by 61 publications

References 27 publications

Acute Neuromuscular Electrical Stimulation (NMES) With Blood Flow Restriction: The Effect of Restriction Pressures

Acute Neuromuscular Electrical Stimulation (NMES) With Blood Flow Restriction: The Effect of Restriction Pressures

Muscle fibre activation and fatigue with low‐load blood flow restricted resistance exercise—An integrative physiology review

Blood Flow Restriction Training in Rehabilitation Following Anterior Cruciate Ligament Reconstructive Surgery: A Review

Contact Info

Product

Resources

About