Effects of Blood Flow Restricted Low-Intensity Concentric or Eccentric Training on Muscle Size and Strength

The authors thank the students who participated in this study. We also thank Toshiaki Nakajima, MD, PhD, Ken Masamune, PhD, Hiroki Kamiuchi, The University of Tokyo, for helpful discussion and technical support.Conceived and designed the experiments: TY TA. Performed the experiments: TY. Analyzed the data: TY JPL TA. Wrote the paper: TY JPL RST TA.We investigated the acute and chronic effects of low-intensity concentric or eccentric resistance training with blood flow restriction (BFR) on muscle size and strength. Ten young men performed 30% of concentric one repetition maximal dumbbell curl exercise (four sets, total 75 reps) 3 days/week for 6 weeks. One arm was randomly chosen for concentric BFR (CON-BFR) exercise only and the other arm performed eccentric BFR (ECC-BFR) exercise only at the same exercise load. During the exercise session, iEMG for biceps brachii muscles increased progressively during CON-BFR, which was greater (p<0.05) than that of the ECC-BFR. Immediately after the exercise, muscle thickness (MTH) of the elbow flexors acutely increased (p<0.01) with both CON-BFR and ECC-BFR, but was greater with CON-BFR (11.7%) (p<0.01) than ECC-BFR (3.9%) at 10-cm above the elbow joint. Following 6-weeks of training, MRI-measured muscle cross-sectional area (CSA) at 10-cm position and mid-upper arm (12.0% and 10.6%, respectively) as well as muscle volume (12.5%) of the elbow flexors were increased (p<0.01) with CON-BFR. Increases in muscle CSA and volume were lower in ECC-BFR (5.1%, 0.8% and 2.9%, respectively) than in the CON-BFR and only muscle CSA at 10-cm position increased significantly (p<0.05) after the training. Maximal voluntary isometric strength of elbow flexors was increased (p<0.05) in CON-BFR (8.6%), but not in ECC (3.8%). These results suggest that CON-BFR training leads to pronounced acute changes in muscle size, an index of muscle cell swelling, the response to which may be an important factor for promoting muscle hypertrophy with BFR resistance training.Yeshttp://www.plosone.org/static/editorial#pee

A review on the mechanisms of blood-flow restriction resistance training-induced muscle hypertrophy

It has traditionally been believed that resistance training can only induce muscle growth when the exercise intensity is greater than 65% of the 1-repetition maximum (RM). However, more recently, the use of low-intensity resistance exercise with blood-flow restriction (BFR) has challenged this theory and consistently shown that hypertrophic adaptations can be induced with much lower exercise intensities (<50% 1-RM). Despite the potent hypertrophic effects of BFR resistance training being demonstrated by numerous studies, the underlying mechanisms responsible for such effects are not well defined. Metabolic stress has been suggested to be a primary factor responsible, and this is theorised to activate numerous other mechanisms, all of which are thought to induce muscle growth via autocrine and/or paracrine actions. However, it is noteworthy that some of these mechanisms do not appear to be mediated to any great extent by metabolic stress but rather by mechanical tension (another primary factor of muscle hypertrophy). Given that the level of mechanical tension is typically low with BFR resistance exercise (<50% 1-RM), one may question the magnitude of involvement of these mechanisms aligned to the adaptations reported with BFR resistance training. However, despite the low level of mechanical tension, it is plausible that the effects induced by the primary factors (mechanical tension and metabolic stress) are, in fact, additive, which ultimately contributes to the adaptations seen with BFR resistance training. Exercise-induced mechanical tension and metabolic stress are theorised to signal a number of mechanisms for the induction of muscle growth, including increased fast-twitch fibre recruitment, mechanotransduction, muscle damage, systemic and localised hormone production, cell swelling, and the production of reactive oxygen species and its variants, including nitric oxide and heat shock proteins. However, the relative extent to which these specific mechanisms are induced by the primary factors with BFR resistance exercise, as well as their magnitude of involvement in BFR resistance training-induced muscle hypertrophy, requires further exploration