The Long-Term Impact on Ankle-Brachial Index from Low Intensity Resistance Exercise with Blood Flow Restriction Technique: A Systematic Review
Volume 14, Issue 1 (2024)
Volume 14, Issue 1 (2024)
The Long-Term Impact on Ankle-Brachial Index from Low Intensity Resistance Exercise with Blood Flow Restriction Technique: A Systematic Review
Abstract:
This comprehensive review delves into the impact of low-intensity resistance training coupled with blood flow
restriction (BFR) on arterial stiffness, evaluated through the ankle-brachial index (ABI). This assessment seeks to discern
any discernible alterations in arterial stiffness attributed to this unique training approach. Employing systematic search
via PubMed and Google Scholar databases, this review examined research articles focusing on the chronic effects of resistance
training with BFR on the ABI. Inclusion criteria encompassed studies assessing this effect across various age groups
while concentrating on healthy individuals and publications in the English language. Among the extensive array of studies,
a selective inclusion of 5 research articles formed the foundational basis of this analysis. Synthesizing analyses from these
studies illuminated the safety of BFR training, particularly at intensities around 20-30% or using elastic bands. Intriguingly,
these modalities exhibited no significant impact on alterations in the ABI, notably observed within elderly subjects.
However, a notable scarcity in studies focusing on young subjects warrants a more comprehensive investigation into this
specific demographic. The findings of this review underscore the safety and efficacy of BFR resistance training methodologies,
especially protocols utilizing 20-30% 1RM or incorporating elastic bands of 75-repetition-scheme, showcasing no
significant impact on the ankle-brachial index, particularly in the elderly population over intervention periods not exceeding
12 weeks. Encouraging practitioners, these established methodologies offer safe practices for the elderly. However, the
evident research gap in young subjects necessitates more expansive investigations.
Keywords:
Ankle-brachial index, Blood flow restriction, Resistance training
Full Text:
References:
Aboyans, V., Criqui, M. H., Abraham, P., Allison, M. A., Creager, M. A., Diehm, C., Fowkes, F. G., Hiatt, W. R., Jönsson, B., Lacroix, P., Marin,
B., McDermott, M. M., Norgren, L., Pande, R. L., Preux, P. M., Stoffers, H. E., Treat-Jacobson, D., American Heart Association Council
on Peripheral Vascular Disease, Council on Epidemiology and Prevention, Council on Clinical Cardiology, … Council on Cardiovascular
Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia. (2012). Measurement and interpretation of the ankle-
brachial index: A scientific statement from the American Heart Association. Circulation, 126(24), 2890–2909. https://doi.org/10.1161/
CIR.0b013e318276fbcb
Casey, S., Lanting, S., Oldmeadow, C., & Chuter, V. (2019). The reliability of the ankle brachial index: A systematic review. Journal of Foot and Ankle
Research, 12, 39.
Cashin, A. G., & McAuley, J. H. (2020). Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. Journal of Physiotherapy, 66(1), 59. https://
doi.org/10.1016/j.jphys.2019.08.005
Clark, B. C., Manini, T. M., Hoffman, R. L., et al. (2011). Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy
adults. Scandinavian Journal of Medicine & Science in Sports, 21(5), 653–662. https://doi.org/10.1111/j.1600-0838.2010.01100.x
Cognetti, D. J., Sheean, A. J., & Owens, J. G. (2022). Blood flow restriction therapy and its use for rehabilitation and return to sport: Physiology,
application, and guidelines for implementation. Arthroscopy, Sports Medicine, and Rehabilitation, 4(1), e71–e76. https://doi.org/10.1016/j.
asmr.2021.09.025
Cook, S. B., LaRoche, D. P., Villa, M. R., Barile, H., & Manini, T. M. (2017). Blood flow restricted resistance training in older adults at risk of mobility
limitations. Experimental Gerontology, 99, 138–145. https://doi.org/10.1016/j.exger.2017.10.004
Cuffe, M., Novak, J., Saithna, A., Strohmeyer, H. S., & Slaven, E. (2022). Current trends in blood flow restriction. Frontiers in Physiology, 13, 882472.
Killinger, B., Zaleski, A. L., Ebben, W. P., & Brown, L. E. (2019). The effects of blood flow restriction on muscle activation and hypoxia in individuals
with chronic ankle instability. Journal of Sport Rehabilitation, 29(5), 633–639.
Lopes, K. G., Libardi, C. A., Tomeleri, C. M., Cavaglieri, C. R., Deminice, R., & Damas, F. (2022). Exercise with blood flow restriction improves
muscle strength and mass while preserving the vascular and microvascular function and structure of older adults. Clinical Hemorheology and
Microcirculation, 82(1), 13–26.
May, A. K., Carey, C. C., Lovalekar, M. T., & Gerhart, H. D. (2022). Muscle adaptations to heavy-load and blood flow restriction resistance training
methods. Frontiers in Physiology, 13, 837697.
Morton, N. A. (2009). The PEDro scale is a valid measure of the methodological quality of clinical trials: A demographic study. Australian Journal of
Physiotherapy, 55(2), 129–133. https://doi.org/10.1016/s0004-9514(09)70043-1
Nakajima, T., Kurano, M., Iida, H., Takano, H., & Oonuma, H. (2006). Use and safety of KAATSU training: Results of a national survey. International
Journal of KAATSU Training Research, 2(1), 5–13.
Patterson, S. D., Hughes, L., Warmington, S., Burr, J., Scott, B. R., Owens, J., Abe, T., Nielsen, J. L., Libardi, C. A., Laurentino, G., Neto, G. R.,
Brandner, C., Martin-Hernandez, J., & Loenneke, J. (2019). Blood flow restriction exercise: Considerations of methodology, application, and
safety. Frontiers in Physiology, 10, 533. https://doi.org/10.3389/fphys.2019.00533
Rolnick, N., & Schoenfeld, B. J. (2020). Blood flow restriction training and the physique athlete: A practical research-based guide to maximizing
muscle size. Strength and Conditioning Journal, 42(5), 22–36. https://doi.org/10.1519/SSC.0000000000000553
Silva, M. D. L. D., Pereira, P. M. G., & Geraldes, A. A. R. (2018). Blood flow restriction and body composition effects of resistance training with
blood flow restriction on the body composition of postmenopausal women. International Physical Medicine & Rehabilitation Journal, 3(3),
200–203.
Wortman, R. J., Fahs, C. A., Rossow, L. M., & Loenneke, J. P. (2021). Blood flow restriction training for athletes: A systematic review. The American
Journal of Sports Medicine, 49(7), 1938–1944.
Xu, D., Zou, L., Xing, Y., Hou, L., Wei, Y., Zhang, J., Qiao, Y., Hu, D., Xu, Y., Li, J., & Ma, Y. (2013). Diagnostic value of ankle-brachial index in
peripheral arterial disease: A meta-analysis. The Canadian Journal of Cardiology, 29(4), 492–498.
Yasuda, T., Fukumura, K., Fukuda, T., et al. (2014). Muscle size and arterial stiffness after blood flow-restricted low-intensity resistance training in
older adults. Scandinavian Journal of Medicine & Science in Sports, 24(5), 799–806. https://doi.org/10.1111/sms.12087
Yasuda, T., Fukumura, K., Iida, H., & Nakajima, T. (2015). Effects of detraining after blood flow-restricted low-load elastic band training on muscle
size and arterial stiffness in older women. SpringerPlus, 4, 348. https://doi.org/10.1186/s40064-015-1132-2
Yasuda, T., Fukumura, K., Tomaru, T., & Nakajima, T. (2016). Thigh muscle size and vascular function after blood flow-restricted elastic band training
in older women. Oncotarget, 7(23), 33595–33607. https://doi.org/10.18632/oncotarget.9564
Yasuda, T., Fukumura, K., Uchida, Y., et al. (2015). Effects of low-load, elastic band resistance training combined with blood flow restriction on muscle
size and arterial stiffness in older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 70(8), 950–958.