If you have come to check out the science behind BFR training you have come to the right place. This is the one-stop shop for all the peer-reviewed scientific literature addressing BFR training.
The works are sectioned out for you regarding what the study was looking for from the examination. Studies are listed multiple times if the authors found multiple outcomes.
We will come out with an article soon on the “How to Read a Scientific Research Article” for those of you interested in the data but are confused when looking at the literature.
While research is a wonderful tool, it’s only useful if what we do with the information actually creates change. If you’re ready to see results with BFR training to increase muscle size, muscular endurance, and
Section 1: Increasing Hypertrophy (Muscle Size)
1. BFR training increases stem cells
Nielsen, J., Aagaard, P., Bech, R., Nygaard, T., Hvid, L., Wernbom, M., Suetta, C., Frandsen, U. 2012. “Proliferation of Myogenic Stem Cells in Human Skeletal Muscle in Response to Low-Load Resistance Training with Blood Flow Restriction.” Journal of Physiology. 590 (17): 4351-4361. DOI:10.1113/jphysiol.2012.237008.
Conclusion – Concluded that short-term low-load resistance exercise performed with partial blood flow restriction leads to a marked proliferation of myogenic stem cells and resulting myonuclei addition in human skeletal muscle, which is accompanied by substantial myofibre hypertrophy.
Link to study.
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2. BFR training increases muscle cell swelling
Loenneke, J., Fahs, C., Rossow, L., Abe, T., Bemben, M. 2012. “The Anabolic Benefits of Venous Blood Flow Restriction Training May Be Induced By Muscle Swelling.” Medical Hypotheses. 78 (1): 151-154. DOI: DOI.org/10.1016/j.mehy.2011.10.014.
Conclusion – Concluded that cell swelling is important for muscle growth and strength adaptation but when coupled with higher metabolic accumulation, this adaptation is even greater. That higher accumulation was from the BFR training.
Link to study.
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3. BFR training increases muscle size
Madarame, H., Neya, M., Ochi, E., Nakazato, K., Sato, Y., Ishii, N. 2008. “Cross-Transfer Effects of Resistance Training with Blood Flow Restriction.” Medicine & Science in Sports & Exercise. 40 (2): 258-263. DOI:10.1249/mss.0b013e31815c6d7e.
Conclusion – Concluded BFR increases muscle size at 30% 1RM.
Link to study.
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4. BFR training increases muscle size
Yasuda, T., Ogasawara, R., Sakamaki, M., Ozaki, H., Sato, Y., Abe, T. 2011. “Combined Effects of Low-Intensity Blood Flow Restriction Training and High-Intensity Resistance Training on Muscle Strength and Size.” European Journal of Applied Physiology. 111: 2525-2533. DOI: https://doi.org/10.1007/s00421-011-1873-8.
Conclusion – Concluded BFR (30% 1RM) combined separately with high intensity (75% 1RM), and when done by itself will increase muscle size.
Link to study.
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5. BFR training increases size with walking
Abe, T., Kearns, C., Sato, Y. 2005. “Muscle Size and Strength are Increased following Walk Training with Restricted Venous Blood Flow from the Leg Muscle, Kaatsu-Walk Training.” American Journal of Applied Physiology. 100: 1460-1466. DOI: https://doi.org/10.1152/japplphysiol.01267.2005.
Conclusion – Concluded BFR combined with walking increased muscle size & strength. Just by walking with them for 10 total minutes! Incredible. Obviously size will increase. But for strength to be increased from walking is amazing! Study performed on the geriatric population.
Link to study.
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6. BFR training increases muscle size
Yamanaka, T., Farley, R., Caputo, J. 2012. “Occlusion Training Increases Muscular Strength in Division IA Football Players.” The Journal of Strength and Conditioning Research. 26 (9): 2523-2529. DOI: 10.1519/JSC.0b013e31823f2b0e.
Conclusion – Concluded BFR significantly increases lower and upper body strength and size in College Football student-athletes after 4 weeks of training.
Link to study.
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7. BFR training increases muscle size in individuals with physical limitations
Lixandrao, M., Ugrinowitsch, C., Berton, R., Vechin, F., Conceicao, M., Damas, F., Libardi, C., Roschel, H. 2018. “Magnitude of Muscle Strength and Mass Adaptations Between High-Load Resistance Training Versus Low-Load Resistance Training Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis.” Sports Medicine. 48 (2): 361-378. DOI: 10.1007/s40279-017-0795-y.
Conclusion – This review concluded BFR combined with resistance training is a valid and effective approach for increasing muscle strength and size in a wide spectrum of ages and physical capacity, although it may seem particularly of interest for those individuals with physical limitations to not engage in High Load Resistance Training.
Link to study.
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8. BFR training increases muscle size systemically
Dankel, S., Jessee, M., Loenneke, J. 2016. “The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure.” Sports Medicine. 46 (1): 23-33. DOI: 10.1007/s40279-015-0407-7.
Conclusion – Concluded low-load BFR training increased muscle size and strength in limbs located proximal (chest, shoulders) and distal (biceps, triceps) to the restrictive stimulus. Some of the musculature in the upper body cannot be directly restricted by the application of BFR. Despite this, increases in muscle size and strength were observed in muscles placed under direct and indirect BFR therefore, causing a Systemic effect!
Link to study.
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9. BFR training increases muscle swelling
Buckner, S., Jessee, M., Dankel, S., Mattocks, K., Mouser, J., Bell, Z., Abe, T., Loenneke, J. 2019. “Acute Skeletal Muscle Responses to Very Low-Load Resistance Exercise With and Without the Application of Blood Flow Restriction in the Upper Body.” Clinical Physiology and Functional Imaging. 39 (3): 201-208. DOI: 10.1111/cpf.12557.
Conclusion – Concluded very low-load exercise with BFR appears to result in greater acute muscle swelling and greater muscular fatigue compared to high load exercise.
Link to study.
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Section 2: Increasing Strength
1. BFR training increases muscle strength
Luebbers, P., Witte, E., Oshel, J., Butler, M. 2019. “Effects of Practical Blood Flow Restriction Training on Adolescent Lower-Body Strength.” The Journal of Strength and Conditioning Research. 33 (10): 2674-2683. DOI:10.1519/JSC.0000000000002302.
Conclusion – Paired-sample t-tests for each group indicated a significant increase in leg strength for the Light Load + BFR group (p = 0.005) but not for the High Load (p = 0.142) or Light Load only groups (p = 1.00). This suggests that a practical BFR training program may be effective in increasing 1 Rep Max squat performance of high school students.
Link to study.
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2. BFR training increases muscle strength
Manimmanakorn, A., Hamlin, M., Ross, J., Taylor, R., Manimmanakorn, N. 2013. “Effects of Low-Load Resistance Training Combined with Blood Flow Restriction or Hypoxia on Muscle Function and Performance in Netball Athletes.” Journal of Science and Medicine in Sports. 16 (4): 337-342. DOI:10.1016/j.jsams.2012.08.009.
Conclusion – Concluded BFR can provide substantial improvements in muscle strength and endurance and may be useful alternatives to traditional training practices.
Link to study.
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3. BFR training increases 1 rep max
Luebbers, P., Fry, A., Kriley, L., Butler, M. 2014. “The Effects of a 7-Week Practical Blood Flow Restriction Program on Well-Trained Collegiate Athletes.” The Journal of Strength and Conditioning Research. 28 (8): 2270-2280. DOI:10.1519/JSC.0000000000000385.
Conclusion – Concluded a significant difference for 1RM squat. This suggests that a practical BFR program used in addition to a traditional strength training program can be effective at increasing 1RM squat performance.
Link to study.
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4. BFR training increases muscle strength
Yasuda, T., Fujita, S., Ogasawara, R., Sato, Y., Abe, T. 2010. “Effects of Low-Intensity Bench Press Training with Restricted Arm Muscle Blood Flow on Chest Muscle Hypertrophy: a pilot study.” Clinical Physiology and Functional Imaging. 30: 338-343. DOI: https://doi.org/10.1111/j.1475-097X.2010.00949.x.
Conclusion – Concluded BFR improves multi-joint exercise strength (Bench Press) at 30% 1RM.
Link to study.
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5. BFR training increases muscle strength systemically
Cook, C., Kilduff, L., Beaven, M. 2013. “Improving Strength and Power in Trained Athletes With 3 Weeks of Occlusion Training.” International Journal of Sports Physiology and Performance. 9 (1): 166-172. DOI: https://doi.org/10.1123/ijspp.2013-0018.
Conclusion – Concluded clear improvement in bench-press strength resulting from lower-body occlusion training suggests a systemic effect of BFR training.
Link to study.
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6. BFR training increases 1 rep max
Abe, T., Yasuda, T., Midorikawa, T., Sato, Y., Kearns, C., Inoue, K., Koizumi, K., Ishii, N. 2005. “Skeletal Muscle Size and Circulating IGF-1 are Increased after Two Weeks of Twice Daily “KAATSU” Resistance Training.” International Journal of KAATSU Training Research. 1 (1): 6-12. https://doi.org/10.3806/ijktr.1.6.
Conclusion – Concluded BFR improved Squat 1RM by 17% using only 20% 1RM in training, and there was a gradual increase in circulating IGF-1 and muscle-bone CSA!
Link to study.
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7. BFR training increases muscle strength
Madarame, H., Neya, M., Ochi, E., Nakazato, K., Sato, Y., Ishii, N. 2008. “Cross-Transfer Effects of Resistance Training with Blood Flow Restriction.” Medicine & Science in Sports & Exercise. 40 (2): 258-263. DOI:10.1249/mss.0b013e31815c6d7e.
Conclusion – Concluded BFR increases muscle strength at 30% 1RM.
Link to study.
__________________________
8. BFR training increases muscle strength
Yasuda, T., Ogasawara, R., Sakamaki, M., Ozaki, H., Sato, Y., Abe, T. 2011. “Combined Effects of Low-Intensity Blood Flow Restriction Training and High-Intensity Resistance Training on Muscle Strength and Size.” European Journal of Applied Physiology. 111: 2525-2533. DOI: https://doi.org/10.1007/s00421-011-1873-8.
Conclusion – Concluded BFR (30% 1RM) combined separately with high intensity (75% 1RM), and when done by itself will increase muscle strength.
Link to study.
__________________________
9. BFR training increases muscle strength
Clark, B., Manini, T., Hoffman, R., Williams, P., Guiler, M., Knutson, M., McGlynn, M., Kushnick, M. 2011. “Relative Safety of 4 Weeks of Blood Flow‐Restricted Resistance Exercise in Young, Healthy Adults.” Scandinavian Journal of Medicine and Science in Sports. 21 (5): 653-662. DOI: https://doi.org/10.1111/j.1600-0838.2010.01100.x.
Conclusion – Concluded these findings indicate that both High load training and Low load BFR training increase strength without altering nerve or vascular function, and that a single bout of both protocols increases fibrinolytic activity without altering selected markers of coagulation or inflammation in healthy individuals.
Link to study.
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10. BFR training increases muscle strength
Evans, C., Vance, S. Brown, M. 2010. “Short-Term Resistance Training with Blood Flow Restriction Enhances Microvascular Filtration Capacity of Human Calf Muscles.” Journal of Sports Sciences. 28 (9): 999-1007. DOI: 10.1080/02640414.2010.485647.
Conclusion – Concluded calf blood filtration capacity increased by 26% in the restricted leg but did not increase significantly in the unrestricted leg. Calf muscle strength was 18% greater in the restricted leg but unchanged in the unrestricted leg. Calf muscle fatigue and resting blood flow did not change in either leg. Resistance training promoted microvascular filtration capacity, an effect that was somewhat enhanced by blood flow restriction, and could be due to increased capillarization.
Link to study.
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11. BFR training increases muscle strength systemically
Dankel, S., Jessee, M., Loenneke, J. 2016. “The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure.” Sports Medicine. 46 (1): 23-33. DOI: 10.1007/s40279-015-0407-7.
Conclusion – Concluded low-load BFR training increased muscle size and strength in limbs located proximal (chest, shoulders) and distal (biceps, triceps) to the restrictive stimulus. Some of the musculature in the upper body cannot be directly restricted by the application of BFR. Despite this, increases in muscle size and strength were observed in muscles placed under direct and indirect BFR therefore, causing a Systemic effect!
Link to study.
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12. BFR training increases muscle strength
Sieljacks, P., Wang, J., Groennebaek, T., Rindom, E., Jakobsgaard, J., Herskind, J., Gravholt, A., Moller, A., Musci, R., Paoli, F., Hamilton, K., Miller, B., Vissing, K. 2019. “Six Weeks of Low-Load Blood Flow Restricted and High-Load Resistance Exercise Training Produce Similar Increases in Cumulative Myofibrillar Protein Synthesis and Ribosomal Biogenesis in Healthy Males.” Frontiers in Physiology. 10 (649): 1-16. DOI: 10.3389/fphys.2019.00649.
Conclusion – Concluded that BFR combined with resistance exercise increases long-term muscle protein turnover, ribosomal biogenesis, and muscle strength to a similar degree as high load resistance exercise.
Link to study.
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Section 3: Increasing “Cardio” Fitness (Endurance)
1. BFR training increases cardio fitness
Taylor, C., Ingham, S., Ferguson, R. 2016. “Acute and Chronic Effect of Sprint Interval Training Combined with Postexercise Blood‐Flow Restriction in Trained Individuals.” Experimental Physiology. 101 (1): 143-154. DOI: https://doi.org/10.1113/EP085293.
Conclusion – Concluded the potency of combining blood‐flow restriction with sprint interval training in increasing maximal oxygen uptake in trained individuals, and specifically increasing capillary growth.
Link to study.
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2. BFR training increases cardio fitness
Abe, T., Fujita, S., Nakajima, T., Sakamaki, M., Ozaki, H., Ogasawara, R., Sugaya, M., Kudo, M., Kurano, M., Yasuda, T., Sato, Y., Ohshima, H., Mukai, C., Ishii, N. 2010. “Effects of Low-Intensity Cycle Training with Restricted Leg Blood Flow on Thigh Muscle Volume and VO2MAX in Young Men.” Journal of Sport Science and Medicine. 9 (3): 452-458. PMCID: PMC3761718.
Conclusion – Concluded BFR combined with low-intensity (40% of VO2max) cycle training can elicit concurrent improvement in muscle hypertrophy & aerobic capacity! Crazy fact here is the BFR group did 15 minutes per session, compared to 45 minutes per session with the other group. Targets athletic population.
Link to study.
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3. BFR training increases muscle endurance
Kacin, A., Strazar, K. 2011. “Frequent Low‐Load Ischemic Resistance Exercise to Failure Enhances Muscle Oxygen Delivery and Endurance Capacity.” Scandinavian Journal of Medicine and Science in Sports. 21 (6): 231-241. DOI: https://doi.org/10.1111/j.1600-0838.2010.01260.x.
Conclusion – Concluded BFR at 15% to FAILURE induces substantial gains in muscle endurance capacity, which were associated with enhanced muscle oxygen delivery. Endurance population!
Link to study.
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4. BFR training increases cardio fitness
Silva, J., Domingos-Gomes, J., Freitas, E., Neto, G., Aniceto, R., Bemben, M., Lima-dos-Santos, A., Cirilo-Sousa, M. 2019. “Physiological and Perceptual Responses to Aerobic Exercise With and Without Blood Flow Restriction.” The Journal of Strength and Conditioning Research. Volume Published Ahead of Print. DOI: 10.1519/JSC.0000000000003178.
Conclusion – Concluded High Intensity Interval Exercise induced the greatest increases in VO2 (Oxygen Consumption) and Heart Rate, although the perceptual responses were essentially the same compared with Low Intensity Aerobic Exercise combined with BFR. However, VO2 was greater during Low Intensity Exercise combined with BFR compared with Low Intensity Aerobic Exercise alone, indicating that the BFR training method may be used to replace High Intensity Interval Exercise and still significantly elevate VO2.
Link to study.
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5. BFR training increases cardio fitness
Bennett, H., Slattery, F. 2019. “Effects of Blood Flow Restriction Training on Aerobic Capacity and Performance: A Systematic Review.” The Journal of Strength and Conditioning Research. 33 (2): 572-583. DOI: 10.1519/JSC.0000000000002963.
Conclusion – Concluded BFR combined with aerobic exercise increased measures of aerobic fitness and performance in younger adults. Despite methodological limitations, BFR combined with aerobic exercise seems to have applications in scenarios where high-intensity aerobic exercise is not appropriate, although more high-quality research is needed to further demonstrate this.
Link to study.
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6. BFR training increases muscular endurance
Evans, C., Vance, S. Brown, M. 2010. “Short-Term Resistance Training with Blood Flow Restriction Enhances Microvascular Filtration Capacity of Human Calf Muscles.” Journal of Sports Sciences. 28 (9): 999-1007. DOI: 10.1080/02640414.2010.485647.
Conclusion – Concluded calf blood filtration capacity increased by 26% in the restricted leg but did not increase significantly in the unrestricted leg. Calf muscle strength was 18% greater in the restricted leg but unchanged in the unrestricted leg. Calf muscle fatigue and resting blood flow did not change in either leg. Resistance training promoted microvascular filtration capacity, an effect that was somewhat enhanced by blood flow restriction, and could be due to increased capillarization.
Link to study.
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Section 4: Increasing Anabolic Metabolites
1. BFR training increases stem cells release
Nielsen, J., Aagaard, P., Bech, R., Nygaard, T., Hvid, L., Wernbom, M., Suetta, C., Frandsen, U. 2016. “Proliferation of Myogenic Stem Cells in Human Skeletal Muscle in Response to Low-Load Resistance Training with Blood Flow Restriction.” Journal of Physiology. 590 (17): 4351-4361. DOI:10.1113/jphysiol.2012.237008.
Conclusion – Concluded that short-term low-load resistance exercise performed with partial blood flow restriction leads to marked proliferation of myogenic stem cells and resulting myonuclei addition in human skeletal muscle, which is accompanied by substantial myofibre hypertrophy.
Link to study.
__________________________
2. BFR training increases metabolites
Loenneke, J., Fahs, C., Rossow, L., Abe, T., Bemben, M. 2012. “The Anabolic Benefits of Venous Blood Flow Restriction Training May Be Induced By Muscle Swelling.” Medical Hypotheses. 78 (1): 151-154. DOI: DOI.org/10.1016/j.mehy.2011.10.014.
Conclusion – Concluded that cell swelling is important for muscle growth and strength adaptation but when coupled with higher metabolic accumulation, this adaptation is even greater. That higher accumulation was from the BFR training.
Link to study.
__________________________
3. BFR training increases IGF-1 secretion
Abe, T., Yasuda, T., Midorikawa, T., Sato, Y., Kearns, C., Inoue, K., Koizumi, K., Ishii, N. 2005. “Skeletal Muscle Size and Circulating IGF-1 are Increased after Two Weeks of Twice Daily “KAATSU” Resistance Training.” International Journal of KAATSU Training Research. 1 (1): 6-12. DOI: https://doi.org/10.3806/ijktr.1.6.
Conclusion – Concluded BFR improved Squat 1 Rep Maximum by 17% using only 20% 1 Rep Maximum in training, and there was a gradual increase in circulating IGF-1 and muscle-bone Cross Sectional Area!
Link to study.
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4. BFR training increases metabolites
Loenneke, J., Wilson, G., Wilson, J. 2010. “A Mechanistic Approach to Blood Flow Occlusion.” International Journal of Sports Medicine. 31 (1): 1-4. DOI: 10.1055/s-0029-1239499.
Conclusion – Concluded BFR proposed mechanisms benefits include increased fiber type recruitment, metabolic accumulation, stimulation of muscle protein synthesis, and cell swelling, although it is likely that many of the aforementioned mechanisms work together!
Link to study.
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5. BFR training increases metabolites
Groennebaek, T., Jespersen, N., Jakobsgaard, E., Sieljacks, P., Wang, J., Rindom, E., Musci, R., Botker, H., Hamilton, K., Miller, B., Paoli, F., Vissing, K. 2018. “Skeletal Muscle Mitochondrial Protein Synthesis and Respiration Increase With Low-Load Blood Flow Restricted as Well as High-Load Resistance Training.” Frontiers in Physiology. 9 (1796): 1-14. DOI: 10.3389/fphys.2018.01796.
Conclusion – Concluded that resistance exercise can stimulate mitochondrial biogenesis and respiratory function to support healthy skeletal muscle and whole-body metabolism. Intriguing, BFR resistance exercise produces similar mitochondrial adaptations at a markedly lower load, which entails great clinical perspective for populations in whom exercise with high loading is undesirable.
Link to study.
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Section 5: BFR Safety
1. BFR training is safe
Loenneke, J., Wilson, J., Wilson, G., Pujol, T., Bemben, M. 2011. “Potential Safety Issues with Blood Flow Restriction Training.” Scandinavian Journal of Medicine and Science in Sports. 21 (4): 510-518. DOI: https://doi.org/10.1111/j.1600-0838.2010.01290.x.
Conclusion – Concluded BFR offered NO greater risk than traditional exercise. Article about safety of BFR.
Link to study.
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2. BFR training is safe
Nakajima, T., Kurano, M., Iida, H., Takano, H., Oonuma, H., Morita, T., Meguro, K., Sato, Y., Nagata, T. 2005. “Use and Safety of KAATSU Training : Results of a National Survey.” International Journal of KAATSU Training Research. 2 (1): 5-13. DOI: 10.3806/ijktr.2.5.
Conclusion – Concluded from a survey of over 12,600 people that the incidence of negative side effects from BFR training was as follows; venous thrombus 5.5% chance (0.055%), pulmonary embolism less than a 1% chance (0.008%), and rhabdomyolysis less than a 1% chance (0.008%). These results indicate that the KAATSU (BFR) training is a safe and promising method for training athletes and healthy persons, and can also be applied to persons with various physical conditions.
Link to study.
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3. BFR training is safe
Clark, B., Manini, T., Hoffman, R., Williams, P., Guiler, M., Knutson, M., McGlynn, M., Kushnick, M. 2011. “Relative Safety of 4 Weeks of Blood Flow‐Restricted Resistance Exercise in Young, Healthy Adults.” Scandinavian Journal of Medicine and Science in Sports. 21 (5): 653-662. DOI: https://doi.org/10.1111/j.1600-0838.2010.01100.x.
Conclusion – Concluded these findings indicate that both High load training and Low load BFR training increase strength without altering nerve or vascular function, and that a single bout of both protocols increases fibrinolytic activity without altering selected markers of coagulation or inflammation in healthy individuals.
Link to study.
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4. BFR training is safe
Crisafulli, A., De Farias, R., Farinatti, P., Lopes, K., Milia, R., Sainas, G., Pinna, V., Palazzolo, G., Doneddu, A., Magnani, S., Mulliri, G., Roberto, S., Oliveira, R. 2018. “Blood Flow Restriction Training Reduces Blood Pressure During Exercise without Affecting Muscle Metaboreflex.” Frontiers in Physiology. 9: 1736. DOI: 10.3389/fphys.2018.01736.
Conclusion – Concluded BFR training reduced blood pressure during handgrip exercise, thereby suggesting a potential hypotensive effect of this modality of training. However, mean arterial pressure (MAP) reduction during handgrip seemed not to be provoked by lowered metaboreflex activity.
Link to study.
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5. BFR training is safe
Souza, T., Pfeiffer, P., Pereira, J., Pereira, N., Elisio, A., Dutra, T., Mendonca, M., Cirilo-Sousa, M. 2019. “Immune System Modulation in Response to Strength Training With Blood Flow Restriction.” The Journal of Strength and Conditioning Research. Volume Published Ahead of Print. DOI: 10.1519/JSC.0000000000003323.
Conclusion – Concluded that compared to the multiple-set training at different intensities, strength training with BFR produces immunoinflammatory responses similar to the low-intensity training and different from the high-intensity training. However, the demargination process of some cells was different depending on the method and intensity used. Nevertheless, these variations are compatible with an appropriate recovery process, because the amplitude and length of the modulation curves of leukocytes, and lymphocyte subpopulations were not compatible with immunosuppression.
Link to study.
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Section 6: Miscellaneous
1. BFR training duration
Loenneke, J., Wilson, J., Marin, P., Zourdos, M., Bemben, M. 2011. “Low Intensity Blood Flow Restriction Training: A Meta-Analysis.” European Journal of Applied Physiology. 112 (5): 1849-1859. DOI: https://doi.org/10.1007/s00421-011-2167-x.
Conclusion – Meta-analysis that states 2-10 weeks of BFR training are need to see benefits.
Link to study.
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2. BFR training can reduce risk of injury
Chen, Y., Hsieh, Y., Ho, J., Lin, J. 2019. “Effects of Running Exercise Combined With Blood Flow Restriction on Strength and Sprint Performance.” The Journal of Strength and Conditioning Research. Volume Published Ahead of Print. DOI: 10.1519/JSC.0000000000003313.
Conclusion – Concluded Running Exercises combined with BFR during a warm-up induced higher Heart Rate, Rating of Perceived Exertion, and Blood Lactate values than did a Running Exercises routine without BFR warm-up immediately after the exercises and at a 5-minute recovery point (p < 0.05). These results suggest that a warm up consisting of Running Exercises combined with BFR may positively augment physiological responses and improve the Hamstring:Quadriceps ratio and isokinetic knee flexor strength. Thus, that same warm-up may be considered a practical warm-up strategy for promoting muscle strength and reducing the risk of hamstring injury in male sprinters.
Link to study.
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3. BFR training strap tightness
Loenneke, J., Pujol, T. 2009. “The Use of Occlusion Training to Produce Muscle Hypertrophy.” Strength and Conditioning Journal. 31 (3): 77-84. DOI:10.1519/SSC.0b013e3181a5a352.
Conclusion – Concluded BFR at 50-100 mmHG (Tightness) is enough to induce its phenomenal effects! AKA you don’t need the fancy equipment like blood pressure cuffs for precision.
Link to study.
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4. BFR training strap tightness
Fatela, P., Reis, J., Mendonca, G., Avela, J., Mil-Homens, P. 2016. “Acute Effects of Exercise Under Different Levels of Blood-Flow Restriction on Muscle Activation and Fatigue.” European Journal of Applied Physiology. 116 (5): 985-995. DOI: 10.1007/s00421-016-3359-1.
Conclusion – Concluded muscular activation, as well as neuromuscular fatigue, varies as a function of relative BFR intensity. Therefore, the individual determination of vascular restriction levels is crucial before engaging in BFR exercise.
Link to study.
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5. BFR training strap tightness
Reis, J., Fatela, P., Mendonca, G., Vaz, J., Valamatos, M., Infante, J., Mil-Homens, P., Alves, F. 2019. “Tissue Oxygenation in Response to Different Relative Levels of Blood-Flow Restricted Exercise.” Frontiers in Physiology. 10 (407): 1-9. DOI: 10.3389/fphys.2019.00407.
Conclusion – Concluded that BFR is effective for increasing deoxygenation and reducing tissue oxygenation during low-intensity exercise. We also showed that when using low loads, a relative pressure above 40% of the AOP (arterial occlusion pressure) at rest is required to elicit changes in microvascular oxygenation compared with the same exercise with unrestricted conditions.
Link to study.
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6. BFR training history
Manini, T., Clark, B. 2009. “Blood Flow Restricted Exercise and Skeletal Muscle Health.” Exercise and Sport Science Reviews. 37 (2): 78-85. DOI:10.1097/JES.0b013e31819c2e5c.
Conclusion – Information about BFR training History. Discusses the concept of exercise training with BFR has been around for nearly 40 years and was popularized in Japan by Yoshiaki Sato in the mid-1980s.
Link to study.
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7. BFR training and muscle damage
Wilson, J., Lowery, R., Joy, J., Loenneke, J., Naimo, M. 2013. “Practical Blood Flow Restriction Training Increases Acute Determinants of Hypertrophy Without Increasing Indices of Muscle Damage.” The Journal of Strength and Conditioning Research. 27 (11): 3068-3075. DOI: 10.1519/JSC.0b013e31828a1ffa.
Conclusion – Concluded BFR significantly increases muscle activation (Neuromuscular) and muscle thickness without increasing indices of damage.
Link to study.
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8. BFR training and neuromuscular function
Cook, S., Kanaley, J., Ploutz-Snyder, L. 2014. “Neuromuscular Function Following Muscular Unloading and Blood Flow Restricted Exercise.” European Journal of Applied Physiology. 114 (7): 1357-1365. DOI: 10.1007/s00421-014-2864-3.
Conclusion – Concluded that BFR combined with resistance training on the Knee Extensor muscles during unloading can maintain muscle mass and strength. Also, it can partially inhibit neuromuscular dysfunction.
Link to study.
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9. BFR training and fatigue
Broxterman, R., Craig, J., Smith, J., Wilcox, S., Jia, C., Warren, S., Barstow, T. 2015. “Influence of Blood Flow Occlusion on the Development of Peripheral and Central Fatigue During Small Muscle Mass Handgrip Exercise.” The Journal of Physiology. 593 (17): 4043-4054. DOI: 10.1113/JP270424.
Conclusion – Concluded that blood flow occlusion exacerbated the development of both peripheral and central fatigue.
Link to study.
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10. BFR training
Yasuda, T., Brechue, W., Fujita, T., Shirakawa, J., Sato, Y., Abe, T. 2009. “Muscle Activation During Low-Intensity Muscle Contractions with Restricted Blood Flow.” Journal of Sports Sciences. 27 (5): 479-489. DOI: 10.1080/02640410802626567.
Conclusion – Concluded low-intensity muscle contractions, with moderate restriction of blood flow, leads to more intense activation of the muscle relative to the external load.
Link to study.
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11. BFR training strap tightness
Lixandrão, M., Ugrinowitsch, C., Laurentino, G., Libardi, C., Aihara, A., Cardoso, F., Tricoli, V., Roschel, H. 2015. “Effects of Exercise Intensity and Occlusion Pressure after 12 Weeks of Resistance Training with Blood-Flow Restriction.” European Journal of Applied Physiology. 115: 2471-2480. DOI: https://doi.org/10.1007/s00421-015-3253-2.
Conclusion – Concluded BFR protocols benefit from higher occlusion pressure (80%) when exercising at very low intensities. Conversely, occlusion pressure seems secondary to exercise intensity in more intense (40% of 1 Rep Max) BFR protocols.
Link to study.
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12. BFR training strap width
Laurentino, G., Teixeira, E., Iared, W., Loenneke, J., Nakajima, E., Tricoli, V. 2015. “The Effect of Cuff Width on Muscle Adaptations after Blood Flow Restriction Training.” Medicine and Science in Sport and Exercise. 48 (5): 1. DOI: 10.1249/MSS.0000000000000833.
Conclusion – Concluded regardless of cuff width, both protocols produced similar increases in 1 Rep Max and elbow flexor muscle Cross Sectional Area (size), and these responses may be related to the similar training volume and/or similar reductions in arterial blood flow produced when both cuffs were inflated to the same relative pressure.
Link to study.
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13. BFR training and metabolic stress
Cayot, T., Lauver, J., Silette, C., Scheuermann, B. 2016. “Effects of Blood Flow Restriction Duration on Muscle Activation and Microvascular Oxygenation During Low-Volume Isometric Exercise.” Clinical Physiology and Functional Imaging. 36 (4): 298-305. DOI: 10.1111/cpf.12228.
Conclusion – Concluded that applying BFR 5 minutes before exercise can enhance the exercise-induced metabolic stress during low-intensity exercise (20% Maximum Voluntary Contraction) compared to applying BFR immediately prior to exercise.
Link to study.
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14. BFR training rest intervals
Scott, B., Loenneke, J., Slattery, K., Dascombe, B. 2015. “Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development.” Sports Medicine. 45 (3): 313-325. DOI: https://doi.org/10.1007/s40279-014-0288-1.
Conclusion – Concluded low exercise loads should be employed (20%–40% of 1 Rep Max) in conjunction with short inter-set rest periods (30–60 seconds) and relatively high training volumes (50–80 total repetitions per exercise) to ensure a sufficient physiological stimulus is achieved.
Link to study.
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15. BFR trainings systemic effects
Cook, C., Kilduff, L., Beaven, M. 2013. “Improving Strength and Power in Trained Athletes With 3 Weeks of Occlusion Training.” International Journal of Sports Physiology and Performance. 9 (1): 166-172. DOI: https://doi.org/10.1123/ijspp.2013-0018.
Conclusion – Concluded clear improvement in bench-press strength resulting from lower-body occlusion training suggests a SYSTEMIC effect of BFR training. HUGE!!!
Link to study.
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16. BFR trainings systemic effects
Dankel, S., Jessee, M., Loenneke, J. 2016. “The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure.” Sports Medicine. 46 (1): 23-33. DOI: 10.1007/s40279-015-0407-7.
Conclusion – Concluded low-load BFR training increased muscle size and strength in limbs located proximal (chest, shoulders) and distal (biceps, triceps) to the restrictive stimulus. Some of the musculature in the upper body cannot be directly restricted by the application of BFR. Despite this, increases in muscle size and strength were observed in muscles placed under direct and indirect BFR therefore, causing a Systemic effect!
Link to study.
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17. BFR training and tendon health
Centner, C., Lauber, B., Seynnes, O., Jerger, S., Sohnius, T., Gollhofer, A., Konig, D. 2019. “Low-Load Blood Flow Restriction Training Induces Similar Morphological and Mechanical Achilles Tendon Adaptations Compared with High-Load Resistance Training.” Journal of Applied Physiology. 127 (6): 1660-1667. DOI: 10.1152/japplphysiol.00602.
Conclusion – Rehabilitation – Concluded Low-load BFR training has been shown to induce beneficial adaptations at the muscular level. However, studies examining the effects on human tendon properties are rare. These findings provide the first evidence that Low-load BFR can increase Achilles tendon mechanical and morphological properties to a similar extent as conventional high-load resistance training. This is of particular importance for individuals who may not tolerate heavy training loads but still aim for improvements in myotendinous function.
Link to study.
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18. BFR training and cardio fitness
Ferguson, R., Hunt, J., Lewis, M., Martin, N., Player, D., Strangier, C., Taylor, C., Turner, M. 2018. “The Acute Angiogenic Signalling Response to Low-Load Resistance Exercise with Blood Flow Restriction.” European Journal of Sport Science. 18 (3): 397-406. DOI: 10.1080/17461391.2017.1422281.
Conclusion – Concluded acute low-load resistance exercise with BFR provides a targeted angiogenic response potentially mediated through enhanced ischaemic and shear stress stimuli. Basically states that BFR helps create new blood vessels.
Link to study.
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19. BFR training and rehabilitation
Ohta, H., Kurosawa, H., Ikeda, H., Iwase, Y., Satou, N., Nakamura, S. 2003. “Low-Load Resistance Muscular Training with Moderate Restriction of Blood Flow after Anterior Cruciate Ligament Reconstruction.” Acta Orthopaedica Scandinavica. 74 (1): 62-68. DOI: 10.1080/00016470310013680.
Conclusion – Concluded that low-load resistance muscular training during moderate restriction of blood flow is an effective exercise for early muscular training after reconstruction of the anterior cruciate ligament. Rehabilitation emphasis.
Link to study.
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20. BFR training
Brandner, C., Clarkson, M., Kidgell, D., Warmington, S. 2019. “Muscular Adaptations to Whole Body Blood Flow Restriction Training and Detraining.” Frontiers in Physiology. 10 (1099): 1-12. DOI: 10.3389/fphys.2019.01099.
Conclusion – Concluded that following a period of detraining (4 weeks), whole body strength remained significantly elevated for both BFR-Training (6%) and High Load-Training (14%). Overall, whole body resistance training with BFR was shown to be an effective training mode to increase muscular strength and mass.
Link to study.
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21. BFR training recommendations
Pope, Z., Willardson, J., Schoenfeld, B. 2013. “Exercise and Blood Flow Restriction.” The Journal of Strength and Conditioning Research. 27 (10): 2914-2926. DOI: 10.1519/JSC.0b013e3182874721.
Conclusion – The authors give practical recommendations for BFR training resistance exercise.
Link to study.
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