Acute Responses in Blood Flow Restriction Low-intensity Aerobic Training: A Meta-analysis.

The purpose was to determine the effect low-intensity training with blood flow restriction (LI-BFR) versus high-intensity aerobic training (HIT) on acute physiological and perceptual responses. The Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, Scopus, SPORTDiscus and Web of Science databases and the reference list of eligible studies were consulted to identify randomized experimental studies, published until July 4, 2022, that analyzed physiological or perceptual responses between LI-BFR versus HIT in healthy young individuals. Mean difference (MD) and standardized mean difference (SMD) were used as effect estimates and random effects models were applied in all analyses. Twelve studies were included in this review. During exercise sessions, HIT promoted higher values of heart rate (MD=28.9 bpm; p<0.00001; I 2 =79%), oxygen consumption (SMD=4.01; p<0.00001; I 2 =83%), ventilation (MD=48.03 l/min; p=0.0001; I 2 =97%), effort (SMD=1.54; p=0.003; I 2 =90%) and blood lactate (MD=3.85 mmol/L; p=0.002; I 2 =97%). Perception of pain/discomfort was lower in HIT (SMD=-1.71; p=0.04; I 2 =77.5%). In conclusion, LI-BFR promotes less pronounced physiological responses than HIT but with greater perception of pain.

Relative age effects on speed trials in Brazilian athletics.

BACKGROUND: Relative age effect (RAE) is a concept related to the possible advantage that older athletes would have over younger ones within the same category. Although many studies have approached this subject in individual sports, there are few clippings by events within the sport. More detailed analyses are necessary for a better understanding of how RAE behaves in sports, especially in athletics, the subject of this study. The objective of this study was to analyze the RAE on speed in track and field events as a whole, separating the flat races from the hurdles races. METHODS: The Brazilian Ranking of Brazilian Athletics Confederation was used for data analysis, and the sample was composed of the 50 best-placed marks in the ranking of speed events in athletics in the categories Under(U)-16 and U-18 (female and male). Statistical analysis was calculated by chi-square, and the effect size was checked by Cramer's V. Likelihood-ratio test (L-Ratio) assessed the probability of the RAE occurring in the total sample and by age groups. RESULTS: In the total sample the results pointed to the emergence of RAE in males in both categories (U-16: p < 0.001; V: 0.13; L-Ratio: 3.64, U-18: p < 0.001; V: 0.13; L-Ratio: 3.80), whereas in females no such effect was found in any category (U-16: p = 0.6; V: 0.09; L-Ratio: 0.09, U-18: p = 0.6; V: 0.07; L-Ratio: 0.12). When the results were separated by type of event, there was only a RAE in the shallow event in the U-18 female category (p = 0.3; V: 0.11; L-Ratio: 8.72). CONCLUSION: The results allow us to conclude that there is a RAE in the speed trials of Brazilian athletics in the U16 and U18 categories for men, while this effect appears only in the shallow trials of the U18 category for women, indicating that the RAE has incidence when there is more participation and competition in the sport.

Acute Effect of Resistance Training With Blood Flow Restriction on Perceptual Responses: A Systematic Review and Meta-Analysis.

CONTEXT: Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory. OBJECTIVES: To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses. DATA SOURCES: CINAHL, Cochrane Library, PubMed®, Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022. STUDY SELECTION: Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer. RESULTS: Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar. CONCLUSION: In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.

Physiological adaptations and myocellular stress in short-term, high-frequency blood flow restriction training: A scoping review.

BACKGROUND: High frequency (1-2 times per day) low-intensity blood flow restriction (BFR) training has been recommended as a prescription approach for short durations of time to maximize relevant physiological adaptations. However, some studies demonstrate negative physiological changes after short periods of high-frequency BFR training, including prolonged strength decline and muscle fiber atrophy. OBJECTIVES: To provide a comprehensive overview of short-term, high-frequency blood flow restriction training, including main adaptations, myocellular stress, limitations in the literature, and future perspectives. METHODS: A systematic search of electronic databases (Scopus, PubMed®, and Web of Science) was performed from the earliest record to April 23, 2022. Two independent reviewers selected experimental studies that analyzed physical training protocols (aerobic or resistance) of high weekly frequency (>4 days/week) and short durations (≤3 weeks). RESULTS: In total, 22 studies were included in this review. The samples were composed exclusively of young predominantly male individuals. Muscle strength and hypertrophy were the main outcomes analyzed in the studies. In general, studies have demonstrated increases in strength and muscle size after short term (1-3 weeks), high-frequency low-intensity BFR training, non-failure, but not after control conditions (non-BFR; equalized training volume). Under failure conditions, some studies have demonstrated strength decline and muscle fiber atrophy after BFR conditions, accompanying increases in muscle damage markers. Significant limitations exist in the current HF-BFR literature due to large heterogeneities in methodologies. CONCLUSION: The synthesis presented indicates that short-term, high-frequency BFR training programs can generate significant neuromuscular adaptations. However, in resistance training to failure, strength declines and muscle fiber atrophy were reported. Currently, there are no studies analyzing low-frequency vs. high-frequency in short-term BFR training. Comparisons between resistance exercises of similar intensities (e.g., combined effort) are lacking, limiting conclusions on whether the effect is a product of proximity to failure or a specific effect of BFR.

Myoelectric Activity and Fatigue in Low-Load Resistance Exercise With Different Pressure of Blood Flow Restriction: A Systematic Review and Meta-Analysis.

Background: Low-load resistance exercise (LL-RE) with blood flow restriction (BFR) promotes increased metabolic response and fatigue, as well as more pronounced myoelectric activity than traditional LL-RE. Some studies have shown that the relative pressure applied during exercise may have an effect on these variables, but existing evidence is contradictory. Purpose: The aim of this study was to systematically review and pool the available evidence on the differences in neuromuscular and metabolic responses at LL-RE with different pressure of BFR. Methods: The systematic review and meta-analysis was reported according to PRISMA items. Searches were performed in the following databases: CINAHL, PubMed, Scopus, SPORTDiscus and Web of Science, until June 15, 2021. Randomized or non-randomized experimental studies that analyzed LL-RE, associated with at least two relative BFR pressures [arterial occlusion pressure (AOP)%], on myoelectric activity, fatigue, or metabolic responses were included. Random-effects meta-analyses were performed for MVC torque (fatigue measure) and myoelectric activity. The quality of evidence was assessed using the PEDro scale. Results: Ten studies were included, all of moderate to high methodological quality. For MVC torque, there were no differences in the comparisons between exercise with 40-50% vs. 80-90% AOP. When analyzing the meta-analysis data, the results indicated differences in comparisons in exercise with 15-20% 1 repetition maximum (1RM), with higher restriction pressure evoking greater MVC torque decline (4 interventions, 73 participants; MD = -5.05 Nm [95%CI = -8.09; -2.01], p = 0.001, I 2 = 0%). For myoelectric activity, meta-analyses indicated a difference between exercise with 40% vs. 60% AOP (3 interventions, 38 participants; SMD = 0.47 [95%CI = 0.02; 0.93], p = 0.04, I2 = 0%), with higher pressure of restriction causing greater myoelectric activity. This result was not identified in the comparisons between 40% vs. 80% AOP. In analysis of studies that adopted pre-defined repetition schemes, differences were found (4 interventions, 52 participants; SMD = 0.58 [95%CI = 0.11; 1.05], p = 0.02, I 2 = 27%). Conclusion: The BFR pressure applied during the LL-RE may affect the magnitude of muscle fatigue and excitability when loads between 15 and 20% of 1RM and predefined repetition protocols (not failure) are prescribed, respectively. Systematic Review Registration: [http://www.crd.york.ac.uk/prospero], identifier [CRD42021229345].

Effect of resistance training with blood flow restriction on muscle damage markers in adults: A systematic review.

BACKGROUND: The purpose of this review was to systematically analyze the evidence regarding the occurrence of muscle damage (changes in muscle damage markers) after resistance training with blood flow restriction sessions. MATERIALS AND METHODS: This systematic review was conducted in accordance with the PRISMA recommendations. Two researchers independently and blindly searched the following electronic databases: PubMed, Scopus, Web of Science, CINAHL, LILACS and SPORTdicus. Randomized and non-randomized clinical trials which analyzed the effect of resistance training with blood flow restriction on muscle damage markers in humans were included. The risk of bias assessment was performed by two blinded and independent researchers using the RoB2 tool. RESULTS: A total of 21 studies involving 352 healthy participants (men, n = 301; women, n = 51) were eligible for this review. The samples in 66.6% of the studies (n = 14) were composed of untrained individuals. All included studies analyzed muscle damage using indirect markers. Most studies had more than one muscle damage marker and Delayed Onset Muscle Soreness was the measure most frequently used. The results for the occurrence of significant changes in muscle damage markers after low-load resistance training with blood flow restriction sessions were contrasting, and the use of a pre-defined repetition scheme versus muscle failure seems to be the determining point for this divergence, mainly in untrained individuals. CONCLUSIONS: In summary, the use of sets until failure is seen to be determinant for the occurrence of significant changes in muscle damage markers after low-load resistance training with blood flow restriction sessions, especially in individuals not used to resistance exercise. TRIAL REGISTRATION: Register number: PROSPERO number: CRD42020177119.

Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals.

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.

Effect of high-intensity interval training on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Our aim was to assess the effect of high-intensity interval training (HIIT) on metabolic parameters and body composition in women with polycystic ovary syndrome (PCOS). METHODS AND ANALYSIS: A systematic review and meta-analysis of randomized controlled trials was conducted using Embase, MEDLINE (via Ovid), PubMed, Sport Discus, Scopus, Web of Science, Cochrane Library and Google Scholar (advanced feature) up to September 2020. Two authors independently screened citations and determined the risk of bias and quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were conducted using random effects model. RESULTS: Seven trials (n = 423) were included in the systematic review. The studies included HIIT interventions vs. moderate exercise or control groups. Most studies were small (average 32, range 24-110 participants) and of relatively short duration (10-16 weeks). The training intensity was performed between 90% and 95% of the maximum heart rate, three times a week, for at least 10 weeks. Insulin resistance, measured using homeostatic model assessment for insulin resistance (HOMA-IR), and body mass index (BMI) showed a significant decrease (MD -0.57; 95% CI, -0.98 to -0.16, p = 0.01), (MD -1.90, 95% CI -3.37, -0.42, p = 0.01) with moderate and high certainty of evidence, respectively. CONCLUSION: Results support that HIIT alone is effective for reducing HOMA-IR and BMI in women with PCOS. However, evidence is limited to discern the effect of HIIT on other outcomes. Future studies with a longer duration (> 16 weeks), larger sample sizes and other outcomes are needed.

Mental Fatigue Reduces Training Volume in Resistance Exercise: A Cross-Over and Randomized Study.

The present study aimed to determine the effect of mental fatigue (MF) on total training volume (TTV; number of repetitions x number of sets x load) and on ratings of perceived exertion (RPE; Borg, 1982) in the half-back squat exercise (HBSE). Nine male subjects (M age = 22.6 years, SD = 2.3; M height = 172.3 cm, SD = 6.8; M weight = 76.2 kg, SD = 9.8; M years of resistance training experience = 4.1, SD = 2.3 years) recruited from a university population were study participants in this participant-blind cross-over and randomized study. Participants underwent either the Stroop task - a highly demanding cognitive task (CT) - or a control condition (CON) in which they viewed a documentary exhibition for 30 minutes. Perception of MF and motivation were assessed after treatments using a visual analog scale of 100 mm. Participants then engaged in a countermovement jump (CMJ) test and three sets of HBSE until they reached momentary concentric failure, reporting RPE at the end of each exercise set. Following the CT, participants showed a significantly increased self-perception of MF in relation to the CON condition (p = 0.01; d = 1.2), but this did not affect their motivation to engage in subsequent tests (p = 0.99; d = 0.006). Neither the CMJ performances nor the RPE were statistically different between CT and CON conditions (p = 0.33; d = 0.09 and p = 0.20; η2 = 0.20, respectively). TTV was significantly lower in the CT relative to the CON experimental condition (Δ = -15.8%; p = 0.04; η2 = 0.48). Prolonged involvement in a CT was associated with reduced volume on a resistance exercise, though this effect was not associated with changes in CMJ performance or motivation to exercise.

Retrospective Study of Risk Factors and the Prevalence of Injuries in HIFT.

The aim of this study was to investigate the risk factors and the incidence of injuries in high-intensity functional training (HIFT) practitioners. A survey was administered to 213 HIFT practitioners. Participants reported the number of injuries, the location of the injuries, and training exposure during the preceding six months and answered questions regarding potential risk factors for injury. We found there were 7.1 injuries for every 1000 hours of training. In addition, we found that individuals with experience in the modality (>2 years) were 3.77 times more likely to be affected by injury when compared with beginner individuals (<6 months) (CI95%=1.59-8.92; p=0.003). When the analysis was performed only for the competitive level, we found that practitioners competing at the national level were 5.69 times more likely to experience an injury than competitors who do not compete (CI95%=1.10-29.54; p=0.038). We also found that the injuries mainly affect the shoulder and lumbar regions. It was possible to conclude that subjects with a higher level of experience in the modality are more likely to be affected by injuries and that the shoulder and lumbar areas are most likely to be injured during HIFT.

The stretch-shortening cycle efficiency is dependent on the maturational stage / A eficiência do ciclo alongamento-encurtamento é dependente do estágio maturacional

Abstract Maturation interferes with physiological and mechanical aspects of muscle contraction. The aim of the present study was to compare the efficiency of the stretch-shortening cycle (SSC) between different maturation stages. One hundred forty six young people, with 72 boys and 74 girls, were recruited to participate in the study. Sexual maturation was measured and the group was stratified into adolescents (> 3 auto-tanner) and children (<2 auto-tanner). Squat jump (SJ) and countermovement jump (CMJ) performance were measured to measure reactive force (RF) capacity, eccentric utilization ratio (EUR) and pre-stretch augmentation (PSAP). The children did not present statistical difference between SJ and CMJ (t(55)= -1.93; ∆ = -0.61; 95% CI = -1.24 to -0.02; p = 0.058), while the adolescents presented higher performance of CMJ (t(89)= -12.28; ∆ = -2.44; 95% CI = -2.84 to -2.05; p <0.001). In addition, adolescents had higher RF performance (t(144)= 5.18; p <0.0001; 95% CI = 2.53 to 1.13), PSAP (t(144)= 4.38; p <0.0001; 95% CI = 14.00 to 5.29) and EUR (t(144)= 4.38; p <0.0001; 95% CI = 0.14 to 0.05). We conclude that more mature young people have better SSC utilization.

Resumo Maturação interfere em aspectos fisiológicos e mecânicos da contração muscular. O objetivo do estudo foi comparar a eficiência do ciclo alongamento-encurtamento (SSC) em diferentes estágios maturacionais. Cento e quarenta e seis jovens, sendo 72 meninos e 74 meninas, foram recrutados para participar do estudo. Maturação sexual foi mensurada e o grupo foi estratificado em adolescentes (≥ 3 e crianças (< estágio 2). Salto estático (SJ) e o salto contramovimento (CMJ) foram utilizados para mensurar a força reativa (RF), razão de utilização da excêntrica (EUR) e aumento do pré-estiramento (PSAP). As crianças não apresentaram diferença significante entre SJ e CMJ (t(55)= -1.93; ∆ = -0.61; 95% CI = -1.24 to -0.02; p = 0.058), Enquanto que os adolescentes apresentaram maior desempenho de CMJ (t(89)= -12.28; ∆ = -2.44; 95% CI = -2.84 to -2.05; p <0.001). Em adição, adolescentes apresentaram maior RF (t(144)= 5.18; p <0.0001; 95% CI = 2.53 to 1.13), PSAP (t(144)= 4.38; p <0.0001; 95% CI = 14.00 to 5.29) e EUR (t(144)= 4.38; p <0.0001; 95% CI = 0.14 to 0.05). Nós concluímos que jovens com mais maturados apresentam maior capacidade de utilização do SSC.