Blood Flow Restriction Training: Implementation into Clinical Practice

International Journal of Exercise Science 10(5): 649-654, 2017. To improve muscular strength and hypertrophy the American College of Sports Medicine recommends moderate to high load resistance training. However, use of moderate to high loads are often not feasible in clinical populations. Therefore, the emergence of low load (LL) blood flow restriction (BFR) training as a rehabilitation tool for clinical populations is becoming popular. Although the majority of research on LL-BFR training has examined healthy populations, clinical applications are emerging. Overall, it appears BFR training is a safe and effective tool for rehabilitation. However, additional research is needed prior to widespread application

Active Gaming and Energy Expenditure in Healthy Adults

poster abstractThe rise in sedentary behavior in US society, along with the associated health risks, makes it necessary to find effective solutions to increase physical activity at all levels. Studies on active gaming have shown promising results in the use of active gaming as a viable exercise tool that combines physical activity with entertainment. However, the research is still mixed on whether active games can elicit similar responses as traditional cardiovascular exercise, such as jogging on a treadmill. This study examined whether participants playing active games could reach a moderate intensity level as defined by the American College of Sports Medicine as 3.0 METs while playing with and without specific instructions designed to maximize physical activity. Twenty young adult participants completed one training session and four experimental sessions. During each session, participants played two 15-minute periods of either Kinect tennis, Kinect boxing, Wii tennis, and Wii boxing. In period one, participants played at a self-selected intensity. During period two, participants were given specific instructions on how to play which were designed to maximize movement during play and down time. During game play, participants wore a portable gas (VO2/VCO2) analyzer to measure energy expenditure. Metabolic equivalents (METS) were analyzed with a repeated measures ANOVA. During period 1, Kinect boxing was able to elicit the highest METs, 3.097±0.3, from the participants. METS during period 2 was significantly greater than during period 1 across all games (p<.001). Participants were able to reach higher than 3.0 METs while playing each of the games during period 2. Regardless of the period, Kinect boxing elicited greater METS than Wii boxing and Wii Tennis (P<.001). This shows evidence that active gaming not only can elicit a moderate intensity level of physical activity, but that specialized instructions can enhance the effects of the active games

Effects of physical training on proprioception in older women

Older adulthood is accompanied by declines in muscular strength, coordination, function, and increased risk of falling. Resistance training increases muscular strength in this population but its effect on proprioception is unknown. To evaluate the effect of resistance training on proprioception, community dwelling older women completed a three-month exercise study. A resistance training (RT) group (N=19) underwent supervised weight training three times per week while a non-strength trained control (NSTC) group (N=19) performed range-of-motion activities that mimicked the movements of the RT group without the benefit of muscle loading. Subjects were evaluated at baseline, 6, and 12 weeks for strength and proprioception. Muscular strength was assessed by measuring the subject’s one repetition maximum performance on four different exercises. Static proprioception was measured by the subject’s ability to reproduce a target knee joint angle while dynamic proprioception was measured by the subject’s ability to detect passive knee motion. The RT group made significant strength improvements compared to the NSTC group. Proprioception significantly improved in both groups by 6 weeks. Our findings suggest that improvements in proprioception can be obtained via regular activity that is independent of heavy muscle loading

ENERGY RETURN OF DIFFERENT SHAPES OF TRACK SPIKES

Different track spike designs (pin, pyramid, post, Christmas tree, and modified Christmas tree) are all touted as being advantageous for track and field performance, but these claims have not been tested and reported in peer-reviewed literature. The purpose of this study was to examine how track spike design impacted energy return on a Mondo track surface. Load-deformation curves of the spikes driven by a machine into the track surface were determined and the energy absorbed and the energy returned by each spike was calculated. On the Mondo track surface, the modified Christmas tree design generated significantly more energy return than the other spike designs while the pin spike absorbed (and therefore returned) significantly less energy than the other spike designs. This information could useful for athletes and coaches looking to enhance performance on a Mondo track

KAATSU Cuff Tightness and Limb Anthropometry: Effect on Blood Flow Restriction

abstractKAATSU resistance training involves low loads (20%1RM) and partial blood flow restriction (BFR). When applying a BFR cuff, the initial cuff tightness (ICT) is important. ICTs can potentially impact the degree of BFR (%BFR) caused by the subsequent inflation to the target training pressures. It’s known that limb anthropometrics can affect the amount of BFR that is produced at specific pressures. Understanding the interaction between limb anthropometrics and ICT is an important first step in standardizing BFR dose between individuals for KAATSU training prescription. Purpose: To determine what limb anthropometrics (circumference, muscle or fat composition) have the greatest effect on %BFR with various ICTs. Methods: Forty-two volunteers (26 men, 16 women) provided informed consent. Caliper skin folds (anterior and posterior), Gulick tape circumferences, and peripheral quantitative computed tomography (pQCT) scans were performed on the randomly assigned ipsilateral arm and leg at the level of the KAATSU cuff. %BFR was measured via pulse-wave Doppler ultrasound at baseline (no cuff) and at 5 ICT pressures (20, 30, 40, 50 and 60mmHg). Variable relationships were assessed using Pearson correlations and stepwise linear regression. Results: The dependent variable for regression analysis was %BFR at each ICT. pQCT-determined muscle (R2= .147, .614, .445, .360, & .232, respectively) and fat composition (R2= .138, .587, .429, .338, & .220, respectively) were significant (p<.05) determinants of BFR at all ICT pressures in the arm. At 30mmHg, circumference was also a determinant (R2=.163). There were no significant correlations between %BFR and any of the ICT pressures for the leg. pQCT fat composition and sum of skin folds correlated significantly (r=.915, p<.05). pQCT circumference and Gulick circumference measures correlated significantly (r=.991, p<.05). Conclusion: Arm anthropometrics impact the %BFR created by 5 ICTs in the arm. Skin fold measures and circumference measures were highly correlated with pQCT data. As a result, skin fold and Gulick circumference measures can be used to predict arm composition at the level of the cuff and may inform prescription of appropriate ICTs that result in more consistent initial %BFR across individuals

Initial KAATSU Cuff Tightness: Effect of Limb Anthropometrics on Blood Flow Restriction

abstractINTRODUCTION KAATSU training involves low load (20%1RM) resistance exercise combined with partial blood flow restriction (BFR). BFR is achieved by positioning a specially designed pneumatic cuff around the proximal aspect of the limb, cinching it to an initial cuff tightness (ICT), then inflating the cuff to a higher restrictive training pressure. ICTs can potentially impact the degree of BFR (%BFR) caused at the higher training pressures, yet many studies use the same ICTs for all subjects (1). Identifying that discrepancies in %BFR exist between subjects with different limb anthropometrics is an important step in moving toward standardization of BFR dose for KAATSU training prescription. The purpose of this study was to identify variation in %BFR between subjects experiencing the same ICT and what limb anthropometrics (circumference, muscle, and fat composition) may be determinants. METHODS Forty-two volunteers (26 men, 16 women) provided informed consent. Caliper skin folds, Gulick tape circumferences, and peripheral quantitative computed tomography (pQCT) scans were performed on the randomly assigned ipsilateral arm and leg at the level of the KAATSU cuff application. %BFR was measured via pulse-wave Doppler ultrasound at baseline (no cuff) and at an ICT of 30 mmHg. Variable relationships were assessed using Pearson correlations and stepwise linear regression. RESULTS The average %BFR (avg±st. dev.) for the arm and leg was 16.01±11.42% and 16.75±9.27% with a range of 46.66% and 36.41%, respectively. The dependent variable for regression analysis was %BFR. In the arm, pQCT-determined muscle (R2=0.614) and fat composition (R2=0.587) were significant (p<0.05) determinants of %BFR. Circumference was also a determinant (R2=0.163). There were no significant correlations between %BFR and the anthropometrics for the leg. pQCT fat composition and sum of skin folds correlated significantly (r=0.915, p<0.05). pQCT circumference and Gulick circumference measures correlated significantly (r=0.991, p<0.05). DISCUSSION Conflicting BFR training results have been reported in the literature. A potential cause could be universal ICT usage causing some individuals to receive an inadequate training stimulus. Individuals using a 30 mmHg ICT will experience different %BFR when limb anthropometrics vary. Thus a method of assigning ICTs specific to individuals’ anthropometric characteristics is needed to ensure equally potent stimuli. Skin fold measures and circumference measures were highly correlated with pQCT data. As a result, skin fold and Gulick circumference measures can be used to predict arm composition at the level of the cuff and may inform prescription of appropriate ICTs that result in more consistent initial %BFR across individuals

ENERGY RETURN OF DIFFERENT DESIGNS OF TRACK SPIKES

INTRODUCTION: Advances in technology and design have generated changes to the traditional track spike. Today, there are a number of different spike shapes, the four most common being needle, pyramid, post, and Christmas tree and modified Christmas tree (the last two are also referred to as “compression tier”) (see Figure 1). Running magazines, product advertisements, coaches, and manufacturers make claims about the potential effects of each type of spike design and their use in different situations. To our knowledge, these types of claims and other information regarding spikes or track surfaces, have not been tested and reported in the peer-reviewed literature. METHODS: The purpose of this preliminary study was to examine whether different shaped spikes elicit quantifiable differences in energy return on a Mondo track surface, the most commonly used at track venues. Five different shaped spikes all 7mm in length were used in this study (see Figure #1). The spikes chosen are those commonly used by athletes on various indoor and outdoor track surfaces. The load-deformation between the spikes the track was measured using a Bose Electroforce 3200 (Eden Praire, MN) testing device. OneWay ANOVAs using Sigma Plot 10.5 (Systat Inc., Richmond, CA) were performed to test for significant differences between spikes. Tukey post-hoc comparisons were performed at the p=0.05 level. RESULTS: Figure 2 shows the ANOVA results [F (4,49)=54.78, p<.001] and Tukey post-hoc comparison for the energy returned. The MTREE spike generated the greatest amount of energy returned and was significantly different from the other spikes (p<=0.05). The PYRA spike generated second largest amount of energy returned and was significant different from the PIN and POST spikes. The PIN or needle spike, as expected, had the least amount of energy returned. All spikes penetrated the track surface. DISCUSSION: The notion that compression spikes have less track penetration is unfounded. All the spikes tested penetrated the track under loads less than 105 N. Considering that vertical ground reaction force (GRF) increases linearly during walking and running from 1.2 BW to approximately 2.5 BW at 6.0 m s−1 and remains constant during forward lean sprinting at higher speeds, the likehood of any of the tested spikes not penetrating the Mondo track surface seems improbable (Keller et al., 1996). For the Mondo track the spike with the largest energy return was the MTREE design. This MTREE provided the largest spike surface area, which helped it to compress the track. The common PIN design provided the least energy return but absorbed the least amount of energy. All the compression spikes seem to provide larger amounts of energy return when compared to the PIN. The measured energy returned by the various spikes is relatively small (N*mm). However, for this study, the energy return was determined for only one spike while most sprint shoes have a sole plate with up to 10 mounted spikes. While it is difficult to assess how much of the energy returned in the spike-track surface interaction might actually aid the sprinter, these findings are nevertheless noteworthy. It is not uncommon for results in sprint races to be separated by only thousandths of a second, where even small levels of energy return could potentially make the difference between winning or losing a race. CONCLUSION: This study shows that spike design affects the amount of energy returned and absorbed by a Mondo track surface. While all of the spikes tested penetrated the track surface, the modified Christmas tree design returned the most energy on the Mondo surface. Knowledge of which spike design offers the highest energy return on the various track surfaces that athletes compete on could be useful to coaches and athletes, as well as, spike and track manufacturers and thus is worthy of further investigation

Proprioception, gait kinematics, and rate of loading during walking: Are they related?

The cyclic nature of walking can lead to repetitive stress and associated complications due to the rate of loading (ROL) experienced by the body at the initial contact of the foot with the ground. An individual’s gait kinematics at initial contact have been suggested to give rise to the ROL, and a repetitive, high ROL may lead to several disorders, including osteoarthritis. Additionally, proprioception, the feedback signaling of limb position and movement, may play a role in how the foot strikes the ground and thus, the ROL. Our goal was to explore the relationship between proprioception, gait kinematics and ROL. Thirty-eight women were recruited for gait analysis, and the gait characteristics 50ms prior to and at initial contact were examined. Two proprioception tests, joint angle reproduction and threshold to detect passive motion were used to examine the subject’s proprioceptive acuity. Our results indicate that individuals with a larger knee angle (i.e., greater extension) 50ms prior to initial contact (IC) experience a higher ROL during gait and have poorer proprioceptive scores. However, it remains unclear whether poor proprioception causes a high ROL or if a high ROL damages the mechanoreceptors involved in proprioception, but the apparent relationship is significant and warrants further investigation

The Effect of Active Gaming on Pressure Pain Sensitivity

poster abstractAn acute bout of moderate to vigorous exercise temporarily reduces pain sensitivity in healthy adults, a phenomenon termed exercise-induced hypoalgesia (EIH). Recently, active gaming, which allows an individual to be physically active during video game play, has been rising in popularity as a means of light to moderate exercise. While evidence has shown that active gaming elicits positive cardiovascular and balance outcomes, no research has investigated active gaming as a modifier of pain. The purpose of this study was to determine whether an acute bout of active gaming increases pressure pain thresholds (PPT) in healthy adults. Fourteen young adults were enrolled in this study. Participants completed a training session and four experimental sessions. During each session, participants played one of the following active games for 15 minutes: Kinect Boxing, Kinect Tennis, Wii Boxing, and Wii Tennis. Pressure pain thresholds were measured on the trapezius muscle and the forearm before and immediately after a 15-minute active gaming session. Heart rate was also measured during game play. PPT data was analyzed with repeated measures ANOVA. Bivariate correlations examined the relationship between average percentage of heart rate reserve (HRR%) during game play and magnitude of pain reduction (post– pre). The results showed that PPTs 1) on the forearm and trapezius muscle significantly increased from pre to posttest during the Kinect Boxing session, 2) increased on the trapezius muscle during the Wii Boxing session, and 3) decreased on the forearm during the control session (p’s<.05). Greater HRR% during game play was associated with greater pain reduction (trapezius r=.33; forearm r=0.28; p’s<.05). In conclusion, active games played at a moderate intensity appear to be capable of temporarily reducing pressure pain sensitivity. This study was sponsored by the NIFS Student Research Fund

The Effect of Active Gaming on Cardiovascular Outcomes

poster abstractThe U.S. society has become more accustomed to a sedentary lifestyle in the past few decades, partially due to increased time spent in front of a screen. Recently, active gaming, which allows an individual to be physically active during video game play, has been rising in popularity as a means of exercise. However, more research is needed to evaluate whether active gaming can produce cardiovascular responses that fall within the recommended ranges for daily physical activity given by the American College of Sports Medicine (40-60% of heart rate reserve (HRR)). The purpose of this study was to determine the effects of active gaming on cardiovascular outcomes and enjoyment. Nine young adults have been enrolled in this study and data collection is ongoing. Participants completed a training session and four experimental sessions. During each session, participants played one of the following active games at a self-selected intensity for 15 minutes. Heart rate (HR) and rate of perceived exertion (RPE) were measured during game play. Enjoyment was assessed on a 10-cm VAS after each game. Repeated measures ANOVAs were used to determine differences in HRR%, RPE, and enjoyment between games. The results showed that HRR% was greater for Kinect boxing (M=42.7±12.5) compared to all other games (p=.012; Kinect Tennis=35.4±10.7, Wii Boxing=31.8±14.5, Wii Tennis=35.4±10.8). RPE was significantly greater for Kinect Boxing (M=11.3±2.0) compared to Wii Tennis (M=9.67±1.5), p=.038. Enjoyment levels did not differ between games, p=.58 (Kinect Boxing=6.6±2.1, Kinect Tennis=7.1±1.2, Wii Boxing=5.9±0.8, Wii Tennis=6.9±0.9). In conclusion, the active games played at a self-selected intensity were perceived as moderately to highly enjoyable and were able to increase cardiovascular responses. However, the intensity of activity depended on the game. Participants achieved a moderate intensity level (i.e., 40-60% of HRR) while playing Kinect Boxing, but only achieved a light intensity level while playing the other games. Mentor: Kelly M. Naugle, Department of Kinesiology, School of Physical Education, Tourism, and Management, IUPU